螯合剂作为根管冲洗剂的研究进展

目前,国内临床上多使用体积分数为3％的过氧化氢和生理盐水交替冲洗根管,但是这2种溶液存在许多缺陷。次氯酸钠具有较强的杀菌性和组织溶解性,所以在国外被普遍应用于根管冲洗中。目前,国内也正逐步将次氯酸钠应用于临床,但是却很少使用螯合剂作为根管常规的冲洗液。螯合剂的优势日益受到关注,螯合剂具有去除根管预备中形成的玷污层的优势,但不能有效溶解残留的牙髓,次氯酸钠具有有效溶解有机残髓的作用,两者联合应用能达到相互补偿、相互增效的作用,是目前用于玷污层去除的有效组合。本文对螯合剂的研究进展作一综述,以期推广其在国内临床上的应用。     

根管冲洗剂的研究进展

根管冲洗是根管预备中必需的环节。目前常用的根管冲洗剂的抗菌能力、清洁作用和组织相容性等各有优缺点,只有了解各种根管冲洗剂的特性,合理搭配使用,才能达到理想效果。     

根管治疗术中根管充填的护理

目的探讨根管治疗术中根管充填的护理方法,以提高根管治疗的效率和质量。方法对112颗进行根管充填的患牙进行护理配合,总结根管充填护理的要点。结果112颗牙根管充填后均取得满意的疗效,无欠填或超填,全冠修复112颗。根管充填后1年无继发疼痛和牙折裂。结论无菌护理、默契配合、器械管理、护患沟通是根管治疗术中根管充填的护理要点。     

根管冲洗剂对玷污层的作用

玷污层可阻碍药物进行深层消毒，降低充填材料与根管壁的密合性，使根尖微漏显著增加．导致根管治疗失败。根管冲洗是根管治疗过程中一个重要环节，能否有效去除玷污层是其关键之一。本文就次氯酸钠，螯合剂及有机酸等常用冲洗剂对玷污层的作用进行概述，可以看出，多种冲洗剂联合使用将更加有效地去除玷污层。     

现代根管治疗术:根管充填

根管充填是根管治疗术的最后一步,也是其十分关键的步骤。约60%的根管治疗失败是由于根管充填不完善(欠填、充填不严密、超填等)造成的。近年来根管充填的技术、材料、器械等方面的进步改善了根管充填的质量,从而使得根管治疗术的成功率得到很大提高。本文就现代根管充填的相关     

干髓剂用于根管治疗的疗效观察

作者在 1997- 0 1～ 1999- 0 2期间将干髓剂用于临床根管治疗中 ,疗效满意 ,现报告如下 :1　临床资料和方法1.1　临床资料门诊牙髓坏死及根尖周炎患者 192例 ,共 2 16牙。其中男 88例 96牙 ,女 10 4例 12 0牙 ,年龄 13～ 6 9岁。患牙为恒前磨牙及磨牙。其中前磨牙 91个 ,磨牙 12 5个。牙髓坏死 34牙 ,急慢性根尖周炎 182牙。1.2　药物配方治疗组 (干髓剂处方 ) :多聚甲醛 2 .0 ｇ ,麝香草酚 0 .5 ｇ ,可卡因 0 .3ｇ ,硫酸锌 2 .0 ｇ ,石棉粉末 1.0 ｇ ,混合并研磨均匀 ,加适量丁香油调成糊剂待用。对照组 :氧化锌丁香油糊剂。1.3　治疗方法…     

219例根管治疗术急症分析

目的 :探讨根管治疗期间急症发生的相关因素。方法 :对 2 19例根管治疗病例进行临床观察 ,并记录病人的反应。结果 :根管治疗期间急症发生率为 15 .98% ,其中器械超出根尖孔 ,患者年龄较大 ,后牙 ,无瘘管型尖周炎等相关因素影响下根管治疗急症发生率较高。结论 :根管治疗期间急症发生较为密切的因素有术者操作水平 ,年龄因素 ,牙位因素 ,根管病变情况等。     

根管治疗并发疼痛的原因分析

根管治疗并发疼痛的原因分析广东省口腔医院（５１０２６０）刘阗根管治疗是牙髓病治疗和根尖周病的常用方法和最佳选择，其最常见的并发症多为疼痛。笔者对行根管治疗的４７９例病例进行总结，分析疼痛发生的原因，现报告如下：临床资料本文收集了近二年来病例完整的４７...     

Tissue necrosis after using an arsenical endodontic preparation: a case report.

A case is reported of severe loss of alveolar bone in the maxilla, as a result of leakage into the tissues of an arsenical paste from the pulp chamber of an endodontically 'treated' tooth. The history of the use of arsenic in dentistry is discussed, as are the hazards inherent in the use of this outmoded and dangerous medicament.     

Mandibular bone necrosis caused by use of arsenic paste during endodontic treatment: two case reports

Aim  To report that arsenical pastes are still employed in endodontics and to highlight the potentially serious consequences of their use.
Summary  Chemotherapeutic agents such as arsenic trioxide and paraformaldehyde were once commonly employed as pulp-necrotizing agents. Their cytotoxic effects are well recognized, and leakage from teeth has been associated with widespread necrosis of periodontal tissues and bone. This report describes two cases of severe bone necrosis affecting the mandible following the use of an arsenical paste.
Key learning points • Pulp-necrotizing agents such as arsenic trioxide can cause severe bone necrosis.
• Arsenical pastes have no place in contemporary dental practice.
• Dentists should employ appropriate local anaesthetic techniques for pulp extirpation instead of relying on toxic necrotizing agents.     

Localized alveolar bone necrosis following the use of an arsenical paste: a case report

AIM: To describe some toxic effects of arsenic trioxide in the mouth, to condemn its continued use, and present a case in which a tooth was preserved despite significant bony destruction. SUMMARY: A case is presented in which severe alveolar bone necrosis resulted from leak-age of an arsenical devitalization paste into the periodontium.The tooth was root canal treated before root amputation, and restored with a cuspal coverage restoration. The tooth was observed to be symptomless and functional at the one-year follow-up. KEY LEARNING POINTS: * Arsenic and its compounds have no place in contemporary endodontics. * Dentists should protect their patients by avoiding the use of arsenic-containing materials and refusing to use products whose constituents are not known. * Localized bone necrosis may not require tooth extraction. Depending on the severity of the case, the tooth may be preserved by a combination of endodontic, periodontal,prosthodontic and maintenance therapies.     

应用自体下颌骨外板行颅面部贴附植骨的临床研究

目的探讨应用自体下颌骨外板行颅面部不同部位贴附植骨后的体积变化情况。方法选择6例采用自体下颌骨外板同时行下颌角及部分体部（角体部）、上颌前部的贴附植骨患者为研究对象,采集患者术后即刻、术后半年的CT数据,利用三维CT分体重建和数据配准分割技术,对配准后的下颌角体部及上颌前部2个植骨区域的术后即刻与术后半年的2组数据同时进行分割,分别独立出2个下颌骨外板贴附植骨区域,对移植骨体积的变化进行测量分析。结果下颌骨外板贴附移植于下颌角体部,术后半年体积缩小20.8％±7.2%,差值分析显示吸收的主要部位为靠近下颌骨下缘及后缘;移植于上颌前部者体积缩小11.2％±2.3%。2个部位移植骨体积吸收率有统计学差异（P<0.05）。结论下颌骨外板贴附移植于颅面部不同部位,骨吸收的程度不同,受区局部力学环境的差异可能是影响因素之一;对吸收率的量化可更好地指导临床应用。     

Gingival and bone necrosis caused by accidental sodium hypochlorite injection instead of anaesthetic solution

AIM: To report clinical complications (pain, necrotic gingival tissue and bone sequestration) resulting from accidental injection of sodium hypochlorite. SUMMARY: Root canal treatment is a routine clinical procedure with few reported complications. Sodium hypochlorite (NaOCl) is commonly used as an irrigant during the procedure because of its tissue-dissolving, antibacterial and lubricating properties. This paper presents a case in which accidental injection of sodium hypochlorite into the lingual gingiva of a female patient caused gingival and bone necrosis. Surgical intervention was required. KEY LEARNING POINTS: *Sodium hypochlorite is dangerous if injected into the tissues. *The presentation of sodium hypochlorite in glass, anaesthetic type cartridges is potentially dangerous, and should be condemned. *All healthcare workers should check carefully the contents of any syringe before injecting into patients.     

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目的评价前牙区牙槽骨水平宽度不足的患者联合应用骨劈开、骨挤压和骨引导再生术行同期种植体植入的临床效果。方法 2004—2009年福州市第一医院口腔科就诊的前牙区牙缺失伴前牙区牙槽骨水平宽度不足的种植患者28例,联合应用骨劈开、骨挤压,填入骨粉,行骨引导再生术后同期植入40颗种植体,术后4～6个月内完成上部修复。术后1年,通过临床检查、全景片等观察效果。结果术前、后牙槽骨平均宽度分别为(3.2±0.89)mm、(6.5±0.75)mm,平均增加了(3.3±0.34)mm。术后牙槽骨宽度与术前相比,差异有统计意义(t=2.47,P<0.05)。术后无明显并发症发生,种植体行使功能良好,仅1例患者的1颗牙种植失败,种植近期成功率达97.5%。结论对前牙区牙槽骨水平宽度不足的患者,联合应用骨劈开、骨挤压和骨引导再生术行同期种植体植入,可增加骨量,获得种植体的同期植入,减少患者痛苦,改善种植修复的临床效果。     

Severe periodontal damage by an ultrasonic endodontic device: a case report

Abstract –  Heat produced within a root canal during use of an ultrasonic instrument can be conducted through the dentin into periodontal ligament, bone and soft tissue. If severe in intensity or long in duration, it can induce damage to these tissues. This report describes a case in which an ultrasonic endodontic instrument apparently induced severe damage to alveolar bone, gingiva and nasal mucosa in a 42-year-old female. Overheating of a maxillary central incisor caused necrosis of soft tissue and bone on the facial and mesial aspects and triggered a protracted inflammatory response in the adjacent nasal cavity. To relieve the severe discomfort associated with this damage, the patient chose to have her maxillary incisors extracted and replaced by a removable partial denture. A defect in the soft tissue and bone was present at a follow-up visit 10 months after the extractions. While morbidity of this nature is rare, this case reinforces the need to maintain adequate cooling of ultrasonic instruments.     

K3根管预备系统根管预备后发生约诊间痛的临床分析

目的：采用K3根管预备系统进行根管预备,观察约诊间痛的情况,探讨发生约诊间痛的影响因素。方法临床选取因龋病或隐裂引起牙髓炎的患者共138例,其中男65例,女73例,年龄18~66岁。随机分成2组,分别采用大锥度K3机用镍钛器械（实验组）和02锥度手用不锈钢K锉（对照组）预备,比较2组根管预备后,患牙约诊间痛（EIAP）发生的情况。结果采用K3机动预备系统预备的患牙约诊间痛发生率显著低于K锉常规法（P=0.02）,两组差异有统计学意义。其中,多根管患牙在2组的差异具有统计学意义（P〈0.05）,单根管患牙无统计学意义（P〉0.05）。结论与手动不锈钢K锉相比,K3机动根管预备系统可以降低根管预备后约诊间疼痛的发生率。