Johnson Bradford R
Department of Endodontics, University of Illinois, Chicago College of Dentistry, Chicago, IL, USA.
Gen Dent. 2009 Nov-Dec;57(6):570-7; quiz 578-9, 595, 679.
Access preparation may be the single most important mechanical phase of root canal therapy. This article reviews the essential components of good access design and research intended to help guide treatment planning and clinical treatment, with an emphasis on using available information to develop a three-dimensional mental image of the tooth prior to endodontic access, allowing for safe and efficient endodontic therapy. Guidelines for developing an ideal access form, locating small and calcified canals, and avoiding iatrogenic mishaps are presented. Specific tools for efficient access preparation are identified and explained; in addition, case selection and indications for possible referral to a specialist are discussed.
开髓预备可能是根管治疗中最重要的机械操作阶段。本文回顾了良好开髓设计的基本要素以及旨在帮助指导治疗计划和临床治疗的研究，重点是在进行牙髓治疗前利用现有信息构建牙齿的三维心理图像，以实现安全、高效的牙髓治疗。文中还介绍了形成理想开髓形态、定位细小和钙化根管以及避免医源性失误的指导原则。确定并解释了用于高效开髓预备的特定工具；此外，还讨论了病例选择以及可能需要转诊给专科医生的指征。
