Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjö B, Engström B
Scand J Dent Res. 1979 Jun;87(3):217-24. doi: 10.1111/j.1600-0722.1979.tb00675.x.
Effects of endodontic retreatment on quality of seal and periapical healing were assessed among 660 previously root-filled roots. The roots were divided into either of two groups according to presence or absence of pathologic alterations in the periapical area. The retreatments, which were carried out by dental students, involved a thorough chemomechanical debridement of the root-canal system aiming to control infection. Following a 2-year observation period 556 roots were reexamined clinically and radiographically. The results showed that root-fillings with technical shortcomings could, following retreatment, be markedly improved as regards effectiveness of seal and distance to the apex. A large number of lumina discernible apical to root-filling could also be treated and filled. Seventy-eight percent of the cases with pathologic lesion present periapically prior to retreatment either completely healed or displayed an obvious size-reduction of the process. Retreatments carried out because of technical inadequacies alone were successful in 94% of the cases. It was concluded that renewed endodontic treatment whenever possible is the method of choice when treating defective endodontic fillings complicated with pathologic processes periapically. Apical surgery may be attempted if no signs of healing are apparent following observation.
在660颗先前已进行根管充填的牙根中评估了根管再治疗对封闭质量和根尖周愈合的影响。根据根尖周区域是否存在病理改变，将这些牙根分为两组。由牙科学生进行的再治疗包括对根管系统进行彻底的化学机械清创，旨在控制感染。经过2年的观察期后，对556颗牙根进行了临床和影像学复查。结果表明，存在技术缺陷的根管充填在再治疗后，其封闭效果和根尖距离方面可得到显著改善。大量在根管充填根尖部可辨别的管腔也可得到治疗和充填。再治疗前根尖周存在病理损害的病例中，78%要么完全愈合，要么病变明显缩小。仅因技术不足而进行的再治疗在94%的病例中取得成功。得出的结论是，对于伴有根尖周病理过程的有缺陷的根管充填，只要有可能，再次进行根管治疗是首选方法。如果观察后没有愈合迹象，可尝试根尖手术。
