根管显微镜在下颌前磨牙根管定位中作用.doc

根管显微镜在下颌前磨牙根管定位中作用[摘要] 目的：评价根管显微镜在下颌前磨牙根管定位中的作用。方法：选取来我院对下颌前磨牙诊治的病例共134例。其中，下颌第一前磨牙59例，第二前磨牙75例。在肉眼下，寻找根管口并记录数目，随后用根管显微镜在×5～×25的放大倍数下，重新寻找并记录。结果：15个（9.87 ％）额外的根管被找出。其中，9个发生在下颌第一前磨牙，6个发生在下颌第二前磨牙。结论：根管显微镜的运用可以增加下颌前磨牙根管口的识别，提高根管治疗的成功率。 [关键词] 根管显微镜；下颌前磨牙；根管定位 [中图分类号] TH787 [文献标识码]A[文章编号]1673-7210（2008）01（a）-036-02 Orifice locating with a dental operating microscope in mandibular premolar LI Wen-jun,LI Ying,HAN Jian-xing (The 2nd Clinical College of Shanxi Medical University,Taiyuan 030001,China) [Abstract] Objective:The purpose of this study was to evaluate the effct ,whether the use of dental operating microscope (DOM) could increase the number of root canal orifices located in mandibular premolar tooth.Methods:134 cases including 59 mandibular first premolar and 75 mandibular second premolar were used. With the naked eye,all access cavities were prepared and the number of canals in each root was recorded. Using a DOM with ×5～×25 magnification, all tooth had the access cavity preparations again examined. Results:After the DOM examination, 15 more canals could be visualized, representing 9.87% increase in the total number of located canals. From these canals ,9 were located in the mandibular first premolar and 6 in the second premolar.Conclusion:The use of the DOM increases the number of root canal orifices located. [Key words] Dental operating microscope;Mandibular premolar;Orifice locating 常规的牙髓治疗包括去除坏死牙髓组织、根管清洗预备及根管充填[1]。下颌前磨牙大都是单根管，但是在实际临床诊治中会出现一定比例的根管变异，由于忽略了根管变异的存在，导致了根管治疗的失败。 在临床牙髓治疗中，为了消除这些变异导致的失败，有很多方法被推荐：①改变X线投射角度。②改变开髓洞型，便于肉眼直观观察[2]。随着根管手术显微镜的问世及临床普遍使用，其优点被临床广大医师所认可。 1 资料与方法 1.1 一般资料 来我院对下颌前磨牙初次诊治并需要做牙髓治疗的病例，共134例。其中，其中下颌第一前磨牙59例，第二前磨牙75例。要求未曾做过牙髓治疗、牙根发育完全、无大面积龋坏、缺损或充填体。 主要器械：根管显微镜Zeiss Pico（德国Carl Zeiss公司）；显微口镜；MC长柄K挫；方片装橡皮障；根管专用冲洗器；根管侧压器；F-1L显微手术充填器；超声工作尖；超声治疗仪等 1.2 方法 所有诊治均由一名有多年临床经验的术者完成，首先对患者进行口腔局部麻醉、橡皮障隔湿。常规肉眼下开髓、揭顶，去除髓腔内容物，双氧水生理盐水交替冲洗，牙髓探针探查，必要时使用超声治疗仪去除牙本质悬突。用K锉探查根管，并记录根管数目。用根管显微镜Zeiss Pico（德国Carl Zeiss公司），