Development and establishment of diagnostic and treatment methods for fiberscope application to endodontic and periodontal disease

本研究探讨了一种新设计的细纤维内窥镜（FS）与内置通道的水冲洗或仪器。本研究利用FS对根面及根尖周/牙周组织进行观察，对器械的设计、结构、使用方法及临床应用进行评价。Nd：YAG激光光纤、K锉或带长握把的倒刺拉刀和射频刀适用于使用内置通道进行内固定的FS。特别是，激光照射，以消除肉芽组织和止血，并使用K-文件的根管渗透被发现是有用的. FS在外科手术中的应用是有效的。使用新型FS进行根尖周刮除术，可通过窦道、最小切口或牙周袋进行刮除，因为术中和术后可观察刮除对象和手术区域。使用FS减少术后临床症状的方法 ...更多信息 h时疼痛、肿胀，手术损伤小，愈合快.侧视FS在观察根管侧面或牙周袋中的根面时能获得良好的发现。FS采用多纤维（10 000像素）和水冲洗通道，经窦道观察根尖周病变内部或根管颈部和中部，图像清晰. FS前注射靛胭脂或亚甲蓝染料，肉芽组织和牙体组织易于区分，根面结构清晰.我们比较了FS和显微镜下的结果，并阐明了除了每种方法的特点之外，根的锥度和直径的影响. FS示范和培训的有效性，确定使用一种新的模型，以重现牙周病与牙周袋和根尖周病变与窦道。少

The present study investigated a newly designed fine fiberscope (FS) with built-in channel for water irrigation or instrumentation. The FS was utilized to observe the root surface and periapical/periodontal tissues in lesions, in order to evaluate the design, structure, use of instruments and methods of clinical application.The following results were obtained :1. Nd : YAG laser fiber, K-file or barbed broach with long grip and radio-knife were applicable to the FS using the built-in channel for instrumentation. In particular, laser irradiation to remove granulation tissue and arrest bleeding, and penetration of root canal using K-file were found to be useful.2. Application of the FS to surgical procedures was effective. Periapical curettage using the new FS enabled curettage by sinus tract, minimum incision or periodontal pocket, because objects for curettage and the operation field can be observed during and after operation. Methods using FS reduced postoperative clinical symptoms suc … More h as pain and swelling, and rapid healing was exhibited, as surgical damage was small.3. Side-viewing FS has enabled good findings when observing the sides of root canals or root surfaces in periodontal pocket. FS with more image fibers (10 000 pixels) and a channel for water irrigation was effective in providing sharper images when applied to observation of the inside of periapical lesions through sinus tract, or the cervical and middle parts of root canal.4. When indigocarmine or methylene blue dye was injected prior to FS procedures, granulation and tooth tissues were easily differentiated and the structure of the root surface was clearly illustrated.5. We compared FS and microscope findings, and clarified the influence of the taper and diameter of the root in addition to the peculiarities of each method.6. The effectiveness of FS demonstrations and training was determined using a new model to reproduce periodontal lesions with periodontal pocket and periapical lesions with sinus tract. Less