Periapical Microsurgery: Can Ultrasonic Root-end Preparations Clinically Create or Propagate Dentinal Defects?

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• 作者：Peter Z. Tawil ; DMD ; MS ; FRCD(C) ; Dip ABE ; ^{pzt@unc.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Dentinal defect ; endodontic microsurgery ; fracture ; root-end preparation ; ultrasonics
• 刊名：Journal of Endodontics
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：42
• 期：10
• 页码：1472-1475
• 全文大小：464 K

文摘

This clinical study evaluates the effect of ultrasonic root-end preparations on dentinal defect creation and propagation.

Methods

Eighty-four teeth were treated with periapical microsurgery using a modern microsurgical protocol in a private practice setting. The root apices were resected and inspected for dentinal defects with a surgical operating microscope and a 0.8-mm diameter light-emitting diode microscope diagnostic probe light, both before and after ultrasonic root-end preparations. A 3-grade scale (none, partial, and full dentinal defect) was used to assess the status of the roots before and after ultrasonic root-end preparation.

Results

Of the 84 treated teeth, 3 had a vertical root fracture, leaving a total of 81 teeth for assessment. Fifty-one teeth were intact upon resection and remained intact after root-end preparation. Twenty-six teeth had partial dentinal defects, and 14 (54%) of these propagated into full dentinal defects after root-end preparation.

Conclusions

This periapical microsurgery study showed that ultrasonic root-end preparations are safe to use on intact roots. Preexisting dentinal defects can be propagated by ultrasonic root-end preparations. Through the use of light-emitting diodes, dentinal defects can be detected, special root-end management can be implemented, and more predictable outcomes may be achieved.