@phdthesis{oai:kdu.repo.nii.ac.jp:00000952,
 author = {天川, 丹 and Amakawa, Akira},
 month = {2016-10-20, 2016-07-06, 2016-07-06},
 note = {2015, application/pdf, 目的 : 垂直歯根破折歯の保存治療はきわめて困難で, 歯科医療において最も解決すべき問題と考えられている. 垂直歯根破折の早期診断が可能になることで, 長期に経過する歯内療法や感染による広範囲な歯槽骨吸収を回避することが可能である. 本研究は, 根管充塡後の垂直歯根破折歯を対象として歯根破折と臨床所見の相関関係を解析し, 歯根破折の早期診断法確立と破折を防止することを目的とした. <br> 材料と方法 : 八ケ岳歯科に来院した患者420名 (27～84歳), 459症例の垂直歯根破折歯を対象とした. 対象歯は根管充塡後の定期検診時に歯根破折と診断され, 臨床症状, エックス線所見, 支台築造形態と性状を臨床的に精査して歯根破折との関連性を調査した. なお, 歯根破折の確定診断は歯科用実体顕微鏡所見と外科治療時の直接観察で行った. <br> 結果 : 歯根破折は50歳代に最も好発し, 歯種別では下顎大臼歯が最も多かった. 歯根破折歯は打診反応が共通して認められた. 歯根破折の特徴的エックス線所見 (Perilateral radiolucency, "Halo" radiolucency) は全体の20%を示したが, ほかの症例は歯周病変および根尖病変との鑑別診断を必要とした. 歯科用実体顕微鏡による確定診断は有用であった. 歯根破折歯の80%は, 歯冠部限局のコアおよび根管長1/4以下のポストコア症例であった. <br> 結論 : 歯根破折の早期診断には定期検診による打診反応と規格エックス線所見が有用であり, 確定診断には歯科用実体顕微鏡所見がきわめて有用であった. 根管充塡後の垂直歯根破折防止には, 根管長1/2以上のポストコアが有用であることが示唆された., Introduction: The presence of a vertical root fracture (VRF) in an endodontically treated tooth has an immense impact on the treatment outcome. Early diagnosis of a VRF is imperative to avoid overtreatment and extensive bone loss. The purpose of this study was to develop a method for the early diagnosis and protection for VRF, by investigating the clinical symptoms of VRF in endodontically treated teeth.<br> Methods: Four hundred fifty-nine endodontically treated teeth in 420 patients (27-84 years old) with clinical signs and symptoms suggestive of VRF teeth were included in the study after informed consent was obtained. The 459 VRF teeth were examined and evaluated based on the clinical findings of radiography, and the condition of the post and core. A final decision on VRF was made based on dental microscope findings and surgical inspection.<br> Results: VRF teeth were observed most frequently in patients aged 50-59, and the mandibular molars were the most frequently fractured. All VRF teeth were found to have percussion pain, although 20% of VRF teeth had detected the effectiveness radiographs (perilateral radiolucency, "halo" radiolucency) with confirmed fractures. A dental microscope can provide valuable diagnostic information in the detection of VRFs. Eighty percent of VRF was within one fourth short post core teeth.<br> Conclusion: Percussion response and dental radiographs in routine examination after endodontics were effective for the early diagnosis of VRF, and a dental microscope can be used to make the final decision. The results of this study showed that long post core teeth had higher fracture resistance than short post core teeth in endodontically treated teeth.},
 school = {神奈川歯科大学},
 title = {根管充塡歯の垂直歯根破折に関する臨床研究:—歯根破折の早期診断法と破折防止法の確立—},
 year = {},
 yomi = {アマカワ, アキラ}
}