银汞桩核用于磨牙修复的七年回顾性研究

目的：对银汞桩核用于磨牙修复进行临床观察和分析。方法：通过对103例行银汞桩核修复的磨牙进行七年回顾性研究,观察其预后。结果：103例修复体中有7例失访,随访的96例均为Ⅰ级,无一例折裂、脱落,而且X线对比显示银汞桩与根管壁之间保持良好的适合性。结论：对于根管弯曲、分叉大、髓室大的磨牙,银汞桩核技术有着明显的优势。     

银汞桩核与分体式铸造桩核用于磨牙修复的疗效对比观察

目的:比较银汞桩核和分体式铸造桩核用于修复磨牙严重缺损病例的临床疗效.方法:将78例磨牙牙体严重缺损病例随机分为银汞桩核修复组40个牙和分体铸造桩核修复组41个牙,并随访观察2～3年.结果:两种桩核修复的临床疗效无显著差异(P＞0.05).结论:银汞桩核和分体式铸造桩核用于修复牙体严重缺损的磨牙都能取得较好的临床效果.     

全银汞桩核与铸造金属桩核用于磨牙修复的临床评价

目的探讨全银汞桩核与铸造金属桩核用于磨牙根管治疗后的修复效果。方法对20例采用全银汞桩核修复、20例采用铸造金属桩核修复的磨牙进行6个月到12个月的临床追踪．X线片检查桩核与牙体的适合性．观察其临床疗效。结果X线牙片检查显示．20例全银汞桩核与根管内壁、根尖方向的牙胶之间结合紧密、无暗影，根尖孔处封闭良好；20例铸造金属桩核患者中，有2例（下颌第一及第二磨牙各1例）X线牙片检查显示铸造金属桩尖端与牙胶间有约2mm间隙，根尖区见低密度影；1例患者X线牙片检查显示远中根管侧穿，根分歧区见低密度影；其余17例X线牙片检查显示铸造桩与根管内壁、根尖方向的牙胶间结合紧密、无暗影，根尖孔处封闭良好。结论全银汞桩核用于牙体缺损较严重的磨牙，较铸造金属桩核修复更安全可靠。     

黏结银汞桩核修复磨牙残冠的临床观察

目的评价黏结银汞桩核修复磨牙残冠的临床效果. 方法对56颗磨牙残冠和43颗磨牙残冠分别采用黏结银汞桩核和成品桩-树脂核修复牙体缺损,全冠修复,并进行1～2年的随防,根据主诉及临床检查观察其疗效. 结果 56颗黏结银汞桩核修复体,3颗失败,成功率为96.4%.43颗采用成品桩-树脂核修复体,12颗失败,成功率为72.1%.两组之间成功率经χ^2检验,差异有统计学意义. 结论磨牙残冠采用黏结银汞桩核修复效果良好且优于成品桩-树脂核修复体.     

不同桩核全冠修复磨牙残冠5年疗效的比较

选择经过完善根管治疗的磨牙残冠200例,采用双根管桩设计,分别利用螺纹桩银汞合金核、螺纹桩树脂核和铸造桩核进行全冠修复,临床随访观察5年,铸造桩核组失败率为1.25%,明显低于其它两组,具有统计学意义;螺纹桩银汞核组与螺纹桩树脂核组间的失败率差异无统计学意义。在磨牙残冠的全冠修复中,铸造桩核较螺纹桩银汞合金核或树脂核的长期疗效好。     

玻璃纤维桩用于含阻塞根管磨牙残冠修复的疗效观察

目的：观察玻璃纤维桩用于含阻塞根管磨牙残冠修复的临床疗效。方法：对25个含有阻塞根管的磨牙残冠采用玻璃纤维桩-树脂核-全冠修复,进行6～24个月的随访,观察其疗效。结果：在25个经治磨牙中,3个出现根尖炎症,1个出现桩松动,21个修复效果满意。结论：只要适应症选择合适,采用玻璃纤维桩修复含阻塞根管的磨牙残冠同样可取得好的临床疗效。     

玻璃纤维桩-树脂核与银汞-银粉玻璃离子桩核修复磨牙残冠的临床研究

目的比较玻璃纤维桩-树脂核与银汞-银粉玻璃离子桩用于磨牙冠缺损的修复效果。方法临床选择55例磨牙缺损患者,共75颗患牙,随机分为两组,玻璃纤维桩-树脂核组共24例29颗患牙,银汞-银粉玻璃离子桩核组31例共46颗患牙,分别进行玻璃纤维桩-树脂核和银汞-银粉玻璃离子桩核全冠修复,2年后对修复效果进行评价。结果玻璃纤维桩-树脂核组有1颗患牙出现根折,成功率96.6%;银汞-银粉玻璃离子桩核组有1颗患牙出现桩折,成功率97.8%,两组均无冠桩脱落,两组成功率差异无统计学意义(χ2=0.161,P>0.05)。结论对于重度磨牙缺损病例,选用玻璃纤维桩-树脂核和银汞-银粉玻璃离子桩核全冠修复均可。     

不同桩核微渗漏情况的体外研究

目的 :比较成品桩钉加复合树脂核、传统银汞桩核和粘结银汞桩核冠向微渗漏情况 ,探讨粘结银汞桩核在后牙修复中的应用前景。方法 :30颗新拔除的磨牙分为 3组 ,分别用成品桩钉加复合树脂核、传统银汞桩核和粘结银汞桩核修复后放入印度墨水中 1周 ,另选择 10颗磨牙作为阴性和阳性对照 ,评价冠方微渗漏情况。结果 :粘结银汞桩核微渗漏明显小于传统银汞桩核 (P <0 .0 1) ;传统银汞桩核与成品桩钉加复合树脂核差异无显著性 (P >0 .0 5 )。结论 :粘结银汞桩核修复可有效降低微渗漏 ,预防桩核修复后因微渗漏导致的并发症     

三种形式桩核冠修复磨牙大面积缺损的临床研究

目的 采用成品桩-光敏树脂核冠、成品桩-汞核冠及铸造桩核冠修复大面积缺损的磨牙,观察并比较其临床修复效果。方法 对87颗经过完善根管充填的大面积缺损的磨牙,14颗用成品桩-树脂核冠,41颗用成品桩-汞核冠,32颗行铸造桩核-冠修复,对其临床效果随访2～3年。结果 成品桩-树脂核冠组有1例桩折断,1例继发龋,成品桩-汞核冠组有1例刺激性龈炎;铸造桩核冠组有1例根折,经统计学检验,汞核冠组及铸造桩核冠组修复效果无显著性差异,树脂核冠组与汞核冠及铸造桩冠组有1例根折,经统计学检验,汞核冠组及铸造桩核冠组修复效果无显著性差异,树脂核冠组与汞核冠及铸造桩冠组有显著性差异。结论 成品桩-汞核冠和铸造桩核冠修复大面积缺损磨牙的效果较成品桩-树脂核冠好。     

后牙桩冠核快速修复法

后牙桩冠核快速修复法广西医科大学口腔医院（５３００２１）廖红兵常规的磨牙桩冠有很多设计，如树脂核或银汞核。笔者在制作树脂核或银汞核时，利用锤造冠改制成成形圈，减少临床操作时间，保证了修复效果，现介绍如下。磨牙牙根已经完善根管治疗，观察一周无临床症状，...     

Techniques for immediate restoration of teeth following root canal therapy

It is incumbent upon the dentist to restore the form and function of endodontically treated teeth. Different approaches and materials are described in the literature for restoring the missing tooth structure, either with a cast post and core or immediately with a chair-side post and core system. This article briefly reviews the available data regarding the microbiological, prosthetic, mechanical, and periodontal aspects while emphasizing the immediate approach using amalgam, composite and glass ionomer materials. The factors affecting retention of the post are presented to guide the clinician in selecting a suitable post and core system in preserving optimal root structure to prevent root fracture. Two clinical cases are presented in which tooth structure was restored using two techniques: in one, a provisional acrylic resin shell was used to house a dowel coronal-radicular amalgam core material, the other used a copper band for a composite post and core system. Both cases emphasize the ease of production and the short chair-time in the stages of crown fabrication.     

Load fatigue of five restoration modalities in structurally compromised premolars

Twenty-five freshly extracted maxillary first premolars were divided equally among five modalities for rebuilding structurally compromised premolars. These modalities were: (A) buccal stainless steel Parapost/amalgam core, (B) palatal stainless steel parapost/amalgam core, (C) two stainless steel Paraposts/amalgam core, (D) two regular Link Plus TMS single-shear Minim pins/amalgam core, and (E) palatal cast gold post and core. Load fatigue was used as the testing protocol, using a 5.2-kg load applied at 72 cycles per minute. Each tooth was prepared with a 1.0-mm ferrule, and an upper limit of 250,000 load cycles was set for the testing. Two failures were exhibited, (1) preliminary failure which involved a crack in the luting cement layer, and (2) catastrophic failure wherein the core and crown separated from the root section. Statistical analysis using Kruskal-Wallis test showed three subsets (P < or = .05). The subset with the highest number of load cycles to failure contained the palatal stainless steel post/amalgam core, two stainless steel Paraposts/amalgam core, and palatal cast gold post and core.     

Clinical procedures in fabricating post and core restorations: case reports.

In this series of case reports, unusual clinical procedures in the implementation of post and core restorations are demonstrated and their difficulties are discussed. First a method for preparing an immediate post and amalgam core, while utilizing the provisional self-curing acrylic resin crown as a matrix for the condensation of amalgam, is presented. The second technique is the fabrication of a cast post and core restoration that fits an abutment root as well as the existing crown of a four-unit fixed restoration. The third case illustrates the clinical procedures involved in preparing an immediate post and core restoration through an opening in the crown, when the extended fixed restoration cannot be removed.     

根管锥度和根管固位材料对牙体组织应力分布影响的三维有限元分析

目的 观察3种锥度根管采用不同根管桩修复对牙体组织应力分布的影响,以期为临床合理选用根管桩提供实验依据.方法 分别建立35号K锉、ProTaper和Profile器械根管预备后的下颌第一磨牙三维有限元模型,并分别模拟纤维树脂桩、不锈钢根管桩和银汞合金桩根管固位修复.运用Marc有限元软件,采用中央垂直加载,分析3种不同根管桩修复时牙颈部和牙根部应力分布的状况.结果 不同根管锥度对3种根管固位方式下的应力分布趋势无明显影响.不锈钢根管桩应力集中部位主要位于远中牙根中上部,远中根管口最高Von-Mises应力约为45 Mpa;银汞桩应力集中部分主要位于远中根管口上端及髓腔内,远中根管口最高Von-Mises应力约为16 Mpa;纤维树脂桩应力分布较均匀,未见明显应力集中.结论 纤维桩是比较理想的根管固位形式,应力分布接近于无根管桩状态;不锈钢根管桩在根中部容易形成高应力集中,增加根折发生率.

Abstract：

Objective To evaluate the effect of root canal taper and post on tooth stress distribution. Methods Three-dimensional finite element models of human mandibular first molar with root canals prepared with 35# K file, ProTaper and Profile were established. The tooth were restored with fiberresin, stainless steel and silver amalgam posts respectively. A vertical load on tooth occlusal surface was simulated. Marc software was used to analyze and calculate the stress distributions in the tooth restored with three kinds of different root canal posts, especially the in the cervical part and root. Results Different tapered root canals had no obvious influence on stress distribution in all three different posts. Stress distribution of stainless steel post located at the cervical and middle part of distal root, the highest Von-Mises stress was about 45 MPa. Stress distribution of silver amalgam post located at the orifice of root canal and pulp fundus, the highest Von-Mises stress was about 16 MPa. Stress distribution of fiber-resin post had no obvious stress concentration. Conclusions Fiber-resin post is the most ideal root canal post. Stainless steel post causes remarkable stress concentration in the root, which may raise the possibility of root fracture.     

Techniques for immediate core buildup of endodontically treated teeth.

Access to the pulp chamber for endodontic treatment is indicated inter alia as a result of extensive caries, trauma to the tooth causing fracture or loss of vitality, requiring restoration of the missing tooth structure. Different approaches and materials are described in the literature for foundation restorations, either with a cast post and core or immediately, with a chairside post-and-core system. This article briefly reviews the current data regarding the microbiologic, prosthetic, mechanical, and periodontal aspects while emphasizing the immediate approach using amalgam, resin composites, and glass ionomers. Factors affecting retention of the post are presented to guide the clinician in selecting a suitable post-and-core system to preserve optimal root structure and prevent root fracture. Three clinical cases are presented in which tooth structure was restored using different techniques: in the first two, provisional acrylic resin shells, one custom made and the other prefabricated, were used to house an amalgam coronal-radicular dowel core, where in the third case, a copper band was used for a composite post-and-core system. All cases emphasize the ease of production and short chairtime in the stages of crown fabrication.     

Restoring a Failed Prefabricated Post and Core With a Sleeve Casting: A Clinical Report

A clinical case is described, and a technique is explained for making a custom sleeve cast post and core to salvage a fractured crown previously treated with an unretrievable prefabricated post. The restorative problem was to design and fabricate some sort of cast post and core that could be cemented to the remaining post. The amalgam and cement in the pulp chamber and coronal portion of the root canal were carefully removed so that a direct pattern could be made to form a tube which would surround the coronal part of the existing post like a sleeve. This sleeve casting was designed to provide attachment for a core to support a new restoration. This direct pattern technique results in a retained core that joins the already cemented post and provides a sound core for the retention of a new crown.     

石英纤维桩对牙体缺损修复的临床疗效评价

目的：探讨石英纤维桩树脂核全冠修复残根、残冠的临床疗效。方法：以96例铸造金属桩核作为对照,随机选择牙体缺损病例61例、89个患牙,行完善的根管治疗后,利用RTD石英纤维桩、Pulpdent双固化树脂核材料恢复桩核,以全瓷冠或贵金属烤瓷全冠修复。分别于修复后1个月、6个月、1年、2年进行随访。结果：石英纤维桩修复后随访2年仅1个发生桩核脱落,1例出现纤维桩折断,89个基牙均未发生根折。总成功率明显高于铸造金属桩修复组（P〈0．05）。结论：石英纤维桩是一种较为理想的桩核修复方法。