Evaluation of the efficacy of selective curettage in endodontic microsurgery
10.13591/j.cnki.kqyx.2024.05.010
- VernacularTitle:选择性刮治在显微根尖手术中的疗效评估
- Author:
Ke WANG
1
;
Jing YOU
;
Wei LU
Author Information
1. 南京医科大学附属口腔医院牙体牙髓病科,口腔疾病研究与防治国家级重点实验室培育建设点(南京医科大学),江苏省口腔转化医学工程研究中心,江苏南京(210029)
- Keywords:
periapical periodontitis;
persistent periapical lesions;
endodontic microsurgery;
selective curettage
- From:
STOMATOLOGY
2024;44(5):375-380
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of selective curettage when apical lesions are adjacent or involved to important struc-tures in endodontic microsurgery(EMS).Methods A total of 264 patients who underwent EMS in the Department of Endodontics,The Affiliated Stomatological Hospital of Nanjing Medical University from January 2021 to January 2023 were selected as the research subjects.The cases of EMS were divided into selective curettage group(SC-EMS)and conventional curettage group(C-EMS).In SC-EMS group,patients with apical lesions involving or adjacent to important structures(mental foramen,mandibular neural tube,naso-palatine neural canal,maxillary sinus,nasal base and adjacent vital pulp teeth)were included,and the adjacent areas around impor-tant structures were selectively cureted.In C-EMS group,patients with apical lesions adjacent to important structures were treated with conventional apical curettage.The postoperative follow-up was 12 months,and the postoperative symptoms and imaging examinations of the patients were observed,and the efficacy was evaluated.The failure cases were examined after tooth extraction and preoperative path-ological review to analyze the causes of failure.Results The success rate of SC-EMS group is 90.2%,and the success rate of C-EMS group is 95.4%.The rate of success in C-EMS group was higher,but there was no statistical difference between the two groups(P＞0.05).Root fracture is the important causes for the failure of the two groups.There were 6 cases of short-term discomfort and 2 cases of long-term discomfort after SC-EMS.The C-EMS group didn't meet any short-term or long-term discomfort case.Conclusion Selective curettage has no significant effect on the success rate of EMS surgery,and is an effective method to protect important structures during surgery.Short-term discomfort may occur after surgery,and irreversible pulp damage of adjacent teeth occurs in a few cases.
