Objective To investigate the effects of root canal preparation treated by endedontists of different levels in different difficulty associated with the root canal anatomy factors. Methods Totally 422 teeth with 901 root canals were randomly selected from the Conservative Dentistry Department, West China Stomatology Hospital,and these teeth were respectively treated by junior specialist postgraduates, senior specialist postgraduates and endodontic specialists. Grading criteria of root canal risk factor and root canal therapy difficulty assessment were found based on 6 items: Tooth type, working length, root curvature, calcification, number of canals, and the previous endodontic treatment. The effects of root canal preparation with different difficulty in different groups were analyzed with R×C Chi-square test. Results Success rates of root canal preparation in junior group and senior group during three difficulty groups were statistically different (P＜0.05), and the root canal therapy difficulty group Ⅰ ＞group Ⅱ ＞ group Ⅲ. The operator factors in root canal therapy difficulty group Ⅰ and group Ⅱ were not significantly different (P＞0.05). But in root canal therapy difficulty group Ⅲ, the endedontic specialist group have highest success rate in root canal preparation. Conclusion The cases of root canal treatment should be treated by endodontist of corresponding level according to the difficulty. In difficult cases, endedontic specialist can provide better root canal preparation result.%目的 分析不同层次医生对与根管解剖因素相关的不同难度根管病例的接诊情况及其根管预备效果.方法 随机选取2005年3月-2006年4月间四川大学华西口腔医院牙体牙髓病科低年级专科研究生、高年级专科研究生以及专科医生分别接诊的共计422颗患牙901个根管为研究对象,按照牙位、工作长度、弯曲度、钙化度、根管数目及根管治疗史建立根管治疗解剖危险因素的难度分级评分标准进行难度评估,采用行×列卡方检验观察以上3组医师对于不同难度根管的预备情况.结果 不同难度根管预备成功率的差异在低年级组和高年级组有统计学意义(P<0.05),成功率为难度系数Ⅰ度>难度系数Ⅱ度>难度系数Ⅲ度.难度系数Ⅰ度和难度系数Ⅱ度在3个组别间预备效果的差异无统计学意义(P>0.05).难度系数Ⅲ度的成功率在3个组别间差异有统计学意义,其中专科组的成功率最高.结论 牙髓专科医生对于高难度根管治疗病例的预备效果更为理想.根管治疗病例应按照难度不同由医生进行分层分级治疗.
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