根分叉病变 同济口腔医学课件资料.ppt

影响菌斑控制和SRP的牙根解剖结构 Root trunk length Interradiculr dimension 根分叉和根间的宽度 Scling and root planing Furcation and plasty Tunnel preparation Root separation and resection (RSR) 根分叉病变治疗的选择 I度 II度 : 根分叉维护: SRP, 根分叉暴露成形: 内斜翻瓣(牙周显 微外科), 根向移位, 根分叉成形术, 骨修整术 , 消除根分叉: GTR, 分根术, 半切术 III度 : 隧道成形术, 分根术, 半切术 Before RSR is performed the following factors must be considered: The length of the root trunk In a patient with progressive periodontal disease a tooth with a short root trunk may have an early involvement of the furcation . tooth with a short root trunk is a good candidate for RSR; The amount of remaining periodontal tissue support following separation and resection is often sufficient to ensure the stability of the remaining root cone. If the root trunk is long, the furcation involvement occurs later in the disease process, but once established the amount of periodontal tissue support left apical of the furcation may be insufficient to allow RSR. Effect of orthodontic treatment of a separated mandibular molar with a small root divergence. (a) After root separation. (b) 3 months after completion of orthodontic therapy The divergence between the root cones The distance between the root cones must be considered. Roots with a short divergence are technically more difficult to separate than roots which are wide apart. orthodontic therapy Odontoplasty of a separated mandibular molar performed during surgery to increase the furcation space. After flap elevation and exposure of the alveolar bone, it is evident that the distance between the two roots is small (a). By preparing the interradicular surfaces during surgery (b) the furcation space is increased and is sufficient for self-performed plaque control measures (c). The length and the shape of the root cones Fusion between root cones When a decision has been made to perform RSR, it is important that t