Causes and management of post-treatment apical periodontitis

根管治疗后出现根尖周病变或原有根尖周病变持续存在，在临床上往往被认为是根管治疗失败。对于这类根管治疗后病变的处理，首先要明确诊断，确定病因，方能为再治疗时机和方法的决策提供依据。临床上，根管治疗失败多与前次根管治疗的质量、患牙病变的性质及患牙存在伴发病变有关。本文将从上述三方面进行分析，并提出相应的处理对策，为临床医生处理根管治疗后病变提供诊断思路和再治疗方法的选择。Endodontic treatment failure is usually characterised by the presence of post-treatment apical periodonti-tis, which may be persistent, emergent or recurrent. Understanding the causes of endodontic treatment failure and mak-ing a correct diagnosis are of paramount importance for the proper management of this condition. In clinical practise, endodontic treatment failure is mainly related to the poor quality of root canal treatment (RCT), the nature of the disease and the concomitant disease of the tooth. This article focuses on the above three factors and discusses the indications and basics of the procedures for optimal clinical management of this condition.国家自然科学基金10561-5662