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根尖显微外科专家共识

Expert consensus on apical microsurgery.

作者信息

Wang Hanguo, Xu Xin, Bian Zhuan, Liang Jingping, Chen Zhi, Hou Benxiang, Qiu Lihong, Chen Wenxia, Wei Xi, Hu Kaijin, Wang Qintao, Wang Zuhua, Li Jiyao, Huang Dingming, Wang Xiaoyan, Huang Zhengwei, Meng Liuyan, Zhang Chen, Xie Fangfang, Yang Di, Yu Jinhua, Zhao Jin, Pan Yihuai, Pan Shuang, Yang Deqin, Niu Weidong, Zhang Qi, Deng Shuli, Ma Jingzhi, Meng Xiuping, Yang Jian, Wu Jiayuan, Du Yi, Ling Junqi, Yue Lin, Zhou Xuedong, Yu Qing

机构信息

State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China.

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

出版信息

Int J Oral Sci. 2025 Jan 2;17(1):2. doi: 10.1038/s41368-024-00334-8.

DOI:10.1038/s41368-024-00334-8
PMID:39743567
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11693765/
Abstract

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.

摘要

根尖显微外科手术精确且微创,并发症少,成功率超过90%。然而,由于普通牙科医生甚至牙髓病医生对根尖显微外科手术缺乏认识和了解,许多临床问题仍有待解决。为此,汇聚国内知名专家进行了一系列专题研讨并达成共识。本文件规定了根尖显微外科手术的适应证、禁忌证、术前准备、操作步骤、并发症预防措施及疗效评估,适用于经系统培训后开展根尖显微外科手术的牙医。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/de97632bf078/41368_2024_334_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/acfda178ec9d/41368_2024_334_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/252059c077cb/41368_2024_334_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/cf2c8f723dfe/41368_2024_334_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/de97632bf078/41368_2024_334_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/acfda178ec9d/41368_2024_334_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/252059c077cb/41368_2024_334_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/cf2c8f723dfe/41368_2024_334_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/096b/11693765/de97632bf078/41368_2024_334_Fig4_HTML.jpg

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本文引用的文献

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The outcome of combined use of iRoot BP Plus and iRoot SP for root-end filling in endodontic microsurgery: a randomized controlled trial.iRoot BP Plus 和 iRoot SP 联合用于根管显微镜下根尖封闭术的效果:一项随机对照试验。
Clin Oral Investig. 2024 Mar 2;28(3):188. doi: 10.1007/s00784-024-05569-7.
2
Endodontic Microsurgery With an Autonomous Robotic System: A Clinical Report.自主机器人系统辅助的牙髓显微外科:一份临床报告。
J Endod. 2024 Jun;50(6):859-864. doi: 10.1016/j.joen.2024.02.005. Epub 2024 Feb 17.
3
Robot-Assisted and Haptic-Guided Endodontic Surgery: A Case Report.
机器人辅助和触觉引导的牙髓病学手术:病例报告。
J Endod. 2024 Apr;50(4):533-539.e1. doi: 10.1016/j.joen.2024.01.012. Epub 2024 Jan 26.
4
Piezoelectric Device and Dynamic Navigation System Integration for Bone Window-Guided Surgery.压电设备与动态导航系统在骨窗引导手术中的整合。
J Endod. 2023 Dec;49(12):1698-1705. doi: 10.1016/j.joen.2023.09.013. Epub 2023 Oct 5.
5
Experts consensus on the procedure of dental operative microscope in endodontics and operative dentistry.口腔内科学与口腔修复学中使用牙科手术显微镜操作程序专家共识
Int J Oral Sci. 2023 Sep 18;15(1):43. doi: 10.1038/s41368-023-00247-y.
6
Diagnosis of Odontogenic Maxillary Sinusitis by Cone-beam Computed Tomography: A Critical Review.锥形束计算机断层扫描对牙源性上颌窦炎的诊断:一项批判性综述。
J Endod. 2023 Nov;49(11):1445-1456. doi: 10.1016/j.joen.2023.08.014. Epub 2023 Sep 1.
7
Conservative endodontic microsurgery to protect critical anatomical structures-selective curettage: a case series.保守性牙髓显微手术保护关键解剖结构——选择性刮治术:病例系列研究。
BMC Oral Health. 2023 Aug 31;23(1):615. doi: 10.1186/s12903-023-03287-2.
8
Retrospective Evaluation of Periradicular Biopsies: An 18-Year Study.回顾性分析根尖周活检:一项长达 18 年的研究。
J Endod. 2023 Nov;49(11):1457-1463. doi: 10.1016/j.joen.2023.07.023. Epub 2023 Aug 4.
9
Process-related Factors Are as Important as Outcomes for Patients Undergoing Nonsurgical Root Canal Treatment, Nonsurgical Root Canal Retreatment, and Endodontic Microsurgery.对于接受非手术根管治疗、非手术根管再治疗和牙髓显微手术的患者而言,过程相关因素与结果同样重要。
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Augmented Reality and 3-Dimensional Dynamic Navigation System Integration for Osteotomy and Root-end Resection.用于截骨术和根尖切除术的增强现实与三维动态导航系统集成
J Endod. 2023 Oct;49(10):1362-1368. doi: 10.1016/j.joen.2023.07.007. Epub 2023 Jul 13.