Expert consensus on the diagnosis and therapy of endo-periodontal lesions

Endo-periodontal lesions (EPLs) involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.

Effect of Application of One-Time Method and Multiple Root Canals on Cryptic Fracture with Endodontic Lesions and VAS Score

Objective:To evaluate the therapeutic efficacy of primary method root canal treatment(ORCT)and multiple root canal treatment(MRCT)for dental cryptocleidosis with endodontic lesions.Methods:88 patients with fissured teeth with endodontic lesions who were admitted to the hospital between November 2021 and November 2023 were selected,and after randomized numerical table grouping,44 cases in the experimental group were included in the ORCT treatment,and 44 cases in the reference group were included in the MRCT treatment,and the total effective rate,root canal filling rate,visual analog scale(VAS)score,periodontal indexes,and the complication rate were compared.Results:The total effective rate and root canal filling rate of the experimental group were higher than that of the reference group;after treatment,the VAS score of the experimental group was lower than that of the reference group,and the periodontal indexes were lower than that of the reference group;and the complication rate of the experimental group was lower than that of the reference group(P<0.05).Conclusion:ORCT can improve the overall efficacy of patients with fissured teeth with endodontic lesions,ensure the filling rate of root canals,significantly reduce pain symptoms,improve a number of periodontal indicators,have high endodontic safety,and have more therapeutic advantages than MRCT.

Successful management of a tooth with endodontic-periodontal lesion:A case report

BACKGROUND Endodontic-periodontal lesion is a commonly encountered dental condition.However,the prognosis of the condition varies from good to poor.Some cases are associated with a poor prognosis that requires tooth extraction.This report presents a case of an endodontic-periodontal lesion in a tooth that was successfully treated by root canal treatment.CASE SUMMARY A 51-year-old female patient with no medical history complained about persistent pain and discomfort in her left mandibular first molar.Clinical examination showed the left mandibular first molar with poor restoration.It was also associated with underlying necrotic pulp and periodontal involvement.Radiographic examination revealed visible bone defects in the apical and periodontal areas.Based on the findings,the patient was diagnosed with a primary endodontic lesion.A root canal treatment for the endodontic lesion was performed.The patient received a coronal all-ceramic endocrown restoration.A follow-up was arranged to check the prognosis.At the 3 mo follow-up,the clinical and radiography evaluations showed complete disappearance of signs and symptoms and an increase in the radiopacity of the root area.CONCLUSION Despite the poor prognosis associated with many endodontic lesions,this case report highlights that a good prognosis is still possible for an endodontic lesion with apical and periodontal bone loss.In this case,it was achieved via successful root canal treatment without the need for periodontal or surgical intervention.

Evaluation of the Effectiveness and Safety of One-Time Endodontics in the Treatment of Chronic Apical Periodontitis with Sinus Tract in Pediatric Deciduous Teeth

Objective:To observe the effectiveness and safety of one-time endodontics in the treatment of chronic apical periodontitis with sinus tract in pediatric deciduous teeth.Methods:109 cases of children with chronic apical periodontitis with sinus tract in the deciduous teeth treated in our hospital from January 2022 to December 2023 were selected and grouped by the randomized numerical table method,with 54 cases in the experimental group and 55 cases in the control group.The experimental group was treated with one-time endodontics and the control group was treated with conventional endodontics.Results:After the treatment,the total effective rate of treatment was higher in the experimental group than in the control group(P<0.05);the incidence of adverse events was lower in the experimental group than in the control group(P<0.05);the satisfaction of the children's family members was higher in the experimental group than in the control group(P<0.05);the pain duration was lower in the experimental group than in the control group(P<0.05).Conclusion:In the experimental group,children with chronic apical periodontitis with sinus tract of the deciduous teeth were given one-time endodontic treatment,and the results of its implementation were relatively good.

Effectiveness and Safety of Computer-controlled Periodontal Ligament Injection System in Endodontic Access to the Mandibular Posterior Teeth

Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament （PDL） injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis. Methods A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth： the premolar group （PM, z2=38）, first molar group （FM, n=66）, and second molar group （SM, n=58）. All the patients received computer-controlled PDL injection with 4% articaine and 1 ＇ 100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure. Results The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups （92.1%, 53.0%, 93.1%, respectively; 2 X =34.3, P〈0.01）. Both the PM and SM groups showed higher success rates than that of the FM group （v=l, f=16.73, P〈0.01, v=l, Z = 4.5, X2 2 P〈0.01）. No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups. Conclusion The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.

A randomized retrospective clinical study on the choice between endodontic surgery and immediate implantation

Background:Periapical endodontic surgery(PES)for root amputation and tooth replacement by immediate implant placement are two possible treatment options for bone lesions in the root apex of a tooth that has previously undergone endodontic treatment.Treatment methods are performed when the effectiveness of orthograde canal revision is questionable or when such treatment cannot be performed.The effectiveness of these methods varies from study to study.Objective:clinical evaluation of the efficacy of periapical endodontic surgery for root amputation and immediate implant placement with simultaneous tooth extraction in the proximate and long-term treatment.Materials and methods:The study included 183 patients between the ages of 24 and 63.Patients were divided into 2 groups;group I-endodontic surgery was performed to resect the apex of the tooth root(108 patients)and group II-an operation to install an implant with simultaneous tooth extraction(75 patients).In group I,in 36 cases,PES was performed in the area of the first molars and premolars,and 72 cases in the area of incisors and canines.In group II,75 patients received 231 implants.Results:In all 108 patients of group I in the postoperative period and within 1 month,the wounds healed without complications.In none of the 36 operated premolars and molars,there was no definitive elimination of the radiographic bone loss(Rude grade 2 and 3)after 12 months.In the area of incisors and canines,complete healing was observed only in 37.5%of cases(I class according to Rud).In group II,out of 184 implants installed immediately after tooth extraction,one was removed one month after implantation.In other cases,all implants were successfully integrated with the subsequent fabrication of prosthetic construction.Conclusion:The complex“implant(installed in the socket of the tooth immediately after its removal)-bone-soft tissues-prosthetic construction”is stable over time in terms of functional and aesthetic parameters,preservation of bone tissue,and mucous membrane.

3D打印技术在口腔医学、颌面外科修复重建中的作用与优势

背景:3D打印技术独特的优势为口腔医学的发展开拓了新的思路。目的:总结3D打印技术在口腔医学中的应用进展。方法:利用计算机检索中国知网和PubMed数据库,以“3D打印,口腔科学”为中文检索词进行分类检索,以“Three-Dimensional printing,stomatology,Dentistry,prosthodontics,oral implant,orthodontics,oral and maxillofacial surgery,dental pulp disease,periodontitis”为英文检索词进行关键词检索,经阅读初步排除与文章主题不相符的文献,根据纳入标准和排除标准,最终纳入54篇文献进行汇总。结果与结论:在口腔医学领域,3D打印技术的应用范围正迅速拓展,逐步取代传统的临床诊断和治疗方式,通过结合数字化技术和先进的材料科学,3D打印可以精确地创建三维模型,为口腔疾病治疗提供了个性化解决方案,确保医师能够在手术前进行详尽的规划和预览,提高手术的安全性。3D打印技术在定制化义齿制作、个性化种植、无托槽隐形矫治等多方面呈现出了显著优势,基于此项技术,医师可以根据患者口腔结构和需求实行精准设计与制作,为患者带来良好的治疗体验和预后效果。3D打印技术在微创牙髓治疗及牙周组织再生方面也展现出了巨大潜力,3D打印的支架和植入物可为干细胞提供适宜环境,促进牙周组织的再生和修复,但目前3D打印在再生治疗仍处于发展阶段,还需更多的研究和实践来验证其临床应用的效果和安全性。

Prevalence of Enterococcus faecalis in saliva and filled root canals of teeth associated with apical periodontitis

To investigate the prevalence of Enterococcus faecalis in saliva and filled root canals of patients requiring endodontic retreatment for apical periodontitis.Patients with apical periodontitis who were referred for endodontic retreatment were examined.The type and quality of the restoration,symptoms,quality of obturation were recorded.During retreatment,an oral rinse sample and root canal sample were cultured using brain-heart infusion agar and bile esculinazide agar to select for E.faecalis.The 16S rRNA technique was used to identify E.faecalis.A total of 32 women and 22 men（mean age：38 years;s.d.：11 years） and 58 teeth were studied.The prevalence of E.faecalis was 19% in the saliva and 38% in the root canals.The odds that root canals harbored E.faecalis were increased if the saliva habored this bacterium（odds ratio59.7;95% confidence interval51.8-51.6;P,0.05）.Teeth with unsatisfactory root obturation had more cultivable bacterial species in root canals than teeth with satisfactory root obturation（P,0.05）.E.faecalis is more common in root canals of teeth with apical periodontitis than in saliva.The prevalence of E.faecalis in root canals is associated with the presence of E.faecalis in saliva.

有/无鼻窦炎症状的牙源性鼻窦炎患者的临床特征比较

目的比较牙源性鼻窦炎(odontogenic sinusitis,ODS)患者中有鼻窦炎症状和无鼻窦炎症状群体的临床表现。方法回顾性收集2020年6月至2022年6月在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科行内镜鼻窦手术的92例ODS患者的临床资料,77例有鼻窦炎症状(sinusitis symptoms,SS组),15例无鼻窦炎症状(non-SS组)。比较两组患者的病史、症状、病因、内镜检查和鼻窦电子计算机断层扫描(computed tomography,CT)等。结果non-SS组患者相比SS组患者的病程更短[(4.9±3.4)个月vs(10.4±11.0)个月,P=0.048],首诊口腔科比例更高(100%vs 24.7%,P=0.035)。两组患者报告牙痛、牙齿松动症状阳性率,差异无统计学意义(29.9%vs 53.3%,P=0.133;18.2%vs 35.3%,P=0.085)。牙周-牙髓联合病变(periodontal-endodontic combined lesions,PECL)、根尖周炎(apical periodontitis,AP)、牙周炎(periodontitis,PE)、医源性占SS组和non-SS组患者病因的比例分别为53.2%vs 20%(P=0.024)、28.6%vs 33.3%(P=0.76)、11.7%vs 26.7%(P=0.215)、6.5%vs 20%(P=0.119)。鼻窦CT显示,与non-SS组患者相比,SS组患者窦口鼻道复合体(ostiomeatal complex,OMC)、筛窦、额窦有更高比例的受累(83.1%vs 26.7%,P=0.000;80.5%vs 20%,P=0.000;41.6%vs 0%,P=0.002)。结论耳鼻喉科与口腔科的多学科合作,可以早期发现无鼻窦炎症状的ODS,及时诊治PECL等牙齿相关性疾病,减少内镜手术概率,提升患者生活质量。

2型糖尿病合并慢性牙周炎患者血清LRG1、LDH与牙周指标和牙周病变程度的关系

目的探究2型糖尿病(T2DM)合并慢性牙周炎(CP)患者血清富含亮氨酸α-2糖蛋白1(LRG1)、乳酸脱氢酶(LDH)与牙周指标和牙周病变程度的关系。方法选取2022年7月至2023年7月宁夏医科大学总医院口腔医院收治的112例T2DM合并CP患者(T2DM合并CP组),根据牙周病变程度将其分为轻度、中度和重度组;选取同期本院112例单纯CP患者(CP组),再选取112例单纯T2DM患者(T2DM组);检测LRG1、LDH和牙周指标;Pearson法分析血清LRG1、LDH及二者与牙周指标的相关性;重度T2DM合并CP的影响因素采用多因素logistic回归分析;绘制ROC曲线分析血清LRG1、LDH对重度T2DM合并CP的诊断价值。结果CP组、T2DM组以及T2DM合并CP组LRG1、LDH水平依次升高(P<0.05)。轻度、中度和重度组血清LRG1、LDH、附着丧失(AL)、牙周探诊深度(PD)、牙龈出血指标(BI)水平依次升高(P<0.05)。根据Pearson相关性分析得知,血清LRG1与LDH呈正相关(P<0.05),二者均与AL、PD、BI呈正相关(P<0.05)。根据logistic回归分析得知LRG1、LDH、AL、PD、BI均为影响重度T2DM合并CP的因素(P<0.05)。根据ROC曲线得知血清LRG1和LDH二者联合诊断重度T2DM合并CP的AUC为0.910,两者联合优于各自单独诊断(Z_(联合vs LRG1)=2.659、Z_(联合vs LDH)=2.627,P<0.05)。结论LRG1、LDH在T2DM合并CP患者血清中显著升高,两者与牙周指标和牙周病变程度有关。

血清GDF5 mRNA在慢性牙周炎患者中的水平及其与病变程度的相关性

目的分析血清生长分化因子5(GDF5)mRNA在慢性牙周炎患者中的水平及其与病变程度的相关性。方法选取2019年1月至2021年1月该院口腔科收治的慢性牙周炎患者150例作为研究组,并根据牙周检查情况分为轻度组(53例),中度组(51例),重度组(46例),另选取同期健康体检者50例作为对照组;采用实时荧光定量聚合酶链反应(qRT-PCR)检测血清GDF5 mRNA水平;采用Pearson相关分析血清GDF5 mRNA水平与牙周袋探诊深度、附着丧失水平和菌斑指数的相关性;采用Spearman相关分析GDF5 mRNA水平与病变程度的相关性;采用多因素Logistic回归分析慢性牙周炎的影响因素;绘制受试者工作特征(ROC)曲线分析血清GDF5 mRNA水平对重度慢性牙周炎的预测价值。结果对照组与研究组GDF5 mRNA水平分别为1.01±0.30、0.70±0.21,研究组明显低于对照组,差异有统计学意义(t=8.061,P<0.001)。血清GDF5 mRNA水平、牙周袋探诊深度、附着丧失水平和菌斑指数在轻度组、中度组和重度组中依次升高,两两组间比较,差异均有统计学意义(P<0.05)。GDF5 mRNA与牙周袋探诊深度、附着丧失水平、菌斑指数、病变程度均呈负相关(r=-0.587、-0.521、-0.628、-0.567,P<0.001)。多因素Logistic回归分析结果显示,GDF5 mRNA水平降低是慢性牙周炎发生的危险因素(P<0.05)。ROC曲线分析结果显示,血清GDF5 mRNA预测重度慢性牙周炎的曲线下面积为0.893,灵敏度为79.23%,特异度为88.31%。结论慢性牙周炎患者血清GDF5 mRNA水平随着病变程度的加重而降低,GDF5 mRNA还可以作为预测重度慢性牙周炎的指标。

牙周治疗联合根管治疗牙周牙髓联合病变的疗效及对炎性因子的影响研究

目的探讨牙周治疗联合根管治疗牙周牙髓联合病变的疗效及对炎性因子的影响。方法非随机选取2023年2月—2024年1月苏州市吴中人民医院收治的82例牙周牙髓联合病变患者为研究对象,根据治疗方式的不同分组,每组41例。对照组在根管治疗的基础上进行基础的龈上洁治,观察组在对照组基础上再联合牙周治疗。对两组治疗疗效、牙周健康状况与炎性因子水平进行比较分析。结果观察组治疗有效率为95.12%(39/41),高于对照组的80.49%(33/41),差异有统计学意义(χ^(2)=4.100,P<0.05)。治疗后,观察组的牙周健康状况、炎性因子水平较对照组均更优,差异有统计学意义(P均<0.05)。结论牙周治疗联合根管治疗的临床疗效显著,且能明显改善患者牙周健康状况,减轻患者炎性因子水平,可为临床提供参考。

光活化消毒技术治疗牙髓-牙周综合征疗效及对患者龈沟液炎症因子水平的影响

目的:探讨光活化消毒技术(PAD)治疗牙髓-牙周综合征疗效及对患者龈沟液炎症因子水平的影响。方法:选取牙髓-牙周综合征患者56例,随机分为两组各28例,对照组接受常规一次性根管治疗术与牙周基础治疗,观察组在对照组的基础上,同时应用PAD治疗。比较两组治疗前后牙周相关指标、龈下细菌相对丰度、龈沟液炎症指标以及临床有效率。结果:两组治疗前牙周相关指标、龈下细菌相对丰度、龈沟液炎症指标水平比较差异均无统计学意义(均P>0.05);治疗后观察组牙龈指数、牙周袋探诊深度、附着丧失水平、探诊出血指标水平低于对照组(均P<0.05);治疗后观察组卟啉单胞菌、中间普雷沃菌、福赛坦纳菌、齿垢密螺旋体相对丰度低于对照组(均P<0.05);治疗后观察组龈沟液肿瘤坏死因子-α、白细胞介素-18、白细胞介素-6、白细胞介素-1β水平低于对照组(均P<0.05);观察组临床治疗有效率(100.00%)高于对照组(71.43%)(P<0.05)。结论:对于牙髓-牙周综合征患者,在常规治疗基础上实施PAD辅助治疗,可有效改善牙周状况,抑制口腔细菌,改善炎症,提高临床疗效。

盐酸米诺环素辅助显微根管联合牙周组织再生术治疗牙周牙髓联合病变伴畸形根面沟的效果观察

目的探讨盐酸米诺环素辅助显微根管联合牙周组织再生术治疗牙周牙髓联合病变伴畸形根面沟的效果。方法选取2020年4月—2022年1月常州市中医医院收治的102例(共102颗患牙)牙周牙髓联合病变伴畸形根面沟患者,以随机数字表法分为对照组和研究组,每组51例。对照组接受显微根管联合牙周组织再生术治疗,研究组在对照组基础上给予盐酸米诺环素治疗。对比两组手术成功率、牙周相关指标、炎症因子、咀嚼功能评分、疼痛情况及并发症。结果研究组术后1年手术成功率(90.20%)高于对照组(72.55%)(P<0.05)。研究组治疗前后龈沟出血指数、探诊深度、牙石指数、菌斑指数、C反应蛋白、肿瘤坏死因子、白细胞介素-17、咀嚼功能评分、视觉模拟评分的差值均高于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论盐酸米诺环素辅助显微根管联合牙周组织再生术治疗牙周牙髓联合病变伴畸形根面沟患者疗效确切,可改善牙周组织状态,减轻炎症反应、疼痛。

GTR联合根尖手术治疗牙周牙髓联合病变伴重度牙槽骨缺损上颌磨牙1例

牙周牙髓联合病变涉及牙髓和牙周组织,其诊疗难度较大,预后一般不佳。本文报道1例牙周源性的牙周牙髓联合病变伴重度牙槽骨缺损的上颌第一磨牙,经根管治疗术、牙周基础治疗、引导性组织再生术(guided tissue regeneration, GTR)和同期根尖手术联合治疗,达到意向性保留患牙的目的。

选择性刮治在显微根尖手术中的疗效评估

目的评估显微根尖手术(endodontic microsurgery,EMS)中根尖病损邻近或累及重要结构时采用选择性刮治的疗效。方法选取2021年1月—2023年1月在南京医科大学附属口腔医院牙体牙髓病科就诊并完成显微根尖手术的264例患者作为研究对象,按根尖刮治方法分为选择性刮治组(SC-EMS组)和常规刮治组(C-EMS组)。SC-EMS组中,患者根尖病损邻近或累及重要结构(颏孔、下颌神经管、鼻腭神经管、上颌窦、鼻底、活髓邻牙),对邻近区域进行选择性刮治;C-EMS组中,患者根尖病损邻近重要结构,进行常规根尖刮治。术后随访12个月,观察患者术后症状并进行影像学检查,评估疗效。对失败病例进行拔牙术后检查和病理诊断回顾,记录失败原因。结果SC-EMS组成功率90.2%,C-EMS组成功率95.4%,C-EMS组成功率较高但两组间无统计学差异(P>0.05),根折是两组患者手术失败的主要原因。SC-EMS组术后患者存在短期不适6例,长期不适2例;C-EMS组中无明显不适病例。结论选择性刮治对显微根尖手术成功率无显著影响,是术中保护重要结构的有效方法。术后可能出现短期不适,少数病例导致邻牙不可逆性牙髓损伤。

意向再植术治疗畸形根面沟临床疗效分析

畸形根面沟是一种牙齿发育畸形,可导致严重的牙周牙髓联合病变,其诊断和治疗是一个临床难题。本文报道了临床上两种类型的畸形根面沟病例,采取意向性再植术联合显微根管治疗术、根面沟封闭术以及显微根尖手术进行综合治疗,经过12个月的随访,其临床和影像学表现均取得满意效果,初步证实意向性再植术应用于畸形根面沟治疗可在短期内取得较好的临床效果。

牙周牙髓联合病变应用综合治疗的效果观察

目的 观察牙周牙髓联合病变患者接受综合治疗(根管治疗+龈下刮治+引导组织再生术)的效果。方法 110例牙周牙髓联合病变患者,随机分为观察组和对照组,每组55例。观察组应用综合治疗(根管治疗+龈下刮治+引导组织再生术),对照组应用传统治疗(根管治疗+龈下刮治)。比较两组治疗效果、牙周指数[探诊深度(PD)、出血指数(BI)、菌斑指数(PLI)、牙龈指数(GI)]、咀嚼功能、预后情况。结果 观察组、对照组的总有效率均为96.36%,比较无显著差异(P>0.05)。治疗后,两组PD、BI、PLI、GI较本组治疗前降低,且观察组PD(3.37±0.47)mm、BI(1.68±0.30)、PLI(0.69±0.09)、GI(1.01±0.38)低于对照组的(4.49±0.53)mm、(2.31±0.34)、(1.12±0.12)、(1.64±0.40)(P<0.05)。治疗后6、12个月,观察组咀嚼功能评分分别为(6.05±0.63)、(7.28±0.79)分,显著高于对照组的(4.11±0.67)、(5.52±0.75)分(P<0.05)。随访1年,观察组的牙齿保留率69.09%显著高于对照组的49.09%,牙周炎复发率3.64%、牙髓炎复发率5.45%显著低于对照组的20.00%、21.82%(P<0.05)。结论 根管治疗+龈下刮治+引导组织再生术在治疗牙周牙髓联合病变方面具有明显优势,不仅能够改善患者的牙周指数以及咀嚼功能,同时还可以提高患者的牙齿保留率,减少牙周炎和牙髓炎的复发,具有显著疗效。

Vitapex联合米诺环素治疗牙周牙髓联合病变效果的Meta分析

目的通过Meta分析评价Vitapex联合米诺环素治疗牙周牙髓联合病变的效果。方法通过PubMed、Web of Science、Embase、Cochrane-Central、知网、万方及维普数据库,检索Vitapex联合米诺环素治疗牙周牙髓联合病变的随机对照试验(RCT),检索时间从建库至2023年10月。由2名研究员按纳入及排除标准独立筛选文献并提取资料,评价纳入研究的方法学质量。采用RevMan5.4软件对最终符合纳入标准的研究数据进行统计学分析。结果最终纳入11篇文献,共1232例患者。Meta分析结果显示,试验组的探诊深度(PD)、出血指数(BI)、C反应蛋白(CRP)、白细胞介素-17(IL-17)改变量大于对照组,差异具有统计学意义(P<0.00001)。结论Vitapex联合米诺环素治疗牙周牙髓联合病变的效果更显著。但由于本研究纳入文献数量较少、质量不一,尚有不足,未来需要有更多大样本、高质量的研究予以证实此结论。

上颌窦解剖结构及其与上颌后牙显微根尖手术的关系

上颌后牙区与上颌窦关系密切,解剖结构复杂,因而该区域显微根尖手术难度较大。上颌窦的一些解剖特征也使得显微根尖手术对临近解剖结构造成伤害的风险增加,影响手术的过程和预后。因此,本文对上颌窦的解剖特征包括其形态与发育、上颌窦口、施耐德黏膜、上颌窦分隔、上牙槽后动脉及其与上颌后牙的关系等进行简要综述,同时就上颌窦对上颌后牙区显微根尖手术的术前准备、手术方式、并发症、手术预后及成功率等的影响进行简要讨论。