国际口腔医学杂志 ›› 2016, Vol. 43 ›› Issue (3): 249-259.doi: 10.7518/gjkq.2016.03.001

• 专家简介 •    下一篇

根管内分离器械的处理评估与取出策略

高原,徐佳蕾,杨倩,黄定明,周学东   

  1. 口腔疾病研究国家重点实验室 华西口腔医院牙体牙髓病科(四川大学) 成都 610041
  • 收稿日期:2016-01-20 修回日期:2016-02-23 出版日期:2016-05-01 发布日期:2016-05-01
  • 通讯作者: 周学东,教授,博士,Email:zhouxd@scu.edu.cn
  • 作者简介:高原,副教授,博士,Email:gaoyuan@scu.edu.cn

Evaluation and removal strategies of the broken instruments in the root canal

Gao Yuan, Xu Jialei, Yang Qian, Huang Dingming, Zhou Xuedong   

  1. State Key Laboratory of Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China)
  • Received:2016-01-20 Revised:2016-02-23 Online:2016-05-01 Published:2016-05-01

摘要: 器械分离是根管治疗过程中较常发生的并发症之一。对于器械分离病例的处理方法分为保守治疗、外科显微手术治疗或拔除,针对不同的病例进行具体评估与分析,进而选择合适的治疗方案尤为重要。本文在分析总结了器械分离的原因及相关因素并结合了临床实践的基础上,阐述器械分离的具体处理及评估方法,重点介绍取出根管内分离器械的策略,为临床医生处理根管内器械分离的病例提供参考依据。

关键词: 器械分离, 评估, 取出, 牙本质厚度, 器械分离, 评估, 取出, 牙本质厚度

Abstract: Separation of endodontic instruments within the root canal is one of the common complications during root canal preparation. Management of separated instruments includes orthograde approaches, surgical approaches and extraction. It is essential to evaluate the conditions of specific cases in order to choose the proper approach. Based on the review of literatures and clinical experiences in dealing with broken instruments, the present article proposes the evaluation methods and management options, especially emphasizing the removal strategies, which may help dentists in treating the separated instrument cases.

Key words: broken instrument, evaluation, removal, dentin thickness, broken instrument, evaluation, removal, dentin thickness

中图分类号: 

  • R 781.33
[1] Shen Y, Peng B, Cheung GS. Factors associated with the removal of fractured NiTi instruments from root canal systems[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2004, 98(5):605-610.
[2] da Silva FM, Kobayashi C, Suda H. Analysis of forces developed during mechanical preparation of extracted teeth using RaCe rotary instruments and ProFiles[J]. Int Endod J, 2005, 38(1):17-21.
[3] Ward JR, Parashos P, Messer HH. Evaluation of an ultrasonic technique to remove fractured rotary nickeltitanium nickeltitanium endodontic instruments from root canals: an experimental study[J]. J Endod, 2003, 29(11):756-763.
[4] Iqbal M, Fillmore E. Preoperative predictors of number of root canals clinically detected in maxillary molars: a PennEndo Database study[J]. J Endod, 2008, 34(4):413-416.
[5] Wu J, Lei G, Yan M, et al. Instrument separation analysis of multi-used ProTaper Universal rotary system during root canal therapy[J]. J Endod, 2011, 37(6):758-763.
[6] Knowles KI, Hammond NB, Biggs SG, et al. Incidence of instrument separation using Light Speed rotary instruments[J]. J Endod, 2006, 32(1):14-16.
[7] Shemesh H, Roeleveld AC, Wesselink PR, et al. Damage to root dentin during retreatment procedures [J]. J Endod, 2011, 37(1):63-66.
[8] Pilo R, Corcino G, Tamse A. Residual dentin thickness in mandibular premolars prepared with hand and rotatory instruments[J]. J Endod, 1998, 24(6):401-404.
[9] Lim SS, Stock CJ. The risk of perforation in the curved canal: anticurvature filing compared with the stepback technique[J]. Int Endod J, 1987, 20(1):33-39.
[10] Souza EM, Bretas RT, Cenci MS, et al. Periapical radiographs overestimate root canal wall thickness during post space preparation[J]. Int Endod J, 2008, 41(8):658-663.
[11] Yang Q, Cheung GS, Shen Y, et al. The remaining dentin thickness investigation of the attempt to remove broken instrument from mesiobuccal canals of maxillary first molars with virtual simulation technique[J]. BMC Oral Health, 2015, 15(1):87.
[12] Gao Y, Shen Y, Zhou X, et al. Remaining root dentin thickness in mesiobuccal canals of maxillary first molars after attempted removal of broken instrument fragments[J]. Aust Endod J, 2015, 41(3):122-127.
[13] Crump MC, Natkin E. Relationship of broken root canal instruments to endodontic case prognosis: a clinical investigation[J]. J Am Dent Assoc, 1970, 80(6):1341-1347.
[14] Ruddle CJ. Broken instrument removal. The endodontic challenge[J]. Dent Today, 2002, 21(7):70-72.
[15] Madarati AA, Qualtrough AJ, Watts DC. Factors affecting temperature rise on the external root surface during ultrasonic retrieval of intracanal separated files[J]. J Endod, 2008, 34(9):1089-1092.
[16] Ruddle CJ. Nonsurgical retreatment[J]. J Endod, 2004, 30(12):827-845.
[17] Hülsmann M. Methods for removing metal obstructions from the root canal[J]. Endod Dent Traumatol, 1993, 9(6):223-237.
[1] 赵志河. 基于治疗方案和牙移动方式的无托槽隐形矫治难度评估[J]. 国际口腔医学杂志, 2022, 49(4): 373-379.
[2] 白皓亮,杨禾,赵蕾. 牙周病风险评估及预后判断工具的研究进展[J]. 国际口腔医学杂志, 2021, 48(6): 696-702.
[3] 邢桂琪,郭林溪,苏勤. 根管治疗后疾病的综合评估和治疗决策[J]. 国际口腔医学杂志, 2021, 48(5): 579-584.
[4] 邓晓宇,张蕴涵,邹静. 低龄儿童龋的早期生物学管理[J]. 国际口腔医学杂志, 2020, 47(5): 581-588.
[5] 徐欣, 何金枝, 周学东. 口腔微生物组在口腔精准医疗中的运用[J]. 国际口腔医学杂志, 2017, 44(6): 619-627.
[6] 魏煦, 杨芸, 张凯, 孙方方. 热压铸瓷面瓷贴面的临床效果评估[J]. 国际口腔医学杂志, 2017, 44(6): 696-700.
[7] 赵旭,李玉娇,刘莉,赵洪岩,张志民. 根管初步预备器械的研究现状[J]. 国际口腔医学杂志, 2017, 44(1): 75-78.
[8] 陆轩,陈小冬,邢文忠,李振春. 全瓷贴面修复的临床效果评估[J]. 国际口腔医学杂志, 2015, 42(2): 170-172.
[9] 杨晓喻,刘长虹,刘伟进,周震. 1例前牙即刻种植的过程与思考——基于风险评估的术式选择与修复设计[J]. 国际口腔医学杂志, 2015, 42(2): 130-134.
[10] 谭咏梅 招少萍 闫文娟 张海兰 吕文杰 周丽娟. 一次根管治疗术与两次根管治疗术术后短期临床疗效的比较[J]. 国际口腔医学杂志, 2014, 41(3): 277-280.
[11] 赵晓曦 李晓英 李灏来 何小丽 熊丽 李春燕. 30例根管内分离器械完整取出的护理[J]. 国际口腔医学杂志, 2014, 41(2): 143-145.
[12] 葛久禹 侯本祥 余擎 黄定明 彭彬. 根管治疗中器械分离是否需要取出[J]. 国际口腔医学杂志, 2014, 41(1): 7-12.
[13] 詹思樾 叶玲. 器械分离对根管治疗预后的影响[J]. 国际口腔医学杂志, 2014, 41(1): 47-51.
[14] 裴仲秋. 种植体落入上颌窦后快速取出1例[J]. 国际口腔医学杂志, 2014, 41(1): 45-46.
[15] 刘思茗综述 胡涛审校. 新型镍钛器械Twisted Files的应用[J]. 国际口腔医学杂志, 2013, 40(2): 185-187.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 张新春. 桩冠修复与无髓牙的保护[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 王昆润. 长期单侧鼻呼吸对头颅发育有不利影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[3] 彭国光. 颈淋巴清扫术中颈交感神经干的解剖变异[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 杨凯. 淋巴化疗的药物运载系统及其应用现状[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 康非吾. 种植义齿下部结构生物力学研究进展[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 柴枫. 可摘局部义齿用Co-Cr合金的激光焊接[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 孟姝,吴亚菲,杨禾. 伴放线放线杆菌产生的细胞致死膨胀毒素及其与牙周病的关系[J]. 国际口腔医学杂志, 2005, 32(06): 458 -460 .
[8] 费晓露,丁一,徐屹. 牙周可疑致病菌对口腔黏膜上皮的粘附和侵入[J]. 国际口腔医学杂志, 2005, 32(06): 452 -454 .
[9] 赵兴福,黄晓晶. 变形链球菌蛋白组学研究进展[J]. 国际口腔医学杂志, 2008, 35(S1): .
[10] 庞莉苹,姚江武. 抛光和上釉对陶瓷表面粗糙度、挠曲强度及磨损性能的影响[J]. 国际口腔医学杂志, 2008, 35(S1): .