Rhodes J S
Department of Conservative Dentistry, GKT Dental Institute, Guy's Hospital, London, UK.
Int Endod J. 2001 Dec;34(8):645-8. doi: 10.1046/j.1365-2591.2001.00441.x.
The aim of this case report is to describe conventional root canal treatment on a mandibular second premolar with four canals.
The pulp of a mandibular second premolar had become irreversibly inflamed, probably as a result of bacterial microleakage from a carious lesion. The general dental practitioner had initiated root canal treatment, but due to procedural difficulties referred the case. Conventional root canal treatment was then performed with magnification. Preparation was undertaken in a crown-down manner using balanced force hand instrumentation with flexible K-type files and files of Greater Taper. The root canals were obturated with vertically condensed gutta-percha technique.
Good illumination and magnification are vital during root canal treatment. Crown-down preparation using the balanced force technique with flexible files makes instrumentation easier and prevents many of the procedural errors that can occur with filing techniques. Greater Taper instruments made of nickel-titanium are sufficiently flexible to be used in complex curved canals and obviate the need for step-back flaring of the apical preparation. Vertical compaction of warm gutta-percha may simplify the obturation of complex root canal systems. When the technical difficulty of a procedure exceeds the expertise of the practitioner, specialist referral may be required.
本病例报告旨在描述对一颗具有四条根管的下颌第二前磨牙进行的常规根管治疗。
下颌第二前磨牙的牙髓已发生不可逆性炎症，可能是由于龋损处的细菌微渗漏所致。全科牙医已开始进行根管治疗，但因操作困难而转诊该病例。随后在放大条件下进行了常规根管治疗。采用冠向深入法，使用平衡力量手动器械以及Flexible K型锉和大锥度锉进行预备。采用垂直加压热牙胶技术对根管进行充填。
根管治疗期间良好的照明和放大至关重要。使用柔性锉采用平衡力量技术进行冠向深入预备可使器械操作更容易，并防止锉法可能出现的许多操作失误。由镍钛制成的大锥度器械足够柔韧，可用于复杂弯曲根管，无需对根尖预备进行逐步后退式扩管。热牙胶垂直加压可简化复杂根管系统的充填。当操作的技术难度超过从业者的专业水平时，可能需要转诊至专科医生处。
