Review International journal of oral science. 2025 Jun 9;17(1):46. doi: 10.1038/s41368-025-00372-w Q110.82024
Expert consensus on management of instrument separation in root canal therapy
根管治疗器械分离的处理专家共识 翻译改进
Yi Fan 1, Yuan Gao 1, Xiangzhu Wang 2, Bing Fan 3, Zhi Chen 3, Qing Yu 4, Ming Xue 5, Xiaoyan Wang 6, Zhengwei Huang 7, Deqin Yang 8, Zhengmei Lin 9, Yihuai Pan 10, Jin Zhao 11, Jinhua Yu 12, Zhuo Chen 13, Sijing Xie 14, He Yuan 15, Kehua Que 16, Shuang Pan 17, Xiaojing Huang 18, Jun Luo 19, Xiuping Meng 20, Jin Zhang 21, Yi Du 22, Lei Zhang 23, Hong Li 24, Wenxia Chen 25, Jiayuan Wu 26, Xin Xu 1, Jing Zou 27, Jiyao Li 1, Dingming Huang 1, Lei Cheng 1, Tiemei Wang 28, Benxiang Hou 29, Xuedong Zhou 30
作者单位 +展开
作者单位
1 State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.2 Department of Endodontics, Xiangya Stomatological Hospital, Central South University, Changsha, China.3 Department of Cariology and Endodontics, Wuhan University & State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.4 State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China.5 Department of Conservative Dentistry and Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.6 Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China.7 Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China.8 Department of Conservative Dentistry and Endodontics, Shanghai Stomatological Hospital & School of Stomatology, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.9 Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.10 Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.11 Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, College of Stomatology of Xinjiang Medical University, Urumqi, China.12 Institute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.13 Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China.14 Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.15 State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.16 Department of Endodontics, School and Hospital of Stomatology, Tianjin Medical University, Tianjin, China.17 Department of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, China.18 Fujian Key Laboratory of Oral Disease & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.19 Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.20 Department of Endodontics, School and Hospital of Stomatology, Jilin University, Changchun, China.21 Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China.22 Jinan Stomatological Hospital, Jinan, China.23 Hohhot Stomatology Hospital, Inner Mongolia, China.24 Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China.25 College & Hospital of Stomatology, Guangxi Medical University, Nanning, China.26 Department of Endodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China.27 State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.28 Department of Oral Radiology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing, China.29 Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China. houbenxiang@gmail.com.30 State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China. zhouxd@scu.edu.cn.
DOI: 10.1038/s41368-025-00372-w PMID: 40484859
摘要 中英对照阅读
Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
© 2025. The Author(s).
Keywords：instrument separation; root canal therapy
器械分离是根管治疗中的一个关键并发症，会影响治疗的成功率和长期牙齿保存。导致器械分离的原因是多因素的，涉及复杂的根管解剖结构、器械相关因素以及操作技术。器械分离会妨碍彻底清洁、成形和充填根管，给成功的治疗结果带来挑战。虽然通常可以取出分离的器械，但这也伴随着风险，包括穿孔、过度去除牙体组织和根部骨折。有效管理分离的器械需要对导致这一问题的因素有全面的理解，进行细致的术前评估，并准确评价取出难度。应用适当的取回技术对于减少并发症和优化临床结果至关重要。当前的手稿提供了一个理解器械分离的原因、风险因素及临床管理原则的框架。通过整合有效的策略，牙髓病专家可以提高决策能力，改善根管治疗的成功率，并确保天然牙齿的保存。
© 2025. 作者保留所有权利。
关键词：器械分离; 根管治疗
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