Qian Wen-hao, Hong Jin, Xu Pei-cheng
Shanghai Xuhui District Dental Center. Shanghai 200032;China.E-mail:
Shanghai Kou Qiang Yi Xue. 2015 Apr;24(2):206-9.
To analyze the possible causes of previous endodontic treatment failure by microscopic inspection during apical microsurgery.
Two hundred and eighty-nine teeth of previous endodontic treatment failure were collected from patients in Shanghai Xuhui District Dental Center, between January 2006 and January 2014. All surgical procedures were performed by using an operating microscope, and 238 roots were included in the study. The surface of the apical root to be resected or the resected root surface after methylene blue staining was examined during the surgical procedure and inspected with 26 magnification to determine the state of the previous endodontic treatment by using an operating microscope. Fisher's exact test was used to analyze the data with SPSS 19.0 software package.
Among the 238 roots with periapical surgery, analysis of the reasons for previous endodontic treatment failure included leaky canal (29.41%), missing canal (15.55%), underfilling (15.55%), anatomical complexity (7.98%), overfilling (4.20%), apical fenestration (4.20%), iatrogenic problem (3.36%), apical calculus (2.52%), apical cracks (1.68%) and unknown reasons (15.55%). The frequency of possible failure causes and tooth position were closely correlated (P<0.001).
Apical microsurgery can better inspect possible causes of previous endodontic treatment failure, in order to improve the success rate of endodontic treatment.
通过根尖显微外科手术中的显微镜检查分析既往根管治疗失败的可能原因。
收集2006年1月至2014年1月期间上海徐汇区牙病防治所患者的289颗既往根管治疗失败的牙齿。所有手术操作均在手术显微镜下进行，共纳入238个牙根进行研究。在手术过程中，对拟切除的根尖牙根表面或亚甲蓝染色后的切除牙根表面进行检查，并使用手术显微镜以26倍放大倍数观察，以确定既往根管治疗的情况。使用SPSS 19.0软件包中的Fisher精确检验对数据进行分析。
在238个进行根尖手术的牙根中，既往根管治疗失败原因分析包括根管渗漏（29.41%）、遗漏根管（15.55%）、充填不足（15.55%）、解剖结构复杂（7.98%）、超充（4.20%）、根尖穿孔（4.20%）、医源性问题（3.36%）、根尖结石（2.52%）、根尖裂纹（1.68%）及原因不明（15.55%）。可能的失败原因频率与牙齿位置密切相关（P<0.001）。
根尖显微外科手术能更好地检查既往根管治疗失败的可能原因，以提高根管治疗的成功率。
