显微根尖外科手术难度评估系统的初步建立

Primary establishment of case difficulty assessment of apical microsurgery

针对根管(再)治疗失败后需进行显微根尖外科手术的患牙,本文首次提出并初步建立“显微根尖外科手术难度评估系统”。该系统纳入手术操作相关因素,包括6个一级项目和22个二级项目,进行单项的难度评估,然后总体评估确定显微根尖外科手术难度。针对单项高危因素,医师需术前充分准备并在术中采用相应措施,以避免并发症发生;总体评估手术难度,辅助临床决策并指导分级治疗,还可应用于医患交流、专科医师技能考核和临床教学质量的评价。“显微根尖外科手术难度评估系统”具有良好的临床应用价值,同时还需要进一步完善。

For the teeth with the post-treatment endodontic disease and the indication of apical microsurgery, the case difficulty assessment is proposed and established for the first time in endodontics. All the surgery related factors, 6 items of criteria and 22 items of sub-criteria, are involved in the evaluation system. After the sub-criteria are assessed individually, overall assessment of case difficulty is determined. For the high-risk factor, the general dentists or endodontists should prepare well before the operation and treat correspondingly in the operation, in order to avoid the complications. The overall case difficulty of apical microsurgery is compared with that of root canal retreatment, which helps to decide the treatment plan. In addition, the system can be used in hierarchical treatment, doctor-patient communication, clinical skill assessment of specialists, and evaluation of clinical teaching quality. In a word, case difficulty assessment of apical microsurgery is valuable in clinic, and needs further improvement.