根尖区手术同期根管充填治疗前牙根尖区明显渗出性病变疗效观察.docVIP

根尖区手术同期根管充填治疗前牙根尖区明显渗出性病变疗效观察【摘要】 目的 观察根尖区手术同期根管充填治疗前牙根尖区明显渗出性病变的临床疗效。方法 选取前牙根尖区病变、渗出明显、无法干燥消毒充填根管的患者60例82颗牙齿。先去除根尖区病变组织，同期行根管充填，以及根尖切除或根尖倒充术。术后2年评价临床疗效。结果 其中行倒充术患者的有效率为97.2%，行根尖切除术患者的有效率为93.5%。总有效率为95.1%。结论 根尖区手术同期根管充填治疗前牙根尖区明显渗出性病变疗程短，疗效好。? 【关键词】 根尖区手术；根管充填；根尖区病变；渗出 Clinical evaluation of root canal filling and endodontic surgery at one time in anterior teeth apical severe effusion disease GAO Li，ZHANG Yan-xi. Department of Stomatology, the Forth Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China ? 【Abstract】 Objective To observe the effect of the root canal filling and endodontic surgery at one time in anterior apical severeeffusiondisease.Methods Sixty patients(82 anterior teeth) with apical severeeffusiondiseasewere studied.The root canal can not be dried, disinfected, and filled.Apicaldisease was removed out,then root canal filling, and apicoectomyor retrograde filling were done at one time.Clinical effect after 2 years were evaluated. Results In 2 years, the effective rate was97.2% in the retrograde filling group, and 93.5% in apicoectomy group, the total effective rate was 95.1%. Conclusion The results of the study suggest that root canal filling and endodontic surgery at one time in anterior apical severeeffusiondisease takes short therapeutic time and has a good curative effect.? 【Key words】 endodontic surgery；Root canal filling；Apical disease；Effusion. 随着根管治疗器械的不断发展,技术水平的日趋成熟,根管治疗疗效有了明显提高。由于良好的根管充填，封闭了根管系统，一般不做手术根尖周病变也能愈合，致使根尖周手术适应范围愈来愈小。但临床上还存在着根管治疗无法解决的病例，如临床上常常遇到根尖区渗出明显的患者，在根管预备后，经多次根管换药仍有明显渗出，无法行根管内消毒及根管充填。本文对该类患者采用根尖区手术同期根管充填治疗的方法，取得了很好疗效，现报告如下。? 1 资料与方法? 1.1 一般资料 选取2008年1~12月在我院就诊的前牙根尖区病变患者60例，82颗牙齿，男38例，女22例，年龄22~58岁，平均34岁。纳入标准：均为死髓牙，病变牙根尖区有肿胀史，牙齿无松动。X线示根尖区有明显阴影区，经常规根管预备,根管内换药4周后仍有明显渗出。X线提示有根管内吸收，根尖孔变大者36颗牙齿；无明显内吸收，根尖孔正常者46颗牙齿。? 1.2 治疗方法 常规消毒铺巾，用含1?∶?10万肾上腺素的2%利多卡因局部浸润或阻滞麻醉，在患牙唇侧黏膜上，距牙龈缘约3 mm处切开，均采用梯形切口，双侧均包含1颗正常牙齿。用骨膜分离器翻起粘骨膜瓣，暴露病变的根尖区, 用涡轮机细裂钻做一穿孔或沿着骨破坏区扩大, 暴露根尖病变区。用挖匙沿破坏区骨壁彻底去除病变的囊肿或肉芽肿组织，用生