Kerezoudis N P, Valavanis D, Prountzos F
Department of Endodontics, Dental Faculty of Athens, Greece.
Int Endod J. 1999 Jan;32(1):53-60. doi: 10.1046/j.1365-2591.1999.00180.x.
It is generally accepted that the success of root-canal treatment is mainly dependent on the proper cleaning, shaping and hermetic obturation of root canals. Obturation of the root canal is of importance as 60% of endodontic failures are attributable to incomplete obliteration of the root-canal system. The clinical application of many obturation techniques used today demands the preservation of the natural apical construction or the preparation of an artificial equivalent during chemo-mechanical preparation. However, in clinical practice there are cases where the apical foramen is wide because of over-instrumentation, root-end resection during periradicular surgery, root resorption or because the apex of the root is incompletely formed. Thus the preparation of an artificial apical stop is very difficult to achieve. It is a common experience that performing usual gutta-percha condensation techniques in such canals often results in overfilling and therefore special obturation techniques are needed. Some clinical cases of teeth with wide apical foramen treated by a special obturation method are presented in this paper. In this method the end point of the primary gutta-percha cone is elasticized with a heated instrument and inserted into the root canal to record the internal morphology of the apical portion.
人们普遍认为,根管治疗的成功主要取决于对根管的适当清理、塑形和严密封闭。根管封闭至关重要,因为60%的牙髓治疗失败归因于根管系统未完全充填。当今使用的许多封闭技术的临床应用要求在化学机械预备过程中保留天然根尖结构或制备人工等效结构。然而,在临床实践中,存在因过度预备、根尖周手术中的根尖切除、牙根吸收或牙根尖未完全形成而导致根尖孔宽大的情况。因此,制备人工根尖止点非常困难。通常的经验是,在这样的根管中进行常规的牙胶尖加压技术往往会导致超充,因此需要特殊的封闭技术。本文介绍了一些采用特殊封闭方法治疗根尖孔宽大牙齿的临床病例。在这种方法中,用加热器械使主牙胶尖的末端弹性化,然后插入根管以记录根尖部分的内部形态。