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C形根管牙髓治疗失败原因分析

Analysis of Cause of Endodontic Failure of C-Shaped Root Canals.

作者信息

Kim Yemi, Lee Donghee, Kim Da-Vin, Kim Sin-Young

机构信息

Department of Conservative Dentistry, Dental Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea.

Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Scanning. 2018 Nov 25;2018:2516832. doi: 10.1155/2018/2516832. eCollection 2018.

Abstract

The purpose of this study was to analyze various characteristics and classification of C-shaped root canals and evaluate the causes of endodontic failure of C-shaped root canals by examining the resected root surface with an endodontic microscope and a scanning electron microscope (SEM). Forty-two teeth with C-shaped root canals were included in this study and had undergone intentional replantation surgery. Before surgery, periapical radiography and cone-beam computed tomography were taken. The root canal configuration was analyzed and classified according to Melton's classification at coronal and apical level. After injection of 1 : 100,000 epinephrine with 2% lidocaine, the tooth was carefully extracted. After the root-end resection, the resected root surface was examined using an operating microscope and SEM. Mandibular second molars were most frequently involved teeth (90.4%). The most frequently observed root canal configurations were C1 at the coronal level (45.2%) and C3 at the apical 3 mm level (45.2%). The most common cause of failure for a C-shaped root canal treatment was a leaky canal (45.2%), followed by an isthmus (23.8%), missing canal, overfilling, and iatrogenic problems. In conclusion, C-shaped root canals were most frequently found in mandibular second molars. The most common cause of failure was a leaky canal and isthmus.

摘要

本研究的目的是分析C形根管的各种特征和分类,并通过牙髓显微镜和扫描电子显微镜(SEM)检查切除的牙根表面,评估C形根管牙髓治疗失败的原因。本研究纳入了42颗有C形根管且接受了意向性再植手术的牙齿。手术前,进行了根尖片和锥形束计算机断层扫描。根据Melton分类法在冠部和根尖部分析并分类根管形态。在注射1∶100,000肾上腺素与2%利多卡因后,小心拔除牙齿。根尖切除后,使用手术显微镜和SEM检查切除的牙根表面。下颌第二磨牙是最常受累的牙齿(90.4%)。在冠部最常观察到的根管形态是C1(45.2%),在根尖3mm处最常观察到的是C3(45.2%)。C形根管治疗失败最常见的原因是根管渗漏(45.2%),其次是峡部(23.8%)、遗漏根管、超充和医源性问题。总之,C形根管最常见于下颌第二磨牙。失败最常见的原因是根管渗漏和峡部。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c09/6286757/0a9e9e71330d/SCANNING2018-2516832.001.jpg

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