截根术治疗上颌第一磨牙近颊根严重病变疗效分析
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摘要
目的:观察截根术治疗上颌第一磨牙近颊根严重病变的临床疗效。方法:选择2012年6月-2014年6月来笔者医院口腔门诊治疗的上颌第一磨牙病变且近颊根破坏最严重的32例患者(共32颗患牙),牙周基础治疗及根管治疗、咬合调整、翻瓣行截根术,术后3个月复查行全冠或联冠修复,1年、2年复查评价治疗效果。结果:术后2年复查,32颗患牙中29颗成功,1颗继发牙周病变致患牙松动拔除,1颗发生根折,1颗失访。结论:截根术治疗上颌第一磨牙近颊根严重病变,能保留牙冠和相对健康的余根继续行使咀嚼功能,疗效满意,是一种有效的治疗方法。
Objective To observe the clinical effect of root amputation in the treatment of maxillary first molar mesiobuccal root severe lesion. Methods 32 patients experiencing maxillary first molar mesiobuccal root severe lesions were chosen from June 2012 to June 2014 to receive stomatology clinic treatment in our hospital. Periodontal basic treatment and after root canal treatment,occlusal adjustment were done. Then the teeth were treated by root amputation. Postoperative 3 months: Full crown or combined crown restoration. The clinical effect was evaluated at 3 months, then 1 year and 2 years after surgery and annual periodic review maintenance. Results 2 years after surgery: 29 of 32 teeth were successfully treated,1 molar was removed because of tooth loosening due to secondary periodontal damage, 1 molar experienced root fracture,and 1 patient was lost. Conclusion Root amputation treatment for maxillary first molar mesiobuccal root severe lesions, can retain the crown and the relative health of the roots. Continue to perform the masticatory function produces satisfactory effects and is an effective treatment method.
Objective To observe the clinical effect of root amputation in the treatment of maxillary first molar mesiobuccal root severe lesion. Methods 32 patients experiencing maxillary first molar mesiobuccal root severe lesions were chosen from June 2012 to June 2014 to receive stomatology clinic treatment in our hospital. Periodontal basic treatment and after root canal treatment,occlusal adjustment were done. Then the teeth were treated by root amputation. Postoperative 3 months: Full crown or combined crown restoration. The clinical effect was evaluated at 3 months, then 1 year and 2 years after surgery and annual periodic review maintenance. Results 2 years after surgery: 29 of 32 teeth were successfully treated,1 molar was removed because of tooth loosening due to secondary periodontal damage, 1 molar experienced root fracture,and 1 patient was lost. Conclusion Root amputation treatment for maxillary first molar mesiobuccal root severe lesions, can retain the crown and the relative health of the roots. Continue to perform the masticatory function produces satisfactory effects and is an effective treatment method.
引文
[1]孟焕新,牙周病学[M].4版.北京:人民卫生出版社,2015:299-300.
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[8]张英,李永强,刘杰,等.陕西汉中人群上颌第一恒磨牙根管系统的CBCT研究[J].牙体牙髓牙周病学杂志,2016,26(6):377-380.
[9]Huynh-Ba G,Kuonen P,Hofer D,et al.The effect of periodontal therapy on the survival rate and incidence of complications of multirooted teeth with furcation involvement after an observation period of at least5 years:A systematic review[J].J Clin Periodontol,2009,36(2):164-176.
[10]JOE Editorial Board.Endodontic-periodontal interrelationships:An online study guide[J].J Endod,2008,34(5 Suppl):e71-e77.
[2]谭葆春,吴文蕾,孙卫斌,等.截根术治疗牙周/牙槽脓肿的疗效回顾[J].华西口腔医学杂志,2012,30(3):283-286.
[3]田福聪,王晓燕,高学军.与上颌窦相关的牙科诊疗三例[J].中华口腔医学杂志,2014,49(5):290-291.
[4]Vanderweele RA,Schwartz SA,Beeson TJ.Effect of blood contamination on retention characteristics of MTA when mixed with different liquids[J].J Endod,2006,32(5):421-424.
[5]杨志良.350例后牙折裂原因分析与防治策略[J].江苏医药,2014,40(3):339-340.
[6]Saad MN,Moreno J,Crawford CV.Hemisection as an alternaltive treatment for decayed multirooted terminal ahutment:a case report[J].J Can Dent Assoc,2009,75(5):387-390.
[7]吴昭君,陈作良.上颌第一磨牙近中颊根第二根管的临床研究现状[J].临床口腔医学杂志,2015,31(2):112-113.
[8]张英,李永强,刘杰,等.陕西汉中人群上颌第一恒磨牙根管系统的CBCT研究[J].牙体牙髓牙周病学杂志,2016,26(6):377-380.
[9]Huynh-Ba G,Kuonen P,Hofer D,et al.The effect of periodontal therapy on the survival rate and incidence of complications of multirooted teeth with furcation involvement after an observation period of at least5 years:A systematic review[J].J Clin Periodontol,2009,36(2):164-176.
[10]JOE Editorial Board.Endodontic-periodontal interrelationships:An online study guide[J].J Endod,2008,34(5 Suppl):e71-e77.