Department of Endodontics, School of Dental Medicine, The Hebrew University-Hadassah, Jerusalem.
J Am Dent Assoc. 2011 Apr;142(4):391-6. doi: 10.14219/jada.archive.2011.0193.
In this review, the authors examine whether there is any decisive evidence to support the revision of root fillings that have been exposed to the oral environment for more than three months, undertaken solely because of suspicions of microleakage. Researchers in numerous endodontic studies have addressed the evaluation of coronal microleakage by using different tracers and techniques. The need to achieve a tight, permanent coronal seal as soon as possible after the completion of endodontic treatment is obvious. However, the clinical importance of microleakage studies recently has been questioned because of their wide range and even contradictory results, and findings from only a few clinical investigations have demonstrated a clear relationship between the endodontic success rate and failure rate owed to coronal microleakage in cases involving high-quality endodontic therapy.
The authors analyzed commonly cited articles regarding the clinical relevance of microleakage studies and the success rate of teeth with compromised restorations.
In a review of the literature, the authors found no clear evidence to support immediate replacement of well-obturated endodontic treatment that has lasted more than three months solely because of suspicions of microleakage. It may be prudent in such cases to make a new coronal restoration immediately and to observe the tooth for at least three months before placing the permanent crown.
在本次综述中,作者研究了是否有任何确凿的证据支持对已暴露于口腔环境超过三个月且仅仅因怀疑微渗漏而进行的根管充填的修改。许多牙髓病学研究的研究人员已经使用不同的示踪剂和技术来评估冠部微渗漏。完成牙髓治疗后,尽快实现紧密、永久的冠部密封是很明显的。然而,由于微渗漏研究的范围广泛,甚至结果相互矛盾,最近其临床重要性受到了质疑,而且只有少数临床研究的结果表明,在涉及高质量牙髓治疗的病例中,根管微渗漏与根管治疗成功率和失败率之间存在明确的关系。
作者分析了常被引用的关于微渗漏研究的临床相关性和有修复体破坏的牙齿的成功率的文章。
在文献综述中,作者没有发现明确的证据支持仅因怀疑微渗漏而立即更换已超过三个月且已良好充填的根管治疗。在这种情况下,立即进行新的冠部修复,并在放置永久冠之前至少观察 3 个月可能是谨慎的做法。