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目的:探讨机用镍钛器械在根尖区折断的特点及临床治疗经验。方法:收集根尖区机用镍钛器械折断患者18例,记录折断器械的种类,型号,患者的年龄,牙位及其治疗结果。结果:18例折断器械中,发生于前牙3例,前磨牙3例,磨牙12例;其中Pro Taper锉11例,Waveone锉5例,Mtwo锉1例,S3锉1例。折断器械成功取出10例,成功率55.6%。其中显微超声技术取出8例,成功率为44.5%;显微镜下加压冲洗法2例,成功率11.1%;保留作为根管充填物5例,旁路通过术2例,显微根尖手术1例。1年根管治疗成功率77.8%。结论:镍钛器械折断好发于磨牙细小根管及复杂根管,折断器械取出的难度大,有效预防器械折断及选择合适的治疗方案是提高根管治疗成功率的关键。
Objective: To discuss the characteristics and clinical experience of machine nickel-titanium instruments broken in apical region. Methods: Eighteen cases of fracture of nickel-titanium devices were collected in the apex area. The types of the fracture devices, the type of the device, the age of the patient, the tooth position and the treatment results were recorded. Results: Among the 18 cases, 3 cases occurred anterior teeth, 3 premolar teeth and 12 molars. There were 11 cases of Pro Taper file, 5 cases of Waveone file, 1 case of Mtwo file and 1 case of S3 file. Successfully removed 10 cases of broken instruments, the success rate of 55.6%. Among them, 8 cases were taken out by microsurgical ultrasound, the success rate was 44.5%; 2 cases under the microscope under pressure washing method, the success rate was 11.1%; 5 cases were preserved as root canal filling, 2 cases were treated by bypass, 1 case. One year root canal treatment success rate of 77.8%. Conclusion: Nickel - titanium device fracture occurred in the fine root canal and complex root canal molar, the fracture device is difficult to remove, the effective prevention of broken instruments and select the appropriate treatment program is to improve the success rate of root canal therapy is the key.