Retrograde approaches in endodontic therapy.
Retrograde approaches in endodontic therapy.
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牙髓治疗中的逆行方法。
DOI：
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发表时间：
1991
期刊：
影响因子：
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通讯作者：
S. Friedman
中科院分区：
文献类型：
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作者：
S. Friedman
根尖手术中逆行充填的常规使用以及为此目的选择的材料一直存在争议。逆行充填是为了封闭引起根尖周病变的感染根管。因此，无论根管充填的表面技术质量如何，在根尖手术期间都应常规进行逆行根管充填，除非结合手术进行顺行根管治疗。当不进行顺行治疗时，逆行根管充填可提高根尖手术的预后。一系列潜在的逆行填充材料已经在体外和体内进行了广泛的研究。一旦证实了材料的生物相容性，临床比较（而非体外密封性研究）是最有效的评价方法。在动物研究中可以避免在患者长期临床研究中遇到的一些困难。回顾过去十年的相关文献表明，汞合金与窝洞保护漆结合使用是首选的逆行充填材料。然而，必须强调的是，逆行充填不能与整个根管的清创和封闭相比。因此，当接近根管的唯一方法是从根尖方向，而不是放置根尖逆行充填时，如果可行的话，应该首选整个根管的逆行根管治疗。
The routine use of retrograde fillings during apical surgery, as well as the material of choice for that purpose, have been debated. A retrograde filling is placed so as to seal an infected root canal causing periapical pathosis. Therefore, retrograde root canal fillings should be performed routinely during apical surgery regardless of the apparent technical quality of the root canal obturation, unless orthograde endodontic treatment is performed in conjunction with surgery. When orthograde treatment is not performed, retrograde root canal filling enhances the prognosis of apical surgery. An array of potential retrograde filling materials have been extensively investigated in vitro and in vivo. Once that the biocompatibility of the materials is confirmed a clinical comparison, rather than in vitro sealability studies, is the most valid evaluation method. Some of the difficulties encountered in long term clinical studies in patients may be avoided in animal studies. The review of the relevant literature of the past decade suggests that amalgam used in conjunction with cavity varnish is the retrograde filling material of choice. It must be stressed, however, that retrograde filling is not comparable to debridement and obturation of the entire root canal. Therefore, when the only way to approach the root canal is from the apical direction, rather than placing an apical retrograde filling, a retrograde endodontic treatment of the entire canal should be preferred, if it is feasible.