华西口腔医学杂志2026，Vol.44Issue(3)：337-348,12.DOI:10.7518/hxkq.2026034
上颌后牙区根尖手术的难点与对策
Challenges and clinical strategies for endodontic microsurgery in the posterior maxillary region
摘要
Abstract
The posterior maxillary region presents substantial challenges in endodontic microsurgery owing to its unique anatomical position and intricate root canal anatomy.Three factors contribute to this complexity:first,the posterior location and limited surgical field,compounded by prominent buccal and palatal contours,severely limit visual clarity and operative maneuverability.Second,the complex root canal anatomy‒particularly isthmuses and the second mesiobuc-cal canal‒increases the difficulties and risks associated with root-end resection and retrograde obturation.Third,the inti-mate proximity of root apices to the maxillary sinus floor poses substantial risks of sinus membrane perforation and sub-sequent complications.To address these challenges,we propose a systematic analytical approach and refine operational strategy throughout the entire surgical procedure,aiming to thoroughly eliminate the source of infection,achieve reliable apical sealing,maximize tooth structure preservation,and ensure the safety of adjacent critical structures.This study sys-tematically analyzes the three major challenges and offers corresponding surgical strategies and recommendations for risk prevention and control,to standardize practice and improve treatment outcomes in maxillary posterior end-odontic microsurgery.关键词
显微根尖手术/上颌后牙/手术入路/根管峡部/近颊第二根管/上颌窦Key words
endodontic microsurgery/maxillary posterior teeth/surgical approach/isthmus/the second mesiobuccal canal/maxillary sinus分类
医药卫生引用本文复制引用
张琛,黄晓想,侯本祥..上颌后牙区根尖手术的难点与对策[J].华西口腔医学杂志,2026,44(3):337-348,12.基金项目
National Natural Science Foundation of China(82370940) （82370940）
Beijing Natural Science Foundation(7232070) （7232070）
Innovation Fund of Beijing Stomatological Hospital,Capital Medical University(CXJJ25110) 国家自然科学基金面上项目(82370940) （CXJJ25110）
北京市自然科学基金(7232070) （7232070）
首都医科大学附属北京口腔医院创新基金(CXJJ25110) （CXJJ25110）
