口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (10): 649-655.DOI: 10.12016/j.issn.2096-1456.2021.10.001

• 专家论坛 • 上一篇    下一篇

显微根尖手术的全周期管理

黄湘雅(),蔡艳玲,韦曦()   

  1. 中山大学光华口腔医学院·附属口腔医院牙体牙髓病科,广东省口腔医学重点实验室,广东 广州(510055)
  • 收稿日期:2021-02-16 修回日期:2021-04-01 出版日期:2021-10-20 发布日期:2021-06-23
  • 通讯作者: 韦曦
  • 作者简介:黄湘雅,副主任医师,博士,Email: hxiangya@mail.sysu.edu.cn
  • 基金资助:
    国家自然科学基金项目(81800960);广东省财政高水平医院建设专项资金项目(174-2018-XMZC-0001-03-0125/A-01);广东省财政高水平医院建设专项资金项目(174-2018-XMZC-0001-03-0125/D-04)

Full-cycle management of endodontic microsurgery

HUANG Xiangya(),CAI Yanling,WEI Xi()   

  1. Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2021-02-16 Revised:2021-04-01 Online:2021-10-20 Published:2021-06-23
  • Contact: Xi WEI
  • Supported by:
    National Natural Science Foundation of China(81800960);Guang-dong Financial Fund for High-Caliber Hospital Construction(174-2018-XMZC-0001-03-0125/A-01);Guang-dong Financial Fund for High-Caliber Hospital Construction(174-2018-XMZC-0001-03-0125/D-04)

摘要:

显微根尖手术是实现疑难根尖周病患牙保存的有效手段。本文提出显微根尖手术的全周期管理理念,针对患者的全身情况和患牙的局部特点制定全面的检查、治疗和复查方案,以达到预期手术疗效,有效保留天然牙。全周期管理包括术前通过对患者的全身评估和口腔术区评估,针对患牙情况选择合适方法进行显微根尖手术;术中应用激光技术、骨窗技术、动静态导航等技术手段,使术式设计多样化,手术更趋于精细、微创;术后根据病史、临床表现及影像学标准评定治疗效果,并对近远期疗效进行解读。

关键词: 显微根尖手术, 临床管理, 根尖周炎, 激光技术, 骨窗技术, 靶向显微根尖手术, 3D影像学预后评估, 远期随访

Abstract:

Contemporary endodontic microsurgery has emerged as a significant treatment modality in the retention of teeth with persistent apical periodontitis. This article proposes the concept of the full-cycle clinical management of endodontic microsurgery based on the condition of the patient and tooth, attempting to develop a comprehensive strategy for the examination, treatment and follow-up to save natural teeth. Full-cycle clinical management included preoperative consideration of the general condition and surgical site and selection of cases for endodontic microsurgery; intraoperative application of techniques such as lasers, "bone window" technique and targeted endodontic microsurgery to make the surgical approaches more varied and the operation minimally invasive; postoperative outcome assessment according to the history, clinical and radiographic examination; and analysis of the short- and long-term outcomes.

Key words: endodontic microsurgery, clinical management, apical periodontitis, laser technique, "bone window" technique, targeted endodontic microsurgery, 3D radiographic outcome assessment, long-term follow-up

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