Madarati A A, Watts D C, Qualtrough A J E
School of Dentistry, University of Manchester, Manchester, UK.
Int Endod J. 2008 Dec;41(12):1079-87. doi: 10.1111/j.1365-2591.2008.01473.x.
To investigate the attitudes of general dental practitioners (GDPs) and endodontists in the UK towards management of fractured endodontic instruments.
A questionnaire was sent to 330 systemically selected GDPs and all endodontists working in the UK (170). It was accompanied by a covering letter explaining the aims of the study and indicating that all the information given would remain confidential. Those who did not respond to the first mailing were sent another two mailings. Data were analysed using chi-square test at P <or= 0.05.
The overall response rate was 75%. Only 18.5% of respondents reported that they would retrieve instruments located in the apical third of root canals with a significantly higher proportion of endodontists (25.9%) compared with that of GDPs (14%) doing so. A significantly higher proportion of endodontists (98.5%) used ultrasonics for removal of fractured instruments compared with GDPs (75.8%). The most common complication of fractured instrument retrieval was thought to be excessive removal of dentine (67%). The majority of respondents (88.5%) reported that they would leave the unsuccessfully removed file in situ and obturate the root canal.
Both endodontists and GDPs were aware of the limitations of root canal anatomy when removal of fractured instruments was considered. Excessive removal of dentine, the most common complication associated with the removal process, suggests the need for more conservative techniques. Both endodontists and GDPs demonstrated a conservative approach when management of fractured instruments failed. Further studies regarding attitudes of GDPs and endodontists towards some specific aspects of fractured instruments management are required.
调查英国普通牙科医生(GDPs)和牙髓病医生对根管内折断器械处理的态度。
向330名系统选取的GDPs和所有在英国工作的牙髓病医生(170名)发送了一份问卷。问卷附有一封说明研究目的的附信,并表明所提供的所有信息将保密。未回复第一次邮寄的人又收到了另外两次邮寄。使用卡方检验在P≤0.05的水平上分析数据。
总体回复率为75%。只有18.5%的受访者表示他们会取出位于根管根尖三分之一处的器械,与GDPs(14%)相比,牙髓病医生这样做的比例(25.9%)显著更高。与GDPs(75.8%)相比,使用超声去除折断器械的牙髓病医生比例(98.5%)显著更高。折断器械取出最常见的并发症被认为是牙本质过度去除(67%)。大多数受访者(88.5%)表示他们会将未成功取出的锉留在原位并对根管进行充填。
在考虑取出折断器械时,牙髓病医生和GDPs都意识到了根管解剖结构的局限性。牙本质过度去除是与取出过程相关的最常见并发症,这表明需要更保守的技术。当折断器械处理失败时,牙髓病医生和GDPs都表现出了保守的方法。需要进一步研究GDPs和牙髓病医生对折断器械处理某些特定方面的态度。