Objective To summarize the experiences and provide clinic data for the improvement of root canal surgery. Methods T 132 recorded and visited cases with 146 teeth were divide into 3 groups according to surgery methods, including group 1-root canal filling method +apicolysis resection with 79 cases, group 2-apicolysis resection + apicecto-my retrograde filling with 36 cases and group 3- root canal filling + apicolysis resection + apicectomy retrograde filling with 31 cases. Results Among 146 teeth, 108 were cured, 18 mended and 19 failed, with general success ratio of 86. 9%. The success ratios of the three groups were 89.9% (71/79),83. 3%(30/36) and 83. 9% (26/31) respectively. The curative effect of group 1 was more effective than the other two groups. Conclusion The root length was adequate, the root canal surgery treatment was a simple, economic and effective adjuvant therapy for refractory root apiex pathology. Among those methods, root canal filling method + apicolysis resection method has the smallest reaction with the highest success rate.%目的 探讨根管治疗的最佳方法.方法 选择有记载、有随访的根管治疗病例132例共146颗牙齿,根据所采用的手术方法分为3组,分别是根管充填术+根尖切除术组79例,根尖切除术+倒充填组36例,根管充填术+根尖切除术+倒充填组31例,分别对3组治疗效果进行比较.结果 146颗牙齿中,治愈109颗,好转18颗,失败19颗,总成功率86.9％,3组的成功率分别是根管充填术+根尖切除术组89.9％(71/79),根尖切除术+倒充填组83.3％(30/36),根管充填术+根尖切除术+倒充填组83.9％(26/31).根管充填术+根尖切除术组疗效优于另外两组(P＜0.05).结论 牙根长度足够的情况下采用根管外科治疗顽固性根尖病变,是一种简单、经济、有效的辅助治疗手段,其中根管充填术+根尖切除术术后反应小,成功率高,可作为临床首选方法.
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