Primović S, Feher P, Marković D, Petrović L
Klinika za stomatologiju, Novi Sad.
Med Pregl. 2000 Jan-Feb;53(1-2):55-8.
If loss of a great number of teeth occurs, one molar in the lateral segment is of great importance. Contemporary techniques and materials provide extremely successful conservative treatment of pulpal diseases and apical periodontitis. In some cases, however, surgery is indicated.
Indications for periapical surgery used to be a matter of double standards. If periapical surgery is indicated in incisors, it is performed without delay, but if it is indicated in molars, it is often exchanged for extraction. Surgical access in the region of upper and lower molars is specific in regard to much more frequently operated incisors due to anatomic structures at the surgical site. Canal filling techniques, implants, endodontic surgical procedures are of importance and can provide better healing. High quality canal filling is condition sine qua non in treatment of apical periodontitis. It is performed prior surgery, by conventional orthograde endodontic techniques, during surgery by orthograde technique and/or retrogradely. Implants provide better bone healing and are recommended in surgery of molar apex. Surgical packing has numerous advantages (better psychological and mechanical care).
Good knowledge of anatomy and surgical techniques is a pre-requisite for molar apicoectomy. Careful establishment of indications and good relations with the patient provide good prognosis of this therapeutic method.
如果大量牙齿缺失，外侧段的一颗磨牙至关重要。当代技术和材料为牙髓疾病和根尖周炎提供了极其成功的保守治疗方法。然而，在某些情况下，需要进行手术。
根尖手术的适应症过去存在双重标准。如果在前牙需要进行根尖手术，会立即进行，但如果在磨牙需要进行根尖手术，往往会选择拔牙。由于手术部位的解剖结构，与更常进行手术的前牙相比，上下磨牙区域的手术入路具有特殊性。根管充填技术、种植体、牙髓外科手术很重要，并且可以促进更好的愈合。高质量的根管充填是根尖周炎治疗的必要条件。它在手术前通过传统的顺行根管治疗技术进行，手术期间通过顺行技术和/或逆行进行。种植体可促进更好的骨愈合，建议在磨牙根尖手术中使用。手术充填有许多优点（更好的心理和机械护理）。
熟悉解剖结构和手术技术是磨牙根尖切除术的前提条件。仔细确定适应症并与患者建立良好关系可为这种治疗方法带来良好的预后。
