Private Practice, Hamburg, Germany.
Int Endod J. 2010 Jul;43(7):545-54. doi: 10.1111/j.1365-2591.2009.01652.x. Epub 2010 May 4.
To determine the success rate of a microendodontic technique for the removal of fractured instruments from root canals.
Removal was attempted on a total of 170 consecutive referral cases with fractured instruments. All removal attempts were performed using an operating microscope and ultrasonic tips using a technique described by Ruddle (2003).
Of the 170 fractured instruments, 162 could be removed without perforation of the root canal, corresponding to a success rate of 95%. At a failure rate of 5%, eight instruments could not be removed, with root wall perforation occurring in one case. The lowest success rate of 93% was found in maxillary molars, the highest success rate of 100% in maxillary premolars and anterior and canine teeth of the maxillary and mandibular jaw. All removal failures occurred in cases where the fractured instruments were located apically or in the middle and apical part of the root. Regarding the angle of root canal curvature, the lowest success rates were found between 21 degrees and 50 degrees.
The position of the instrument within the root canal, the angle of the curvature of the root canal and the location of the fractured instrument in relation to the root canal curvature were the decisive factors that had a negative influence on the treatment outcome.The removal method tested represents a highly effective technique for the retrieval of fractured instruments.
确定一种用于从根管中取出折断器械的显微根管技术的成功率。
对总共 170 例连续转诊的有折断器械的病例进行了尝试取出。所有的取出尝试均使用手术显微镜和超声尖端，采用 Ruddle（2003 年）描述的技术进行。
在 170 个折断器械中，有 162 个可以在不穿透根管的情况下取出，成功率为 95%。在 5%的失败率下，有 8 个器械无法取出，其中 1 例发生根管壁穿孔。上颌磨牙的成功率最低，为 93%，上颌前磨牙和尖牙以及上颌和下颌前牙的成功率最高，为 100%。所有的取出失败都发生在折断器械位于根尖或根管的中上部的病例中。就根管弯曲角度而言，成功率最低的是在 21 度至 50 度之间。
器械在根管内的位置、根管弯曲角度以及折断器械相对于根管弯曲的位置是对治疗结果有负面影响的决定性因素。所测试的取出方法代表了一种非常有效的取出折断器械的技术。
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