口腔医学 ›› 2026, Vol. 46 ›› Issue (10): 802-806.doi: 10.13591/j.cnki.kqyx.2026.10.013

• 基础与临床研究 • 上一篇    下一篇

数字化导板在显微根尖手术中的临床应用研究

张堃1, 杨奕涵2, 邵乐瑶2, 李响1, 苏明3, 李长顺4, 张昕5()   

  1. 1 徐州医科大学附属口腔医院牙体牙髓病科, 江苏徐州 (221000)
    2 徐州医科大学口腔医学院, 江苏徐州 (221000)
    3 徐州医科大学附属口腔医院口腔正畸科, 江苏徐州 (221000)
    4 徐州医科大学附属口腔医院口腔综合科, 江苏徐州 (221000)
    5 徐州医科大学附属口腔医院儿童口腔科, 江苏徐州 (221000)
  • 收稿日期:2025-09-20 出版日期:2026-10-28 发布日期:2026-10-16
  • 通讯作者: 张昕 E-mail:77474706@qq.com
  • 作者简介:第一联系人: 张堃负责研究实施,数据统计分析和论文撰写,杨奕涵负责图片采集,邵乐瑶负责数据采集,李响负责数据统计学分析,苏明负责数字化导板制作,李长顺负责手术实施及术后资料收集,张昕负责手术方案确定以及手术实施、研究技术指导以及论文指导。
  • 基金资助:
    江苏省卫生健康委科研项目(ZQ2025022)

Clinical application research on digital surgical guides in microsurgical apicoectomy

ZHANG Kun1, YANG Yihan2, SHAO Leyao2, LI Xiang1, SU Ming3, LI Changshun4, ZHANG Xin5()   

  1. Department of Endodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou 221000, China
  • Received:2025-09-20 Online:2026-10-28 Published:2026-10-16

摘要:

目的 探讨数字化导板在难治性根尖周病显微根尖手术中的精准定位作用及其对术后愈合的影响。方法 纳入30例经传统根管治疗失败后确诊为难治性根尖周病的患者,随机分为研究组(数字化导板辅助显微根尖手术)和对照组(传统自由手显微手术),手术前后拍摄锥形束计算机断层扫描进行手术精确性对比分析。对比两组手术时间、根尖切除精准度、术后疼痛情况。结果 研究组手术时间为(24.05±0.92)min,短于对照组的(32.10±0.80)min(P<0.001);根尖切除精准度方面,研究组与对照组相比,根尖切除长度、根尖切除角度均更为理想,两组数据差异均具有统计学意义(P<0.001)。30例患者均未出现明显并发症;对照组术后第1、3、7天出现较为明显的疼痛症状,第1天、第3天两组间差异均具有统计学意义(P<0.01)。结论 数字化导板能够提升难治性根尖周病手术的精准性,减少手术时间,减轻术后疼痛。

关键词: 数字化导板, 难治性根尖周病, 显微根尖手术

Abstract:

Objective To investigate the precise positioning role of digital surgical guides in microsurgical apicoectomy for refractory periapical periodontitis and their impact on postoperative healing. Methods Thirty patients diagnosed with refractory periapical periodontitis who had failed conventional root canal treatment were enrolled and randomly divided into an experimental group (digital surgical guides assisted microsurgical apicoectomy) and a control group (traditional freehand microsurgery). Cone-beam computed tomography (CBCT) was performed before and after surgery to compare and analyze surgical accuracy. The surgical time, accuracy of root-end resection, and postoperative pain were compared between the two groups. Results The surgical time in the experimental group (24.05±0.92) min was significantly shorter than that in the control group (32.10±0.80) min. In terms of root-end resection accuracy, the experimental group showed more ideal root-end resection length and angle compared to the control group, with statistically significant differences(P<0.001). No significant complications occurred in any of the thirty patients. The control group exhibited more pronounced pain symptoms on the first, third, and seventh days postoperatively, with statistically significant differences between the two groups on the first and third days(P<0.01). Conclusion Digital surgical guides can enhance the precision of surgery for refractory periapical periodontitis, reduce surgical time, and alleviate postoperative pain.

Key words: digital surgical guides, refractory periapical periodontitis, microsurgical apicoectomy

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