髓腔通路设计的微创理念及其研究进展

The minimally invasive concept and research progress on access cavity design

牙髓病和根尖周病是临床常见的口腔疾病,根管治疗是治疗这类疾病最有效的手段。髓腔通路预备即开髓,是根管治疗的首要步骤,一个设计良好的髓腔通路对于根管治疗的成功至关重要。近年来随着微创牙髓治疗学概念的提出,学者们建议对传统髓腔通路设计进行微创改良,强调有目的性地保留部分髓室顶及颈周牙本质的精细开髓,以尽可能保存健康牙体组织。虽然微创髓腔通路设计减少了牙颈部区域的应力集中,但目前没有明显的证据支持其可以提高根管治疗后牙齿的抗折性能,且微创开髓可能使治疗复杂化,增加根管治疗的难度,存在影响根管治疗效果和增加医源性损伤的风险。本文就髓腔通路设计的微创理念及其在根管治疗效果和牙齿抗折性能方面的研究进展作一综述。

Pulp and periapical diseases are common clinical oral diseases,and root canal therapy is the most effective option for these diseases.Access cavity preparation is the first step of root canal therapy.A well-designed access cavity is crucial to the success of root canal therapy.In recent years,with the concept of minimally invasive endodontics proposed,a minimally invasive improvement of traditional endodontic cavities is recommended,which emphasizes the purposeful preservation of part of the chamber roof and peri-cervical dentin to preserve the healthy tooth tissue as much as possible.Although minimal access cavity designs can reduce the stress concentration in the cervical regions,evidence on its improvement of the fracture resistance of the endodontically treated teeth is lacking.Moreover,minimally invasive access may complicate treatment and increase the difficulty of root canal therapy,which may affect the effect of root canal therapy and increase the prevalence of iatrogenic complications during endodontic procedures.This article reviews the minimally invasive concept of access cavity design and its research progress in the effect of root canal therapy and fracture resistance of teeth.