欢迎来到OAJRC平台！

期刊栏目

投稿

审稿

期刊目次

加入编委

期刊订阅

添加您的邮件地址以接收即将发行期刊数据：

当前位置：国际口腔科学研究 > 2026年 5卷 (1)期

Open Access Article

International Oral Science Research. 2026; 5: (1) ; 34-43 ; DOI: 10.12208/j.iosr.20260008.

Research on the clinical application and development of root canal treatment techniques
根管治疗技术的临床应用与发展研究

作者： 王燕 *

大连大学辽宁大连

*通讯作者：王燕,单位：大连大学辽宁大连；

发布时间: 2026-06-28 总浏览量: 20 下载量: 加载中...

PDF 全文下载引用本文

摘要

目的综述根管治疗技术在器械、冲洗、充填及复杂病例处理方面的临床应用与发展。方法检索中国知网、万方、PubMed及Web of Science数据库中2019-2025年发表的相关文献，围绕根管预备、冲洗消毒、根管充填、器械分离、数字化导板及显微根尖手术等主题进行筛选与归纳。重点关注系统评价、Meta分析、临床研究及与技术机制相关的实验研究，并结合研究类型和证据层级讨论其临床应用价值与局限性。本文为基于上述检索的叙述性综述，未采用系统评价的固定检索式、偏倚评价流程与可重复性检索报告。结果热处理镍钛器械与往复运动系统改善了器械抗疲劳性能，但次氯酸钠暴露与温度等因素仍影响其寿命；冲洗活化技术提升了玷污层与感染物的清除效果，但不同活化方式之间的相对优势尚无一致结论；以生物陶瓷封闭剂为基础的单尖充填改变了以牙胶为主的传统充填理念；数字化导板与显微技术拓展了钙化根管与根尖手术的处理能力。结论根管治疗技术呈现微创化与数字化趋势，器械分离处理、充填质量评价、导板精度与远期疗效证据仍是今后研究的重点。

关键词： 根管治疗；镍钛器械；根管冲洗；生物陶瓷封闭剂；单尖充填；导板牙髓治疗；显微根尖手术；综述

Abstract

Objective To review the clinical application and development of root canal treatment techniques regarding instrumentation, irrigation, obturation, and the management of complex cases.
Methods Relevant literature published between 2019 and 2025 was retrieved from the CNKI, Wanfang, PubMed, and Web of Science databases. The literature was screened and summarized based on topics such as root canal preparation, irrigation and disinfection, obturation, instrument separation management, digital guides, and microscopic periapical surgery. Emphasis was placed on systematic reviews, meta-analyses, clinical studies, and experimental research concerning technical mechanisms; the clinical value and limitations of these techniques were discussed in the context of study types and levels of evidence. This article is a narrative review based on the aforementioned search; it did not employ the fixed search strategies, bias assessment protocols, or reproducible search reporting typical of systematic reviews.
Results Heat-treated nickel-titanium (NiTi) instruments and reciprocating motion systems have improved fatigue resistance, although factors such as sodium hypochlorite exposure and temperature continue to affect their service life. Irrigation activation techniques have enhanced the removal of the smear layer and infectious debris, though there is no consensus regarding the relative advantages of different activation methods. Bioceramic sealer-based single-cone obturation has shifted the traditional paradigm centered on gutta-percha. Digital guides and microscopic techniques have expanded capabilities for managing calcified root canals and performing periapical surgery.
Conclusion Root canal treatment techniques are trending toward minimally invasive and digital approaches. Future research should focus on the management of separated instruments, the assessment of obturation quality, guide accuracy, and evidence regarding long-term clinical outcomes.

Key words： Root canal treatment; NiTi instruments; Root canal irrigation; Bioceramic sealer; Single-cone obturation; Guided endodontics; Microscopic periapical surgery; Review

参考文献 References

[1] 李宝玉, 龚启梅. 根管超填临床预后的研究进展[J]. 中华口腔医学杂志, 2021, 56(2): 210-215.

[2] 中华口腔医学会牙体牙髓病学专业委员会, 边专, 孟柳燕. 牙体牙髓病诊疗中口腔放射学的应用指南[J]. 中华口腔医学杂志, 2021, 56(4): 311-317.

[3] Duque J A, Bramante C M, Duarte M A H, et al. Cyclic fatigue resistance of nickel-titanium reciprocating instruments after simulated clinical use[J]. J Endod, 2020, 46(11): 1771-1775.

[4] Sobral T K M, Piasecki L, Tomazinho F S F, et al. Dynamic cyclic fatigue resistance of heat-treated nickel titanium instruments in reciprocating motion[J]. Eur Endod J, 2023, 8(3): 201-206.

[5] Weissheimer T, Duarte M A H, Só M V R, et al. Evaluation of cyclic and torsional fatigue resistance of several heat-treated reciprocating nickel-titanium instruments[J]. Aust Endod J, 2023, 49(3): 524-529.

[6] Silva E J N L, Martins J N R, Ajuz N C, et al. Design, metallurgy, mechanical properties, and shaping ability of 3 heat-treated reciprocating systems: a multimethod investigation[J]. Clin Oral Investig, 2023, 27(5): 2427-2436.

[7] 王天祺, 李家有, 许家宁, 等. 三种机用镍钛器械根管预备中心定位能力的体外研究[J]. 中国实用口腔科杂志, 2022, 15(3): 304-308.

[8] Dos Reis-Prado A H, Abreu L G, de Arantes L C, et al. Influence of sodium hypochlorite on cyclic fatigue resistance of nickel-titanium instruments: a systematic review and meta-analysis of in vitro studies[J]. Clin Oral Investig, 2023, 27(11): 6291-6319.

[9] Khoury R D, de Carvalho L S, do Nascimento M F R, et al. Endodontic irrigants from a comprehensive perspective[J]. World J Clin Cases, 2024, 12(21): 4460-4468.

[10] Orlowski N B, Schimdt T F, Teixeira C D S, et al. Smear layer removal using passive ultrasonic irrigation and different concentrations of sodium hypochlorite[J]. J Endod, 2020, 46(11): 1738-1744.

[11] Abaza M M, Harhash T A H, Zaky A A. Comparative analysis of laser and ultrasonic irrigation techniques for smear layer removal in endodontics[J]. Lasers Med Sci, 2025, 40(1): 522.

[12] Cheung A W T, Lee A H C, Cheung G S P. Clinical efficacy of activated irrigation in endodontics: a focused review[J]. Restor Dent Endod, 2021, 46(1): e10.

[13] 刘红艳, 韦曦, 凌均棨. 根管封药的应用现状及研究进展[J]. 中华口腔医学研究杂志(电子版), 2023, 17(2): 69-74.

[14] Cardinali F, Camilleri J. A critical review of the material properties guiding the clinician's choice of root canal sealers[J]. Clin Oral Investig, 2023, 27(8): 4147-4155.

[15] Casino-Alegre A, Aranda-Verdú S, Zarzosa-López J I, et al. Intratubular penetration ability in the canal perimeter using HiFlow bioceramic sealer with warm obturation techniques and single cone[J]. J Clin Exp Dent, 2022, 14(8): e639-e645.

[16] Alkahtany S M, AlHussain A A, AlMthen H A, et al. Obturation quality of bioceramic sealers with different obturation techniques: a micro-CT evaluation[J]. Sci Rep, 2024, 14(1): 31146.

[17] Sabeti M A, Karimpourtalebi N, Shahravan A, et al. Clinical and radiographic failure of nonsurgical endodontic treatment and retreatment using single-cone technique with calcium silicate-based sealers: a systematic review and meta-analysis[J]. J Endod, 2024, 50(6): 735-746.e1.

[18] 王祥柱. 根管治疗器械分离的临床管理[J]. 中华口腔医学研究杂志(电子版), 2023, 17(3): 153-161.

[19] Connert T, Weiger R, Krastl G. Present status and future directions: guided endodontics[J]. Int Endod J, 2022, 55(Suppl 4): 995-1002.

[20] 高羽轩, 汪鎏, 傅裕杰, 等. 数字化导板引导技术辅助微创治疗前牙钙化根管[J]. 华西口腔医学杂志, 2022, 40(1): 111-120.

[21] García Franco C, Riad Deglow E, Montero J, et al. Endodontic access with different computer navigation systems in calcified root canals[J]. J Am Dent Assoc, 2024, 155(12): 1043-1052.

[22] 焦明阳, 周煜萃, 蒋正源, 等. 数字化导板技术在牙髓治疗领域的研究进展[J]. 国际口腔医学杂志, 2024, 51(5): 550-557.

[23] 王瑛瑛, 薛明. 锥形束CT导航下应用显微超声技术治疗牙髓钙化1例报告[J]. 中国实用口腔科杂志, 2021, 14(1): 126-128.

[24] Connert T, Walter E, Benz L, et al. Guided endodontics: potential and limitations[J]. Aust Dent J, 2025, 70(Suppl 1): S118-S128.

[25] 黄湘雅, 蔡艳玲, 韦曦. 显微根尖手术的全周期管理[J]. 口腔疾病防治, 2021, 29(10): 649-655.

[26] 陈益燕, Pradan Siras Prasad, 杨锦波. 302例显微根尖手术的回顾性研究[J]. 华西口腔医学杂志, 2021, 39(4): 458-463.

引用本文

王燕, 根管治疗技术的临床应用与发展研究[J]. 国际口腔科学研究, 2026; 5: (1) : 34-43.

入驻平台

回到顶部

搜索文章: