不同器械预备根管对根管治疗期间急症发生率的评价

目的探讨手用K锉与H锉结合使用预备根管对根管治疗期间的急症(Endodontic interappointment emergencies IAE)的预防效果。方法将250例患者250牙髓炎患牙按牙位、年龄、性别随机分为A、B两组,A组140例,140颗牙采用手用K锉逐步后退法预备根管;B组110例,110颗牙采用手用K锉与H锉结合使用预备根管,对A、B两组IAE发生率比较,两组根管预备后6h、24h、72h、3d-1w疼痛程度比较。结果A、B两组IAE发生率分别为27．14％和14．55％,有显著差异(P<0．05);B组疼痛程度比A组轻,差异具有统计学意义(P<0．05)。结论手用K锉与H锉结合使用预备根管可减少IAE的发生率及疼痛程度。     

Incidence and Related Factors Associated with Postpreparation Pain after Intracanal Procedures in a Dental Teaching Hospital

目的:了解根管预备后疼痛发生率,并对一些可能与疼痛发生有关的因素进行分析.方法:选取2001年7月至2002年2月间武汉大学口腔医院牙体牙髓科完成的非一次法根管治疗纪录表,将相关信息输入计算机后作Chi-square test和logistic回归分析.结果:根管预备后疼痛发生率为11.5%.单因素分析和logistic回归发现身体状况、年龄、牙位于上颌或下颌、术前有无叩痛及牙髓活力为影响疼痛发生率的主要因素.结论:根管预备术后疼痛发生率较低;根管预备术后疼痛发生率受多种因素影响.     

根管充填后疼痛的发生率及其有关临床因素

目的 探讨根管充填后疼痛的发生率及其与临床因素之间的关系。方法 对牙髓病、根尖周病患牙４５８例，采用逐步后退法进行根管预备，２０例根管仅用生理盐水冲洗，２２８例根管以３％Ｈ２Ｏ２和生理盐水交替冲洗，并封入ＦＣ棉捻消毒根管，均以氯仿牙胶糊剂加牙胶尖侧压根充，术后拍Ｘ线牙片。结果 根充后疼痛发生率为１１．５８％，疼痛的发生与超填、不彻底的根管冲洗及消毒和根管治疗中的症状有明显的关系；与患者的性别、年龄     

根管预备后开放引流对根管治疗期间急症发生的影响

目的探讨减少根管治疗期间急症的方法。方法选择460颗慢性根尖周炎患牙，随机分为2组。试验组在根管预备后预防性开放引流3—4d，复诊时超声治疗仪荡洗根管后行根管充填。对照组进行封药后常规根管治疗。观察2组在根管预备和根管充填后发生根管治疗期间急症的情况。结果根管预备后，试验组有33例出现疼痛等不良反应，发生率为14．47％；对照组有54例出现不良反应，发生率为23．28％；2组间差异有统计学意义（P〈0．05）。试验组有195颗患牙如期完成根管充填，其中20例发生急症，发生率为10．23％，对照组有183颗如期完成充填，21例发生急症，发生率为11．48％，两组间差异无统计学意义（P〉0．05）。结论根管预备后开放引流可减少根管预备后急症的发生。     

根管治疗期间急症的相关因素及防治

目的　探讨根管治疗期间急症(EIE)的临床相关因素及防治方法。方法　544颗患牙分为3组:①常规治疗组　392颗患牙按常规步骤行根管治疗;②口服药物组　91颗患牙在根管预备后给予患者地塞米松口服,余同常规治疗组;③开放引流组　61颗患牙初诊时预备根管后开放引流2~3 d,余同常规治疗组。记录各相关因素,统计各组EIE发生率和急性发作指数(FUI)。比较各因素与EIE关系以及不同实验组EIE的差异。结果　常规治疗组中,19·1%的患牙发生EIE;根管预备超出根尖孔的患牙EIE发生率和FUI值均显著高于根管预备长度欠和恰的患牙;患者的年龄、性别及患牙的牙位、病变程度与EIE发生率无明显关系。口服药物组较常规治疗组FUI值显著降低。开放引流组与常规治疗组比较,其EIE发生率和FUI值均无显著差异。结论　操作因素与EIE发作有显著关系,药物等预防措施可能减少EIE发作。     

不同处理步骤对根管治疗诊间及术后疼痛的影响

目的观察不同根管治疗方法处理患牙后诊间急症和根充后疼痛的发生率。方法选择200例40岁以上患者共200颗牙髓坏死的磨牙随机分为A、B、C、D、E组,分别按照不同的根管治疗处理步骤进行治疗,A组开放2 d,封药1周,再行根管预备、根管充填;B组开放2 d,根管预备后封药1周,再行根管充填;C组开髓、拔髓后封药1周,根管预备后封药1周,再行根管充填;D组开髓、拔髓后封药1周,再行根管预备、根管充填;E组开髓、拔髓、根管预备后封药1周,再行根管充填。观察5组的约诊间疼痛和根充后疼痛的发生情况。结果 A、B组均未发生诊间痛,C、D组先行开髓,拔髓后诊间痛发生率最高分别为20.0%和22.5%,其中D组最高。结论对于易发生诊间疼痛和根充后疼痛的患者及患牙先行开放2 d,再行根管治疗可有效减少诊间急症和根充后疼痛的发生。     

Maillefer Profile 机用根管器械预备磨牙根管的近期效果分析

目的了解临床应用Maillefer Profile镍钛合金机用根管锉在预备前磨牙和磨牙根管的根管预备效果.方法Maillefer Profile机用根管器械采用逐步深入法预备前磨牙和磨牙根管共62个牙;手用根管器械采用逐步后退法预备前磨牙和磨牙根管共60个牙;并通过术前、术后的X线牙片和近期临床症状(疼痛发生率等)对比分析.结果Maillefer Profile镍钛合金机用根管锉预备牙根管的时间短、根管偏移率和近期临床效果亦优于手用根管器械.结论Maillefer     

根管治疗中一次法和多次法对术后疼痛的影响

目的:采用Mtwo根管预备系统进行根管预备,观察一次法根管治疗和多次法根管治疗术后疼痛的发生情况,探讨根管治疗术后疼痛的影响因素。方法:选择212例患者的212例患牙,随机分为2组,A组为一次性完成根管治疗,B组分次完成根管预备和根管充填,所有组内患牙均使用Mtwo根管预备系统进行根管预备,并于每次术后询问治疗后的疼痛情况,采用SPSS13.0软件包中的非参数Mann-Whitney U检验和χ2检验进行两组间疼痛情况的比较。结果:采用Mtwo根管预备系统进行根管预备,一次法完成根管治疗术后疼痛发生率(6.88%)和多次法完成根管治疗术后疼痛发生率(15.08%)没有显著性差异。结论:采用Mtwo根管预备系统进行根管预备后,一次法完成根管治疗和多次法完成根管治疗术后疼痛发生率相同,2组根管治疗术后疼痛均表现为无疼痛或轻度疼痛。     

恒牙根管弯曲的解剖学特征

恒牙弯曲根管的预备易导致根管偏移等并发症,因此获悉弯曲根管在不同牙位的发生情况,特别是了解X线片上不易看到的根管弯曲,对于临床医师在术前评估根管治疗的难易程度,在治疗过程中选择合适的预备方法是非常有必要的。本文就不同牙位恒牙根管弯曲的发生率和程度作一综述。     

不同预备方法对根管治疗诊间急症和充填效果的影响

目的： 比较不同根管预备方法对根管治疗诊间急症(interappointment emergencies,IAE)发生率和根管充填效果的影响。方法： 2018年8月—2021年8月因牙髓炎或根尖周炎需要做根管治疗的恒磨牙96颗,随机分为2组（n=48）颗,MT组使用 Mtwo机用镍钛锉改良 Mtwo根管预备法,同步组使用改良 Mtwo预备技术加同步根管长度测量根管预备法。根管预备完成后拍摄根尖片,根管内封入氢氧化钙,复诊时行常规热牙胶根管充填。采用 SPSS 22.0 软件包分析IAE的发生情况及术后充填效果。结果： 术后即刻及术后第3 天、1周,2组IAE发生率无显著差异（P>0.05）;术后第1、2 天,同步组IAE发生率显著低于MT组（P<0.05）,同步组根管充填的合格率显著高于MT组（P<0.05）。结论： 同步法能减少根管预备过程中根尖区的机械刺激,严格控制根管的工作长度,维持根尖区屏障,从而降低IAE发生率并有效提高根管充填合格率。     

Incidence of interappointment emergency associated with endodontic therapy.

Endodontic interappointment emergency (EIE) occurs in a low incidence following treatment by qualified operators. The purpose of this study was to assess the incidence of EIE after treatment by undergraduate students and to examine its correlation with preoperative and operative parameters. Randomly selected 334 records were retrospectively surveyed for unscheduled emergency appointments following endodontic treatment by undergraduate students. Treatment included step-back canal preparation in multiple visits with formocresol interappointment dressing. The incidence of EIE was 4.2%, and unrelated to the patients' sex and age or to tooth location. It was significantly higher in nonvital than in vital teeth (p < 0.05), with the highest occurrence in nonvital teeth unassociated with periapical radiolucency. Clinically, EIE was associated with swelling in half of the cases. It is concluded that the incidence of EIE following treatment by undergraduate students is low and related to tooth vitality.     

后牙根折的临床及CBCT影像学研究

目的：探讨非外伤根折后牙的临床特点及锥形束CT（Cone beam computed tomography,CBCT）上的影像学表现。方法：收集经CBCT明确诊断的47名患者的60颗非外伤根折后牙的下列临床资料：患者性别、年龄、根管治疗情况。同时对CBCT图像上根折的部位、方向、根折移位情况,伴发的其它病变进行分析研究,使用卡方检验进行统计学分析。结果：不同年龄段及男、女性根折牙发生比例均具有显著性差异。根管治疗与非根管治疗根折牙数目之间没有显著差异。根折最常见于下颌第一磨牙近中根（36.2%）,其次为上颌第一磨牙腭根（29.3%）。51.7%的根折表现为牙根全长根折。牙根颊舌向根折是最常见的根折方向（41.7%）。51.7%的根折牙伴发根尖周骨质吸收。结论：患者的年龄、性别是影响根折的重要因素。CBCT可以对根折牙的根折部位、方向,根折移位情况及伴发病变进行精确的定位和评价,是一种可以明确诊断根折牙的诊断方法并为我们探讨非外伤根折后牙的临床特点提供了很好的影像学支持。     

Single visit root canal treatment: incidence of postoperative pain using three different instrumentation techniques

A clinical study was carried out on nonvital maxillary central incisors to evaluate the incidence of postoperative pain following single-visit root canal treatment using three different instrumentation techniques. Ninety teeth from 78 patients whose ages ranged from 14 to 63 years were selected and divided into three groups. Each group (30 teeth) was prepared by a different coronal-to-apical technique using different instrument movement depending upon the technique employed: modified double-flared, crown-downpressureless and balanced force techniques. No difference was observed in the incidence of postoperative pain among the groups.     

The root and root canal morphology of the human mandibular first premolar: a literature review

The purpose of this study was to undertake a comprehensive literature review of the root and root canal morphology of the mandibular first premolar. Published studies citing the anatomy and morphology of mandibular premolars report data for over 6,700 teeth. These studies were divided into anatomical studies reporting number of roots, number of canals, and apical morphology. Variations because of sex and ethnic background have also been reported, along with case reports of anomalies. Approximately 98% of the teeth in these studies were single-rooted. The incidence of two roots was 1.8%. Three roots when reported were found in 0.2% of the teeth studied. Four roots were rare and were found in less than 0.1% of the teeth studied. Studies of the internal canal morphology revealed that a single canal was present in 75.8% of the teeth. Two or more canals were found in 24.2% of the teeth studied. A single apical foramen was found in 78.9% of the teeth, whereas 21.1% had two or more apical foramina. The role of genetics and racial variation may result in differences of incidence of root number and canal number in human populations. The dental literature is not unique in studying ethnicity and sex variations. Higher incidences of teeth with additional canals and roots have been reported in Chinese, Australian, and sub-Sahara African populations. Physical anthropology studies seem to show the lowest incidence in Western Eurasian, Japanese and American Arctic populations. The root and root canal morphology of this tooth can be complex and requires careful evaluation prior to root canal therapy.     

Radiographic "working length" revisited.

The desired "working length" for the biomechanical preparation and resultant obturation of the root canal system is one of the most important phases of endodontics. Traditionally, radiographs are used to confirm working length of the root length and to evaluate the subsequent obturation of the root canal system. This study attempts to determine if radiographs are an accurate method of root length determination in a period when electronic apex locators are proposed as their replacement. Eight-seven vital and 24 nonvital teeth were accessed and files placed to and the radiographic working length before the file and teeth were extracted for sectioning. Results showed that the radiographic distance of the file from the apical vertex was 0.7 mm shorter than the actual file position. This discrepancy can lead the clinician to try to get closer to the radiographic apex, when in reality the end of the file is closer to the vertex than is suspected. The average distance short of the vertex as established by Kuttler should be increased to lie between 1.5 and 2.0 mm from the apical vertex to prevent overfilling the root canal.     

根管超声冲洗的临床及细菌学效果评价

目的　评价根管超声冲洗技术的应用效果。方法　将需作根管治疗的 198颗牙 ,随机分为超声冲洗组 (U组 )和注射冲洗组 (S组 )。每组分别用甲醛甲酚 (FC)、樟脑对氯酚 (CMCP)、氢氧化钙 (CH)封药 ,比较两组术中疼痛发生率及疼痛指数。两组中随机选 6 0例 ,于封药前取样进行细菌培养检测 ,并进行比较。结果　U组疼痛发生率及疼痛指数与S组相比有显著性差异 (P <0 .0 5 ) ;U组细菌检出率及菌落计数与S组相比也有显著性差异 (P <0 .0 1)。结论　超声冲洗技术可以较好地清除根管内感染物和病原菌 ,使根管治疗期间急症的发生明显减少。     

Histological study of therapy for infected nonvital permanent teeth with incompletely formed apices.

The histological response of periapical tissues to root canal fillings with calcium hydroxide (Ca(OH)2)-iodoform paste, Vitapex (Neo Dental Chemical Products Co., Ltd., Tokyo, Japan), and Ca(OH)2-camphorated paramonochlorophenol (CMCP) paste in nonvital permanent teeth with incompletely formed apices was investigated in 160 root canals from 90 dog premolar and incisor teeth. Periapical inflammatory lesions were initially induced in the experimental teeth. After debridement and cleaning, root canals were filled with one of the two materials. The animals were sacrificed after 30, 60, 120, or 180 days, and histological sections of each specimen were prepared with hematoxylin and eosin staining. Histological findings showed periapical repair and apical closure in both experimental groups. However, the differences in the level of inflammation, apical closure, and reparative process among the two groups were significant (p less than 0.05). It was concluded that the Ca(OH)2-iodoform paste, Vitapex, produced better results than Ca(OH)2-CMCP paste in treatment of infected nonvital permanent teeth with incompletely formed apices.     

上颌第二乳磨牙根管数目的临床研究

目的 观察临床治疗中上颌第二乳磨牙根管数目.方法 选取需行上颌第二乳磨牙根管治疗的3~8岁患儿204例,共216颗患牙.常规方法开髓、制备开髓洞型,使髓室底完全暴露,用小号锉结合17%乙二胺四乙酸(ethylene diamine tetraacetic acid,EDTA)溶液探查各根管口的位置,确定并记录根管数目,根管预备完成后采用碘仿氧化锌糊剂进行根管充填.结果 216颗上颌第二乳磨牙中,122颗为3根管(占56.5%);94颗为4根管(占43.5%),根管数目变异以近中颊根第二根管(second mesiobuccal canal,MB2)出现频率较高,占比41.2%.上颌第二乳磨牙MB2的发现率在性别(X2=1.004,P=0.316)及牙位方面的差异(X2=0.072,P=0.788)没有统计学意义.结论 上颌第二乳磨牙根管数目存在较多变异,MB2发现率较高.     

Pain in intracanal treatment. A clinical study apropos of 150 cases]

This study was conducted to determine the incidence of pain during and after root canal treatment. Complete debridement and root canal preparation was performed in first visit. The frequency of pain was recorded and evaluated in 150 patients receiving root canal treatment. Results has shown that incidence of pain was 6.66% root canal preparation in vital teeth and 21% in non-vital teeth (necrosis). Post-obturation pain occurred in 18.75% for vital teeth and 13.15% non-vital teeth (necrosis).