ObturaⅡ&System B与Thermafil在扁根管内断离器械旁路充填的实验研究

目的:比较热塑牙胶充填(ObturaⅡ&System B和Thermafil)与冷牙胶侧方加压充填在扁根管内器械断离行旁路根管充填的效果。方法:将60颗扁根管离体下颌第一前磨牙随机分为3组,每组20颗牙。将新的15#不锈钢K锉(25 mm)断离在距根尖4 mm处,断离长度3 mm;从断离器械旁用Mtwo镍钛锉配合vdw.silver机用马达行根管旁路预备。在手术显微镜下分别采用ObturaⅡ&System B、Thermafil与冷牙胶侧方加压旁路充填。在距根尖2、5、8 mm处横断牙根,电子显微镜下记录在距根尖5 mm处断离器械与根充材料之间的缝隙,充填后根管内残余的空隙;分别记录在距根尖2 mm与8 mm处牙胶、空隙与糊剂占根管横断面的比例,分析不同充填方式的效果。结果:在离体的条件下,热牙胶充填在扁根管内器械断离后行旁路根管充填的效果优于冷侧压充填(P<0.05),ObturaⅡ&System B优于Thermafil,但无统计学差异(P>0.05)。结论:当器械断离在扁根管内,从断离器械旁建立通路进行根管预备,ObturaⅡ&System B充填,可达到严密封闭根管的目的。     

3 种方法充填下颌第二磨牙C型根管的实验研究

目的:探讨ObturaⅡ、冷侧压法与Thermafil充填下颌第二磨牙C型根管的效果。方法:分别用ObturaⅡ、冷牙胶侧压与Thermafil3种方法充填下颌第二磨牙C型根管,每组7例,X线观察气泡、侧枝和网状根尖三角的出现几率;透明牙法观测根尖渗漏;牙根切片比较牙胶、糊剂、空隙占根颈、根中、根尖三横截面管腔面积百分比。结果:Thermafil组网状根尖三角出现概率最高(4/7),P<0.05;冷侧压法染色线最长(1.47±0.14)mm,与其他2组比较差异有统计学意义(P<0.01);Thermafil组牙胶占根中、根尖横截面面积百分比最高(P<0.05),糊剂在三截面中占比例最低(P<0.05)。ObturaⅡ组在根中截面空隙比例最低(P<0.05)。结论:在3种充填方法中,Thermafil组C形根管根尖充填效果好,ObturaⅡ组在根中充填效果好。     

4种充填方法对椭圆形根管充填效果的体外研究

目的:研究不同充填方法对椭圆形根管的充填效果。方法:选60颗拔除的椭圆形根管的下颌前磨牙,用ProTaper机用旋转镍钛锉预备根管后,随机分成4组。分别用Dentsply变锥度牙胶尖单尖充填法、标准牙胶尖侧方加压充填法、System B ObturaⅡ充填法以及Thermafil充填法进行充填。将填充后的牙齿在距离根尖2、5、8mm处水平切断。对每个横断面进行显微拍照,并用图象处理软件分析获得充填面积占根管横截面面积的百分率。最后对所有牙的填充百分比进行统计分析和比较。结果:在2mm水平,Thermafil的牙胶百分比最高,空隙率和糊剂百分比最低(P<0.05)。在5mm水平,System B ObturaⅡ和Thermafil的牙胶百分比都高于其他2种方法,空隙率和糊剂百分比都较低(P<0.05),但两者之间无统计学差异(P>0.05)。System B Ob-turaⅡ在8mm处空隙率最低(P<0.05)。用变锥度单尖充填,牙胶百分比在各截面都最低,空隙百分比和糊剂百分比在2mm横截面与标准牙胶尖侧方加压充填法相近,无统计学差异(P>0.05)。结论:Thermafil充填法充填椭圆形根管的根尖区域效果好,System B ObturaⅡ充填法充填椭圆形根管的冠方更有优势,冷牙胶侧方加压和大锥度单尖充填椭圆形根管效果较差。     

不同根管充填技术对椭圆形根管充填效果的比较

目的:通过比较3种不同方法充填椭圆形根管后的牙胶充填面积百分数来评价各种充填法的效果。方法:选取人离体单根管前磨牙30个,手用ProTaper预备后随机分为3组,分别用冷牙胶侧方加压法、热塑牙胶注射加压法(ObturaⅢ)和连续波充填法(System B+ObturaⅢ)进行充填,然后分别在距根尖2、5、8 mm处横断,各个横断面在手术显微镜下拍照,再用图像分析软件记录横断面的根管面积和牙胶充填面积,从而计算出牙胶充填面积百分数。结果:在2 mm处,3种充填法的牙胶充填面积百分数无显著性差异(P>0.05);在5 mm处,ObturaⅢ组和SystemB+ObturaⅢ组无显著性差异(P>0.05),但都显著大于冷牙胶侧压组(P<0.05),8 mm与5 mm处结果相同。结论:在5,8 mm水平,ObturaⅢ和SystemB+ObturaⅢ充填法的效果好于冷牙胶侧压法,而在2 mm水平,3种充填法的的效果无明显差别。     

三种热牙胶根管充填技术牙胶充填面积百分数的比较研究

目的:比较3种热牙胶根管充填术后牙胶密度即牙胶充填而积百分数(percentage of gutta-percha-filled area,PGFA),评价3种热牙胶充填技术的充填效果.方法:采用人完整单根管离体牙40颗随机分成4组,根管预备后分别采用冷牙胶侧向加压法、热牙胶垂直加压法、热塑牙胶注射加压法(Obtura Ⅱ)和超声振动侧向加压法进行根管充填.每个根管分别在距离解剖根尖3、6和9 mm处横断,通过图像分析软件记录根管横断面积和牙胶充填的面积,计箅出牙胶充填面积百分数.结果:热牙胶垂直加压组和Obtura Ⅱ组的PGFA显著高于冷牙胶侧压组和超声侧压组(P＜0.05),热牙胶垂直加压组和Obtura Ⅱ组的PGFA之间无显著性差异(P＞0.05),且与根管充填的深度也无明显相关性(P＞0.05).热牙胶垂直加压组和Obtura Ⅱ组的PGFA在9 him和3 mm处明显大于冷牙胶侧压和超声侧压组(P＜0.05);在6 mm处,3种热牙胶的PGFA无显著性差异(P＞0.05).超声侧压组的PGFA与根管深度明显相关(P＜0.05).结论:热牙胶垂直加压法和Obtura Ⅱ允填后牙胶密度高,在9 mm和3mm处效果优于超声振动侧向加压法.超声振动侧向加压法充填效果受到根管深度影响.     

常温流动牙胶Guttaflow充填根管密合性的体外评价

目的 体外评价常温流动牙胶(Guttaflow)充填根管的致密性。方法 选择60个单根管下颌第一前磨牙,使用ProTaper冠向下法预备根管,然后随机分为3组进行根管充填。组1:以Guttaflow(加06锥度单牙胶尖)根管充填;组2:连续波热牙胶根管充填;组3:冷侧压法根管充填。然后在距根尖狭窄2、4、6、8mm处垂直于牙体长轴切开牙体,体视显微镜下观察切片中根管充填的情况,并采集图像,利用图像分析软件计算根管充填物中牙胶面积的百分比(PGP)。结果 在距根尖2mm和4mm处Guttaflow组的PGP明显高于热牙胶组和冷侧压组P<0.05),而热牙胶组和冷侧压组无显著差异(P>0.05)。在距根尖6mm和8mm处,Guttaflow组与热牙胶组无显著差异(P>0.05),但两者都高于冷侧压组P<0.05)。结论 Guttaflow根管充填法充填具有很好的密合性。     

ObturaⅡ热牙胶系统根管充填的微渗漏研究

目的:比较ObturaⅡ热牙胶系统在3种加热温度设定下充填根管后根尖封闭效果的差异,并与冷牙胶侧压充填技术的密封性进行比较.方法:28个离体单根管恒牙,根管预备后随机均分为4组:A组用传统的泠牙胶侧压充填法进行充填,B、C、D组用ObturaⅡ系统将牙胶分别加热至160℃、180℃、200℃进行充填.使用染料渗入法检测根尖微渗漏的发生情况.结果:ObturaⅡ热牙胶系统在160℃、180℃、200℃的温度设定下充填后的微渗漏与冷牙胶侧压法相比差异有统计学意义(P<0.05),但温度设定不同的热牙胶充填组间的微渗漏差异无统计学意义(P<0.05).结论:ObturaⅡ热牙胶系统加热温度设定在160℃、180℃、200℃进行充填时根尖封闭能力无显著差异,但其根管封闭能力明显优于冷牙胶侧压充填技术.     

ObturaⅡ热熔牙胶充填根管的微渗漏实验研究

目的：评价ObturaⅡ热熔牙胶系统充填后根尖部的微渗漏。方法：60个离体下颌第一前磨牙随机分为3组，用Profile器械预备根管至06/^#25后给予不同处理：A组用ObturaⅡ热熔牙胶系统充填；B组常规充填氧化锌丁香油糊剂加牙胶尖；C组不充填，作为阴性对照。各组牙齿在墨水中浸泡7d后，测量染色线长度，检测各级的微渗漏情况。结果：用ObturaⅡ系统充填时，热熔牙胶的根管封闭性良好。     

Obtura Ⅱ热牙胶充填根管的微渗漏研究

目的:研究ObturaⅡ热牙胶充填根管的密封性能.方法:将40颗新鲜拔出人的单根管牙,随机分为2组,每组20颗.分别用根管糊剂加牙胶尖和ObturaⅡ热牙胶充填根管,用印度墨水染色法对比研究不同根管充填材料的密封性能.结果:根管糊剂加牙胶尖组的染色线均值为1.85±0.51mm;ObturaⅡ热牙胶组的染色线均值为0.45±0.12mm,两组之间差异显著(P＜0.05).结论:ObturaⅡ热牙胶具有较好的密封性能,用ObturaⅡ热牙胶充填根管对提高根管治疗的质量具有重要作用.     

连续波热牙胶在后牙弯曲根管治疗中的作用

目的：评价连续波热牙胶根管充填技术（continuous wave of condensation technique,CW）充填后牙弯曲根管的效果。方法：选取2008年6月～2010年1月确诊为牙髓根尖周病的后牙弯曲根管60例,随机分为三组（每组各20例）,实验组分别采用连续波热牙胶、ObturaⅡ、冷牙胶侧压三种方法充填根管,记录单个根管的根管充填时间,根充后即刻拍X线牙片评价根充效果,术后半年定期复查评价疗效。比较三种充填方法的根充时间、充填效果以及疗效。结果：连续波热牙胶组根管充填时间少于ObturaⅡ与冷牙胶侧压组,充填效果优于冷牙胶侧压组,疗效优于ObturaⅡ组与冷牙胶侧压组。结论：连续波热牙胶根管充填适用于后牙弯曲根管,操作快速有效,是一种值得在临床推荐使用的根管充填方法。     

Thermafil根管充填技术的临床评价

目的 :研究Thermafil根管充填技术的效果。方法 :选择牙髓病或根尖周病患者 60例 ,按就诊顺序随机分为 2组。即Thermafil根管充填组 (TC组 )和冷牙胶侧方加压充填组 (LC组 )。对 2组的根管充填时间、术中疼痛情况和根管充填效果进行比较。术后 3个月和 6个月进行复查 ,并拍摄X线片。结果 :以牙为单位 ,TC组适充 18颗 ,超充 11颗 ,欠充 1颗 ;在LC组中 ,适充 2 7颗 ,超充 3颗 ,无欠充 (P <0 .0 5)。TC组术中不适 4颗 ,LC组 2颗 (P >0 .0 5)。以根管为单位 ,根管充填时间Thermafil充填技术组平均 3 6.6s/根管 ,LC组平均 2 47.4s/根管 (P <0 .0 1)。结论 :Thermafil充填技术临床操作简便省时 ,但容易造成超充     

Degradation of trans-polyisoprene after root filling with thermoplasticized techniques

Aim To evaluate ex vivo degradation of gutta‐percha following six thermoplastic obturation techniques. Methodology Ninety human‐extracted mandibular premolars were selected and divided randomly into nine groups for filling. Group 1: thermomechanical compaction for 3 s with Konne gutta‐percha points (Konne Ind. e Com. de Mat. Odontol., Belo Horizonte, MG, Brazil); Group 2: thermomechanical compaction for 3 s with Dentsply TP gutta‐percha points (Dentsply Indústria e Comércio Ltda, Petrópolis, R.J. Brazil); Group 3: thermomechanical compaction for 10 s with Konne; Group 4: thermomechanical compaction for 10 s with Dentsply TP; Group 5: warm vertical condensation using System B (EIE/Analytic, Richmond, WA, USA) with Konne; Group 6: warm vertical condensation using System B with Dentsply TP; Group 7: vertical condensation with Konne; Group 8: vertical condensation with Dentsply TP; Group 9: Microseal cone (Analytic Endodontics, Glendora, CA, USA). A further four groups were assessed without using teeth, Group 10: Microseal microflow (Analytic Endodontics); Group 11: Obtura (Obtura Corporation, Penton, MO, USA); Group 12: Obtura flow (Obtura Corporation); Group 13: Thermafil (Dentsply Maillefer, Tulsa, OK, USA). The filling material was removed from the root canal and trans‐1,4‐polyisoprene isolated by solubilization of the root filling remnants in chloroform followed by filtration and centrifugation. By gel permeation chromatography and infrared spectroscopy, the occurrence and degree of degradation were assessed. The results were analysed statistically using the Kruskal–Wallis test. With differential scanning calorimetry, the thermal behaviour of the gutta‐percha was determined. Results A significant decrease in polymer molar mass and the production of carboxyl and hydroxyl groups in the polymer were observed with thermomechanical compaction used for 10 s and vertical condensation filling techniques (P = 0.0001 and P = 0.0005, respectively). Other techniques caused no polymer degradation. Conclusion Polyisoprene degrades with high temperature. Thermomechanical compaction for 10 s and vertical condensation were associated with the greatest degradative process.     

Volumetric analysis of root fillings using spiral computed tomography: an in vitro study

Aim  To analyse volumetrically using spiral computed tomography (SCT) the efficacy of various techniques to fill root canals.
Methodology  Root canals in 40 maxillary central incisors were instrumented with K-files to size 60 and the volume of the canal measured using SCT. The teeth were divided into four groups of 10 each and root filled by lateral compaction, Thermafil, Obtura II and System B techniques, respectively. AH plus was used as sealer with all techniques. The filled volume in each canal was measured using SCT and the percentage of obturated volume (POV) was calculated. The data were statistically analysed using Kruskal–Wallis test and Mann–Whitney U -test.
Results  The four groups were comparable in canal volume. The overall POV was 80.4%, 93.3%, 84.8% and 93.7% for lateral compaction, Thermafil, Obtura II and System B, respectively ( P  < 0.05).
Conclusion  The greatest POV was obtained with System B and Thermafil. Voids were seen in all root fillings.     

Effectiveness of different obturation techniques in the filling of simulated lateral canals

The purpose of this in vitro study was to evaluate the ability of lateral compaction of gutta-percha and of five thermoplasticized gutta-percha filling techniques to obturate simulated lateral canals. Sixty extracted single-rooted human teeth were instrumented at the working length to a #35 file before creating three simulated lateral canals on the mesial and distal surfaces of the root, one in each third, using a #15 engine reamer. After enlarging root canals to a #45 file, the teeth were randomly divided into six equal groups of 10 and obturated according to the following techniques: lateral compaction of gutta-percha (group A), hybrid technique (group B), Ultrafil (group C), Obtura II (group D), System B + Obtura II (group E), and Thermafil (group F). AH26 was used as the sealer. A greater number of simulated lateral canals were obturated when Ultrafil, Thermafil, and System B + Obtura II were used, in comparison with canals obturated with the hybrid technique, Obtura II, or lateral compaction of gutta-percha. This difference was statistically significant (p < 0.05). No statistically significant differences were found between results obtained in the obturation of simulated lateral canals in the different thirds of the root (p > 0.05).     

Negative influence of continuous wave technique on apical sealing of the root canal system with Resilon

The aim of this study was to investigate apical microleakage after use of the Resilon system in comparison with gutta-percha. The materials used were 54 mesial roots of mandibular molars with an apical curvature of 20-40 degrees . The root canals were instrumented with the Prosystem GT(R) and obturated with: Group I: Gutta-percha + Sealer by lateral condensation (n = 25); Group II: Gutta-percha + Sealer, complemented by System B and Obtura II (n = 25); Group III: Resilon + System B and Obtura II (n = 25); Group IV: Resilon by lateral condensation (n = 25). After immersion in India ink, the specimens were demineralized and rendered transparent. Apical dye leakage was analyzed with a stereomicroscope and a digital camera connected to a computerized system. All groups showed different degrees of apical dye microleakage. The Kruskal-Wallis test revealed that the largest leakage occurred in Group I (P < 0.05), whereas the other groups presented a similar pattern of microleakage (P > 0.05). Thermoplastification negatively influenced the apical sealing ability of Resilon. Gutta-percha points and conventional sealer yielded the highest values of apical leakage, especially when the lateral condensation technique was used. Regardless of the obturation technique employed, the Resilon system provided the lowest mean values of apical leakage, but did not provide hermetic sealing of the root canal system.     

The sealing ability of a new silicone-based root canal filling material (GuttaFlow): an in vitro study using the percentage of gutta-percha-filled area

Percentage of gutta-percha-filled area (PGFA) was used to investigate the sealing ability of GuttaFlow. A total of 80 mandibular first premolars with single canal were randomly divided into 4 Groups (n=20) according to root canal filling technique and/or material - Group1: cold lateral condensation technique; Group 2: continuous wave condensation technique; Group 3: GuttaFlow; Group 4: GuttaFlow and accessory gutta-percha cones without lateral condensation. The PGFA values of Groups 3 and 4 were significantly higher than those of Groups 1 and 2 (p<0.05), but there were no significant differences between Group 3 and Group 4 (p>0.05). It was concluded that GuttaFlow provided superior sealing ability, such that accessory gutta-percha cones became unnecessary when filling root canals with GuttaFlow.     

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目的分析冷牙胶侧向加压与热牙胶垂直加压法充填后根管壁应力及其与牙本质裂纹发生的关系。方法选取2011年4—6月于哈尔滨医科大学附属口腔医院口腔外科门诊因正畸需要或牙周病原因新鲜拔除的人完整单根管离体牙40颗,采用冷牙胶侧向加压法、热牙胶垂直加压法分别对单根管前磨牙进行根管充填。应用医学3D图像编辑处理软件提取根管充填后的牙胶形态,通过特定有限元分析软件计算根管壁应力及其位置,并且分别在距离解剖根尖3、6和9mm处通过图像分析软件观察牙胶形态和牙本质裂纹。结果冷牙胶侧向加压法的牙本质裂纹明显多于热牙胶垂直加压法,所产生的根管壁应力也高于热牙胶垂直加压法。结论冷牙胶侧向加压法的根管壁应力高于热牙胶垂直加压法,并且易造成牙本质裂纹。     

不同根管充填方法和根管封闭剂根尖微渗漏的研究

目的：探讨不同根管充填方法和根管封闭剂的根尖封闭效果。方法：选择150颗近期拔除的单根管牙,选取140颗分为A、B、C、D4组（每组35颗）,其它10颗随机分为E组：阳性对照组（n=5）和F组：阴性对照组（n=5）,采用手用Pro-taper镍钛根管锉预备根管,分别采用Cortisomol根管封闭剂加冷牙胶侧方加压充填技术（A组）、AHplus根管封闭剂加冷牙胶侧方加压充填技术（B组）、Cortisomol根管封闭剂加Obtura-Ⅱ热牙胶充填技术（c组）、AHplus根管封闭剂加Obtura—II热牙胶充填技术（D组）进行根管充填,采用染料渗透法检测根尖微渗漏,对染料渗透的长度进行测量并对结果进行分析。结果：A组和B组、A组和C组、C组和D组的染料渗透长度有显著性差异@〈0．05）,B组和D组的染料渗透长度无显著性差异（P〉0．05）。结论：热牙胶垂直加压术的根尖封闭效果好于冷侧压充填术,AH-plus根管封闭剂的封闭性能好于Cortisomol根管封闭剂。     

Effectiveness of gutta-percha and Resilon in filling lateral root canals using the Obtura II system

The aim of this study was to evaluate the effectiveness of gutta-percha and Resilon in filling lateral root canals by using the Obtura II system. Root canals of artificial teeth were prepared using a standard protocol, and lateral canals were made in three thirds of the root canal. The root canals were filled with either Obtura gutta-percha (OB), Endo-points flow gutta-percha (ED), or Resilon (RE) by using the Obtura II system. The fillings were evaluated using digitized radiographs and analyzed by using Image Tool software. Outlines of the total areas of the lateral canals and the filled areas were used to determine the percentage of filling in each lateral canal. Data were analyzed with the Kruskal-Wallis and Dunn tests at a 5% significance level. RE and ED showed better results than OB did in the three thirds of the root canals. When the root canal thirds were compared, OB and RE were more effective in the cervical third than in the apical third (p < 0.05). In conclusion, Resilon and EndoFlow gutta-percha were effective in filling lateral canals by using the Obtura II system.     

锥形束CT评价3种根管充填方法的再治疗效率

［摘要］ 目的 锥形束CT扫描评价3种方法根管充填后采用Mtwo-R再治疗的效率。方法 30颗离体单根管下颌前磨牙,截冠后使用Mtwo镍钛锉根管预备,随机分为3组,每组10颗牙,分别采用GuttaFlow常温流动牙胶充填、iRoot SP单尖法充填和冷牙胶侧方加压充填。Mtwo-R再治疗锉去除根充物,记录再治疗所用时间。再治疗前后分别进行CBCT 扫描,超声荡洗2 min,再次CBCT 扫描,测量Mtwo-R再治疗后及超声荡洗后根管充填材料体积,计算剩余根管充填材料体积百分比。结果 操作时间GuttaFlow组＜冷侧压组＜iRoot SP组,各组间均有统计学差异（P<0.05）。Mtwo-R再治疗后剩余充填材料体积百分比GuttaFlow组＜冷侧压组＜iRoot SP组,GuttaFlow组与其他2组之间均有显著性差异（P<0.05）,而冷侧压组与iRoot SP组之间无显著性差异（P>0.05）。超声荡洗后剩余充填材料体积百分比GuttaFlow组＜iRoot SP组＜冷侧压组。GuttaFlow组显著低于其他2组（P<0.05）,iRoot SP组与冷侧压组间无显著性差异（P>0.05）。在辅助超声荡洗后,3组剩余充填材料体积百分比均显著降低（P<0.05）。结论 根管再治疗后3组均会残留根管充填材料,常温流动牙胶充填后充填材料更容易被去除,iRoot SP最不容易被清除,辅助超声荡洗能提高iRoot SP的清除率。