摘要
本文以文献为基础,系统回顾笔者15年来显微根管外科失败病例,分析失败原因,根据时间分为近期和远期失败两类.诊断错误、治疗方案不合理和手术操作不规范导致近期失败,而远期失败主要因为继发性根裂、继发其它病变、手术操作不完善和合并严重牙周病变.针对失败原因,提出相应处理方案,即纠正错误、拔除患牙和再次手术.预防策略包括建立正确诊断、选择合适病例、制定合理治疗计划以及进行规范化操作,避免近期失败,降低远期失败发生率,以提高手术成功率,有效治疗牙髓根尖周病,保存健康天然牙.
Abstract
Based on the literature,this paper systematically reviews the failure cases of endodontic microsurgery in the past 15 years.according to the time point:short-term and long-term failuresthe reasons for the failures are analyzed and classified into two categories.Incorrect diagnosis,unreasonable treatment plans,and non-standard surgical procedures lead to short-term failures,while long-term failures are mainly due to secondary vertical root fracture,other diseases,imperfect surgical procedures,and severe periodontal disease.Corresponding treatment plan is proposed,including error correction,extraction,and re-surgery.Prevention strategies include establishing correct diagnosis,selecting appropriate cases,developing reasonable treatment plans,and implementing standardized procedures to avoid short-term failures,reduce long-term failure,to improve the success rate of endodontic microsurgery,effectively treat pulp and periapical diseases,and preserve healthy natural teeth.
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