【摘要】：研究目的鈣化根管疏通中輔助使用錐形束CT(Cone beam computed tomography,CBCT),并統(tǒng)計其成功率,評價CBCT輔助治療鈣化根管的臨床效果,探討其臨床應(yīng)用價值。研究方法選取2010年4月至2015年3月于天津市口腔醫(yī)院國際診療中心就診患者的患牙374顆,所選患牙均需要根管治療且根尖片顯示其根管完全鈣化。這些患牙中常規(guī)根管治療不能疏通的鈣化根管,在口腔顯微鏡下使用超聲器械進行疏通。對仍未疏通者拍攝CBCT,參照CBCT影像信息,在顯微鏡下再次使用超聲疏通,以插入診斷絲拍攝根尖片及使用根尖定位儀定位確認疏通至生理性根尖孔處為疏通成功的標(biāo)準(zhǔn),統(tǒng)計鈣化根管的疏通成功率。結(jié)果374顆患牙經(jīng)過常規(guī)根管治療,疏通患牙260顆,未疏通114顆(185個根管)。對未疏通的185個根管在顯微鏡下超聲疏通139個根管,疏通成功率為75.14%。仍未疏通的根管拍攝CBCT后又疏通27個,將成功率提高到89.72%。這些患牙的CBCT影像中27個顯示有根管影像,19個未見根管影像。前者包括細小根管11個,根管口鈣化物未去凈的9個及疏通方向偏離的根管7個,在鏡下調(diào)整疏通方向或使用超聲器械去除根管上段鈣化物后全部疏通,無根管影像的鈣化根管疏通失敗。結(jié)論CBCT能夠輔助定位鈣化根管口,顯示根管數(shù)目、走向、彎曲度等,在一定程度上輔助提高鈣化根管的疏通率。
[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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R781.05

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