中国实用口腔科杂志 ›› 2024, Vol. 17 ›› Issue (5): 513-517.DOI: 10.19538/j.kq.2024.05.001

• 专题笔谈 •    下一篇

根管的机械预备与感染控制

杨荣霖,王华超,薛    明   

  1. 中国医科大学口腔医学院·附属口腔医院牙体牙髓病学教研室,辽宁省口腔疾病重点实验室,辽宁 沈阳110002
  • 出版日期:2024-09-30 发布日期:2024-09-30
  • 作者简介:薛明,教授、主任医师、硕士研究生导师。现任中国医科大学口腔医学院牙体牙髓病学教研室副主任,国家住院医师规范化培训口腔全科基地(中国医科大学)教学主任。兼任中华口腔医学会继续教育部显微根管治疗技术首席推广专家、牙体牙髓病学专业委员会常务委员,辽宁省口腔医学会第六届理事会理事、牙体牙髓病学专业委员会主任委员,《中国实用口腔科杂志》编委,《国际口腔医学杂志》《中国组织工程学杂志》审稿专家。主持辽宁省自然科学基金项目1项、沈阳市科委重点研发项目1项、中国医科大学口腔医学院临床新技术项目2项,参与国家自然科学基金项目2项、省级课题研究3项。参编专著1部,发表学术论文50余篇。

  • Online:2024-09-30 Published:2024-09-30

摘要: 牙髓病和根尖周病主要由细菌感染所致,治疗的核心是感染控制。由于尚无研究表明根管内感染源可被彻底清除,因此根管预备的目标在于尽可能地去除感染源。感染控制的难点主要包括根管解剖系统的复杂性和根管内微生物种类及毒力的复杂性两方面。机械预备的物理切削作用有助于更好地清除根管系统内的感染牙髓组织、感染牙本质及细菌生物膜,同时根管预备的最终形态很大程度上影响冲洗、封药及充填的质量。文章旨在对根管内感染控制的难点、机械预备清理成形及其与冲洗、封药、充填的关系做一介绍,以便更好地控制根管感染,促进组织愈合,提高治疗成功率。

关键词: 根管机械预备, 感染控制, 镍钛器械, 清理成形, 冲洗充填

Abstract: Endodontic and periapical diseases are caused primarily by bacterial infection, and the core of treatment is infection control. Since no study has shown that the source of infection in the root canal can be completely removed,the goal of root canal preparation is to remove as much of the source of infection as possible. The difficulties in infection control include the complexity of the anatomical system of the root canal and the complexity of the microbial species and virulence of the root canal. The physical cutting action of mechanical preparation helps to better remove infected pulp tissue,infected dentin,and bacterial biofilm from the root canal system,and the final shape of the root canal preparation greatly affects the quality of the irrigation,sealing and obturation. The aim of this article is to introduce the difficulties in infection control, the cleaning and shaping of mechanical preparation and its relationship with irrigation,sealing,and obturation,in order to better control root canal infection,promote tissue healing,and improve the success rate of treatment.

Key words: mechanical root canal preparation, infection control, nickel-titanium instruments, cleaning and shaping, irrigation and obturation