Publikationsserver der Universitätsbibliothek Marburg
Titel:Evaluation von Perforationsdeckungen in endodontologischen Fachpraxen - eine retrospektive Multicenter-Studie
Autor:Pontius, Valerie
Weitere Beteiligte: Frankenberger, Roland (Prof. Dr.)
Veröffentlicht:2012
URI:https://archiv.ub.uni-marburg.de/diss/z2012/0864
URN: urn:nbn:de:hebis:04-z2012-08640
DOI: https://doi.org/10.17192/z2012.0864
DDC: Medizin
Titel (trans.):Evaluation of root perforation management in the private endodontic practice - a retrospective multicenter study
Publikationsdatum:2012-11-16
Lizenz:https://rightsstatements.org/vocab/InC-NC/1.0/

Dokument

Schlagwörter:
Endodontie, Mineraltrioxidaggregat, Zahnerhaltung, MTA, Endodontology, Endodontics, Mineral trioxide aggregate, Wurzelkanalbehandlung, Perforation, Endodontic specialist, Perforation, Wurzelperforation, MTA, Root perforation

Zusammenfassung:
Problemstellung und Zielsetzung: Die Endodontie stellt einen bedeutenden Bereich der konservierenden Zahnheilkunde dar. Mit dem Erscheinen neuer Materialien und Techniken konnten die Grenzen der Zahnerhaltung verschoben werden. Durch den Einsatz des Operationsmikroskops für die Wurzelkanalbehandlung etwa lassen sich diffizile Behandlungsschritte realisieren. Die Perforation einer Zahnwurzel, beispielsweise während der Suche von Wurzelkanälen, der Wurzelkanalaufbereitung, der Stiftkanalpräparation oder durch entzündlich-resorptive Prozesse zählt zu den kompliziertesten Situationen in der endodontischen Therapie. Nicht selten werden perforierte Zähne extrahiert. Das Ziel der vorliegenden Studie ist die retrospektive Untersuchung von Zähnen, die während der Wurzelkanalbehandlung eine Perforation der Zahnwurzel erfuhren und von Spezialisten für Endodontie behandelt wurden. Die Auswertung der Daten beinhaltet verschiedene klinische und röntgenologische Parameter, die einen Einfluss auf den Erfolg einer Wurzelkanalbehandlung haben können. Material und Methode: Es wurden behandelte Perforationen die in den endodontischen Fachpraxen Dr. Oliver Pontius, Dr. Terrell Pannkuk, Dr. Marga Ree, Dr. Sashi Nallapati, Dr. Raphael Bellamy, Dr. Francesco Maggiore erfolgten, in diese Studie einbezogen. Im Zeitraum von Januar 1998 bis März 2010 wurden insgesamt 69 Patienten (resp. 70 Zähne) zur Deckung einer oder mehrer Perforationen (Summe: 74) endodontisch oder endodontisch-mikrochirurgisch behandelt. Die Behandlung erfolgte ausschließlich durch Spezialisten für Endodontologie mit einer mehrjährigen Weiterbildung unter Zuhilfenahme eines Operationsmikroskopes. Zwei kalibrierte Untersucher beurteilten die klinischen und röntgenologischen Ergebnisse nach 6 bis 116 Monaten (Mittelwert 41 Monate, Recallrate 71,02 %). Prä-, intra- und postoperative Informationen mit Bezug auf potenzielle prognostische Faktoren wurden evaluiert. Ergebnisse: Von den 54 Perforationen an 50 Zähnen wurden 90 % der behandelten Zähne als geheilt klassifiziert. Von allen analysierten prognostischen Faktoren zeigte nur die radiologische Ausgangssituation einen signifikanten Einfluss auf den Behandlungserfolg. Die Erfolgsrate der vorliegenden Studie war zudem höher als in vergleichbaren Studien. Schlussfolgerungen: Eine Perforation ist nicht zwingend die Indikation für eine Extraktion des betroffenen Zahnes und kann sehr wohl durch einen Spezialisten für Endodontologie - ensprechendes Equipment und Compliance des Patienten vorausgesetzt - behandelt werden. Dabei beachtet werden müssen aber bestimmte prognostische Faktoren, vor allem die parodontale Situation, um letztendlich zusammen mit dem Patienten zu entscheiden, welcher Therapieweg eingeschlagen wird und ob ein Zahnerhalt möglich und sinnvoll ist.

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