华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

根尖大面积病变手术治疗的临床疗效观察

王霄 黎远皋 潘向勇   

  1. 北京大学第三医院口腔科, 北京100191
  • 收稿日期:2010-12-25 修回日期:2010-12-25 出版日期:2010-12-20 发布日期:2010-12-20
  • 通讯作者: 王霄,Tel:010-82266344
  • 作者简介:王霄(1970—),男,山东人,副主任医师,硕士

Clinical evaluation of large periapical lesions following apical surgery

WANG Xiao, LI Yuan-gao, PAN Xiang- yong   

  1. Dept. of Stomatology, The Third Hospital of Peking University, Beijing 100191, China
  • Received:2010-12-25 Revised:2010-12-25 Online:2010-12-20 Published:2010-12-20
  • Contact: WANG Xiao,Tel:010-82266344

摘要:

目的评估根尖手术治疗大面积根尖病变患牙的疗效。方法选择存在大面积根尖病变的59例患者(59处根尖病变,91颗患牙)为研究对象,根尖病变范围6~21 mm,在根管治疗后进行根尖手术。术后1、3、6、9、12、24个月复诊,对患牙及根尖病变进行临床及影像学评估,综合二者结果进行疗效评估,并对可能影响其术后疗效的各种因素进行统计学分析。结果59例患者中52例(88.1%)被评估为成功,6例(10.2%)被评估为失败,1例(1.7%)被评估为有效。老年组患者的成功率(63.6%)明显比青年组(87.5%)和中青年组(95.0%)低,具有统计学差异(P=0.037,P=0.017);磨牙的成功率(75.0%)比前牙(92.6%)和前磨牙(90.0%)均低,具有统计学差异(P=0.041,P=0.047);性别、根尖病变侵及牙齿数量、根尖病变范围等因素对成功率的影响未见统计学差异(P>0.05)。结论对于存在大面积根尖病变的患牙,根管治疗后配合根尖手术治疗是一项可选择的治疗方式。

关键词: 根尖手术, 大面积根尖病变, 根管治疗

Abstract:

Objective To evaluate the therapeutic effect of teeth with large periapical lesions followed apical surgery. Methods 59 patients(59 periapical lesions, 91 teeth) with large periapical lesions ranging in size from 6 mm to 21 mm in diameter were included in this study. All teeth were treated by root canal therapy and apical surgery, and the surgical procedure was completed with microsurgical technology and ultrasonic root -end preparation. The outcomes were evaluated clinically and radiographically at 1, 3, 6, 9, 12 and 24-month intervals, and the various factors which may affect the success rate were analyzed statistically. Results 52 cases(88.1%) of 59 patients were considered success, 6 cases(10.2%) were considered failure, and 1 case(1.7%) was considered in progress. The success rate of elderly patients group(63.6%) was significantly lower than that of the youth group(87.5%) and middle-aged group(95.0%)(P=0.037;P=0.017). The success rate of molar group(75.0%) was significantly lower than that of the anterior group(92.6%) and the premolar group(90.0%)(P=0.041, P=0.047);however, there was no significant difference in the gender, the number of teeth invaded in lesions, the size of periapical lesion(P>0.05). Conclusion It is an effective therapy for the teeth with large periapical lesions by apical surgery after root canal treatment.

Key words: apical surgery, large periapical lesion, root canal therapy