应用釉质成形预防性树脂修复年轻恒牙畸形中央尖的临床观察

目的观察釉质成形预防性树脂修复法预防年轻前磨牙畸形中央尖折断的临床效果,并与一次性磨除间接/直接盖髓后树脂修复法作一比较。方法选择口内前磨牙畸形中央尖对称性萌出且未达咬合平面的患儿20例,62颗患牙,随机分为两组:釉质成形预防性树脂修复组(即树脂加固组)和一次性磨除间接或直接盖髓后树脂修复组,每组各31颗患牙,随访观察1年。结果釉质成形预防性树脂修复组未发现有失败病例,一次性磨除组31颗患牙中有4颗失败,成功率为87.10%,二者差异无统计学意义(P>0.05)。结论早期发现畸形中央尖患牙,并在其未达咬合平面之前应用釉质成形预防性树脂修复方法加固畸形中央尖,可以有效预防畸形中央尖的折断,保证其牙根正常发育。     

不同盖髓材料用于盖髓术的临床研究

目的 比较可乐丽菲露SE3 BOND和Dycal氢氧化钙盖髓的临床效果。方法 将79例患者的84颗患牙分成2组,乐丽菲露SE3 BOND 组62颗患牙,Dycal氢氧化钙组22颗患牙。2组病例分别用Dycal氢氧化钙以及可乐丽菲露SE3 BOND盖髓,光固化玻璃离子垫底,光固化复合树脂充填。结果 盖髓治疗8个月后追踪观察,深龋近髓的患牙用Dycal氢氧化钙盖髓的成功率93.5%,与用可乐丽菲露SE3 BOND盖髓（87.1%）比较,差异无统计学意义(P>0.05）;深龋穿髓的患牙用Dycal氢氧化钙盖髓的成功率（75%）明显高于可乐丽菲露SE3 BOND（50% ）,差异有统计学意义（P<0.05）。结论 在深龋近髓患牙盖髓术治疗中,可乐丽菲露SE3 BOND和Dycal氢氧化钙的疗效均佳,但在深龋穿髓患牙盖髓术治疗的病例中,Dycal氢氧化钙对深龋穿髓疗效明显优于可乐丽菲露SE3 BOND。     

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目的探求适合青少年前磨牙畸形中央尖的治疗方法。方法选择2007年6月至2009年6月来济宁口腔医院儿童牙科就诊的前磨牙畸形中央尖患儿30例(54颗患牙),按就诊顺序随机分为两组:一次磨除法组(15例,29颗患牙)采用一次磨除后盖髓充填法,多次磨除法组(15例,25颗患牙)采用多次少量磨除法,随诊观察1年。结果治疗1年后复查,一次磨除法组治疗成功率为93.1%,多次磨除法组成功率为72.0%,二者差异有统计学意义(P<0.05)。结论早期在局麻下对前磨牙畸形中央尖进行磨除并盖髓充填的治疗方法有着积极的临床意义。     

多发多病程前磨牙畸形中央尖1例

该文报道1例因畸形中央尖折断导致严重根尖周感染的患者,其双侧上颌第二前磨牙、下颌前磨牙共6颗牙均患畸形中央尖,而且患牙处于不同病变发展阶段,经对症处理,治疗效果良好。结合该罕见病例并回顾相关文献,总结畸形中央尖患牙的临床表现、分类和相应的治疗措施,为畸形中央尖患牙的早期诊疗和其继发病变的预防提供切实可行的方案。     

TheraCal LC和Dycal两种盖髓剂用于乳牙和恒牙直接盖髓的疗效比较

目的 比较TheraCal LC和Dycal两种盖髓剂用于乳、恒牙直接盖髓术的临床疗效。方法 选择深龋意外露髓的乳牙180颗和恒牙243颗做直接盖髓术,乳、恒牙均按单双数就诊顺序采用半随机方法分为两组,乳牙TheraCal LC组81例患者（90颗牙）;乳牙Dycal组76例患者（90颗牙）。恒牙TheraCal LC组102例患者（122颗牙）;恒牙Dycal组109例患者（121颗牙）。术后12个月,比较两种材料的治疗成功率。结果 治疗12个月后,恒牙TheraCal LC组成功率为95.1%,恒牙Dycal组成功率为93.3%,两组之间差异无统计学意义（P>0.05）。乳牙TheraCal LC组成功率为87.7%,乳牙Dycal组成功率为46.9%,两组之间有显著差异（P<0.05）。结论 TheraCal LC盖髓剂更适合乳、恒牙的盖髓剂,乳牙的优势可能更为明显。     

应用窝沟封闭剂预防畸形中央尖折断的疗效观察

目的探讨应用窝沟封闭剂预防畸形中央尖折断的治疗效果。方法对21例患儿共31颗萌出但未达到咬合平面、具有细而高的畸形中央尖患牙,采用窝沟封闭剂进行预防性加强固定、同时逐步调磨的治疗。观察1年以上是否发生畸形中央尖折断、牙髓感染症状,判断为治疗成功和不成功。结果 30颗患牙治疗成功,1颗治疗失败,成功率为96.7%。结论应用窝沟封闭剂和分次调磨能有效地避免细而高的畸形中央尖牙在咬合过程中折断,是一种较好的预防性治疗方法。     

MTA用于犬牙直接盖髓术的组织学观察

目的 通过组织学观察，比较MTA（Mineral Trioxide Aggregate)和氢氧化钙制剂(Dycal)在直接盖髓时对牙髓的影响。方法 3条健康杂种犬尖牙12颗，随机分为2组：MTA，Dycal。用裂钻在尖牙唇侧颈部穿髓后以MTA和Dycal盖髓，GIC修复牙体缺损。4个月后将犬处死取下尖牙，常规制作组织切片，观察牙髓炎症反应和牙本质桥形成情况。结果 MTA盖髓的实验组中，5／6无炎症或仅有轻度炎症反应，该组所有标本均有牙本质桥形成。Dycal盖髓的对照组牙髓均有轻度或中度的炎症反应，只有2例出现了牙本质桥。结论 MTA具有良好的生物相容性，适用于直接盖髓术，有望替代现有的盖髓材料。     

富血小板血浆用于犬牙直接盖髓的实验研究

目的:观察富血小板血浆(platelet-rich plasma,PRP)直接盖髓后修复性牙本质的形成。方法:成年雄性健康杂种犬2只,分别取静脉血制备PRP后,选取每只犬的所有切牙,尖牙和前磨牙共48个牙作为对象,于颈部制作穿髓模型后,按拆分口设计原则随机分为6组(MTA、Dycal、MTA+PRP、Dycal+PRP、PRP、空白),分别用相应盖髓剂进行直接盖髓治疗,3个月后应用牙科CT观察各组穿髓处硬组织和牙本质桥形成情况。结果:实验3个月后,MTA,MTA+PRP,Dycal+PRP组修复性牙本质形成的效果均优于单纯氢氧化钙组(Dycal)。PRP组、空白组无完整的牙本质桥形成。结论:PRP+Dycal能促进犬富血小板血浆牙髓组织修复,是一种很有希望的复合型生物盖髓剂。     

畸形中央尖折断的预防性充填及根尖诱导治疗的体会

畸形中央尖是一种牙齿形态异常。其发生率约为2%~10%[1],且多发于下颌前磨牙,多呈对称性分布。牙齿萌出不久,在咬合过程中,中央尖的磨损或折断,导致牙髓感染坏死,造成牙根发育中断。畸形中央尖早期发现及时治疗、预防性充填具有重要意义。我科自2000~2005年以来对46例92颗畸形中央尖患牙进行治疗,追踪观察1~4年,大多数牙根能钙化封闭,根尖继续发育完成。现报道如下。1临床资料1.1一般资料本组资料共46例92颗畸形中央尖患牙,男性21例,女性25例,年龄8.5~12岁。所选病例均为双侧对称发生的畸形中央尖患牙,下颌第一前磨牙20例,下颌第二前磨牙26…     

Dycal在上前牙烤瓷冠备牙穿髓时直接盖髓的应用

目的 探讨在烤瓷冠美容修复上前牙的备牙过程中，部分穿髓牙活髓保存的可能性。方法 应用Dycal对43颗活髓牙的穿髓处即刻直接盖髓，而后取模行烤瓷冠修复。结果 经过6个月至3年的观察，除2例失败处，其余均获得满意的疗效。结论 在上前牙备牙过程中，可应用Dycal在穿髓孔处行即刻直接盖髓，以保存活髓，从而取代拔除牙髓，一性性根充的疗法。     

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目的观察Dycal和矿物三氧化物凝聚体（MTA）在大鼠磨牙直接盖髓后骨形态发生蛋白（BMP）-2的表达变化。方法本研究于2011年3月至2012年12月在中国医科大学口腔医学院中心实验室及辽宁省口腔医学研究所进行。42只雌性Wistar大鼠双侧上下第一磨牙分别用Dycal和MTA直接盖髓，在各观察时点（盖髓后12h及1、3、7、14、21、28d）处死动物取材，进行BMP-2免疫组织化学染色，用图像分析软件测定各组标本中BMP-2阳性染色的平均光密度值。用SPSS13．0统计软件对数据分别进行配对t检验和Dunnett-t检验。结果在正常牙髓组织中BMP-2表达呈阴性，Dycal和MTA直接盖髓后12h牙髓中BMP-2出现低水平表达并逐渐增强，7d时达到高峰，14d后表达开始下降，至28d时接近正常水平。MTA组修复性牙本质形成较Dycal组连续且致密，7、14d时MTA组BMP-2表达强度高于Dycal组。结论MTA组形成修复性牙本质较Dycal组连续且致密，BMP-2的表达高于Dycal组；MTA可能通过调节BMP-2的表达参与诱导修复性牙本质的形成，BMP-2的表达强度可能影响了牙髓损伤修复。     

两种不同盖髓剂对人牙髓细胞毒性的体外研究

目的:研究丁香酚及Dycal对人牙髓细胞的毒性。方法:体外组织块法培养人牙髓细胞,采用噻唑蓝比色法(MTT法)及台盼蓝染色活细胞计数法来评价不同浓度及不同时间段丁香酚及Dycal对牙髓细胞细胞毒性,比色法测定丁香酚干预组细胞内总谷胱甘肽含量。结果:0.1mmol/L浓度的丁香酚及0.1%浓度的Dycal对人牙髓细胞毒性明显,其对细胞毒性反应成浓度及时间依赖性改变。各丁香酚组细胞内谷胱甘肽含量低于对照组,第3天丁香酚最低浓度组细胞内谷胱甘肽含量高于高浓度组。结论:高浓度丁香酚及Dycal对牙髓细胞毒性明显,细胞毒性与浓度及作用时间有关。低浓度丁香酚可能通过谷胱甘肽的参与抵抗氧化应激,从而起到对细胞的保护作用。Dycal可能更加适合用于间接盖髓。     

Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial

AIM: To investigate the pulpal response to direct pulp capping in healthy human teeth with mineral trioxide aggregate (MTA) as against calcium hydroxide cement (Dycal) as control. METHODOLOGY: Twenty healthy human third molars had iatrogenic pulpotomy and direct pulp capping with MTA. Another 13 teeth were capped with Dycal as controls. The teeth were restored, with IRM, clinically reviewed and extracted after a number of pre-determined intervals (1 week, 1 month and 3 months). The specimens were fixed, decalcified, subdivided axially into two halves in the oro-buccal (lingual-buccal) plane, embedded in plastic, serial sectioned and evaluated qualitatively and quantitatively by correlative light and transmission electron microscopy with appropriate statistical evaluation of the quantitative data. RESULTS: Iatrogenic pulpal wounds treated with MTA were mostly free from inflammation after 1 week and became covered with a compact, hard tissue barrier of steadily increasing length and thickness within 3 months following capping. Control teeth treated with Dycal revealed distinctly less consistent formation of a hard tissue barrier that had numerous tunnel defects. The presence of pulpal inflammation up to the longest observation period (3 months) after capping, was a common feature in Dycal specimens. CONCLUSIONS: The MTA was clinically easier to use as a direct pulp-capping agent and resulted in less pulpal inflammation and more predictable hard tissue barrier formation than Dycal. Therefore, MTA or equivalent products should be the material of choice for direct pulp capping procedures instead of hard setting calcium hydroxide cements.     

A clinical and histological evaluation of conservative pulpal therapy in human teeth.

Three intermediary base materials, a zinc oxide-eugenol (Cavitec) and two calcium hydroxide liners (Life and Dycal), were selected at random for use as a base beneath amalgam or composite restorations on humans following complete caries removal. Life and Dycal, selected at random, were also used as direct and indirect pulp capping agents as clinically indicated. Clinical evaluations of signs and symptoms were made before treatment and at one-week, six-month, and one-year intervals following treatment. Histological evaluations were performed on three complete caries removal teeth and 18 direct pulp capping teeth six months following treatment. No significant differences in clinical symptomatology resulted between the materials in the complete caries removal group or the indirect and direct pulp capping groups.     

Anti-inflammatory and Mineralization Effects of ProRoot MTA and Endocem MTA in Studies of Human and Rat Dental Pulps In Vitro and In Vivo

Introduction

Few studies have reported direct pulp capping in inflamed pulp conditions. The purpose of this study was to investigate the in vitro and in vivo responses of dental pulp during direct pulp capping using various pulp capping materials in inflamed conditions.

A comparative histological analysis of human pulp following direct pulp capping with Propolis, mineral trioxide aggregate and Dycal

Background:  Permanent teeth pulp exposures have traditionally been treated with calcium hydroxide pulp capping. The aim of this study was to investigate the response of human pulp tissue which were mechanically exposed to a new material, Propolis and compare it with two existing and commonly used pulp capping agents (mineral trioxide aggregate and Dycal).
Methods:  Thirty-six intact human premolars were mechanically exposed. Teeth were divided into six groups of 6 teeth each and were capped with Propolis, mineral trioxide aggregate and Dycal. Final restoration was done with posterior composite resin using light cured glass ionomer cement as a liner. The teeth were then extracted on the 15th or the 45th day and processed for histological evaluation.
Results:  Differences in inflammatory response and dentine bridge formation of the exposed pulp to the three different materials were statistically calculated using chi-square test and were found to be non-significant. There was more pulp inflammation in teeth treated with Dycal than with Propolis and MTA on the 15th as well as on the 45th day. Propolis and MTA showed bridge formation in more teeth, and the bridges were in closer proximity to pulp capping material than teeth treated with Dycal on the 45th day.
Conclusions:  The response of pulps to Propolis as a pulp capping agent was comparable to MTA and Dycal.