| Objective:The clinical data of 120 patients(totally 132 teeth) who were diagnosed with post-treatment endodontic disease were summerised and analyzed,combining with the related literature review,to investigate the cause 、 diagnosis and treatment of PED,providing some effective basis to prevent clinical PED and improve the success rate of retreatment.Methods:1.The related literatures about PED were reviewed,in order to understand the latest research progress.2.The clinical data of 120 patients(totally 132 teeth)who were diagnosed with PED were collected,these patients who visited the Department of Comprehensive Treatment,Hospital of Stomatology,Shanxi Medical University,from Jun,2013 to Dec,2014.The clinical symptoms,X-ray films,the quality of original root canal therapy,the condition of prosthesis situations and the condition of root canal retreatment were recorded separately.All of the information above were summarized and analyzed.Results:1.The 120 patients(132 teeth)with PED,52 were males and 68 were females,19~70years old,the mean age was 39. Including 36 anterior teeth(27.27%),23 premolars(17.42%)and 73 molars(55.30%).2.Among 132 teeth,there were 74 teeth had clinical symptoms of acute and chronic apical periodontitis, and 58 teeth were asymptomatic which needed to receive root canalretreatment for crown restorations. All of the teeth showed periapical radiolucencies.92 teeth were underfilling、2 were overfilling、38 were loose filling;31 teeth had missing canals,6 had fractured endodontic instruments in canals.3.The place of previous root canal therapy:92 cases in private clinics,18 cases in department of stomatology of general hospital,10 cases in specialized hospital of stomatology.4.Teeth defects and prosthesis situationsin in crown:16 teeth were single-side cavity,116 teeth were complex cavity.29 teeth prosthesis were off;55 teeth were filling restoration,including 30 were partly defect,16 were loose and 9 with cracks;48 teeth with full crowns, among which 8 were off,30 were loose,5 were damaged and 5 were intact.5.Treatment:118 teeth received endodontic retreatment,the duration of treatment were 2 to 6 times;4 were temporarily filled the crown defects;10 were extracted.6.Prosthesis after retreatment:109 restoration with full crowns or post core crowns;6 restoration with composite resins;3 without permanent restoration.7.The effectiveness:1month after treatment,102 patients(113 teeth) were reexamined with the rate of return visit is 96.23%, among which 110 successed(97.35%), 3 failed(2.65%).3 months later, 56 patients(58 teeth) were reexamined with the rate of return visit is 52.83%, among which 55 successed(94.83%),3 failed(5.17%).6months later, 98 cases who can be got in touch with by telephone interview,95 patients said the original symptoms had been improved or disappeared, accounting for 96.94%.Conclusions:Occurrence of PED is related to a variety of factors,among which intraradicular and extraradicular with existing infection is the main reason. Root canal retreatment is primary therapy which is more difficult than root canal therapy,and the success rate is lower.Clinicians should master relevant theory of PED and standardize clinical operation,in order to prevent and reduce the occurrence of PED. |
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