[Clinical consideration and strategy on endodontic microsurgery].

Root canal therapy is the most widely used method to treat the teeth with pulpal and periapical disorders. However, due to the complexity of root canal system, the existence of extraradicular biofilms and occurrence of true cyst, some teeth with pulpal and periapical diseases couldn't be treated effectively by non-surgical therapies. Then the combination of the surgical treatment, i.e., endodontic surgery, is necessary. The endodontic microsurgery, under the magnification and illumination provided by the dental operation microscope and with the proper use of micro instruments, ultrasonic retrotips and bioceramics root end filling materials, can treat the teeth with pulpal or periapical disorders precisely and less traumatically with high success rate. This article reviews the indications, contraindications, clinical strategy and latest advancement in endodontic microsurgery.根管治疗术是目前治疗牙髓病和根尖周病最常用的有效方法。由于根管系统的复杂性、根管外细菌生物膜及真性囊肿的存在，根管治疗术等非手术方法并不能治疗所有的牙髓病和根尖周病，此时需要联合应用根管外科手术。显微根管外科借助显微镜的放大和照明功能，使用显微器械和超声工作系统以及生物活性材料进行根管外科手术，精确、微创、疗效高。本文详细论述了显微根管外科的适应证、禁忌证、临床策略以及本领域的新进展。.