显微超声技术结合CBCT诊治恒牙变异根管的临床疗效观察

Clinical Observation of Micro-ultrasound Combined with CBCT in the Diagnosis and Treatment of Permanent Teeth with Variable Root Canals

目的:探讨显微超声技术结合锥形束CT(Cone beam computed tomography,CBCT)在恒牙变异根管诊治中的临床疗效。方法:分析83例常规治疗失败的变异根管经显微根管再治疗过程及愈后,主要通过术前分析CBCT影像中变异根管的数量、位置、钙化程度、弯曲方向,在口腔手术显微镜下应用超声治疗仪探寻变异根管,镍钛预备、热牙胶垂直加压充填。总结变异根管类型及治疗并发症,评价治疗效果。结果:83例变异根管中,80例成功寻及并疏通,1例发生带状穿孔,MTA即刻修补,2例未疏通至根尖,经0.5~2年复查无临床症状及体征,X线表现无异常。结论:应用显微超声技术结合CBCT能有效定位、疏通恒牙变异根管,提高治疗成功率。

Objective To investigate the clinical effect of micro-ultrasound technology combined with CBCT in the diagnosis and treatment of permanent teeth with variant root canals.Methods Analyze 83 cases of variant root canals that have failed conventional treatment through microscopic root canal retreatment and recovery,mainly through preoperative analysis of the number,position,degree of calcification,and bending direction of the variable root canals in CBCT images,and apply it under a dental microscope Ultrasonic therapy instrument is used to search for variant root canals,nickel-titanium preparation,and vertical pressure filling with hot gutta percha.Summarize variant root canal types and treatment complications,and evaluate the treatment effect.Results Among the 83 cases of variant root canals,80 cases were successfully found and unblocked,and 1 case had banded perforation.MTA was immediately repaired.2 cases did not dredge to the apex.After 6 months to 2 years,there were no clinical symptoms and signs and no abnormal X-ray findings.Conclusion The application of micro-ultrasound technology combined with CBCT can effectively locate and dredge the variable root canals of permanent teeth,and improve the success rate of treatment.