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目的评价锥形束CT(CBCT)辅助治疗钙化根管的临床效果,探讨其临床应用价值。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根尖片表现为根管完全性钙化且需根管治疗的患牙374颗,对于常规根管治疗不能疏通的185个钙化根管(患牙114颗),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,在显微镜下再次超声疏通,统计钙化根管的疏通成功率。结果185个钙化根管中,显微镜下超声疏通139个,疏通率为75.14%。对未疏通的46个根管拍摄CBCT后,其中27个显示有根管影像,19个未见根管影像。前者包括11个根管细小、9个根管口钙化物未去净及7个根管疏通方向偏离,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,全部疏通,疏通率提高到89.72%。结论CBCT能够辅助定位钙化根管,显示根管走向,在一定程度上提高治疗钙化根管的疏通率。
Objective To evaluate the clinical effects of cone beam computed tomography (CBCT) in the treatment of calcified root canal and its clinical value. Methods From April 2010 to March 2015, the apical pieces of patients who visited the International Clinic of Tianjin Stomatological Hospital showed 374 teeth with complete root canal calcification and root canal treatment, which can not be cleared for conventional root canal therapy Of 185 calcified roots (114 teeth) were dissected using an ultrasound machine under an oral microscope. CBCT has not been dredged, reference CBCT image information, again under the microscope ultrasound dredging, statistics, success rate of calcified root canal dredging. Results In 185 calcified root canal, there were 139 clear ultrasonic waves under the microscope, the clearance rate was 75.14%. After uncured 46 root canal CBCT, 27 showed root canal images and 19 had no root canal images. The former includes 11 small root canal, 9 root canal calcification did not go to the net and 7 root canal to divert the direction of deviation in the mirror to adjust the direction of dredging or the use of ultrasound equipment to remove the upper root canal calcification, all dredge, dredge rate To 89.72%. Conclusion CBCT can assist in the localization of calcified root canal, showing the root canal direction, to a certain extent, improve the treatment of calcified root canal dredging rate.