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根管治疗难度评估的专家共识。

Expert consensus on difficulty assessment of endodontic therapy.

机构信息

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.

Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.

出版信息

Int J Oral Sci. 2024 Mar 1;16(1):22. doi: 10.1038/s41368-024-00285-0.

Abstract

Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

摘要

牙髓病是一种慢性感染性口腔疾病。常见的牙髓病治疗理念是基于清除发炎或坏死的牙髓组织,并使用牙胶尖进行填充。然而,根管系统的清创和预防根管治疗(RCT)后根管系统的细菌再感染对于牙髓病的治疗至关重要。最近的研究,包括细菌病因学和先进的成像技术,有助于我们理解根管系统的解剖复杂性和 RCT 的技术敏感性。RCT 的成功取决于患者、感染严重程度、根管解剖和治疗技术等因素。因此,改善疾病管理是防治牙髓病和治愈根尖周病变的关键问题。RCT 的临床难度评估系统是基于患者情况、牙齿状况、根管形态和需要再治疗的根管建立的,并强调了治疗前的风险评估,以获得最佳的治疗效果。研究结果表明,危险因素的存在可能与实现 RCT 高标准的挑战相关。这些见解不仅有助于提高教育水平,还有助于临床医生在牙髓病治疗领域进行治疗计划和转诊决策。

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