一次性根管治疗术对急性牙髓炎的临床效果评价

目的评价与研究一次性根管治疗术对急性牙髓炎的临床效果。方法在特定时间段内(2018年10月~2019年10月)选取66例急性牙髓炎患者,对其进行随机编号(1~66号),1~33号采取多次根管治疗(对比组,n=33),34-66号给予一次性根管治疗(研究组,n=33),比较临床效果。结果研究组临床总有效率(96.97%)高于对比组(81.82%),差异显著,P<0.05。结论给予急性牙髓炎患者一次性根管术治疗,临床总有效率较高。     

一次法根管治疗术治疗牙髓病和根尖周病疗效

目的通过在临床中应用一次法根管诊治根尖周病和牙髓病的疗效显著。方法本文主要选取我院在2018年5月~2019年5月就诊的110例牙髓病和根尖周病患者,在采用随机抽选的方法后将这些患者分为对观察组和对照组。其中观察组采取的治疗方法为一次法根管治疗术;观察组采用的治疗方法为多次法根管治疗术。结果观察组无论是从疼痛评分方面还是在疼痛率方法均低于对照组,且差异具有统计学意义(P<0.05)。结论在治疗牙髓病和根尖周病时采用一次法根管治疗术,其临床疗效较为显著,能够缓解患者的疼痛,值得在临床中进行推广。     

AH-Plus和RoekoSeal用于根管充填在牙髓病治疗中的效果比较

目的 AH-Plus和RoekoSeal用于根管充填在牙髓病治疗中的效果比较.方法 对95例患者进行随机分组,两组患者接受常规检查及牙齿硬组织龋坏清除处理后,治疗组患者接受AH-Plus根管充填治疗,对照组患者接受RoekoSeal根管充填治疗.疗效标准分以痊愈、显效、有效、无效四项标准,对两组患者的治疗成效进行对比....     

一次性根管治疗牙髓炎的临床效果及可行性

目的探讨牙髓炎实施一次性根管治疗的临床效果及可行性。方法将牙科120例牙髓炎患者(2018年1月到2020年6月间)纳入研究,根据患者实际治疗方案分为:一次组(n=60)、常规组(n=60),对一次组实施一次性根管治疗,对常规组实施常规根管治疗,分析效果。结果一次组治疗后2年总有效率与常规组组间对比更高,一次组中并发症发生率与常规组组间对比更低,一次组治疗后2周C反应蛋白水平与常规组组间对比更低,一次组患者对治疗体验和口腔功能恢复满意度评分与常规组组间对比更高,差异显著(P<0.05)。结论牙髓炎实施一次性根管治疗效果良好,且可提升炎症控制效果,减少并发症,提升患者满意度。     

不同根管填充程度对牙体牙髓治疗患者的疗效影响分析

目的探讨不同根管填充程度对牙体牙髓治疗患者的疗效影响。方法将2017年3月~2019年6月于我院治疗的330例牙体牙髓患者纳入本次研究对象,根据不同的根管填充程度等分为Ⅰ组、Ⅱ组、Ⅲ组,Ⅰ组为适充组110例,Ⅱ组为超充组110例,Ⅲ组为欠充组110例,观察对比三组治疗效果并进行分析。结果Ⅰ组适充患者的治疗有效率95.45%要明显优于Ⅱ组超充治疗有效率76.36%和Ⅲ组欠充治疗有效率77.27%,p<0.05;Ⅱ组超充治疗有效率和Ⅲ组欠充治疗有效率之间无太大差别,P>0.05;Ⅰ组适充患者的并发症发生几率2.73%明显低于Ⅱ组超充患者19.09%和Ⅲ组欠充治疗患者20.90%,P<0.05;Ⅱ组超充患者并发症发生几率和Ⅲ组欠充患者并发症发生几率之间无太大差别,P>0.05。结论不同根管填充程度能够直接影响牙体牙髓患者的治疗效果,但超充或欠充都会使治疗效果降低,建议治疗时结合患者的病牙情况选择最合适的根管填充治疗方式。     

根尖疏通对老年人根管治疗术后疼痛的临床评价

目的评价根尖疏通对老年人根管治疗术后疼痛。方法病例选取时间开始于2018年4月结束于2019年9月,研究样本定义为62例我院收治的老年根管治疗患者,根据就诊次序分为两组(研究组与对照组)各31例。对照组患者为非根尖疏通,研究组进行根尖疏通。对比两种治疗方法术后12h、24h、48h、6d疼痛。结果研究组治疗12h、24h、48h、6d后,患者疼痛评分低于对照组(P<0.05)。结论本研究中患者无剧痛、急性疼痛现象。老年人根尖牙周炎根管治疗中,根尖疏通可改善疼痛现象。     

活性银离子抗菌液对根管冲洗的疗效评价

目的评价活性银离子抗菌液对根管冲洗的临床效果。方法将120例根尖周病变患者,随机分为观察组与对照组,每组60例,对照组患者采用0.3%过氧化氢冲洗根管,观察组采用0.3%过氧化氢+活性银离子抗菌液冲洗根管,对两组患者根管冲洗治疗后1年的有效率进行分析对比。结果观察组患者治疗有效率为95.0%;对照组治疗成功率为80.0%,观察组治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。结论活性银离子抗菌液具有较强的抗菌作用,是临床根管冲洗的一个较好选择,其与0.3%过氧化氢联合使用更能有效杀灭感染根管内的细菌,提高根管治疗的成功率。     

冠修复与根管治疗同步治疗牙隐裂的疗效

目的探讨治疗牙隐裂同步使用冠修复与根管治疗的效果。方法选择2018年5月~2019年7月我院收治的56例牙隐裂患者,随机分入对照组和观察组。其中观察组用冠修复和根管治疗同步治疗法,对照组用传统治疗法。疗程结束后对其疗效与患者满意度进行对比。结果观察组疗效总有效率和患者度均高于对照组,其差异具备统计学意义(P<0.05)。结论冠修复与根管治疗同步治疗牙隐裂可以有效缓解患者症状,减少治疗所需时间,提高患者的满意度,可以进行临床推广应用。     

三种测量根管工作长度方法准确性的评价研究

目的比较与评价临床常用的手感法、X线指感法和ROOT ZX电测法测定根管工作长度的准确性.方法随机将101例患者、150颗需根管治疗的牙齿分成3组,每组50颗,分别用手测法、X线指感法和ROOT ZX法测定根管工作长度,比较其准确度.结果ROOT ZX法与X线指感法的适填率为94%、92%,差异无显著性,手感法的适填率为76%,ROOT ZX法与手感法差异有显著性.结论ROOT ZX组在减少术后超填方面优于手感法.ROOT ZX组与X线指感法无显著差异,但ROOT ZX测量根管操作方便,患者受到的辐射少,费用低.     

去髓术、根管治疗术一次法治疗慢性牙髓炎的临床疗效及其安全性研究

目的针对慢性牙髓炎患者,探讨去髓术、根管治疗术一次法的治疗效果及其安全性。方法收集2108年1月~2018年12月在我院治疗的慢性牙髓炎患者72例,按照数字法随机分成实验组和参照组。实验组采取去髓术、根管治疗术一次法治疗,参照组采取常规的根管治疗术。对比两组的治疗效果。结果实验组治疗有效率为97.22%,参照组为83.33%,实验组的治疗效果优于参照组,差异具有统计学意义(P<0.05);两组均无严重不良反应。结论将去髓术、根管治疗术一次法用于慢性牙髓炎的治疗,可有效缓解临床症状,且安全性高。     

Tooth anatomy risk factors influencing root canal working length accessibility

The aim of this study was to analyze the specific influence of root canal anatomy on the accessibility of working length during root canal therapy. Four hundred seventy-six root canal therapy cases (amounting to a total of 1 005 root canals) were examined. The anatomy risk factors assessed in each case included: tooth type (tooth location), root canal curvature, and root canal calcification, as well as endodontic retreatment. The investigation examined the correlation between each of these anatomic factors and the working length, with statistical analysis consisting of Chi-square tests and multiple logistic regression analysis. In an independent factor analysis, tooth type (tooth location), root canal curvature, canal calcification, and endodontic retreat- ment were determined to be the primary risk factors. In a multiple-factor regression model, root curvature and canal calcification were found to most significantly influence root canal working length accessibility (P<0.05). Root canal anatomy increases the difficulty of root canal preparation. Appropriate consideration of tooth anatomy will assist in accurate determination of preparation difficulty before instrumentation. This study alerts clinical therapists to anatomical factors influencing the working length accessibility, and allows for a direct estimate of success rate given in situ measurements of tooth factors during the root canal treatment procedure.     

盐酸米诺环素辅助根管治疗牙周-牙髓联合病变的可行性分析

目的探析牙周-牙髓联合病变采取盐酸米诺环素辅助根管治疗的临床可行性。方法选取2019年5月~2020年8月于本院就诊的牙周-牙髓联合病变患者,统计52例,以随机法分组,即对照组(n=26)和实验组(n=26),对照组予根管治疗,且服用替硝唑片,实验组以此为基础采取盐酸米诺环素,比较两组效果。结果实验组有效率与对照组比明显提高(P<0.05);实验组各临床指标明显著优于对照组(P<0.05);两组不良反应无较大差异(P>0.05)。结论牙周-牙髓联合病变采取盐酸米诺环素辅助根管治疗效果理想,应用安全性及可行性高,值得推广。     

An in vitro study on the efficacy of removing calcium hydroxide from curved root canal systems in root canal therapy

To compare the efficacy of various irrigants (citric acid, ethylenediaminetetraacetic acid (EDTA) and NaOCl) and techniques in removing Ca(OH)2 in two types of curved root canal systems, simulated root canals with specific curvatures were used to investigate the effects of different irrigants and instruments on Ca(OH)2 removal. The optimal methods were verified on extracted human teeth. Simulated root canals were assigned to one of two groups based on the irrigation solution:10% citric acid or 2.5%NaOCl. Each group was divided into four subgroups according to the technique used to remove Ca(OH)2. The percentage of Ca(OH)2 removal in different sections of root canals was calculated. On the basis of the results obtained for the simulated canals, 10%citric acid and 17% EDTA were applied to remove Ca(OH)2 from the extracted human teeth with curved root canal systems. The teeth were scanned by micro computed tomography to calculate the percentage of Ca(OH)2 removal in the canals. In simulated root canals, we found that 10% citric acid removed more Ca(OH)2 than 2.5% NaOCl in the 0–1 mm group from the apex level (P<0.05). Ultrasonic and EndoActivator activation significantly removed more Ca(OH)2 than a size 30 K file in the apical third (P<0.05). However, there were no significant differences in any sections of the canals for 10%citric acid or 17%EDTA in removing Ca(OH)2 in extracted human teeth. We concluded that it was effective to remove residual Ca(OH)2 using the decalcifying solution with EndoActivator or Passive Ultrasonic Irrigation in a curved root canal system. A protocol for Ca(OH)2 removal was provided based on the conclusions of this study and the methods recommended in previous studies.     

Dental injuries due to miniplate osteosynthesis. Classification, treatment management, complications, and prognosis]

BACKGROUND: In spite of a monocortical design, miniplate osteosynthesis can injure dental roots directly as well as damage dental substance indirectly by interrupting the apical blood stream. PURPOSE: The present retrospective study classifies different types of dental root trauma caused by monocortical screws, suggests therapeutic options based on diagnosis, and documents survival probability and prognosis after tooth trauma. PATIENTS AND METHODS: During a period of 11 years, 380 patients with permanent dentition underwent miniplate osteosynthesis for the treatment of mandibular fractures, 29 of whom sustained dental root trauma caused by drilling failure. These patients were clinically and radiographically examined for a follow-up time of not less than 38 months. RESULTS: The 29 patients could be classified into four different types of dental root trauma: 13 pulp injuries above the apical third of the root (type Ia), 6 pulp injuries in the apical third of the root or extradental lesions interrupting the apical blood stream (type Ib), 4 lesions to the central radicular dentin without pulp injury (type II), and 6 lesions to the peripheral radicular dentin and root cementum (type III). Of 13 type Ia injuries, 5 developed apical periodontitis and dilatation of the periodontal space. Therefore one root canal treatment and three apicoectomies were performed. One tooth had to be extracted. Three further type Ia injuries and two type Ib injuries showed root resorptions inducing two root canal treatments. One of six type Ib injuries required root canal treatment because of apical periodontitis. One of four type II injuries caused root resorption not requiring therapy. No relevant, pathological finding could be identified after type III injury. CONCLUSIONS: The type of dental root trauma caused by miniplate osteosynthesis determines therapy, complication rate, and survival of the injured tooth.     

Incidence of C-shaped root canal systems in mandibular second molars in the native Chinese population by analysis of clinical methods

The aims of the study were to investigate the incidence of C-shaped root canal systems in mandibular second molars in a native Chinese population using radiography and clinical examination under microscope and to compare the relative efficacies of these methods.For the recognition of C-shaped root canal system,1 146 mandibular second molars were selected and examined.Teeth with C-shaped canal systems were categorized by using the radiographic classification criteria and the modified Melton’s method.C-shaped canals were identified in 397(34.64%) mandibular second molars by radiography(type I,31.23%;type II,38.29%;type III,30.48%).Clinical examination showed that 449(39.18%) cases exhibited C-shaped canal systems(C1,22.94%;C2,48.11%;C3a,15.59%;C3b,13.36%).As for the result of the radiographic and clinical combined examination,C-shaped root canals were found in 473(41.27%) mandibular second molars(C1,21.78%;C2,45.67%;C3a,16.70%;C3b,15.86%).The incidence of C-shaped root canal diagnosed by radiographic method was statistically different from that by clinical examination and the combined examination(P,0.05).The study indicated a high incidence of C-shaped canal system in a Chinese population.The combination of microscopic and radiographic examination is an effective method in identifying the C-shaped root canal system.     

Comparison of the rheological properties of four root canal sealers

The flowability of a root canal sealer is clinically important because it improves the penetration of the sealer into the complex root canal system. The purpose of this study was to compare the flowabi...     

后天性外耳道狭窄的手术治疗

目的探讨后天性外耳道狭窄的手术治疗方法及效果。方法对26例（27耳）外耳道狭窄行外耳道成形术或厢乳突根治鼓室成型术，取大腿内侧自体游离中厚皮片植皮，碘仿纱条压迫并扩张耳道。结果26例病人27耳随访6个月至8年，24耳外耳道宽敞，无再狭窄；3耳出现轻度狭窄，发生率11．1％（3／27），效果满意。结论对后天性外耳道狭窄的治疗可根据狭窄的原因、部位及程度等不同情况采用外耳道成形、游离中厚皮片移植或同时进行乳突根治鼓室成型术等手术治疗，术后局部换药，即能取得较好效果。     

颞骨次全切除术治疗外耳道腺样囊性癌的疗效分析

目的 探讨颞骨次全切除术在外耳道腺样囊性癌的临床应用效果。方法 回顾性分析2015—2019年收治的8例外耳道腺样囊性癌患者的临床资料，其中男2例，女6例；年龄33~76岁，平均年龄55.6岁。耳痛7例，外耳道肿块、耳溢液、听力下降各6例，面瘫1例；从最初出现症状到确诊平均为2.75年，5例曾被误诊，3例曾被误治手术；6例行颞骨次全切除+腮腺浅叶切除术，2例行颞骨次全切除+全腮腺切除术。结果 围手术期内1例患者出现局部切口感染，1例出现脑脊液漏。全部患者平均随访4.34年；6例患者无瘤存活；1例复发患者于我院二次手术后3年再次出现局部复发伴肺转移，接受放射治疗，目前带瘤生存；1例患者术后随访3.5年死于其他疾病。结论 外耳道腺样囊性癌早期症状不典型，容易误诊；确诊后应实施颞骨次全切除术以达到彻底切除肿瘤目的，术中应同时处理腮腺；术后放疗也是一种可选择的补充治疗手段。     

Diagnosis and treatment of carcinoma in external auditory canal

ObjectivesTo evaluate outcomes in treating carcinoma of external auditory canal (EAC) and to analysis factors which effect the prognosis of this disease.MethodsA retrospectively review of 16 patients treated for carcinoma of EAC at our department between April 2000 and April 2014 was conducted. All patients underwent surgical treatment and the diagnosis confirmed by pathological examination.ResultsThere were adenoid cystic carcinoma (ACC) in 8 patients, squamous cell carcinoma (SCC) in 5 patients, adenocarcinoma (AC) in 2 patients, and verrucous carcinoma (VC) in 1 patient. The tumors were classified as Stage I in 4 cases, Stage II in 2 cases, Stage III in 3 cases, and Stage IV in 7 cases. Five patients underwent extensive tumor resection (ETR), 2 patients underwent lateral temporal bone resection (LTBR), 5 patients underwent modified LTBR, 2 patients underwent subtotal temporal bone resection (STBR), and 2 patients underwent only open biopsy. Besides, adjunctive procedures, including neck dissection, parotidectomy and pinna resection were performed when indicated. Ten patients received postoperative radiotherapy. By the end of follow up, two patients had died of their disease, 2 lost to follow up, 2 survived with the disease, and the rest survived disease-free. The median follow-up period was 24 months.ConclusionComplete tumor resection appears to be an effective treatment for carcinoma of the EAC. Patients with SCC seem to have worse prognosis than those with ACC. Radiation therapy seems less effective for the disease than surgical treatment.