显微根尖手术联合MTA治疗难治性慢性根尖周炎的研究

doi:10.13701/j.cnki.kqyxyj.2017.07.020

口腔医学研究 ›› 2017, Vol. 33 ›› Issue (7): 770-773.DOI: 10.13701/j.cnki.kqyxyj.2017.07.020

显微根尖手术联合MTA治疗难治性慢性根尖周炎的研究

邱小玲¹, 贾搏², 韩久松², 褚洪星², 孙书昱^1*

1. 南方医科大学口腔医院,广东省口腔医院牙体牙髓科广东广州 510280;
2. 南方医科大学口腔医院,广东省口腔医院口腔颌面外科广东广州 510280

收稿日期:2017-01-05 出版日期:2017-07-20 发布日期:2017-07-27
通讯作者: 孙书昱,电话:18922314972
作者简介:邱小玲(1981~ ),女,江西人,主治医师,博士在读,从事人骨髓间充质干细胞成骨相关的lncRNA的相关研究。
基金资助:
广东省自然科学基金项目(编号:2015A030313787)广东省医学科学技术研究基金项目(编号:B2017103)广东省科技计划项目(编号:2013B021800153)

Outcome Evaluation of 106 Cases of Apical Microsurgery Retrofilled with MTA.

QIU Xiao-ling¹, JIA Bo², HAN Jiu-song², CHU Hong-xing², SUN Shu-yu^1*.

1. Department of Endodontics, Stomatological Hospital of Southern Medical University, Guangdong Provincial Stomatological Hospital, Guangzhou 510280, China;
2. Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Southern Medical University, Guangdong Provincial Stomatological Hospital, Guangzhou 510280, China.

Received:2017-01-05 Online:2017-07-20 Published:2017-07-27

摘要/Abstract

摘要： 目的:研究在显微根尖手术治疗难治性慢性根尖周炎时应用MTA的可行性、特点、成功率及相关影响因素。方法:分析2013年1月~2015年12月间本院牙体牙髓科完成的显微根尖外科手术106例计146颗难治性慢性根尖周炎患牙的临床资料,其中上颌前牙75例、下颌前牙13例、上颌前磨牙6例、下颌前磨牙4例、上颌磨牙4例、下颌磨牙4例。手术包括根尖切除、根尖倒预备、根尖倒充填主要步骤,术后1年回访,通过临床症状和放射学检查评估疗效,并对预后影响因素进行卡方检验分析。结果:显微根尖外科手术联合MTA应用的1年成功率达95.9％(140/146),根据患者性别、年龄、牙位、根尖病灶范围分别统计手术疗效,组间差异均无统计学意义。失败5例6颗患牙,主要原因为根折及合并重度牙周炎。结论:在治疗难治性慢性根尖周炎时采用显微根尖手术联合MTA应用可取得满意效果;显微根尖手术是治疗慢性根尖周炎的有效手段。

关键词: MTA(三氧化矿物凝聚体), 口腔显微镜显微根尖手术, 慢性根尖周炎

Abstract: Objective: To analyze the clinical effect of apical microsurgery retrofilled with MTA in treatment of chronic apical periodontitis and provide references for the clinic treatment. Methods: One hundred and six patients (146 teeth) who received apical microsurgery in our hospital were followed up for one year. Surgical treatment included root-end resection, retropreparation with ultrasonic microtips, and root-end filling with MTA. All patients were reviewed after one year, and the clinical and radiographical examination were performed. Chi-square test was used to analyze the results. Results: The one year success rate was 95.9% (140/146). Gender, age, tooth position, and lesion diameter had no significant influences on the outcome of apical microsurgery. Five cases were failed because of root fracture and severe periodontitis. Conclusion: Effect of apical microsurgery retrofilled with MTA in the treatment of persistent chronic periapical periodontitis is satisfactory.

Key words: Mineral trioxide aggregate (MTA) , Dental operating microscope (DOM) , Apical microsurgery, Chronic apical periodontitis

中图分类号:

R781.4

邱小玲, 贾搏, 韩久松, 褚洪星, 孙书昱. 显微根尖手术联合MTA治疗难治性慢性根尖周炎的研究[J]. 口腔医学研究, 2017, 33(7): 770-773.

QIU Xiao-ling, JIA Bo, HAN Jiu-song, CHU Hong-xing, SUN Shu-yu.. Outcome Evaluation of 106 Cases of Apical Microsurgery Retrofilled with MTA.[J]. Journal of Oral Science Research, 2017, 33(7): 770-773.

参考文献

[1] Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review [J]. J Endod, 2006, 32(7)∶601-623
[2] Setzer FC, Shah SB, Kohli MR, et al. Outcome of endodontic surgery: a meta-analysis of the literature: part 1: comparison of traditional root-end surgery and endodontic microsurgery[J]. J Endod,2010,36(11)∶1757-1765
[3] von Arx T. Walker WA 3rd Microsurgical instruments for root-end cavity preparation following apicoectomy : a literature review. Endod Dent Traumatol [J], 2000 ,16(2)∶47-62
[4] 高阳,余承军,苏凌云,等.银汞材料与 MTA 材料作为根尖倒充填材料的临床效果评价[J].北京口腔医学,2009,17(3)∶149-151
[5] 申静,高静,杜兴华,等.97例显微根尖外科手术短期疗效评估[J].口腔医学研究,2015,31(8)∶807-810
[6] Rubinstein RA, Kim S. Long-term follow-up of cases considered healed one year after apical microsurgery [J] . J Endod,2002,28 (5)∶378-383
[7] Polycarpou N, Ng YL, Canavan D, et al. Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing [J]. Int Endod,2005,38(3)∶169-178
[8] Nair PN. On the causes of persistent apical periodontitis: A revie [J]. International Endodontic Journal, 2006, 39(4)∶249-281
[9] Song M Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic Inspection during endodontic microsurgery [J]. J Endod,2011,37(11)∶961-970
[10] de Almeida J, Pimenta AL. A laboratory assessment of bacterial leakage in MTA apical plugs exposed to phosphate buffered saline [J]. Acta Odontol Latinoam, 2015, 28(2)∶144-148
[11] Baek SH, Plenk H Jr, Kim S. Periapical tissue responses and cementum regeneration with amalgam, Super EBA, and MTA as root-end filling materials J Endod, 2005, 31(6)∶444-449

显微根尖手术联合MTA治疗难治性慢性根尖周炎的研究

Outcome Evaluation of 106 Cases of Apical Microsurgery Retrofilled with MTA.

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