华西口腔医学杂志

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根尖感染的控制技术

余擎 杨扬 常蓓   

  1. 军事口腔医学国家重点实验室，第四军医大学口腔医院牙体牙髓病科，西安 710032
  • 收稿日期:2014-03-25 修回日期:2014-08-01 出版日期:2014-10-01 发布日期:2014-10-01
  • 通讯作者: 余擎，教授，博士，E-mail：yuqing@fmmu.edu.cn
  • 作者简介:余擎，教授，博士，E-mail：yuqing@fmmu.edu.cn
  • 基金资助:

    国家自然科学基金资助项目（81170948，31271048）

The technology of apical infection control

Yu Qing, Yang Yang, Chang Bei.   

  1. State Key Laboratory of Military Stomatology, Dept. of Endodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
  • Received:2014-03-25 Revised:2014-08-01 Online:2014-10-01 Published:2014-10-01

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摘要：

根管治疗术是治疗牙髓病、根尖周病的首选方法，其目标是彻底清除根管系统内的感染，并严密充填以防止再感染。由于根管系统解剖复杂性和感染多样化的存在，使得常规化的根管治疗常常难以彻底清除感染，尤其是根尖部（包括根管内根部1/3和根尖外组织）。根尖部的位置隐蔽，根尖分歧、根管侧支等解剖结构多，治疗器械难以达到，感染控制难度大。本文就根尖部感染的特点和难点进行总结，并对根尖内和根尖外的感染控制策略进行简要介绍，包括根尖部的预备方法，根管消毒和严密根管充填的方法等。

关键词: 根尖感染控制, 根管治疗, 根管解剖形态, 细菌生物膜, 激光, 根尖外科手术

Abstract:

Root canal therapy is the most efficient way to treat pulptitis and periapical inflammation, which can clear infections of root canal systems, fill the root canal firmly, and avoid reinfection. However, the variations in root canal morphology and complexity of infection confer difficulty in thoroughly eliminating microorganisms and their by-products in the root canal system, especially in the root apex area (including the top one-third of the root canal and periapical tissue), which is described as the hardest area to clean during endodontic treatment. Infection is difficult to remove entirely because the apex area is hard to approach using dental instruments and because of the existence of special morphological structures, such as apical ramification, intercanal anastomoses, and lateral branch of root canal. This review gives a brief introduction of the characteristics and difficulties of apical infection and knowledge on how to control such infections, including root apex preparation, irrigation and disinfection, and root canal filling.

Key words: apical infection controlling, root canal treatment, root canal morphology, bacteria biofilm, laser, apical microsurgery

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