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慢性根尖周炎多系龋病,严重楔状缺损造成。邻面、唇颊侧龋洞,楔状缺损(以下简称为侧面洞)在行根管治疗时,需在患牙(牙合)面开髓,形成复面洞。亦有(牙合)面龋与邻面龋同时存在,经去腐质备洞扩通者;侧面洞破坏过大越过牙体纵轴中线,致使患牙抗咀嚼能力大部丧失,往往进食时在正常(牙合)力作用下造成冠折。对于有瘘型慢性根尖脓肿的病例尚有瘘管存在,治疗不得当,常常耗费掉大量时间和精力,最终因疗效不佳不得已拔除了之。笔者自1983年起,从复面洞着手,采用自制钢丝根管钎行根管内支撑,先补侧面洞,后行根管治疗术。侧壁洞破坏过大者则行根管钎内固定术。对于难治的有瘘型慢性根尖脓肿、利用根管钎消除侧壁洞,采用瘘管通过术治疗,经临床反复实践,效果颇为满意,现将方法介绍如下: 步骤与方法 1.患牙常规(牙合)面开髓、扩大根管,并去除侧面洞
Chronic apical periodontitis more than dental caries, severe wedge-shaped defect caused. Opposite, lip and buccal cavities, wedge-shaped defect (hereinafter referred to as the lateral hole) in the root canal treatment, the need to open the pulp in the occlusal surface, the formation of complex holes. There are also (occlusal) face caries and adjacent caries at the same time, by the detritus hole extension; side hole damage is too large to cross the longitudinal axis of the tooth, resulting in most of the ability to resist teeth chewing loss, often when eating In the normal (occlusal) force caused by the crown off. For fistula chronic apical abscess cases fistula exist, the treatment is not appropriate, often consume a lot of time and effort, and ultimately ineffective culling. Since 1983, the author has started with the multi-faceted hole and braided the root canal with a self-made wire rod root canal. Side wall hole damage is excessive root canal brazing fixation. For intractable fistula chronic apical abscess, the use of root canal brazing to eliminate the side wall hole, the use of fistula through surgery, repeated clinical practice, the effect is quite satisfactory, the method is described below: Steps and methods 1. Teeth Conventional (occlusal) face open pulp, expand the root canal, and remove the side holes