Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument ...Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument fracture is reported to range between 0.28% and 16.2%. This article presents an overview of the prevention and management of instruments fractured during endodontic therapy on the basis of literature retrieved from Pub Med and selected journal searches. Instrument fracture occurs because of reduced metal fatigue and/or torsional resistance. The reasons include canal morphology and curvature, manufacturing processes and instrument design, instrument use times and technique, rotational speeds and operator experience. With the development of various equipment and techniques, most of the retained instrument separations can be removed safely. However, in canals without associated periapical disease not every fractured separation should be removed from difficult locations because of the increased risk for root perforation and fracture. In difficult cases, either retain or bypass the fragment in the root canal and ensure regular follow-up reviews. Fractured instruments retained in the presence of periapical disease reduce significantly the prognosis of endodontically treated teeth, indicating a greater need to attempt the removal or bypass of the file separations. Apical surgery might be required in some instances, emphasizing the importance of preventing instrument fracture.展开更多
Management of mid-root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This article presents two varied treatment options for mid...Management of mid-root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This article presents two varied treatment options for mid-root fractures. A 15-year-old female reported an impact injury to the maxillary anterior teeth 2 days after its occurrence. Clinically,the maxillary left central incisor was palatally-extruded with a negative vitality response and radiographic evidence of an oblique fracture at the middle third of the root. An endodontic implant was employed which utilized an open technique and has been on follow-up for ten months. A 32-year-old male reported an injury,which resulted in a mobile maxillary right central incisor,three months after its occurrence. Through clinical and radiographic means,a discolored,extruded,and non-vital maxillary right central incisor with an oblique root fracture at the alveolar-crest level was observed. Exploratory surgery was performed; an apical barrier was created with a mineral trioxide aggregate and obturated with gutta percha. The fragments were stabilized with a fiber post and patient has been on follow-up for five months. Short-term follow-up for both of the cases showed promising results both clinically and radiographically.展开更多
目的:探讨创伤性骨折术后红外线治疗及基于根本原因分析法(root cause analysis,RCA)的预见性护理的应用效果。方法:选取2020年1月至2021年7月于江苏省人民医院接受创伤性骨折术的162例患者为研究对象,依据随机数表法分对照组与研究组,...目的:探讨创伤性骨折术后红外线治疗及基于根本原因分析法(root cause analysis,RCA)的预见性护理的应用效果。方法:选取2020年1月至2021年7月于江苏省人民医院接受创伤性骨折术的162例患者为研究对象,依据随机数表法分对照组与研究组,各81例。对照组于术后接受常规治疗、红外线治疗及康复护理,研究组在对照组的基础上接受基于RCA的预见性护理。出院前,对比两组视觉模拟量表(visual analog scale,VAS)评分、并发症发生率(包括压疮、肺部感染、深静脉血栓、关节僵直、便秘、泌尿感染)及肿胀度。结果:术后12 h,两组VAS评分相比,差异无统计学意义(P>0.05);术后24、48、72 h,两组VAS评分逐渐降低,且研究组患者的VAS评分明显低于对照组,差异有统计学意义(P<0.05)。研究组患者的并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。研究组患者的肿胀II、III度占比明显低于对照组,差异有统计学意义(P<0.05)。结论:创伤性骨折术后红外线治疗联合基于RCA的预见性护理可明显改善肿胀度、减轻疼痛,同时可有效降低并发症发生率,值得推广应用。展开更多
文摘Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument fracture is reported to range between 0.28% and 16.2%. This article presents an overview of the prevention and management of instruments fractured during endodontic therapy on the basis of literature retrieved from Pub Med and selected journal searches. Instrument fracture occurs because of reduced metal fatigue and/or torsional resistance. The reasons include canal morphology and curvature, manufacturing processes and instrument design, instrument use times and technique, rotational speeds and operator experience. With the development of various equipment and techniques, most of the retained instrument separations can be removed safely. However, in canals without associated periapical disease not every fractured separation should be removed from difficult locations because of the increased risk for root perforation and fracture. In difficult cases, either retain or bypass the fragment in the root canal and ensure regular follow-up reviews. Fractured instruments retained in the presence of periapical disease reduce significantly the prognosis of endodontically treated teeth, indicating a greater need to attempt the removal or bypass of the file separations. Apical surgery might be required in some instances, emphasizing the importance of preventing instrument fracture.
文摘Management of mid-root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This article presents two varied treatment options for mid-root fractures. A 15-year-old female reported an impact injury to the maxillary anterior teeth 2 days after its occurrence. Clinically,the maxillary left central incisor was palatally-extruded with a negative vitality response and radiographic evidence of an oblique fracture at the middle third of the root. An endodontic implant was employed which utilized an open technique and has been on follow-up for ten months. A 32-year-old male reported an injury,which resulted in a mobile maxillary right central incisor,three months after its occurrence. Through clinical and radiographic means,a discolored,extruded,and non-vital maxillary right central incisor with an oblique root fracture at the alveolar-crest level was observed. Exploratory surgery was performed; an apical barrier was created with a mineral trioxide aggregate and obturated with gutta percha. The fragments were stabilized with a fiber post and patient has been on follow-up for five months. Short-term follow-up for both of the cases showed promising results both clinically and radiographically.
文摘目的:探讨创伤性骨折术后红外线治疗及基于根本原因分析法(root cause analysis,RCA)的预见性护理的应用效果。方法:选取2020年1月至2021年7月于江苏省人民医院接受创伤性骨折术的162例患者为研究对象,依据随机数表法分对照组与研究组,各81例。对照组于术后接受常规治疗、红外线治疗及康复护理,研究组在对照组的基础上接受基于RCA的预见性护理。出院前,对比两组视觉模拟量表(visual analog scale,VAS)评分、并发症发生率(包括压疮、肺部感染、深静脉血栓、关节僵直、便秘、泌尿感染)及肿胀度。结果:术后12 h,两组VAS评分相比,差异无统计学意义(P>0.05);术后24、48、72 h,两组VAS评分逐渐降低,且研究组患者的VAS评分明显低于对照组,差异有统计学意义(P<0.05)。研究组患者的并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。研究组患者的肿胀II、III度占比明显低于对照组,差异有统计学意义(P<0.05)。结论:创伤性骨折术后红外线治疗联合基于RCA的预见性护理可明显改善肿胀度、减轻疼痛,同时可有效降低并发症发生率,值得推广应用。
