根管内药物消毒作用的探讨

根管治疗是目前治疗各种牙髓病和根尖周病最有效的方法。通过根管预备、消毒和充填 ,防止根尖周病变的发生 ,并促进根尖周病变的愈合 ,但对根管内药物消毒的必要性有人提出质疑。本组旨在对根管内药物消毒的作用进行探讨。1　材料和方法1.1　临床资料选择门诊因各类牙髓和根尖周病需进行根管治疗的患牙 32 6个 ,其中前牙 117个 ,前磨牙 116个 ,磨牙 93个 ;牙髓有活力者 16 1牙 ,有窦道者 48牙。随机分为对照组 (16 2牙 )和实验组 (16 4牙 )。1.2　方法对 32 6例患牙均采用常规的多次法完成根管治疗。治疗中 ,对照组仅用生理盐水冲洗根管 ,消…     

4种根管消毒药物对离体人牙根管内致病菌抗菌活性的研究

目的:对比氢氧化钙糊剂、碘仿糊剂、FC、Vitapex4种根管消毒药物对离体牙根管内优势致病菌的抗菌活性。方法:选取50个新鲜拔除的人单根管牙,在釉牙骨质界处切除牙冠。将所有牙根随机分为5组,每组10个。清理根管后将细菌混合悬液接种培养,10d后取样做细菌计数后进行根管预备,取样进行细菌计数,将氢氧化钙糊剂、碘仿糊剂、FC、Vitapex和无菌纸捻分别封入5组根管内,7d后再取样做细菌记数。结果:统计学分析发现:根管预备前后各组牙根根管内细菌数量存在显著性差异(P<0.05);对比封药前后根管内细菌数量发现4种药物均有抗菌作用,但4种药物的抗菌活性无显著统计学差异(P>0.05)。结论:完善的根管预备能够去除根管内的大部分致病菌,4种根管消毒药物抗菌活性无显著差异。     

感染根管常用药物抗菌作用的实验研究

近年来由于厌氧培养技术的发展,有关感染根管微生物学研究有了明显突破,在感染根管中分离到各种厌氧的、兼性厌氧的和需氧的细菌,对于这些混合菌感染的研究及有效药物选择,是目前感兴趣的课题。本文在感染根管细菌学研究的基础上,讨论了临床常用药物,对与感染根管关系比较密切的细菌,如产黑色素拟杆菌,具核梭杆菌,干酪乳杆菌,口腔链球菌等的抗菌作用。其目的是为牙髓病和慢性根尖周病的临床治疗,在有效药物的选择方面提供实验依据。     

对氢氧化钙根管消毒作用的再认识

氢氧化钙是临床上常用的根管消毒药物之一,其消毒效果得到广泛认同.但近年来的研究表明,氢氧化钙的抗菌作用并非全能,特别是对于一些难治性根尖周病的病原菌抗菌效果不佳,其药物剂型和临床操作也存在着一定的局限性.本文就氢氧化钙的抗菌作用、临床操作等作一综述.     

戊二醛对感染根管消毒作用研究

通过实验室细菌学检验和临床应用研究，证实戊二醛消毒剂对感染根管的消毒作用显著优于甲醛甲酚（ＦＣ）消毒剂。戊二醛消毒感染根管１００例，细菌培养阳性率为２％；用甲醛甲酚消毒感染根管１００例，细菌培养阳性率为１８％。用戊二醛患者的感觉良好率为９７％，甲醛甲酚的感觉良好率为５３．３％，表明戊二醛是一种良好的根管消毒剂。     

天然药物应用于根管消毒的研究进展

根管消毒是根管治疗的基础步骤之一。根管消毒方法众多,其中药物消毒最为常用。目前临床最常用的根管消毒剂氢氧化钙糊剂因具有抗菌力和抗菌谱不足、清除率低、起效慢等问题,需要新型根管消毒剂代替和补充。天然药物因种类繁多、药效广泛、廉价易得而备受青睐。目前国内外众多研究显示多种天然药物或复合制剂具备良好的抗菌力以及其他优于传统根管消毒剂的特性,但也存在其自身及研究上的不足。本文就近年来试用于根管消毒的天然药物进行综述。     

空管药物消毒根管对预防根管治疗术复诊间痛的临床观察

目的：通过暂封空管药物来消毒根管，达到预防根管治疗术复诊间痛的发生。方法：选择患急、慢性根尖周炎，牙髓坏死需接受根管治疗的362例患者共376个患牙为受试对象，随机分成实验组180例186个患牙和对照组182例190个患牙。两组均行两次法完成根管治疗术。实验组暂封空管药物，对照组暂封FC。比较两组患牙在根管治疗期间发生疼痛的比率。结果：暂封空管药物组发生疼痛的患牙为21个（11.29%），对照组发生疼痛的患牙为41个（21.58%），经统计学检验，两组有显著差异（P＜0.01）。结论：暂封空管药物可以有效预防根管治疗术复诊间痛的发生。     

根管治疗中应用空管药物消毒根管的临床效果观察

目的 :用空管药物消毒根管 ,观察其对根管的消毒效果。方法 :随机选择患急慢性根尖周炎、牙髓坏死需接受根管治疗的 3 6例患者共 3 6颗患牙为受试对象 ,随机分成实验组 18人 18颗患牙和对照组 18人 18颗患牙 ,2组均行 2次法完成根管治疗术 ,实验组于根管口暂封空管药物 ,对照组暂封甲醛甲酚合剂(formaldehydecresylol,FC) ,分别在封药前后采集细菌标本进行细菌培养鉴定。 结果 :从根管内采集并培养细菌 ,封药前 ,2组患牙根管内细菌检出率均为 10 0 % ,均包含需氧菌和厌氧菌 ;封药 1周 ,2组患牙中各有 1颗患牙检出细菌 ,其余患牙根管内未检测到细菌。结论 :根管口暂封空管药物可以有效杀灭根管系统的细菌 ,达到根管消毒的目的。     

四种根管消毒剂对乳牙根管消毒作用的临床观察

目的：对比大蒜素、甲硝唑、甲醛甲酚（FC）、樟脑酚（CP）4种根管消毒药物,对乳牙感染根管消毒作用的应用前景,从中选出较适用于乳牙感染根管的消毒药物。方法：选择2．5～8岁患儿乳牙牙髓炎、根尖周炎160例共168个牙,随机分成4组,分别封人大蒜素、甲硝唑、FC、CP,7d复诊,观察临床疗效。结果：4种根管消毒剂对乳牙感染根管的消毒作用,大蒜素组有效率90％,甲硝唑组有效率88％;FC组有效率89％;三组间比较无显著性差异（P〉0．05）,CP组有效率77％。组间比较有显著性差异（P〈0．05）,4种根管消毒药物与牙位无显著性差异,4组病例中FC组出现2例治疗期间急症,对有瘘型根尖炎大蒜素和甲硝唑组与FC和cP组比较有显著性差异。结论：4种根管消毒药物应用于乳牙感染根管最佳选择依次为大蒜素,甲硝唑、甲醛甲酚、樟脑酚。     

下颌前牙根管形态的研究进展

下颌前牙多为单根单管,但根管变异亦屡见不鲜,因而遗漏根管导致下颌前牙根管治疗失败的情况时有发生。本文通过回溯国内外近年来下颌前牙根管形态的研究结果,分析了下颌前牙根管形态特点及根管变异与根管治疗效果的关系,提出几点建议,以期为临床治疗提供参考。     

氢氧化钙糊剂用于乳牙根管充填的疗效观察

目的 :观察氢氧化钙碘仿糊剂作为乳牙根管充填材料的临床疗效。方法 :用两种根管充填材料对乳磨牙进行根管充填 ,实验组用氢氧化钙碘仿糊剂根管充填 ,对照组用氧化锌碘仿糊剂根管充填 ,观察一年后的疗效。结果 :实验组平均有效率为 84.1% ,对照组有效率为 81.4% ,实验组与对照组无显著差异(P >0 .0 5 )。结论 :氢氧化钙碘仿糊剂用于乳牙根管充填的疗效比较理想。     

根管润滑剂对根管预备后细菌检出率的影响

目的:从临床应用方面评价根管预备过程中根管润滑剂对根管内细菌清除能力的影响。方法:100个临床诊断为慢性根尖周炎的前牙随机分成两组:实验组使用根管润滑剂,对照组不使用根管润滑剂,两组均采用手用ProTaper冠向下法预备至F3。所有根管在预备前和预备后即刻用无菌纸捻置根管内30 s取样接种,观察并计数单位体积菌落数以评价根管润滑剂对根管内细菌的清除能力。结果:根管预备能显著去除根管内细菌(P<0.05),使用润滑剂后能明显降低根管内需氧菌、厌氧菌、产黑类杆菌、放线菌、梭杆菌检出率(P<0.05)。结论:根管预备时使用根管润滑剂能够明显减少根管内细菌数。     

Investigation of the root canal configurations of mandibular permanent teeth in the Turkish population

AIM: To investigate the root and canal morphology of mandibular permanent teeth collected from an indigenous Turkish population. METHODOLOGY: A total of 1400 extracted mandibular permanent teeth were evaluated. The teeth were divided into seven groups as central incisors, lateral incisors, canines, first premolars, second premolars, first molars and second molars in order to evaluate their root canal configurations. Access cavities were prepared and pulp tissue removed using 5.25% sodium hypochlorite solution. The teeth were stored in 5% nitric acid solution for 5 days, then rinsed under running water for 4 h and placed in increasing concentrations of ethyl alcohol. The teeth were rendered transparent by immersion in xylene solution for 3 days until complete transparency was achieved. Following this procedure, India ink was injected in the root canal systems and their configurations were examined and compared with the classification of Vertucci. The following observations were made: (i) root canal classification of mandibular teeth; (ii) morphology of the mandibular permanent teeth. The classification of Vertucci was taken as a reference during the evaluation; however additional canal morphological types were evaluated as separate groups. RESULTS: The presence of a second canal was detected in 68% of mandibular central incisors and 63% of lateral incisors. Lateral canals were found in 6.5% of mandibular central incisors and in 13% of lateral incisors. Overall, 62% of mandibular first premolar teeth had a single canal whereas 71% of second premolars had a single canal. The mandibular first and second molar teeth exhibited similar root canal configurations except for a group of second molar teeth that had a single root and canal. CONCLUSIONS: The morphological characteristics of teeth in this Turkish population were consistent with those of other studies performed on different populations using similar methodology.     

Root canal treatment of a mandibular canine with three root canals. Case report

The differing morphological manifestations of the root canal system have been the subject of research, and the incidence of various shapes of root canal systems has been classified. The present case describes the root canal treatment of a rare morphological pattern, namely a mandibular permanent canine with three root canals. No report of a similar case has been published previously.     

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提要：产黑色素类杆菌是感染根管内的优势菌,与自发性疼痛、脓肿、根管内恶臭等牙髓病和根尖周病的临床症状关系密切。有效地去除产黑色素类杆菌对治疗牙髓病和根尖周病具有重要意义。本文从几种临床根管消毒方法对产黑色素类杆菌抑菌作用方面进行综述。     

The external and internal anatomy of human mandibular canine teeth with two roots

Abstract— This study investigated the internal anatomy of 65 human mandibular canines with two well-defined roots. The teeth were decalcified and injected with gelatin coloured with india ink. Diaphanization was carried out using clear resin to allow permanent preservation. It was found that all mandibular canines with two roots had two root canals. Lateral canals were found in 68.9% of teeth and 19.7% had lateral canals at the bifurcation. The results of the external measurements (cusp tip to root apex) showed that the average buccal root length was 23.0 mm and the average lingual root length was 22.7 mm. The maximum and minimum buccal lengths were 26.7 mm and 17.9 mm respectively and the maximum and minimum lingual lengths were 27.2 mm and 17.1 mm respectively. The buccal root was the larger of the two in 47.7% of teeth and 43.1% had roots of equal size. The lingual root was larger than the buccal root in 9.2% of cases. Clinicians should be aware of the anatomical variation that exists for mandibular canines.     

老年人活髓牙一次性根管治疗术的术后观察对比

目的：观察和对比老年人与青年人两个不同年龄组活髓牙一次性根管治疗术的术后急性炎症反应及远期疗效。方法：实验组343例589颗活髓患牙,对照组616例1249颗活髓患牙,均采用一次性根管治疗术,观察和对比术后临床反应及远期疗效。结果：术后2天内出现根管治疗术术后急发症的比例分别为,实验组为0级：48.7%,1级：45.7%,2级：5.3%,3级：0.34%;对照组为0级：46.8%,1级：48.8%,2级：4.4%,3级：未发生。通过术后2年的观察,其回访率达80%以上,实验组和对照组根管治疗的成功率分别为94.4%和96.2%。结论：老年人与青年人活髓牙一次性根管治疗术的术后反应概率及远期疗效对比无明显差别。     

ROOT ZX根尖定位仪测量老年人后牙牙齿操作长度的应用

目的 :探讨ROOTZX根尖定位仪测量老年人后牙牙齿操作长度的准确性和实用性。方法 :选择 12 9例拟行根管治疗的 6 0岁以上老年患者 ,共计 137个后牙 ,330个根管。将患者随机分成两组 ,实验组采用ROOTZX根尖定位仪测量牙齿操作长度 ,对照组采用感觉法估计牙齿操作长度 ,进行常规根管预备、根管充填后摄X线牙片了解其准确性。结果 :实验组充填成功率明显高于对照组 (P <0 .0 1)。结论 :ROOTZX根尖定位仪测量老年人后牙牙齿操作长度的准确性较高。     

ROOT ZX根尖定位仪在乳牙根管测量中的应用

目的:探讨ROOTZX根尖定位仪测量乳牙根管长度的精确性。方法:选择3 8例拟行根管治疗的4～6岁儿童,共65个乳牙(乳切牙2 5个、乳磨牙40个、共计160个根管) ,采用ROOTZX测量根管工作长度,按此长度充填根管,拍摄X线根尖片。结果:ROOTZX测量结果与X线根尖片显示根管充填长度相等或偏短,这个结果不受牙齿形态、根管形态、根尖周情况的影响(P >0 .0 5 )。结论:ROOTZX可用于乳牙根管长度的测量,特别适用于有牙科畏惧症、躁动不安的儿童。