Vitapex治疗根尖囊肿的临床疗效分析

目的:比较Vitapex糊剂作为根管消毒药物治疗较大根尖囊肿的临床疗效。方法:将临床诊断为根尖囊肿的52例患牙随机分为两组,每组26例,以氢氧化钙糊剂为对照组,根管内封氢氧化钙1周后即AH-plus糊剂和牙胶尖充填,6个月和12个月复诊。Vitapex糊剂为实验组,根管内封Vitapex 6个月,复诊时再以AH-plus糊剂牙胶尖充填,继续观察6个月,即12个月时复诊。比较6个月复诊及12个月复诊时实验组及对照组的治疗效果。结果:6个月复诊时,氢氧化钙组的成功率为73.1%,Vitapex组的成功率为76.9%。两组间无显著性差异。12个月复诊时,氢氧化钙组的成功率为69.2%,Vitapex组的成功率为92.3%,两组间有显著性差异。结论:根尖囊肿采取Vitapex多次封药,可以促进根尖病变愈合,提高疗效。     

一次性根管充填奥硝唑碘仿糊剂对根尖周炎的疗效评价

目的 评价一次性根管充填奥硝唑碘仿糊剂对根尖周炎(PP)的实效性。方法 选择自2012年1月至2013年7月期间无锡市惠山区堰桥医院接诊的PP患者96例,按根管治疗方式将患者分为:接受奥硝唑碘仿糊剂治疗的观察组和封入氢氧化钙糊剂治疗的对照组各48例, 2组均采用一次性根管填充,考察2种治疗方法的疗效,并对术后疼痛反应进行评价。结果 观察组的根尖周炎患牙术后疼痛反应的发生率为31.25%,明显低于对照组术后的发生率52.08%, 2组差异具有统计学意义(P<0.05)。术后一周,观察组的疼痛反应主要为0级和Ⅰ级;而对照组的主要表现为Ⅰ级和Ⅱ级。术后1年,观察组的有效率达89.58%(43/48),而对照组的有效率为70.83%(34/48), 2组相比差异具有统计学意义(P<0.05)。结论 一次性根管充填奥硝唑碘仿糊剂治疗根尖周炎比使用氢氧化钙糊剂的疗效更显著,能相对减轻疼痛,且术后临床有效性较高,适合在临床上推广应用。     

两种根管糊剂用于热牙胶根管充填的疗效观察

目的探讨两种根管糊剂在热牙胶根管充填中的临床应用效果。方法 145颗热牙胶根管充填治疗的单根管患牙,随机分为2组,Corstimol组72颗患牙根管充填时用Corstimol糊剂,AH-plus组73颗患牙根管充填时用AH-Plus糊剂,2年后回访观察2组的成功率,并行统计学分析。结果 2年后回访91颗患牙,回访率62.8%。两组根管糊剂充填2年后,Corstimol组回访42颗,成功34颗,成功率81.0%;AH-plus组回访49颗,成功45颗,成功率91.8%,比较临床效果差异有统计学意义(χ2=5.7857,P<0.05)。结论 AH-Plus糊剂用于热牙胶根管充填的疗效优于Corstimol糊剂。     

3种糊剂根充效果观察

目的 观察CRCS氢氧化钙糊剂、AH-plus糊剂、Cortisomol糊剂在根管充填术后1周的急性反应及1年的临床效果。方法 慢性根尖周病患牙360颗随机分成三组,其中CRCS氢氧化钙糊剂组119颗,AH-plus糊剂组117颗,Cortisomol糊剂组124颗。分别采用糊剂加牙胶尖根管充填,观察术后1周及1年的疗效。结果 CRCS氢氧化钙糊剂根充后1周无疼痛发生率为87.4%,根充后1年的总有效率为92.4%;AH-plus糊剂根充后1周无疼痛发生率为87.2%,根充后1年的总有效率为92.3%;Cortisomol糊剂根充后1周无疼痛发生率为84.7%,根充后1年的总有效率为91.1%;无统计学意义。结论 三种根充糊剂均为目前较理想的根充糊剂。     

AH-plus糊剂与碘仿糊剂在一次法根管治疗中的临床疗效观察

目的：比较AH-plus根充糊剂和碘仿根充糊剂在一次法根管治疗术中的临床疗效。方法：282个急性牙髓炎患牙随机分成两组。治疗组采用AH-plus＋牙胶尖充填根管,对照组采用碘仿根充糊剂＋牙胶尖充填根管,观察两组病例术后2天及1年后的临床效果。结果：根管充填2天后复查,治疗组疼痛发生率较对照组低,有显著性差异（P〈0.05）。术后一年复查,治疗组疗效优于对照组,有显著性差异（P〈0.05）。结论：AH-plus根充糊剂临床疗效优于碘仿根充糊剂。     

超声冲洗用于慢性牙髓炎一次法根管治疗术的临床评价

目的 评价根管超声冲洗技术对成人磨牙慢性牙髓炎一次法根管治疗术短期疗效的影响。方法 168 颗患牙按掷硬币的方法分为超声冲洗组86 颗和常规组82 颗,局麻下开髓、拔髓和根管预备,根管充填前常规组用2 mL 5.25% 的次氯酸钠溶液冲洗;超声冲洗组用2ml5.25% 次氯酸钠溶液注入根管,15号超声锉荡洗2min,期间不断补充新鲜液体。2组最后均使用17% EDTA 冲洗,吸干热牙胶垂直加压充填根管,窝洞暂封。3 天后复诊完成冠部充填。治疗后观察根管充填质量及侧枝根管充填情况、3天内疼痛发生情况以及1年后的治疗疗效。结果 超声组术后即刻侧支根管充填率提高,两组差异有统计学意义(P<0.05);根管充填后3 天内超声组疼痛发生率明显低于常规组(P<0.05);2 组1 年后疗效差异无统计学意义(P>0.05)。结论 超声冲洗能短期内降低术后疼痛发生率,提高侧支根管充填率,有很好的临床应用效果。     

新型纳米羟基磷灰石(n-HA)糊剂封闭根尖性能及其对病原菌抗菌活性的体外实验

目的：研究新型纳米羟基磷灰石根管充填糊剂（n-HA）、AH-Plus根管封闭剂的根尖封闭性能以及二者对感染根管优势菌牙龈卟啉单胞菌（Porphyromonas gingivalis,Pg）、具核梭杆菌（Fusobacteria nu-cleatum,Fn）、中间普氏菌（Prevotalla intermedius,Pi）生长的影响。方法：实验一34个离体单根管牙随机分为4组,用镍钛旋转器械Protaper预备根管,阳性对照（2个）、阴性对照（2个）、2个实验组（各15个）,分别用新型n-HA、AH-plus根充糊剂加牙胶尖以冷侧压法根充恰填,染料渗入法检查根尖微渗漏。实验二选用Pg、Fn、Pi作为实验菌株,常规打孔法测定新型纳米羟基磷灰石根管充填料、AH-Plus根管封闭剂的抑菌效果。结果：所有根充糊剂充填后根尖部位均有微渗漏,AH-plus组的微渗漏值低于n-HA组,2组结果间无统计学意义（P〉0.05）。n-HA与AH-Plus糊剂对Pg、Fn、Pi均有一定的抑菌作用,但n-HA的抑菌作用明显强于AH-Plus。结论：2种根充糊剂充填后都不能完全封闭根尖孔,AH-plus根充糊剂的根尖封闭性优于n-HA组。n-HA根充糊剂具有较理想的抑菌效果。     

三种根管糊剂在离体牙热牙胶充填中根尖封闭效果的比较研究

目的:以直接热牙胶充填后的根管密封性为标准,比较并评估cortisomol(碧兰)、vitapex、AH-plus三种不同根管糊剂在热才胶系统中充填根管后根尖封闭效果及差异.方法:选取62个离体单根管恒牙,截除牙冠,冠向下法根管预备后,其中56个随机均分为4组(每组14个):A组不使用根管糊剂,B、C、D组分别使用co...     

3种根充材料在一次法根管治疗中临床疗效观察

目的:比较三种根管充填材料一次法根充的临床疗效。方法:5 0 2个需根管治疗的患牙随机分为3组;分别采用Cortisomol糊剂加牙胶尖、Vitapex糊剂加牙胶尖、氧化锌糊剂加牙胶尖充填根管。观察术后1周内疼痛发生情况及1年后的疗效。结果:Cortisomol组和Vitapex组疼痛发生率较氧化锌组低,有显著性差异(P <0 .0 5 ) ;术后一年复查,Cortisomol组和Vitapex组总疗效好于氧化锌组,但无显著性差异(P >0 .0 5 )。根尖有暗影患牙的疗效Vitapex组好于Cortisomol组和氧化锌组,有显著性差异(P <0 .0 5 )。结论:Cortisomol糊剂和Vitapex糊剂充填根管可以有效减少一次性根管充填术后急症的发生,对根尖有暗影患牙的治疗Vitapex糊剂更有效。     

两种根充糊剂治疗乳牙根尖周炎的疗效观察

目的观察Vitapex糊剂与氧化锌丁香油糊剂应用于乳牙根充的临床疗效。方法选择186例乳牙患急、慢性根尖周炎病例,随机分为观察组(Vitapex)和对照组(氧化锌丁香油糊剂)各93例,观察根管充填后临床疗效。结果两组根充后根尖反应程度和治疗效果差异有显著性。观察组根充反应程度(6.48%)低于对照组(10.58%),根充成功率观察组(87.04%)高于对照组(74.04%)。结论采用Vitapex糊剂作为乳牙根尖周炎治疗后的充填药物,治愈成功率优于传统的根充药物。     

Endodontically treated teeth and periapical findings in the elderly

The radiographic quality of root-canal fillings, the prevalence of periapical findings and their associations with gender and age and were investigated in 133 dentate old people living at home (45 males and 88 females, aged 76, 81, and 86 years and who had endodontically treated teeth or periapical lesions. Sixteen per cent of the endodontically treated teeth (n= 507) exhibited periapical lesions, compared with 4% for the teeth not endodontically treated (P < 0.0001) (χ² test). Lesions were least prevalent in association with radiographically adequate root canal fillings (10%), and most prevalent in teeth with root canal post perforation (100%). Overfilled root canals and multi-rooted teeth with one or more unfilled roots also showed a high percentage of lesions (19% and 22%, respectively). Men had more periapical lesions than women in endodontically treated teeth (P < 0.0001, Mann-Whitney U-test), a finding contrary to previous studies in younger subjects. There were no other statistically significant differences between the sexes or age groups, although the percentage of root-filled teeth increased with age.     

Technical quality of root fillings and periapical status in root filled teeth in Jönköping,Sweden

Aim To study changes in technical quality of root fillings and periapical status in root filled teeth in random samples of 20 to 70 year‐olds between 1973 and 2003. Methodology Data from dentate subjects aged 20–70 years from examinations conducted in 1973 (n = 498), 1983 (n = 530), 1993 (n = 547) and 2003 (n = 491) were used for the analysis. Length of root fillings were measured on radiographs to the nearest 0.1 mm. Adequate seal was defined as a root filling without lateral and/or apical voids. Periapical status was assessed according to the periapical index. All observations were made by one calibrated observer registered from full mouth radiographic examinations. Teeth with root fillings ending within the canal without lateral or apical voids were considered adequate. The association between root filling quality and periapical status was analysed by means of the Chi‐squared test and a multilevel logistic regression analysis. Results Adequately root filled teeth had a significantly lower frequency of apical periodontitis than inadequately root filled teeth (11.8% vs. 22.8%). The frequency of technically adequate root fillings increased statistically significant from 1973 (23.7%) to 2003 (36.4%) without a concomitant improvement of the periapical status in root filled teeth over time (24.5% vs. 24.6%). Conclusions This study reports on an improving technical quality of root fillings over time, without a concomitant improvement of the periapical status in root filled teeth. A larger proportion of treated molars over time may be of importance for the result.     

The quality of root canal treatment and periapical status of permanent teeth in Turkish children and teens: a retrospective CBCT study

Objective

This study aimed to assess the quality of root canal fillings and the prevalence of periapical radiolucencies in the permanent teeth of 6–18 year-old Turkish children.

Methods

CBCT images of 150 patients’ 235 teeth with a mean age of 16.0?±?2.06 years were included. Root development stage, quality of root canal filling, the presence and severity of periapical radiolucencies, and their relationship with anatomical structures were recorded. Correlations between the quality of root canal filling, periapical lesion, and lesion size were assessed using regression analyses.

Results

A total of 235 teeth (528 root canals) were evaluated. 65.5% of root canals had periapical lesions. Immature roots and mandibular teeth had the highest prevalence and the largest size of periapical radiolucencies (p?<?0.05). Overfilling (n?=?52), underfilling (n?=?93), unfilled (n?=?46), inhomogeneously filled (n?=?113) root canals and poor coronal restoration (n?=?85 teeth) were observed in terms of technical failures of endodontic treatment. The quality of endodontic treatment was associated with the presence of periapical lesion and lesion size (p?<?0.05). Teeth with under-filled, overfilled or inhomogeneously filled root canals and poor coronal restoration had a periapical lesion larger than 5 mm (p?<?0.05). Immature teeth were most associated with the presence of lesion (OR?=?4.07) and the lesion size?>?5 mm (OR?=?3.71).

Conclusion

The prevalence of periapical radiolucencies in young permanent teeth showed an increase when the tooth was an incisor, had incomplete root development, or the root filling had technical errors.

     

Prevalence and quality of root canal fillings in a German adult population

The few studies in which prevalence, technical quality, and success rates of root canal fillings performed in daily practice have been assessed demonstrated a high proportion of inappropriate root fillings and a great variety of periapical radiolucencies (25–60%). The aim of the present retrospective radiographic study was to determine if changes in prevalence, technical quality, and success of root canal fillings had occurred within a decade. To achieve this goal, orthopantomograms taken in patients who attended a University Dental Clinic for the first time in 1983 (group A) and in 1992 (group B) were evaluated by a calibrated examiner. The following criteria were applied to assess the root-filled teeth: length and homogeneity of the root fillings and the periapical state. The prevalence of root-filled teeth increased significantly from an average 0.5 per person in 1983 to 0.8 per person in 1992. The increase was proportionally greater in older patients. In group A, 55.2% of the root fillings ended 0–2 mm before the radiographic apex and in group B this percentage was 56.8. Insufficient homogeneity was found in 25.0% (group A) and 21.9% (group B) of the root fillings. The prevalence of root-filled teeth without periapical destructions was 76.1% (group A) and 74.1% (group B). It is concluded that, in the future, endodontic treatment need will increase because of the steadily growing number of older people. Further efforts in research and dental education should focus on the treatment of curved root canals. Received: 5 May 1997 / Accepted: 30 March 1998     

光动力疗法对伴糖尿病根尖周炎患者的根管治疗效果

目的 观察光动力疗法对伴糖尿病根尖周炎患者的根管治疗疗效。方法 随机选择180例伴有糖尿病的根尖周炎患者，随机平均分为试验组和对照组，每组90例，对照组常规进行根管预备消毒，试验组行根管预备消毒+光动力辅助根管消毒。使用视觉量表法（VAS）评价根管预备术后3天局部疼痛状况，2年后根据患者临床症状、临床检查和X线检查情况统计根管治疗的成功率。结果 根管预备后3天，试验组疼痛反应轻于对照组，具有统计学差异(P<0.05)。根管治疗后2年，试验组成功率（93.33%）大于对照组（83.33%），具有统计学差异(P<0.05)。结论 对伴有糖尿病的根尖周炎患者，使用光动力疗法对其根管进行消毒，可减轻根管预备后急性疼痛症状，提高根管治疗的成功率。     

5种根管充填糊剂的根管封闭能力的比较

目的：比较5种根管充填糊剂的根管封闭能力。方法：选择75个直根管的恒牙,经开髓拔髓,Mtwo镍钛根管器械预备后反复冲洗后随机分为5组,分别采用实验组1：氧化锌丁香油糊剂,实验组2：Endomethasone根管充填糊剂,实验组3：Cortisomol根管充填糊剂,实验组4：Vitapex糊剂,实验组5：AH-plus糊剂,加牙胶尖严密充填。将所有离体牙置于37℃,100%湿度的恒温箱3d后选用透明牙染色法测量微渗漏深度。结果：实验组1：（2.35±0.768）mm,实验组2：（1.78±0.548）mm,实验组3：（1.54±0.322）mm,实验组4：（3.22±0.452）mm,实验组5：（0.98±0.536）mm。各组微渗漏深度值差异有显著性（P〈0.05）。其中实验组4的微渗漏值显著高于其他各组（P〈0.05）,实验组5的微渗漏值显著低于其他各组（P〈0.05）,实验组2的微渗漏值稍高于实验组3,结果无显著差异。结论：在Mtwo镍钛器械预备下,AH-Plus糊剂充填根管可有效的减少根管微渗漏的发生,但长远疗效有待进一步的观察。     

Cross-sectional evaluation of the periapical status and quality of root canal treatment in a selected population of urban Turkish adults

AIM: To investigate the prevalence of apical periodontitis and the quality of root canal treatment in an adult Turkish population who visited a university dental clinic. SUMMARY: The periapical status of 8863 teeth belonging to 375 patients was evaluated by two pre-calibrated observers from panoramic radiographs. The presence of apical periodontitis, and the prevalence and quality of root fillings were recorded. The relationship between the radiographic quality of root fillings and apical periodontitis was examined by chi-squared statistical-analysis. Of 8863 teeth, 470 (5.3%) had undergone root canal treatment. Forty-seven per cent of all the subjects had at least one root-filled tooth. Periapical radiolucencies were visible on 4.2% of teeth examined, with 53.5% of root-filled teeth presenting apical periodontitis. Ninety-one per cent of root-filled teeth with periapical pathosis were determined to have inadequate root fillings. A statistically significant correlation was found between the quality of root fillings and the presence of apical periodontitis (P < 0.05). KEY LEARNING POINTS: The radiographic quality of root fillings correlated with periapical radiographic signs of pathosis in a selected population of Turkish adults. There is a need to improve the standards of root canal treatment in the study population.     

The Influence of Missed Canals on the Prevalence of Periapical Lesions in Endodontically Treated Teeth: A Cross-sectional Study

IntroductionUntreated root canals may have a direct impact on the prognosis of root canal treatment. The objective of this cross-sectional study was to evaluate the association of missed canals with periapical lesions in endodontically treated teeth.MethodsOne thousand one hundred sixty preexisting cone-beam computed tomographic scans from 8 different health centers were assessed between January 2018 and December 2018 by 5 independently calibrated observers. Two thousand three hundred five endodontically treated teeth were identified in a sample of 20,836 teeth (27,046 roots). All endodontically treated teeth were evaluated for the presence or absence of missed root canals and periapical lesions. The z test for proportions was used to analyze differences between groups, and an odds ratio was calculated in order to analyze the association between missed canals and lesions. P < .05 was considered statistically significant.ResultsThe prevalence of missed canals was 12.0%, and teeth with untreated canals were associated with periapical pathology in 82.6% of the cases. The root presenting with the highest percentage of missed canals (62.8%) was the mesiobuccal root of the maxillary first molar, being associated with periapical lesions in 75.2% of cases. Maxillary molar mesiobuccal roots presenting with a missed canal were 3.1 times more likely to be associated with periapical pathology than maxillary molars with all canals identified and treated.ConclusionsThe association between untreated root canals and the presence of periapical lesions noted in the present study shows that missed canals have a significant impact on treatment prognosis.     

Periapical status of root-filled teeth in Norwegian children and adolescents

Objective. To study the periapical status of root-filled permanent teeth of 9–17-year-olds in Møre & Romsdal county, Norway. Materials and methods. All permanent teeth with endodontic treatment in patients born in 1994–2001 were identified in the dental records of the Public Dental Service. The data collected consisted of chart entries and radiographs. Of 1182 teeth, 174 teeth in 155 patients met further inclusion criteria, i.e. completed endodontic treatment and a follow-up with a readable radiograph of at least 1 year. Periapical status was assessed with the Periapical Index (PAI) and the technical quality of the root fillings was also quantified on a 4-grade visual scale. Results. Apical periodontitis was found on follow-up radiographs in 25% of all teeth and in 48% of the teeth with pre-operative apical periodontitis. Forty-two per cent of root fillings were of adequate technical quality. Adequate technical quality of the root filling was significantly correlated with radiographic success. Conclusions. About one fourth of all root-filled teeth and almost half of the teeth with pre-operative apical periodontitis showed clear signs of the disease at recall.     

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

Objective

This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation.

Material and Methods

The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test.

Results

The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth].

Conclusions

The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.