应用CBCT对根管治疗失败原因的分析

目的:应用锥形束CT（CBCT）探讨根管治疗失败的原因。方法:选取在我所就诊的根管治疗失败病例122例，通过X线根尖片检查和CBCT检查，分析失败原因。结果:122例根管治疗失败病例中，根管欠充32例（26.23%），根充不严密28例（22.95%），遗漏根管23例（18.85%），牙周牙髓联合病变16例（13.11%），根管超充9例（7.38%），冠渗漏7例（5.74%），根折6例（4.92%），根管侧穿1例（0.82%）。结论:技术操作原因造成的根管清理不彻底和根充封闭不严密是根管治疗失败的主要原因，牙周病损是影响根管治疗预后的重要伴发疾病。CBCT可以为根管治疗失败病因的判定提供有力依据，并对后续治疗方案的确定具有重要的指导作用。 

Analysis of Causes of Root Canal Therapy Failure by CBCT

Objective: To investigate the causes of root canal therapy failure by CBCT (cone beam computed tomography). Methods: 122 cases of root canal therapy failure in our hospital were selected. The causes of failure were analyzed by X-ray periapical film and CBCT. Results: in 122 cases of failure, 32 cases of root canal filling shortage (26.23%), 28 cases of root canal imprecision (22.95%), 23 cases of missing root canal (18.85%), 16 cases of combined periodontal-endodontic lesions (13.11%), 9 cases of root canal overcharge (7.38%), 7 cases of coronal leakage (5.74%), 6 cases of root fracture (4.92%), 1 cases of lateral canal perforation (0.82%). Conclusion: the main causes of root canal treatment failure are the incomplete cleaning of root canal and the inadequate obturation of root canal. The periodontal lesion is an important concomitant disease affecting the prognosis of root canal therapy. CBCT can provide a powerful basis for judging the cause of root canal therapy failure, and has an important guiding role in the follow-up treatment program.