锥形束CT辅助治疗钙化根管的临床研究

发布时间：2018-12-05 17:11

【摘要】：研究目的钙化根管疏通中辅助使用锥形束CT(Cone beam computed tomography,CBCT),并统计其成功率,评价CBCT辅助治疗钙化根管的临床效果,探讨其临床应用价值。研究方法选取2010年4月至2015年3月于天津市口腔医院国际诊疗中心就诊患者的患牙374颗,所选患牙均需要根管治疗且根尖片显示其根管完全钙化。这些患牙中常规根管治疗不能疏通的钙化根管,在口腔显微镜下使用超声器械进行疏通。对仍未疏通者拍摄CBCT,参照CBCT影像信息,在显微镜下再次使用超声疏通,以插入诊断丝拍摄根尖片及使用根尖定位仪定位确认疏通至生理性根尖孔处为疏通成功的标准,统计钙化根管的疏通成功率。结果374颗患牙经过常规根管治疗,疏通患牙260颗,未疏通114颗(185个根管)。对未疏通的185个根管在显微镜下超声疏通139个根管,疏通成功率为75.14%。仍未疏通的根管拍摄CBCT后又疏通27个,将成功率提高到89.72%。这些患牙的CBCT影像中27个显示有根管影像,19个未见根管影像。前者包括细小根管11个,根管口钙化物未去净的9个及疏通方向偏离的根管7个,在镜下调整疏通方向或使用超声器械去除根管上段钙化物后全部疏通,无根管影像的钙化根管疏通失败。结论CBCT能够辅助定位钙化根管口,显示根管数目、走向、弯曲度等,在一定程度上辅助提高钙化根管的疏通率。
[Abstract]:Objective to evaluate the clinical effect of calcified root canal by using conical bundle (CT (Cone beam computed tomography,CBCT) in calcified root canal drainage, and to evaluate the clinical value of CBCT in the treatment of calcified root canal. Methods from April 2010 to March 2015, 374 teeth were selected from the International diagnosis and treatment Center of Tianjin Stomatology Hospital. All of the selected teeth needed root canal treatment and the apical radiographs showed complete calcification of the root canal. Calcified canals that cannot be cleared by conventional root canal therapy in these teeth are cleared with ultrasound instruments under a dental microscope. According to the information of CBCT image, ultrasound was used again under microscope to take CBCT, for those who still had not been cleared, and the standard of successful dredge was to insert diagnostic wire to take the root tip film and to use the root tip locator to confirm the dredge to the physiological apical foramen. The successful rate of osseosis of calcified root canal was calculated. Results 374 teeth were treated with conventional root canal therapy, 260 teeth were untreated and 114 teeth (185 root canals) were untreated. Among the 185 root canals that were not cleared, 139 root canals were cleared by ultrasound under microscope, and the success rate was 75.14%. After shooting CBCT, 27 root canals were cleared, and the success rate was increased to 89.72%. CBCT images of these teeth showed root canal images in 27 and root canal images in 19. The former included 11 fine root canals, 9 root canal calcifications that had not been removed, and 7 root canals that had deviated from the dredge direction. All the canals were cleared by adjusting the dredge direction under the microscope or removing the calcification of the upper part of the root canal with ultrasonic instruments. Calcified root canal dredge failed in rootless images. Conclusion CBCT can assist the location of calcified root canal orifice, display the number, direction and curvature of root canal, and improve the rate of osmosis of calcified root canal to a certain extent.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.05

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