Mtwo机用镍钛锉根管预备的临床效果观察

目的探讨Mtwo机用镍钛锉预备根管的临床效果。方法选取拟行根管治疗的患牙80颗,随机分为试验组和对照组,每组40颗,试验组采用Mtwo机用镍钛锉及改良逐步后退法进行根管预备,对照组采用手用不锈钢K锉和逐步后退法进行根管预备,2组均采用侧向加压法充填根管。比较2组的根管预备时间、根管预备术后疼痛反应和根管充填质量。结果试验组根管预备时间平均为（5.81±0.95）min/根,对照组平均为（13.45±1.08）min/根,试验组明显短于对照组,差异有统计学意义（t=17.15,P〈0.05）;试验组根管预备术后疼痛发生率明显低于对照组,且差异有统计学意义（χ2=4.45,P〈0.05）;试验组根管适充率96.6%,对照组根管适充率85.2%,2组差异有统计学意义（χ2=5.79,P〈0.05）。结论Mtwo机用镍钛锉预备根管快速有效,根管成形、根管充填效果好,并发症少,值得临床推广。     

C+锉在磨牙根管再治疗中的应用

目的  评价C+锉应用于磨牙根管再治疗其疏通根管的临床效果。方法  选取需根管再治疗的磨牙60颗，随机分成2组，分别用C+锉和不锈钢K锉进行根管疏通，机用ProTaper完成根管预备并垂直加压充填，X线片评价根管疏通的效果。结果  C+锉疏通根管的成功率高于不锈钢K锉（P <0.05）,为87.7%。结论  C+锉在磨牙根管再治疗中有良好的疏通效果，但应注意预防根管侧穿。

     

Accidental ingestion of foreign object: Systematic review,recommendations and report of a case

One of the serious complications during a routine endodontic procedure is accidental ingestion/aspiration of the endodontic instruments, which can happen when proper isolation is not done. There are at present no clear guidelines whether foreign body ingestion in the gastrointestinal tract should be managed conservatively, endoscopically or surgically. A 5 year old boy reported to the Department of Pediatric and Preventive Dentistry, D.A. Pandu Memorial R.V. Dental College, Bangalore, India, with a complaint of pain and swelling in the lower right back teeth region. Endodontic therapy was planned for the affected tooth. During the course of treatment the child accidentally swallowed a 21 mm 15 size K file. Endoscopy was performed immediately but the instrument could not be retrieved. The instrument passed out uneventfully along with the stools 48 h after ingestion.Careful evaluation of the patient immediately after the accident helps in managing the patient effectively along with following the recommended guidelines.     

超声根管预备效果的猴牙实验研究

４只猴的６４个牙，造成实验性尖周炎后，随机分２组进行超声或手持器械预备极管。分别于治疗后３、６、９、１２个月将猴处死，每个牙根经根尖孔制６μｍ厚的牙颌组织切片，１式３份，经不同染色显示尖周的炎症状况和根管系统内细菌的存在状况，结果表明，不论哪一种方法都不能彻底去除极管系统内的细菌和牙髓组织；所有切片均显示不同程度的尖周炎症。     

Diabetes increases interleukin-17 levels in periapical,hepatic, and renal tissues in rats

ObjectivesThis study aimed to evaluate the association between endodontic infection and diabetes on interleukin-17 levels in periapical, hepatic, and renal tissues of rats.DesignForty male rats were divided into groups: normoglycemic rats (N), normoglycemic rats with apical periodontitis (N-AP), rats with experimental diabetes (ED), and rats with experimental diabetes and apical periodontitis (ED-AP). Diabetes was induced by intravenous streptozotocin injection, and blood sugar levels were monitored to confirm disease development. Apical periodontitis (AP) was induced by pulp exposure to the oral environment during 30 days. After 30 days, hepatic and renal tissues were obtained, and IL-17 levels were quantified by ELISA. The right hemi-jaw was used to quantify IL-17 levels by immunohistochemistry. The values obtained in parametric tests were tabulated and analyzed statistically by analysis of variance (ANOVA) and Tukey tests, and the values obtained for scores were statistically analyzed by using the Kruskal-Wallis and Dun tests. The level of significance was set at 5%.ResultsED and ED-AP groups expressed significantly higher IL-17 levels in both hepatic and renal tissues (p < 0.05), compared to N and N-AP groups. Apical periodontitis (AP) in ED-AP group was significantly more severe than that in N-AP group (p < 0.05). Furthermore, there was a significantly larger increase in the IL-17 levels in ED-AP group compared to N group (p < 0.05).ConclusionOur results indicate that diabetes increases IL-17 levels in hepatic and renal tissues and also enhances IL-17 production in apical periodontitis area of rats.     

Pathfile与WaveOne联合运用在模拟根管内的成型效果

目的 评价Pathfile与WaveOne联合运用在树脂模拟弯曲根管的成型效果.方法 选用20个弯曲根管树脂模块分组为W组(WaveOne)、PW组(Pathfile+WaveOne),记录两组根管预备的时间、器械分离的数量,并且通过扫描仪获取这两组预备前后的根管图像.使用Photoshop与ImageJ2X软件进行图像重叠并测量根管弯曲的变化值.从距根尖孔1 mm作为第一个观测点,在根管长轴方向每隔1 mm定一个观测点,测量每个观测点在弯曲内、外侧树脂去除量,共10个观测点,计算中心定位力.ImageJ2X软件测量根管内外侧壁的树脂去除量.对两组内,外侧去除树脂量的多少进行分析和比较.结果 两组均无器械分离的现象,两组根管预备的时间及两组根管预备长度变化的差异无统计学意义(P>0.05).但在距根尖4、5 mm位点处W组偏移程度为别为-0.085±0.05 mm、-0.312±0.068 mm,PW组的偏移程度分别为:-0.071±0.042 mm、-0.26±0.103 mm,两组间差异有统计学意义(P<0.05).结论 两组均能较好的完成根管预备,但两组预备后在根管中下段均有部分偏移,PW组的偏移程度较W组小.     

汉族与维吾尔族慢性根尖周炎患者根管治疗后疼痛差异及口服布洛芬后镇痛效果比较

目的:比较汉族、维吾尔族慢性根尖周炎患者根管治疗术后疼痛发生率,比较布洛芬对汉族、维吾尔族慢性根尖周炎患者一次性根管治疗后疼痛的镇痛效果,优化术后用药方案.方法:选取切牙、尖牙、前磨牙单根管慢性根尖周炎的汉族、维吾尔族患者各250例,均给予一次性根管充填治疗.术后按照随机双盲原则,分别将维吾尔族患者分为实验组(维)、对照组(维),将汉族患者分为实验组(汉)和对照组(汉).其中实验组患者参照说明书,服用布洛芬缓释胶囊,对照组患者则服用安慰剂(淀粉胶囊),医生与患者在整个实验过程中对分组和服药情况均保持不知情.利用VAS痛觉量表记录患者术后6、12、24、48、72 h和1周的疼痛程度,采用SPSS11.0软件包对数据进行x2检验.结果:实验期间,各组患者根管治疗后疼痛的发生率从大至小依次为对照组(维)＞对照组(汉)＞实验组(维)＞实验组(汉),各组两两之间均有显著差异.从时间分布上来看,根管治疗后疼痛多发生于24～48 h之间,疼痛的最大值也多集中在这一时间段.不论是根管治疗术后疼痛的发生率还是剧烈程度,实验组(汉)与对照组(汉)之间的差异,均比实验组(维)和对照组(维)之间的差异更为显著.结论:单根管慢性根尖周炎一次性根管治疗后,维吾尔族患者疼痛发生率高于汉族患者;服用布洛芬对于维吾尔族和汉族患者都能有效预防、缓解根管治疗中疼痛,但是布洛芬对于维吾尔族患者的镇痛效果不如对汉族患者的镇痛效果明显.