牙体解剖学精品课件（中山大学）13.1根管治疗绪论.pptVIP

4.2 Sealing of the canal system to prevent microleakage Prevention the development of periradicular pathosis Promote the healing of existed periapical pathosis Master cone selection Lateral condensation The necessity of the canal obturation Bacteria resided in the cleaned and shaped root canal system (dentinal tubules) Free immunity of the canal system in the body Serum (seeping from the apical tissues) serves as the furnishes for the micro-organisms persistent in the tubules overfilling filling short of the apex exactly filling 4.3 Conservation of tooth structure Balance between adequate access and removing too much dentine Develop a continuously tapering form Keep the apical foramen as small as practical Optimal working width Initial apical file (IAF, 初尖锉） The first file that binds in the canal at WL Initial working width (IWW) Master apical file (MAF, 主尖锉） The largest file that perform apical enlargement Three sizes larger than IAF: IAF#10-MAF#25 Final working width (FWW) Master apical file 5. Evaluating success and failure 5.1 Methods of Evaluation The success rates of endodontic treatment: 53%-94% WHO Suggested that the length of time necessary for adequate postoperative follow-up is 2 years Aspects of Evaluation ①Clinical Symptoms Spontaneous pain Dull persistent ache Swelling Mastication sensitivity Absence of symptoms does not confirm success, because periradicular pathosis without significant symptoms is usually present ②Clinical Signs Restorative Examination Coronal leakage Periodontal Examination Periodontal probing Mobility assessment Sinus tract ③Radiographic assessment Apparent quality of root filling Apical resorption Size of radiolucency 5.2 Criteria of Evaluation Clinical criteria for success Absence of pain or swelling Healing of sinus tract No evidence of soft tissue destruction, including probing defects Absence of periapical lesion or significantly reduced periradicular lesion Clinical criteria for failure