氢氧化钙糊剂根管消毒的临床疗效观察

目的评价氢氧化钙作为根管内消毒药物预防术后疼痛的效果。方法选择96颗有根管治疗指征的患牙,将其随机分为A、B2组,每组48颗牙。每组患牙均为二次完成根管治疗,Α组患牙约诊期间根管内封Ca(OH)2糊剂,B组患牙约诊期间根管内封FC棉球或CP棉捻。分别于封药后1周和充填后1周复诊,并记录2组约诊期间和根管充填术后1周内患牙疼痛情况。结果Α组患者约诊期间和根管充填术后1周内患牙疼痛的发生率均明显低于Β组,经χ2检验,2组疼痛发生率的差异有统计学意义。结论氢氧化钙作为根管内消毒药物可有效地预防根管治疗约诊期间及充填后疼痛的发生。     

氢氧化钙预防根管治疗术后疼痛的临床观察

目的评价氢氧化钙作为根管内药物预防根管治疗术后疼痛的效果。方法选择90颗牙髓坏死的前磨牙,将其随机分为A、B、C组,每组30颗牙。A组患牙1次完成根管治疗;B组患牙2次完成根管治疗,但约诊期间根管内不封任何药物;C组患牙2次完成根管治疗,但约诊期间根管内封Ca(OH)2糊剂。采用改良10点视觉模拟量表对患者根管治疗后疼痛的严重程度进行评价,比较3组患者根管治疗后的疼痛水平。结果A组与B组、B组与C组患者根管治疗术后疼痛的差异有统计学意义(P<0.05),A组与C组患者根管治疗术后疼痛的差异无统计学意义(P>0.05)。结论氢氧化钙作为根管内封药可有效预防根管充填后疼痛的发生。     

地塞米松-氢氧化钙糊剂根管内封药的临床观察

目的：观察地塞米松-氢氧化钙糊剂用于根管封药的临床疗效以及对根管治疗期间急症的预防效果。方法：分别用甲醛甲酚（FC）、氢氧化钙糊剂和地塞米松-氢氧化钙糊剂对患急、慢性根尖周炎、牙髓坏死等需接受根管治疗的206例273个患牙进行根管内封药，观察其近期疗效和治疗期间急性疼痛发作率。结果：FC、氢氧化钙及地塞米松-氢氧化钙糊剂根管内封药疗效呈递增趋势，其根管治疗期间急症发生率呈递减趋势，各组之间在统计学上有显著差异（P〈0．05）。结论：氢氧化钙糊剂、地塞米松-氢氧化钙糊剂根管内封药均可提高疗效和减少根管治疗期间急症的发生，地塞米松-氢氧化钙糊剂效果更佳。     

氢氧化钙用于根管内封药的疗效观察

氢氧化钙作为一种根管内封药，近年来在临床治疗中得以广泛应用。本组用氢氧化钙甘油糊剂和传统的根管消毒药FC进行根管内封药，对其治疗结果进行评价。发现氢氧化钙在减少治疗期间疼痛和降低对根尖周组织刺激方面效果较好。     

甲硝唑-地塞米松糊剂预防根管治疗术期间急症的临床研究

目的探讨在急性牙髓炎患牙中,根管内封入甲硝唑-地塞米松糊剂对根管治疗期间急症发生的影响。方法162个急性牙髓炎患牙随机分为两组,实验组经根管预备用甲硝唑-地塞米松糊剂封药,对照组经根管预备用FC封药。用flare-upindex(FUI)定量的方法评价两种药物对根管治疗期间急症的影响,并根据急症引起的疼痛程度不同评价两种药物的临床疗效。结果甲硝唑-地塞米松组急症发生率为3.7%,显著低于对照组23.45%(P<0.01)。甲硝唑-地塞米松组急症的FUI均值为3.00,显著低于对照组5.47(P<0.05)。结论甲硝唑-地塞米松糊剂用于急性牙髓炎根管内封药能有效降低根管治疗间期急症的发生和疼痛程度。     

氢氧化钙预防根管治疗期间急症的临床观察

目的 观察氢氧化钙根管内封药对预防根管治疗期间急症的临床疗效。方法 使用氢氧化钙及传统根管内消毒药物樟脑对氯酚、甲醛甲酚根管内封药，观察疼痛指数并比较其根管治疗期间急症的发生率。结果 氢氧化钙封药后根管治疗期间急症的发生率最低，与传统药物相比，其差异有统计学意义。结论 氢氧化钙根管内封药。对预防根管治疗期间的急症有较好的作用。     

根管治疗期间并发症发生原因探讨

目的总结牙髓病和根尖周病治疗期间发生疼痛、肿胀的原因,探讨其预防措施。方法收集2003—2006年510例560颗根管治疗的牙齿,对病人的年龄、性别、牙位、治疗史、有无瘘管、消毒药物、根充的质量进行记录并分析。结果69颗(12.32%)发生不同程度的术中或术后疼痛,23颗(4.10%)发生术中或术后肿胀。其中死髓牙、无瘘型根尖周炎、后牙、超充牙、根管再治疗发生疼痛、肿胀的比例较高。应用甲硝唑、地塞米松糊剂作根管内暂封可预防根管治疗期间疼痛、肿胀的发生。结论对于死髓牙要有足量、柔和的根管冲洗,酌情增加复诊次数,局部性牙髓炎、外伤牙和根管恰充牙不易发生根管治疗期间疼痛、肿胀。应用甲硝唑、地塞米松糊剂作根管内暂封可减少其发生率。     

根管治疗期间急症的防治

目的:探讨根管治疗期间急症的防治.方法:将患牙髓炎、牙髓坏死、根尖周炎,需接受根管治疗的348例(348颗患牙)随机分成4组,分别在根管内封甲醛甲酚(FC)、奥硝唑、氢氧化钙、地塞米松-氢氧化钙,观察其根管治疗期间急性疼痛发作率.结果:奥硝唑与氢氧化钙组比较,差异无显著性(P>0.05).地塞米松-氢氧化钙组与奥硝唑组、氢氧化钙组比较,各组之间有显著差异(P<0.05),地塞米松-氢氧化钙糊剂同FC组比较具有非常显著差异(P<0.01).结论:根管内封地塞米松-氢氧化钙能较好预防和降低EIAE的发生率,并能减轻疼痛程度.     

不同药物预防根管治疗期间急症的临床研究

目的:通过在根管治疗期间使用不同药物进行根管内封药,比较其对预防根管治疗期间急症(EIAE)的临床效果. 方法:选择因牙髓坏死、慢性根尖周炎、牙髓治疗失败而需要进行根管治疗或再治疗的患牙146颗,根据用药不同随机分为3组:甲醛甲酚(FC)、氢氧化钙(CH)及奥硝唑-地塞米松(OD),7天后复诊由同一名医师记录患者在约诊期间出现的疼痛肿胀情况, 并计算急性发作指数(FUI). 结果:FC组、CH组及OD组预防EIAE的有效率分别为61.2%、79.6%和85.4%,3组FUI均值分别为3.52±1.39、2.30±0.95和1.43±0.53. 经x2检验和秩和检验:FC组与另外两组的差异均有统计学意义(P<0.05),CH组与OD组差异无统计学意义(P>0.05). 结论:氢氧化钙和奥硝唑-地塞米松糊剂较甲醛甲酚更能有效预防EIAE的发生并可降低EIAE的疼痛程度.     

氢氧化钙在脱位再植牙牙髓坏死治疗中的应用

目的：观察氢氧化钙（calcium hydroxide,CH)及其制剂作为根管内封药和根管充填糊剂在外伤脱位牙牙髓坏死根管治疗术（root canal therapy,RCT)中的应用效果。方法：对使用不同药物根管内封药和不同根管糊剂充填根管治疗外伤脱位再植牙牙髓坏死的疗效进行对比。结果：CMCP、FC、IPI、CH组根管治疗期间的急症发生率差异非常明显，疼痛指数亦以CH组最低；1年后牙根吸收情况和2年失牙率、牙再植成功率CH组与其它组有非常显著差异。结论：CH可以预防其急症的发生和减少牙根吸收，提高牙再植的成功率。     

根管治疗期间疼痛的药物防治临床疗效观察

目的:观察口服替硝唑和地塞米松防治根管治疗期间疼痛(EIP)的临床疗效。方法:将82例牙髓炎或根尖周炎病例随机分成两组,治疗组根管预备封药后口服替硝唑和地塞米松,对照组根管预备封药后不口服替硝唑和地塞米松。结果:两组病例根管治疗期间疼痛的发生有显著性差异(P<0.05)。结论:口服替硝唑和地塞米松防治根管治疗期间疼痛有较好的临床效果。     

Vitapex糊剂根管封药对老年糖尿病患者根管治疗期间疼痛的影响

目的：观察比较Vitapex糊剂根管封药和传统的根管消毒剂甲醛甲酚封药对老年糖尿病患者根管治疗期间疼痛的影响。方法：选择154例老年人慢性根尖周炎伴糖尿病患者,随机分为两组,常规根管预备后,实验组根管内封入Vitapex糊剂,对照组用甲醛甲酚髓腔封药,一周后观察比较两组患牙根管封药期间疼痛的发生率。结果：实验组的疼痛发生率明显低于对照组,有显著性差异（P〈0．05）。结论：Vitapex糊剂根管封药能有效减少老年糖尿病患者根管治疗期间疼痛的发生率。     

根管治疗期间疼痛问题的临床观察

目的 探讨根管治疗期间疼痛发生的原因。方法 对330例临床病人366颗根管治疗的牙齿进行临床观察。结果37颗牙（10.1％）发生了不同程度的根管治疗术后疼痛,其中死髓牙、后牙、根尖阴影小的牙和近期有过疼痛史的牙齿发生疼痛的比例较高。结论 与根管治疗术后疼痛发生关系较为密切的因素有牙髓坏死、牙位、根尖阴影和疼痛史等,确切原因尚有待于进一步研究。     

Delayed root canal therapy: an analysis of treatment over time.

A retrospective study of 898 teeth receiving root canal therapy was performed to document the sequelae of delayed completion of root canal treatment. Teeth were categorized into a prompt treatment group and a delayed treatment group. Comparisons of prompt and delayed treatment groups were made with regard to preoperative pain, interappointment emergencies, postobturation pain, and final treatment. Findings from this study show that a palliative endodontic procedure is an extremely effective treatment. However, 56% of teeth with incomplete root canal therapy eventually were extracted compared with 2 to 3% for the root canal filling treatment groups. By emphasizing the potential loss of the tooth rather than the potential of interappointment emergencies, the clinician may be more effective in achieving compliance among patients receiving delayed treatment.     

Interappointment pain: mechanisms,diagnosis, and treatment

Knowledge on the causes of and the mechanisms behind interappointment pain in endodontics is of utmost importance for the clinician to properly prevent or manage this undesirable condition. The causative factors of interappointment pain encompass mechanical, chemical, and/or microbial injury to the pulp or periradicular tissues, which are induced or exacerbated during root canal treatment. Microorganisms can participate in causation of interappointment pain in the following situations: apical extrusion of debris; incomplete instrumentation leading to changes in the endodontic microbiota or in environmental conditions; and secondary intraradicular infections. Interappointment pain is almost exclusively due to the development of acute inflammation at the periradicular tissues in response to an increase in the intensity of injury coming from the root canal system. When an interappointment emergency occurs, proper diagnosis and active treatment are required for the clinician to succeed in solving the problem. This review focuses on the mechanisms of interappointment pain, with special emphasis placed on the causative agents and the host response to injury that can precipitate pain. In addition, diagnostic measures and treatment approaches to manage interappointment pain are also discussed.     

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??Endodontic interappointment pain is one of the common complications of root canal therapy. It arises from microbial??mechanical and chemical stimuli to root apical tissue during the root canal treatment??which can cause acute inflammation of the root apical tissue??and the clinical manifestations are local pain and swelling. With the development of science and technology??a great many nickel-titanium rotary instruments are widely used??so that it is possible to reduce the endodontic interappointment pain in patients in the process of treatment. This paper introduced the research status of occurrence mechanism and preventive control approach during the treatment of the root canal therapy.     

氢氧化钙碘仿糊剂根管封药的临床观察

目的:比较氢氧化钙碘仿(CHI)糊剂与传统的根管消毒剂甲醛甲酚(FC)、樟脑酚(CP)的临床效果。方法:选择需作根管治疗的患者142例,患牙165颗,随机分为CHI、FC、CP组,常规镍钛根管预备后分别封入上述药物于根管及髓腔中,观察比较根管预备封药后发生根管治疗期间疼痛(EIP)的情况、临床疗效及完成根管治疗的复诊次数。结果:CHI组EIP的发生率最低、临床有效率最高、复诊次数最少,与FC组有显著性差异(P<0.05),但与CP组的差异无显著性(P>0.05)。讨论:与传统的酚类根管消毒药物(FC、CP)相比较,CHI封药不易导致EIP,临床疗效高、疗程短、操作简便、无细胞毒性及抗原性,是一种较理想的根管消毒剂。     

A prospective randomized double-blind trial on efficacy of dexamethasone for endodontic interappointment pain in teeth with asymptomatic inflamed pulps

To determine whether a relatively large dose of oral dexamethasone given for a short period of time would be effective in reducing endodontic interappointment pain, the current double-blind, placebo-controlled study was undertaken. After the visit for instrumentation, 40 patients with asymptomatic teeth having vital-inflamed pulps were randomly given either dexamethasone (3 tablets of 4 mg each) or a dextrose placebo identical in appearance (same dosage schedule). The outcome showed that the oral administration of dexamethasone resulted in a statistically significant reduction in endodontic interappointment pain at all three time periods evaluated, that is, at 8 hours, 24 hours, and 48 hours (p less than 0.01). It appears from the results of this study that this dosage schedule of oral dexamethasone is sufficient to significantly reduce endodontic interappointment pain for teeth with asymptomatic vital-inflamed pulps. Further studies are needed for teeth with other endodontic pulpal-periapical conditions and for symptomatic teeth.     

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目的探讨超声冲洗技术对根管治疗约诊间疼痛（endodontic interappointment pain,EIAP）的影响。方法选择2012年7—8月中国医科大学口腔医学院综合急诊科收治的50例根尖周炎患者（64颗患牙）,按照就诊顺序随机分为超声冲洗组和注射器冲洗组,比较两组患者EIAP的发生率。结果超声冲洗组患者EIAP发生率（12．5％）低于注射器冲洗组（37．5％）,差异有统计学意义（Х^2=5．33,P=0．021）。结论超声冲洗可减少EIAP的发生,值得在临床推广和应用。