Cheung G S
Department of Conservative Dentistry, University of Hong Kong, Faculty of Dentistry, Hong Kong.
Int Dent J. 1996 Jun;46(3):131-8.
The underlying reason for endodontic failures is almost invariably due to bacterial infection. The bacteria may be situated within a previously missed or uninstrumented portion of a root canal, infiltrate via a leaky coronal restoration and root filling, or cause contamination from an extra-radicular infection. Management of the failing root canal filling begins with the identification of the source of persistent infection. Should the infection be present within the root canal system, such as a missed canal, orthograde retreatment is the choice of treatment. This is also true for asymptomatic cases which had been inadequately obturated and which require the placement of a dowel into the canal for restorative reasons. Periapical surgery is best reserved for cases with no sign of healing after orthograde retreatment and those with extra-radicular infection. This paper discusses the relationship between endodontics and restorative dentistry, treatment planning for endodontic failures, and the reported rates of success with orthograde and surgical retreatments.
牙髓治疗失败的根本原因几乎总是细菌感染。细菌可能位于根管先前遗漏或未进行器械操作的部分，通过渗漏的冠部修复体和根管充填物侵入，或由根周外感染引起污染。对失败的根管充填进行处理首先要确定持续感染的来源。如果感染存在于根管系统内，如遗漏根管，正行再治疗是首选的治疗方法。对于充填不充分且因修复原因需要在根管内放置桩的无症状病例也是如此。根尖手术最好用于正行再治疗后无愈合迹象以及存在根周外感染的病例。本文讨论了牙髓病学与修复牙科学的关系、牙髓治疗失败的治疗计划以及正行和手术再治疗的报道成功率。
