關於根尖病變的保守性根管治療

Conservative Endodontics for Periapical Pathosis

王淑惠(Shuw-Hwei Wang)

《慈濟醫學雜誌》 3卷4期 (1991/12) Pp. 310-317

https://doi.org/10.6440/TZUCMJ.199112.0310

摘要

對於有根尖病變的牙齒，往往會考慮保守性根管治療、或開刀、或拔牙處理。而治療根尖病變的原則為徹底拿除膿腫病灶，以防再發。除了遵循根管治療原則外，建議二種可行方法，即過度器械化或藥物過度充填，以產生一個短暫性急性發炎狀態，即使對巨大牙根尖病變或已經穿出口外的皮膚竇管仍有治癒的可能。處理術間急性腫痛可使用止痛劑、抗生素或環鋸法以利引流。碘仿糊劑和氫氧化鈣是牙科常用的藥性臨時充填材，其促進根尖病灶癒合有不錯的效果。對於存在根尖病灶的牙齒，一般預後追蹤應在施行永久充填後二年觀察才施行根柱冠製作為較理想的期限。本文並提出六個成功的臨床實例報告。

關鍵字

保守性根管治療 ； 過度器械化 ； 藥物過度充填

並列摘要

Each non-vital teeth with periapical lesion is considered the question of whether conservative retention, or surgery, or extraction in indicated. Treatment of periapical lesion consists of removal of the focus infecton, conservative encodontics should be attempted firs. According to the principle of endodontic therapy, overin-strumentation and overmedication are suggested, either one can make periapical lesion a state of acute inflammation, even a large cyst or oro-cutaneous fistula, undergo resolution. During therapy, acute exacerbation can be relieved by analgesics, antibiotics or trephination. At present, Iodoform and Calcium hydroxide are popular agent for temporary medical root canal filling material, which enhances apical lesion resolution and bone regeneration. Two years follow-up is indicated after permanent filling. This article discuss the technique, mechanism, property of medical filling material, and six clinical cases are also reported.

並列關鍵字

conservative endodontics ； overinstrumentation ； overmedication