矿物三氧化物凝聚体与光固化氢氧化钙修复乳磨牙髓室底穿孔临床疗效观察

目的 观察矿物三氧化物凝聚体（MTA）与光固化氢氧化钙（DMG）在乳磨牙髓室底穿孔修复中的临床疗效。方法 选取2010—2012年沈阳市口腔医院儿童牙科就诊的116例患儿,将142颗髓室底穿孔的乳磨牙分为2组,分别采用MTA修复和DMG修复,经过6 ~ 12个月观察,通过临床和X线片检查评价疗效。结果 2组相比,MTA组治疗成功率（6个月92.96%,12个月88.73%）略高于DMG组（6个月90.14%,12个月87.32%）,但差异无统计学意义（P＞0.05）。结论 MTA与DMG修复乳磨牙髓室底穿孔均能取得较好效果,且疗效相近。     

MTA用于髓腔穿孔修复中的相关研究

髓腔穿孔一直是牙体牙髓病治疗中的难点,MTA在髓腔穿孔修复中具有独特优越性。本文就现有研究文献对MTA的性能及其在髓腔穿孔修复中的应用作一综述。     

iRoot BP plus与MTA修补乳磨牙髓室底穿孔的临床疗效观察

目的研究iRoot BP plus与MTA修补乳磨牙髓室底穿孔的临床效果。方法将36颗髓室底穿孔的乳磨牙分为2组,分别采用iRoot BP plus与MTA修补,通过比较两种材料修补时间;分析3个月,6个月,12个月的临床检查和X线片检查,评价两种材料的临床应用效果。结果操作时间iRoot BP plus(3.14±0.22)min,MTA(5.31±0.29)min,操作时间存在显著性差异(P<0.05)。iRoot BP plus治疗成功率为:3个月100%,6个月100%,12个月94.4%;MTA治疗成功率为:3个月100%,6个月100%,12个月88.9%。两组无统计学差异(P>0.05)。结论 iRoot BP plus与MTA修补乳磨牙髓室底穿孔均能取得比较好的临床效果;修补乳磨牙髓室底穿孔iRoot BP plus操作更快捷。     

MTA用于犬牙直接盖髓术的组织学观察

目的 通过组织学观察，比较MTA（Mineral Trioxide Aggregate)和氢氧化钙制剂(Dycal)在直接盖髓时对牙髓的影响。方法 3条健康杂种犬尖牙12颗，随机分为2组：MTA，Dycal。用裂钻在尖牙唇侧颈部穿髓后以MTA和Dycal盖髓，GIC修复牙体缺损。4个月后将犬处死取下尖牙，常规制作组织切片，观察牙髓炎症反应和牙本质桥形成情况。结果 MTA盖髓的实验组中，5／6无炎症或仅有轻度炎症反应，该组所有标本均有牙本质桥形成。Dycal盖髓的对照组牙髓均有轻度或中度的炎症反应，只有2例出现了牙本质桥。结论 MTA具有良好的生物相容性，适用于直接盖髓术，有望替代现有的盖髓材料。     

应用VITAPEX与玻璃离子水门汀联合修复磨牙髓室底穿孔的临床研究

随着牙体治疗修复技术的快速发展和牙科材料的不断更新，许多残根残冠得到修复。笔者自1999年8月至2002年8月期间，共接诊髓室底穿孔磨牙37颗，采用VITAPEX与玻璃离子水门汀联合修补穿孔处，效果明显。     

用MTA修复髓室底较大穿孔的临床观察

目的:髓室底较大穿孔在临床上常常导致牙齿丧失.为了保存和恢复受损牙的功能,采用MTA修复髓室底较大穿孔以观察其临床疗效.方法:选取7例临床上髓室底较大穿孔(>2mm)的病例,第一次就诊:清理髓腔和根管,髓腔内和根管内封入氢氧化钙类药物(Vitapex),1周后,常规根管充填,髓室底穿孔处置MTA,厚度约1～4 mm,上置一湿棉球,暂封5～7 d后常规充填窝洞,拍摄术前、术中、术后X线片.术后0.5、1、2年后根据临床症状和X线片观察疗效.结果:7个髓室底较大穿孔的患牙1年后5个获得成功,无临床症状,能正常行使咀嚼功能.X线检查骨破坏面积缩小.2个患牙失败.结论:MTA具有良好的生物相容性,边缘密封好,微渗漏小,可以用于髓室底较大穿孔的修复,但它的远期疗效尚需进一步观察.     

牙髓组织增龄变化的组织学定量研究

采用组织学定量方法及组化与免疫组化手段,对各年龄组的各类牙齿进行研究,进一步了解到牙髓组织各成分的老化过程,其中牙髓细胞随年龄而递减的趋势十分明显,它的变化及组织退变可能是牙髓老化的标志。     

乳磨牙髓室底穿孔治疗方法的探讨

目的:探讨乳磨牙髓底穿孔后,保留患牙的治疗方法。方法:清除穿孔处炎性感染物质后,常规根管治疗,用复方抗生素糊剂覆盖髓底穿孔处,双层基底封闭髓室底。结果:该方法有效地控制了炎症,保存了患牙。治疗成功率92.96%。结论:去除局部炎性组织后,运用复方抗生素糊剂覆盖髓底穿孔,能够有效地保留患牙,达到乳恒牙顺利替换的目的。     

MTA应用于牙髓根尖周病治疗的研究进展

矿物三氧化物凝聚体(mineral trioxide aggregate,MTA)是20世纪90年代首先应用于临床,是一种治疗牙髓根尖周疾病的材料。MTA具有良好的生物相容性和封闭性,具有一定的抗菌性,目前临床上已广泛应用于盖髓术、活髓切断术、开放根尖孔的根尖屏障术、穿孔修复术及根管充填术,并且取得了良好的治疗效果。     

羟基磷灰石治疗髓室低穿孔的组织学研究

本研究以三只狗的２０只前磨牙和磨牙以同一条狗左右侧为实验组和对照组，人工行髓室穿底穿孔，分别用羟基磷灰石和氢氧化钙行穿通髓室底修补，在一周，一月和两个月作组织学观察，２个月时，两组修补区均在炎症浸润下方有纤维肉芽组织生成和上皮增生，但羟基磷灰石组炎症反应较氢氧化钙组。     

无机三氧化复合物性能的研究现状

许多体内外实验研究表明，无机三氧化复合物(Mineral Trioxide Aggregate，MTA)作为牙髓病的修复性材料，它具有防止微漏、生物相容性好、促进组织再生等诸多优点。本文对MTA的性能和临床应用现状作一综述。     

三氧化矿物凝聚体用于修补髓腔穿孔的临床效果观察

目的 研究三氧化矿物凝聚体(mineral trioxide aggregate,MTA)修补髓腔穿孔的临床效果.方法 收集临床髓室底或髓室、根管侧壁穿孔的恒牙8颗,用MTA对穿孔处填塞、修补.完成根管充填及永久充填后定期复查.追踪观察0.5～5.0年.结果 经复查8颗患牙无临床不适症状,咀嚼功能正常,X线片显示穿孔处未见新的牙槽骨病变,或原有牙槽骨病变缩小.结论 MTA是一种较理想的髓腔穿孔修补材料.     

Treatment Outcome of Mineral Trioxide Aggregate: Repair of Root Perforations—Long-term Results

Introduction

This historical cohort study follows on a previously reported trial, with the aim of assessing the outcome for teeth with root perforations managed by the orthograde placement of mineral trioxide aggregate (MTA) and identifying potential outcome factors for such treatment with a larger sample size and longer follow-up periods than in the first phase of the project.

Methods

The treatment outcomes of 64 root perforations repaired between 2000 and 2012 with MTA were investigated. The root perforations were located in different areas of the root. Calibrated examiners assessed clinical and radiographic outcomes by using standardized follow-up protocols 12–107 months after treatment (median, 27.5 months). Preoperative, intraoperative, and postoperative information was evaluated. The outcomes were dichotomized as healed or diseased.

Results

Of the 64 teeth examined (85% recall rate), 86% were healed. The univariate analyses (χ² tests) identified 2 potential prognostic factors, experience of the treatment providers (odds ratio, 2.14; 95% confidence interval, 0.39–11.74; P < .01) and placement of a post after treatment (odds ratio, 0.06; 95% confidence interval, 0.01–0.27; P < .01). In the multivariate stepwise logistic Cox regression, none of the potential prognostic factors displayed a significant effect on the outcome at the 5% level.

Conclusions

MTA appears to have good long-term sealing ability for root perforations regardless of the location. The results of this historical cohort study confirm the results of the first phase of this project.     

Antifungal Activity of Endosequence Root Repair Material and Mineral Trioxide Aggregate

Introduction

The purpose of this study was to investigate the antifungal activity of Endosequence Root Repair Material (ERRM; Brasseler USA, Savannah, GA) as compared with mineral trioxide aggregate (MTA) using Candida albicans.

Methods

All materials were packed into sterilized intravenous tubing to obtain standardized samples and allowed to set for 3 or 24 hours and then exposed to a suspension of C. albicans for incubations of 24 or 48 hours. To analyze the mechanisms of the material's antifungal activity, additional samples of each test material were prepared in the same manner and allowed to set for 24 hours; these were then incubated in a culture medium for 24 hours. The pH of each conditioned media was measured before transferring to wells containing C. albicans. The development of biofilm was analyzed after 24 and 48 hours with 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-([phenyl amino] carbonyl)-2H-tetrazolium hydroxide reduction assay.

Results

Materials in both experimental groups significantly limited biofilm formation at each interval (ie, 24 and 48 hours). After incubating for a 24-hour period in the presence of C. albicans, ERRM in both experimental groups showed a reduction in biofilm formation that was statistically significant in comparison with MTA. However, when set for 24 hours and incubated for 48 hours, gray MTA and white MTA showed a more substantial reduction in biofilm formation than comparable samples of ERRM. Cultured media conditioned with test materials showed statistically significant antifungal biofilm activity after 48 hours.

Conclusions

All materials tested have comparable antifungal biofilm activity. It appeared that changing the environment, such as the pH, contributed to this activity.     

Reinforcement of Simulated Immature Permanent Teeth after Mineral Trioxide Aggregate Apexification

Objectives

The objectives of this study were to compare the fracture resistance of simulated human immature teeth that have undergone mineral trioxide aggregate (MTA) apexification and have been root-filled with fiber post, composite resin, MTA, or gutta-percha.

Repair of Furcal Iatrogenic Perforation with Mineral Trioxide Aggregate: Two Years Follow-up of Two Cases

Furcal perforation is usually an undesired complication that can occur during preparation of endodontic access cavities or exploring canal orifice of multirooted teeth. Inadequacy of the repair materials has been a contributing factor to the poor outcome of repair procedures. On the basis of the recent physical and biologic property studies of the relatively new introduced mineral trioxide aggregate, this material may be suitable for closing the communication between the pulp chamber and the underlying periodontal tissues. There are few reports on repair of furcal perforation with MTA in molar teeth. The purpose of this case report was to describe the treatment of two furcal perforation using MTA in molar teeth. The perforations were cleaned with NaOCl and saline solution and sealed with MTA without internal matrix. Finally, the teeth were endodontically treated and coronally restored with composite resin and ceramic veneer crown and bridge. After 2 years, the absence of periradicular radiolucent lesions, pain, and swelling along with functional tooth stability indicated a successful outcome of sealing perforations in two cases.     

乳磨牙MTA直接盖髓术后即刻充填的临床观察

目的 评价乳磨牙MTA直接盖髓术后即刻充填临床疗效.方法 用MTA对4～8岁儿童的36颗深龋洞去腐露髓或意外穿髓的乳磨牙进行直接盖髓术后即刻充填治疗,治疗后6个月和2年后随访,观察盖髓后患牙症状、牙髓活力、X线片等疗效指标.结果 MTA治疗36颗乳磨牙,经6个月和2年后随访,其中34颗成功,牙髓活力正常,可见X线片修复性牙本质形成;2颗失败.结论 MTA应用于儿童乳磨牙直接盖髓术是有效的盖髓剂.     

Effect of Nano Silica on Setting Time and Physical Properties of Mineral Trioxide Aggregate

IntroductionMineral trioxide aggregate (MTA) has been widely used in all fields of endodontics. One of the major drawbacks of this material is the long setting time. MTA is primarily composed of type 1 Portland cement and bismuth oxide. In cement, nanoscale SiO₂ behaves as a filler to improve microstructure and to accelerate hydration process. The aforementioned reaction is also expected in MTA because of the same structure. Thus, the aim of this study was to evaluate the effect of addition of nano-SiO₂ to MTA on the setting time and its physical properties.MethodsTwo concentrations (8% and 10%) of nano-SiO₂ were added to the white MTA powder. After mixing with water, the setting time, compressive strength, and flexural strength were investigated and compared with pure MTA.ResultsWith the addition of 8% and 10% of nano-SiO₂ to the MTA, the setting time of both mixtures decreased significantly (P < .05). However, the compressive strength (after 1 day and 1 week) and flexural strength increased; this was not significant (P > .05). There was no significant difference between MTA mixed with 8% and 10% nano-SiO₂ in setting time, compressive strength, and flexural strength (P > .05).ConclusionsThe addition of 8% and 10% of nano-SiO₂ to MTA accelerated the hydration process, reduced the setting time, and had no adverse effect on the compressive and flexural strength of MTA.     

White Mineral Trioxide Aggregate Induces Migration and Proliferation of Stem Cells from the Apical Papilla

Introduction

Regenerative endodontic protocols recommend white mineral trioxide aggregate (WMTA) as a capping material because of its osteoinductive properties. Stem cells from the apical papilla (SCAP) are presumed to be involved in this regenerative process, but the effects of WMTA on SCAP are largely unknown. Our hypothesis was that WMTA induces proliferation and migration of SCAP.

Methods

Here we used an unsorted population of SCAP (passages 3–5) characterized by high CD24, CD146, and Stro-1 expression. The effect of WMTA on SCAP migration was assessed by using transwells, and its effect on proliferation was determined by the WST-1 assay. Fetal bovine serum (FBS) and calcium chloride–enriched medium were used as positive controls.

Results

The SCAP analyzed here showed a low percentage of STRO-1+ and CD24+ cells. Both set and unset WMTA significantly increased the short-term migration of SCAP after 6 hours (P < .05), whereas calcium chloride–enriched medium did after 24 hours of exposure. Set WMTA significantly increased proliferation on days 1–5, whereas calcium-enriched medium showed a significant increase on day 7, with a significant reduction on proliferation afterwards. SCAP migration and proliferation were significantly and steadily induced by the presence of 2% and 10% FBS.

Conclusions

Collectively, these data demonstrate that WMTA induced an early short-term migration and proliferation of a mixed population of stem cells from apical papilla as compared with a later and longer-term induction by calcium chloride or FBS.