根管内器械分离的医方责任和纠纷防范

doi:10.13591/j.cnki.kqyx.2022.07.001

Abstract

Abstract: Instrument separation is one of the common complications in the process of root canal therapy, which is closely related to the complex anatomical morphology of the root canal, the performance of instrument and the factors of the operator, and cannot be avoided under the existing medical technology conditions. In addition to the failure of root canal treatment, instrument separation can also cause psychological burden to both doctors and patients, and easily lead to medical disputes. Although the instrument separation is not a medical accident, the doctor should also take some responsibility. Comprehensive preoperative evaluation and standardized operation can reduce the occurrence of instrument separation. Preoperative notification, detailed medical records and making the best clinical decision after instrument separation to reduce adverse consequences are beneficial to reduce medical disputes.

Key words: instrument separation, nickel-titanium instrument, legal liability, medical dispute

CLC Number:

R781.05

YANG Yinjie, HOU Benxiang. Legal liability and prevention of medical disputes about endodontic instruments separation[J]. Stomatology, 2022, 42(7): 577-581.

References

[1] Madarati AA, Hunter MJ, Dummer PMH. Management of intracanal separated instruments[J]. J Endod, 2013, 39(5):569-581.
[2] Kim HC, Yum J, Hur B, et al. Cyclic fatigue and fracture characteristics of ground and twisted nickel-titanium rotary files[J]. J Endod, 2010, 36(1):147-152.
[3] Lopes HP, Gambarra-Soares T, Elias CN, et al. Comparison of the mechanical properties of rotary instruments made of conventional nickel-titanium wire, M-wire, or nickel-titanium alloy in R-phase[J]. J Endod, 2013, 39(4):516-520.
[4] Cheung GSP, Peng B, Bian Z, et al. Defects in ProTaper S1 instruments after clinical use:Fractographic examination[J]. Int Endod J, 2005, 38(11):802-809.
[5] Shen Y, Cheung GSP, Peng B, et al. Defects in nickel-titanium instruments after clinical use. Part 2:Fractographic analysis of fractured surface in a cohort study[J]. J Endod, 2009, 35(1):133-136.
[6] Parashos P, Gordon I, Messer HH. Factors influencing defects of rotary nickel-titanium endodontic instruments after clinical use[J]. J Endod, 2004, 30(10):722-725.
[7] Pruett JP, Clement DJ, Carnes DL Jr. Cyclic fatigue testing of nickel-titanium endodontic instruments[J]. J Endod, 1997, 23(2):77-85.
[8] Peters OA, Peters CI,Schönenberger K, et al. ProTaper rotary root canal preparation:Assessment of torque and force in relation to canal anatomy[J]. Int Endod J, 2003, 36(2):93-99.
[9] 杨殷杰, 侯本祥, 侯晓玫. 三种特殊热处理技术对镍钛根管锉相变行为、弯曲性能和抗疲劳折断性能影响的研究[J]. 中华口腔医学杂志, 2018, 53(8):539-545.
[10] Gündoğar M, Özyürek T. Cyclicfatigue resistance of OneShape, HyFlex EDM, WaveOne gold, and reciproc blue nickel-titanium instruments[J]. J Endod, 2017, 43(7):1192-1196.
[11] Hieawy A, Haapasalo M, Zhou HM, et al. Phase transformation behavior and resistance to bending and cyclic fatigue of ProTaper gold and ProTaper universal instruments[J]. J Endod, 2015, 41(7):1134-1138.
[12] De-Deus G, Silva EJNL, Vieira VTL, et al. Blue thermomechani-cal treatment optimizes fatigue resistance and flexibility of the reciproc files[J]. J Endod, 2017, 43(3):462-466.
[13] 杨殷杰, 侯本祥, 侯晓玫. 自适应往复运动镍钛根管锉TFA的疲劳折断性能研究[J]. 牙体牙髓牙周病学杂志, 2016, 26(3):163-166.
[14] Pedullà E, Lo Savio F, Boninelli S, et al. Torsional and cyclic fatigue resistance of a new nickel-titanium instrument manufactured by electrical discharge machining[J]. J Endod, 2016, 42(1):156-159.
[15] Bahia MGA, Melo MCC, Buono VTL. Influence of simulated clinical use on the torsional behavior of nickel-titanium rotary endodontic instruments[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(5):675-680.
[16] Kiefner P, Ban M, De-Deus G. Is the reciprocating movement per se able to improve the cyclic fatigue resistance of instruments?[J]. Int Endod J, 2014, 47(5):430-436.
[17] Blum JY, Cohen A, Machtou P, et al. Analysis of forces developed during mechanical preparation of extracted teeth using Profile NiTi rotary instruments[J]. Int Endod J, 1999, 32(1):24-31.
[18] Yared G, Bou Dagher F, Kulkarni K. Influence of torque control motors and the operator's proficiency on ProTaper failures[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 96(2):229-233.
[19] Fayyad DM, Mahran AH. Atomic force microscopic evaluation of nanostructure alterations of rotary NiTi instruments after immersion in irrigating solutions[J]. Int Endod J, 2014, 47(6):567-573.
[20] Viana ACD, Gonzalez BM, Buono VTL, et al. Influence of sterilization on mechanical properties and fatigue resistance of nickel-titanium rotary endodontic instruments[J]. Int Endod J, 2006, 39(9):709-715.
[21] Plotino G, Costanzo A, Grande NM,et al. Experimental evaluation on the influence of autoclave sterilization on the cyclic fatigue of new nickel-titanium rotary instruments[J]. J Endod, 2012, 38(2):222-225.
[22] Hilfer PB, Bergeron BE, Mayerchak MJ, et al. Multiple autoclave cycle effects on cyclic fatigue of nickel-titanium rotary files produced by new manufacturing methods[J]. J Endod, 2011, 37(1):72-74.
[23] 葛久禹, 侯本祥, 余擎, 等. 根管治疗中器械分离是否需要取出[J]. 国际口腔医学杂志, 2014, 41(1):7-12.
[24] 南京市鼓楼区人民法院.(2015)鼓民初字第2633号民事判决书[EB/OL]. (2015-12-10)[2022-04-29].https://wenshu.court.gov.cn/website/wenshu/181107ANFZ0BXSK4/index.html?docId=69f3a573cae2482abd73e15da0e4e450.
[25] 内蒙古自治区新巴尔虎右旗人民法院.(2017)内0727民初279号民事判决书[EB/OL].(2017-11-02)[2022-05-06].https://wenshu.court.gov.cn/website/wenshu/181107ANFZ0BXSK4/index.html?docId=eb4a35f710344ce28667a7b400f7efe0.
[26] 沈曙铭. 执业医师维权与自律Ⅰ.医疗纠纷中的责任过失[J]. 中华口腔医学杂志, 2005, 40(1):78-80.

Legal liability and prevention of medical disputes about endodontic instruments separation

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[2]	. Correlation study of defects in Mtwo instruments after clinical use [J]. , 2016, 36(12): 1078-1082.
[3]	. Larger Taper Nickel-titanium Instrument And Periodontal-endodontic lesion In The ‘Danger Zone’ [J]. , 2016, 36(10): 953-956.
[4]	. The clinical effects of molars root canal therapy with Waveone [J]. , 2015, 35(8): 670-672.
[5]	. Research progress on instrument separation [J]. , 2015, 35(3): 223-228.
[6]	. Micro-Computed Tomography Analysis of Canal Transportation after Root Canal Preparation with WaveOne [J]. , 2014, 34(11): 823-827.