地塞米松-氢氧化钙糊剂根管内封药的临床观察

目的：观察地塞米松-氢氧化钙糊剂用于根管封药的临床疗效以及对根管治疗期间急症的预防效果。方法：分别用甲醛甲酚（FC）、氢氧化钙糊剂和地塞米松-氢氧化钙糊剂对患急、慢性根尖周炎、牙髓坏死等需接受根管治疗的206例273个患牙进行根管内封药，观察其近期疗效和治疗期间急性疼痛发作率。结果：FC、氢氧化钙及地塞米松-氢氧化钙糊剂根管内封药疗效呈递增趋势，其根管治疗期间急症发生率呈递减趋势，各组之间在统计学上有显著差异（P〈0．05）。结论：氢氧化钙糊剂、地塞米松-氢氧化钙糊剂根管内封药均可提高疗效和减少根管治疗期间急症的发生，地塞米松-氢氧化钙糊剂效果更佳。     

氢氧化钙根管内封药预防根管治疗期间的急症

目的：探讨氢氧化钙（calcium hycroxide,CH)根管内封药对根管治疗期间急症（Endodontic interappointment emergencies,IAE)的预防效果。方法：对使用不同药物根管内封药IAE的发生率进行比较。结果：CMCP、PC、IPI、CH组IAE发生率分别是为22．0％、28．0％、26．0％和4．0％，有非常明显的差异，疼痛指数亦以CH组最优。结论：CH根管内封药，对IAE的发生有较好的预防作用。     

氢氧化钙在脱位再植牙牙髓坏死治疗中的应用

目的：观察氢氧化钙（calcium hydroxide,CH)及其制剂作为根管内封药和根管充填糊剂在外伤脱位牙牙髓坏死根管治疗术（root canal therapy,RCT)中的应用效果。方法：对使用不同药物根管内封药和不同根管糊剂充填根管治疗外伤脱位再植牙牙髓坏死的疗效进行对比。结果：CMCP、FC、IPI、CH组根管治疗期间的急症发生率差异非常明显，疼痛指数亦以CH组最低；1年后牙根吸收情况和2年失牙率、牙再植成功率CH组与其它组有非常显著差异。结论：CH可以预防其急症的发生和减少牙根吸收，提高牙再植的成功率。     

根管治疗期间急症的防治

目的:探讨根管治疗期间急症的防治.方法:将患牙髓炎、牙髓坏死、根尖周炎,需接受根管治疗的348例(348颗患牙)随机分成4组,分别在根管内封甲醛甲酚(FC)、奥硝唑、氢氧化钙、地塞米松-氢氧化钙,观察其根管治疗期间急性疼痛发作率.结果:奥硝唑与氢氧化钙组比较,差异无显著性(P>0.05).地塞米松-氢氧化钙组与奥硝唑组、氢氧化钙组比较,各组之间有显著差异(P<0.05),地塞米松-氢氧化钙糊剂同FC组比较具有非常显著差异(P<0.01).结论:根管内封地塞米松-氢氧化钙能较好预防和降低EIAE的发生率,并能减轻疼痛程度.     

METAPEX糊剂防治根管治疗期间疼痛的临床评价

目的:评价采用METAPEX(氢氧化钙碘仿)糊剂根管封药预防根管治疗期间急症疼痛的临床效果。方法:218例根管治疗分为METAPEX氢氧化钙碘仿糊剂封药实验组(109例)和使用甲醛甲酚(FC)根管消毒的对照组(109例),评价其疗效。结果:METAPEX糊剂根管治疗期间疼痛的发生率4.59%,明显低于对照组16.51%。结论:METAPEX糊剂能有效预防根管治疗期间疼痛的发生。     

氢氧化钙糊剂根管消毒的临床疗效观察

目的评价氢氧化钙作为根管内消毒药物预防术后疼痛的效果。方法选择96颗有根管治疗指征的患牙,将其随机分为A、B2组,每组48颗牙。每组患牙均为二次完成根管治疗,Α组患牙约诊期间根管内封Ca(OH)2糊剂,B组患牙约诊期间根管内封FC棉球或CP棉捻。分别于封药后1周和充填后1周复诊,并记录2组约诊期间和根管充填术后1周内患牙疼痛情况。结果Α组患者约诊期间和根管充填术后1周内患牙疼痛的发生率均明显低于Β组,经χ2检验,2组疼痛发生率的差异有统计学意义。结论氢氧化钙作为根管内消毒药物可有效地预防根管治疗约诊期间及充填后疼痛的发生。     

氢氧化钙-地塞米松糊剂预防根管治疗期间急症的临床研究

目的：评价采用氢氧化钙-地塞米松糊剂根管封药预防根管治疗期间急症的临床效果。方法：200例慢性根尖周炎、牙髓坏死、残根、残冠,需行根管治疗的患者,随机分为两组,实验组用氢氧化钙-地塞米松糊剂封药,对照组用FC封药,每组100例。结果：实验组急症发生率（4％）,显著低于对照组（28％）。结论：氢氧化钙-地塞米松糊剂能有效预防根管治疗期间急症的发生和降低约诊间疼痛程度。     

氢氧化钙预防根管治疗期间急症的临床应用

目的通过对比氢氧化钙与甲醛甲酚(FC)根管封药后对诊间痛的控制及影响情况,评价氢氧化钙作为根管消毒剂的临床效果。方法收集慢性根尖周炎病例200例,随机分入实验组和对照组。实验组使用氢氧化钙糊剂封药,对照组使用FC封药。根管充填时评价约诊间急症情况。结果实验组与对照组的IAE(根管治疗期间急症)发生率无显著差异。实验组的症状指数小于对照组(P<0.05)。结论氢氧化钙比甲醛甲酚能更有效降低根管治疗期间疼痛和肿胀的程度。     

氢氧化钙预防根管治疗术后疼痛的临床观察

目的评价氢氧化钙作为根管内药物预防根管治疗术后疼痛的效果。方法选择90颗牙髓坏死的前磨牙,将其随机分为A、B、C组,每组30颗牙。A组患牙1次完成根管治疗;B组患牙2次完成根管治疗,但约诊期间根管内不封任何药物;C组患牙2次完成根管治疗,但约诊期间根管内封Ca(OH)2糊剂。采用改良10点视觉模拟量表对患者根管治疗后疼痛的严重程度进行评价,比较3组患者根管治疗后的疼痛水平。结果A组与B组、B组与C组患者根管治疗术后疼痛的差异有统计学意义(P<0.05),A组与C组患者根管治疗术后疼痛的差异无统计学意义(P>0.05)。结论氢氧化钙作为根管内封药可有效预防根管充填后疼痛的发生。     

根管治疗期间急症的发生原因和处理

目的探讨根管治疗期间急症的发生原因及其治疗方法。方法对55例根管治疗期间急症的患牙进行临床分析。用地塞米松和甲硝唑行根管内封药,1周后用Vitapex糊剂加牙胶尖行根管充填;术后随访1a,评价其疗效。结果根管治疗期间急症的发生率为12.59%(55/437)。牙髓炎组(5.13%)与牙髓坏死、根尖周炎组(16.73%)的急症发生率差异有显著性(P<0.01),前牙组与后牙组发生率差异有显著性(P<0.01)。随访1年时疗效评定为成功者达92.7%。结论根管治疗期间急症的发生与术前患牙的牙髓状况、牙位等有关;用地塞米松和甲硝唑行根管内封药及用Vitapex糊剂加牙胶尖行根管充填治疗,效果可靠。     

氢氧化钙碘仿糊剂根管封药的临床观察

目的:比较氢氧化钙碘仿(CHI)糊剂与传统的根管消毒剂甲醛甲酚(FC)、樟脑酚(CP)的临床效果。方法:选择需作根管治疗的患者142例,患牙165颗,随机分为CHI、FC、CP组,常规镍钛根管预备后分别封入上述药物于根管及髓腔中,观察比较根管预备封药后发生根管治疗期间疼痛(EIP)的情况、临床疗效及完成根管治疗的复诊次数。结果:CHI组EIP的发生率最低、临床有效率最高、复诊次数最少,与FC组有显著性差异(P<0.05),但与CP组的差异无显著性(P>0.05)。讨论:与传统的酚类根管消毒药物(FC、CP)相比较,CHI封药不易导致EIP,临床疗效高、疗程短、操作简便、无细胞毒性及抗原性,是一种较理想的根管消毒剂。     

根管消毒药物体外细胞毒性和细胞回复能力的研究

目的:探讨5种常用根管消毒药物的细胞毒性以及毒性的可逆性,寻找一种较理想的根管消毒药物。方法:用体外培养的人牙周膜成纤维细胞(HPLFs),通过MTT法、ALP活性测定法以及透射电镜等方法,系统评价甲醛甲酚(FC)、樟脑酚(CP)、甲硝唑、氢氧化钙和中药制剂的细胞毒性及其毒性的可逆性。采用SPSS11.5软件包,所有数据均经正态分布检验、方差齐性检验、t检验和方差分析。结果:FC和CP对HPLFs的增殖、ALP活性均有显著抑制作用(P<0.01、P<0.05)。FC的细胞毒性为3～4级,细胞回复度<30%。CP的细胞毒性为1～3级,细胞回复度<30%。甲硝唑对HPLFs的增殖、ALP活性有轻微抑制作用,细胞毒性为1级,细胞回复度为32%～85%。氢氧化钙和中药制剂对HPLFs的增殖和ALP活性均无显著抑制作用(P>0.05),细胞毒性为0～1级,细胞回复度>90%。通过透射电镜观察,HPLFs的超微结构显示,FC、CP有重度毒性,甲硝唑有轻度毒性,而氢氧化钙和中药制剂基本无毒性。结论:FC、CP细胞毒性大,且毒性不可逆;甲硝唑有轻微细胞毒性,但毒性可逆;氢氧化钙和中药制剂无细胞毒性。临床上可用氢氧化钙或中药制剂作为较理想的根管消毒药替代有毒性的FC、CP。     

Flare-ups incidence and severity after using calcium hydroxide as intracanal dressing

Acute pain and swelling following endodontic treatment are a challenge for both the patient and the dentist. According to previous studies, the incidence of flare-ups increases after endodontic treatment of teeth with necrotic pulps. Calcium hydroxide is currently used as a multi-purpose drug in root canal therapy. The aim of this study was to evaluate the incidence and severity of flare-ups after treatment of pulpless teeth using calcium hydroxide as an intracanal dressing. Sixty patients with single-root necrotic teeth participated in this study. These patients were randomly divided into three groups of 20. The patients were treated in Group A in a single-visit approach, in group B with a two-visit approach without any intracanal dressing and group C with a two-visit approach using calcium hydroxide as an intracanal dressing for one week. All of the patients were followed for 72 hours after each treatment session. The information about the incidence and severity of pain and swelling was recorded in tables, using a modified Visual Analogue Scale for pain severity measurement and a scale with four degrees for measuring the severity of swelling. The data were analyzed by chi-square test and GENMODE procedure.     

The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals

Abstract The bactericidal efficacy of calcium hydroxide, camphorated phenol and camphorated paramonochlorophenol as intracanal dressings was evaluated clinically when the root canals of 65 single-rooted teeth with periapical lesions were treated. A bacteriological technique that could detect even small numbers of anaerobic bacteria in the canals was used. After treatment, including intracanal dressing with calcium hydroxide paste (Calasept), bacteria were recovered from one of 35 treated root canals. After use of camphorated phenol or camphorated paramonochlorophenol as the dressing, bacteria were recovered from 10 of 30 treated root canals. The isolated bacteria were predominantly Gram-positive and anaerobic. There was no indication that specific bacteria were resistant to the treatment. The results indicate that the endodontic treatment of infected root canals can be completed in two appointments when calcium hydroxide paste is used as an intracanal dressing.     

Assessment of depth of penetration and antibiofilm properties of Boswellia sacra compared with calcium hydroxide intracanal medicament (in vitro study)

Successful endodontic treatment requires advanced materials to eliminate biofilm This study aims to assess the penetration depth and the effectiveness of Boswellia sacra as a novel intracanal medicament compared with calcium hydroxide against Enterococcus faecalis biofilm. 60 single-rooted teeth were decoronated, prepared and sterilised. Fifty teeth were contaminated with a culture of E. faecalis (ATCC 19433) for 21 days. Two teeth were used to confirm the biofilm using scanning electron microscope. For colony-forming unit (CFU), 40 samples were divided into one control group (calcium hydroxide) and the other experimental group (B. sacra). Each group was divided into two subgroups to be tested at 3 and 7 days. The minimum inhibitory concentration (MIC) of B. sacra was determined, and the B. sacra's ethanolic extract medicament was prepared. Eight discs divided into groups similar to CFU were used to evaluate live/dead bacteria using confocal laser scanning microscopy (CLSM). Ten teeth were selected for penetration depth using CLSM. The intracanal medicaments were mixed with 0.1% rhodamine B. were inserted into the root canals 0.2 slices were dissected and viewed under CLSM. The MIC of B. sacra was 1.25 mg/ml. The CFU evaluation proved that B. sacra are more effective than calcium hydroxide in the 3 days groups. However, it was statistically insignificant compared with calcium hydroxide after 7 days. The depth of penetration of B. sacra exceeds that of calcium hydroxide. B. sacra is an effective intracanal medicament.     

Effect of immediate calcium hydroxide treatment and permanent root-filling on periodontal healing in contaminated replanted teeth

The effect of immediate permanent root-filling and immediate intracanal calcium hydroxide treatment on experimentally contaminated and necrotized periodontal membranes (PDM) in avulsed and subsequently replanted monkey teeth was studied. Almost the entire root surface in the non-endodontically treated control teeth were covered with inflammatory resorption. A significant shift towards ankylosis not associated with root resorption (greater than 80% of the total root surface area) was noted following calcium hydroxide treatment. About two thirds of the root surfaces from the teeth with permanent root fillings showed surface resorptions or ankylosis preceded by root resorption. The root surface area which would have been covered by inflammatory resorption, unless endodontic treatment had been implemented, were instead predominantly covered by either surface resorption (permanent root filling) or ankylosis (calcium hydroxide treatment). Ankylosis compared with surface resorption may in the long term lead to progressive loss of root substance due to replacement resorption. It was concluded that calcium hydroxide may be an excellent initial intracanal treatment in teeth with healthy PDM, but care should be taken not to risk unnecessary development of ankylosis by prolonged treatment of teeth with compromised PDM.     

Calcium hydroxide in endodontic retreatment after two nonsurgical and two surgical failures: report of a case

AIM: To describe the role of calcium hydroxide in infection control during complex endodontic retreatment. SUMMARY: A case is presented in which two conventional endodontic treatments and two surgical interventions failed to bring periapical healing. Despite this history, a further conventional treatment augmented by long-term disinfection with calcium hydroxide finally delivered a successful outcome. KEY LEARNING POINTS: Periapical healing follows proper intracanal infection control. Despite repeated surgical and nonsurgical intervention, careful retreatment can often bring healing. Calcium hydroxide has long-acting antimicrobial and soft-tissue dissolving activity. It is a helpful adjunct in endodontic retreatment.     

Periradicular repair after two-visit endodontic treatment using two different intracanal medications compared to single-visit endodontic treatment

The number of appointments necessary to treat infected root canals is one of the most controversial issues in endodontics. This study evaluated, in dogs, the response of the periradicular tissues to the endodontic treatment of infected root canals performed in a single visit or in two visits, using different interappointment dressings. Periradicular lesions were induced by inoculating Enterococcus faecalis in the root canals. After confirming that a periradicular lesion developed, the root canals were treated within one or two visits, using either ozonized oil or calcium hydroxide in camphorated paramonochlorophenol (CMCP) as an intracanal medication. After 6 months, the animals were sacrificed and the specimens were processed for histological and histobacteriological analysis. The root canals treated in a single visit showed a success rate of 46%. When a calcium hydroxide/CMCP-based interappointment intracanal medication was used, 74% of the cases were categorized as success. In cases where ozonized oil was used as the intracanal medication, a success rate of 77% was observed. These results of the present study demonstrated that the two-visit treatment offered a higher success rate compared to one-visit therapy. In addition, ozonized oil may potentially be used as an intracanal medication.     

The diagnostic accuracy of microbiologic root canal sampling and the influence of antimicrobial dressings

The routine approach to endodontic treatment of teeth with apical periodontitis often involves an interappointment dressing with calcium hydroxide. However, investigations have demonstrated a negative influence of calcium hydroxide on the accuracy of microbiological root canal sampling (MRS). The aim of the present study was to investigate whether the use of a fluid dressing like 5% iodine potassium iodide (IPI) would increase the accuracy of MRS. Following instrumentation of 50 teeth with radiographically verified apical periodontitis the root canals received IPI as an intracanal dressing. One week after closure canals were sampled, "test sample" (TS), and then left filled with sampling fluid and temporarily scaled. Seven days later a "gold standard" (GS) sample was obtained. Bacteria were recovered in 22 teeth (44%) in TS as well as in GS. Fifteen teeth (30%) were positive for growth in both samples. Using the detection level "very sparse growth" of microbes the sensitivity and specificity of MRS reached 68% and 75%, respectively. In an earlier study, following the same experimental protocol, but with calcium hydroxide as intracanal dressing, the corresponding values were 33% and 81%. In 25% of these cases bacteria persisted in the canals. As compared to calcium hydroxide, the use of IPI resulted in improved test accuracy, but loss of antibacterial capacity. Conclusively, intracanal dressings seem to vary in their influence on the microbiologic test performance as well as in their antibacterial efficacy. In a clinical situation the choice of interappointment dressing should include consideration of these potentially conflicting properties.