Vitapex糊剂一次法充填治疗瘘管型慢性根尖周炎的疗效观察

目的观察Vitapex糊剂一次法充填治疗瘘管型慢性根尖周炎的临床疗效。方法选择58颗瘘管型慢性根尖周炎的患牙,3%过氧化氢液冲洗后进行一次法根管充填。结果58颗患牙经一次法根管治疗后,成功54颗,失败4颗,成功率为93.1%。结论Vitapex糊剂一次法充填治疗瘘管型慢性根尖周炎患牙疗程短,疗效可。     

复合替硝唑液冲洗消毒根管的疗效观察

目的 评价复合替硝唑液冲洗消毒根管的临床疗效。方法 用替硝唑液、庆大霉素、地塞米松配制成复合替硝唑液。共１７２颗需根管治疗的患牙随机分成两组，试验组用复合硝唑液冲洗根管并封入消毒根管，对照组用３％Ｈ２Ｏ２和生理盐水联合冲洗后用甲酚甲醛（ＦＣ）消毒根管。结果 经统计学分析，试验组在缓解患者临床症状方面与常规治疗组有显著差异。结论 用复合替硝唑液冲洗并消毒根管是一种可行性方法之一。     

中老年人重度磨耗患牙活髓切断治疗临床疗效研究

目的 研究中老年人重度磨耗患牙活髓切断治疗的临床疗效。方法 收集28例40岁以上患者中因重度磨耗引起牙髓炎症状的患牙56颗,每名患者均有2颗患牙,同一患者的2颗患牙,随机1颗为试验组,另1颗为对照组,对照组患牙行根管治疗,试验组患牙使用MTA作为盖髓材料进行活髓切断治疗,术后观察6个月,比较两组的临床疗效。结果 对照组有4颗患牙失败,总成功率为85.2%,试验组失败的患牙有3颗,总成功率为88.9%,两者间差异无统计学意义(P>0.05)。结论 中老年人重度磨耗患牙进行活髓切断治疗具有良好的短期疗效,与根管治疗的成功率无显著差异,严格把控适应证是治疗成功的关键所在。     

机用镍钛器械与超声根管冲洗联合应用于慢性根尖周炎一次性根管治疗的临床研究

目的 应用机用镍钛器械、超声根管冲洗对上下颌前牙患有慢性根尖周炎者进行一次性根管治疗的术后疼痛反应及远期临床疗效进行评价。方法 将280颗患牙随机分成对照组、镍钛组、超声组、联合组4组,对照组患牙69颗,采用K锉预备根管,注射器冲洗;镍钛组患牙70颗,采用机用镍钛锉预备根管,注射器冲洗; 超声组患牙70颗,采用K锉预备根管,超声冲洗;联合组患牙71颗,采用机用镍钛锉预备根管,超声冲洗。4组患牙均行一次性根管治疗,充填1周后评价各组术后疼痛反应发生率,2年后评价其远期临床疗效。结果 术后1周,联合组术后反应最轻,疼痛发生率为9.86%;镍钛组与超声组次之,疼痛发生率分别为28.6%和27.1%;对照组术后反应最重,疼痛发生率为50.7%。术后2年,对照组与联合组间临床疗效有显著差异（P<0.02）,而其他各两组间临床疗效差异均无统计学意义（P>0.05）。结论 联合应用机用镍钛器械与超声根管冲洗对上下颌前牙患有慢性根尖周炎者行一次性根管治疗,能明显减少术后疼痛反应,提高患牙远期临床疗效,临床上值得推广。     

碘复冲洗消毒根管的临床疗效观察

评价磺复冲洗消毒根管的临床效果。方法１４７颗作根管治疗的患牙,随机分为２组。试验组０．０５％碘复冲洗根管并用０．５％碘复消根管;对照组用３％Ｈ２Ｏ２和生理盐水联合冲洗根管及用甲酚醛液消毒根管。     

根管再治疗的临床疗效分析

目的探讨根管再治疗的临床效果。方法对128颗根管治疗失败的患牙用丁克除和逐步后退法行根管再治疗，1年后复查治疗效果。结果回访105颗，总有效率81．9％，其中成功71颗，好转15颗，失败19颗。结论根管治疗失败后的患牙行根管再治疗仍可使患牙得以保存。     

牙髓病及根尖周病

5种冲洗剂组合对前牙直根管清洁效果的比较；复合骨形成蛋白治疗剂治疗根尖周病的动物实验研究；牙髓治疗失败的原因分析；E—Q根管充填系统的临床评价；替硝唑氢氧化钙糊剂充填根管的临床疗效观察；干髓术失败患牙的根管再治疗。     

Vitapex糊剂治疗乳牙根尖周炎疗效观察

目的：观察Vitapex糊剂治疗牙瘘管型慢性根尖周炎的临床疗效。方法：选择70颗瘘管型慢性根尖周炎的乳牙，用甲硝唑注射液冲洗后Vitapex进行根管充填。结果：70颗患牙中成功64颗，成功率为91．43％。结论：本方法是保存乳牙至乳恒牙正常替换的较理想的治疗方法。     

根管内器械分离后行旁路根管治疗的临床评价

目的观察根管内器械分离患牙行旁路根管治疗后的临床疗效。方法选择32颗根管内器械分离不能完全取出的患牙为试验组,采用从分离器械旁建立通路到达根尖的方法进行根管预备和充填;同时选择器械分离后不能取出也不能行旁路根管治疗的患牙13颗为对照组,未发生器械分离的常规根管治疗患牙30颗为常规治疗组。观察3组患牙2年后的临床疗效并进行评价。结果试验组2年后回访牙数25颗,根管治疗成功率为80.00%;对照组2年后回访牙数11颗,成功率为36.36％;2组失败病例均为器械分离发生在根尖1/3处的患牙。常规治疗组2年后回访牙数22颗,成功率为90.91％。结论旁路根管治疗法是器械分离后进行根管治疗的一种可行和有效的方法。     

Vitapex和甲硝唑治疗慢性根尖周炎的疗效观察

目的：观察Vitapex充填治疗瘘管型慢性根尖周炎的临床疗效。方法：选择62个瘘管型慢性根尖周炎的患牙，甲硝唑液冲洗后用Vitapex进行根管充填。结果：62个患牙中成功57个，成功率为91.94%。结论：本方法是治疗瘘管型慢性根尖周炎较理想方法。     

Effect of conventional needle irrigation,passive ultrasonic irrigation,sonic irrigation and XP-endo finisher in removing intracanal Vitapex paste

To compare the efficiency of conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation and XP-endo Finisher in removing Vitapex paste from root canals. The root canals of human single-rooted teeth were prepared and obturated with Vitapex paste. After 2 weeks, the 48 teeth were randomly allocated into four groups: conventional needle irrigation (CNI) group, passive ultrasonic irrigation (PUI) group, sonic irrigation (SI) group and XP-endo Finisher (XP) group. The specimens of four groups were scanned using a micro-computed tomography after the Vitapex pastes was removed. The results showed that more residual paste was left in the CNI group than in the other three groups (p < 0.05). There was no significant difference among the PUI, SI and XP group (p > 0.05). And, the majority of the residual Vitapex was found in the apical third, with a small amount in the middle third after using any of the three agitated irrigation techniques.     

超声冲洗应用于老年人隐裂牙牙髓炎一次性根管充填治疗术的临床评价

目的：对超声冲洗应用于老年人隐裂牙一次性根充治疗术的临床疗效进行评价。方法：对110例老年患者110颗牙按就诊顺序随机分为实验组和对照组。两组均采用手用镍钛Protaper根管预备后,实验组：57颗患牙进行超声根管冲洗,一次法完成根管充填治疗。对照组：53颗患牙进行注射器冲洗,一次法完成根管充填治疗。冲洗液均为0.9%生理盐水。观察根管充填一周后的术后疼痛反应及一年后充填疗效。结果：1周后复诊两组术后疼痛反应有显著性差异（P〈0.05）。术后1年复诊,2组疗效无明显差异（P〉0.05）。结论：超声冲洗对于治疗老年人隐裂牙牙髓炎一次法完成根管充填,短期内可减少患者复诊次数,缩短疗程,同时提高根管充填质量,值得临床推广使用。     

干扰(牙合)对特发性牙颈部病损临床疗效影响的研究

目的:研究干扰(牙合)对特发性牙颈部病损临床治疗效果的影响.方法:第一部分:纳入该院口腔科特发性牙颈部病损就诊患者83例,患牙295颗;临床检查存在干扰142颗作为治疗1组,无干扰(牙合)153颗作为治疗2组,分别行纳米树脂治疗.随访2年.评价疗效,卡方检验.第二部分:治疗l组失败患牙60颗,随机分为实验组和对照组,各30颗.实验组纳米树脂充填治疗特发性牙颈部病损后精确去除咬合干扰因素,对照组仅纳米树脂充填治疗.治疗2组失败患牙29颗,随机分为实验组14颗和对照组15颗.实验组降低咬合,对照组仅纳米树脂充填治疗.随访1年,评价效疗,卡方检验.结果:第一部分:治疗1组和2组牙颈部病损治疗成功率分别为57.75％和81.05％ (P ＜0.05).第二部分:治疗1组失败患牙60颗,实验组和对照组成功率分别为83.33％和56.67％ (P ＜0.05).治疗2组失败患牙29颗,实验组和对照组成功率分别为85.72％和40％ (P ＜0.05).结论:充填治疗时配合精确去除咬合干扰因素治疗,可提高特发性牙颈部病损的临床疗效.     

Incidence of endodontic implantitis and implant endodontitis occurring with single-tooth implants: a retrospective study

The purposes of this study were to determine success and survival rates for implants and teeth adjacent to implants and the incidence of endodontic implantitis (E-I) (endodontic involvement in adjacent teeth causing implant failure) and implant endodontitis (I-E) (implant placement causing endodontic failure). The data were from 233 single-tooth implants placed in 116 subjects by postgraduate periodontal students with recall radiographs taken >or=9 months after implant placement. Three groups were analyzed: group A, implants with no adjacent teeth (n = 90); group B, implants with nonendodontically treated adjacent teeth (n = 123); and group C, implants with endodontically treated adjacent teeth (n = 20). The success and survival rates for implants were both 92.2% in group A, 98.4% and 99.2% for group B, and 85% and 95% for group C, respectively. For adjacent teeth, they were both 99.4% in group B compared with 75% and 90% in group C. However, after case review, none of the implants or adjacent teeth in group B were considered to have E-I or I-E, and one (5%) of the implants in group C had E-I and two (10%) of the adjacent teeth may have had I-E. The results of the present study agree with previous research, which suggests that endodontically treated teeth adjacent to single-tooth implants are usually successful and should be maintained.     

In vivo evaluation of ProPex electronic apex locator

The aim of this in vivo study was to evaluate the performance of ProPex apex locator after extirpation and in presence of different irrigation solutions: 2.5% NaOCl, 0.9% NaCl, and 0.2% chlorhexidine gluconate solutions. Twenty-seven single-rooted human teeth scheduled for extraction with mature apices were selected for this study. Measurements were performed by using ProPex after extirpation and in presence of the irrigation solutions. After extraction of the teeth, a stereomicroscope was used to confirm visually the relationship of the tip of the endodontic file to the apical foramen, and actual lengths (ALs) were determined by reducing 0.5 mm from these lengths. The data were statistically analyzed with cluster analysis. The results of this study showed that measurements after extirpation had the smallest distance to the ALs. Among the irrigation solution groups, chlorhexidine gluconate group had the smallest distance to the ALs, whereas saline group had the greatest. Most accurate measurements were obtained after extirpation.     

Comparison of apexification with mineral trioxide aggregate and calcium hydroxide

PURPOSE: The aim of this study was to compare mineral trioxide aggregate (MTA) with calcium hydroxide [Ca(OH)2] clinically and radiographically as materials used to induce root-end closure in necrotic permanent teeth with immature apices (apexification). METHODS: Fifteen children, each with at least 2 necrotic permanent teeth requiring root-end closure (apexification), were selected for this study. All selected teeth were evenly divided into 2 test groups. In group 1, the conventional calcium hydroxide apexification (control) was performed, whereas in group 2, the MTA apexification (experimental) was done. The children were recalled for clinical and radiographic evaluations after 3, 6, and 12 months. RESULTS: The follow-up evaluations revealed failure due to persistent periradicular inflammation and tenderness to percussion detected at 6 and 12 months postoperative evaluation in only 2 teeth treated with Ca(OH)2. The remaining 13 teeth appeared to be clinically and radiographically successful 12 months postoperatively. None of the MTA-treated teeth showed any clinical or radiographic pathology. CONCLUSIONS: Mineral trioxide aggregate showed clinical and radiographic success as a material used to induce root-end closure and is a suitable replacement for calcium hydroxide for the apexification procedure.     

复方替硝唑糊剂治疗乳磨牙根尖周炎的疗效观察

目的：观察复方替硝唑糊剂在乳磨牙有窦道型慢性根尖周炎治疗中的临床疗效。方法：用复方替硝唑糊剂或氢氧化钙甘油为根管充填材料分别对205个患牙进行根管充填并于充填后1、2年观察其疗效。结果：复方替硝唑糊剂2年根管充填成功率95．29％，氢氧化钙甘油成功率71．72％。结论：复方替硝唑糊剂是治疗乳磨牙有窦道型慢性根尖周炎较为理想的药物。     

Comparison of the antimicrobial efficacy of 1.3% NaOCl/BioPure MTAD to 5.25% NaOCl/15% EDTA for root canal irrigation

The purpose of this study was to compare the antimicrobial efficacy of 1.3% NaOCl/BioPure MTAD to 5.25% NaOCl/15% EDTA for root canal irrigation. Twenty-six bilaterally matched pairs of human teeth were collected. The teeth were incubated with Enterococcus faecalis for 4 weeks. The teeth were divided into two experimental groups and one positive control group. The canals were instrumented and irrigated with either 5.25% NaOCl/15% EDTA or 1.3% NaOCl/BioPure MTAD. Bacterial samples were collected after instrumentation/irrigation and after additional canal enlargement. Statistical analysis of the data using the Wilcoxon Signed Rank test showed significant differences between the experimental groups. The first bacterial samples revealed growth in 0 of 20 samples with 5.25% NaOCl/15% EDTA irrigation and in 8 of 20 samples with 1.3% NaOCl/BioPure MTAD irrigation. Samples taken after additional canal enlargement revealed growth in 0 of 20 samples in 5.25% NaOCl/15% EDTA and in 10 of 20 samples in 1.3% NaOCl/BioPure MTAD group. This investigation showed consistent disinfection of infected root canals with 5.25% NaOCl/15% EDTA. The combination of 1.3% NaOCl/BioPure MTAD left nearly 50% of the canals contaminated with E. faecalis.     

Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol

PURPOSE: The objective of this study was to assess the effect of mineral trioxide aggregate (MTA) as pulp dressing material following pulpotomy in primary molars with carious pulp exposure and compare them to those of formocresol (FC). METHODS: Of 33 children, primary molars treated via a conventional pulpotomy technique were randomly assigned to the MTA group (33 teeth) or FC group (29 teeth). Clinical and radiographic follow-up ranged between 4 and 74 months. The mean follow-up time was 38 months, with no difference between the groups. Twenty-nine teeth were followed until uneventful shedding (mean=33 months). Failures were detected after a mean period of 16 months (range=4 to 30). RESULTS: The success rate of pulpotomy was 97% for MTA (1 failure) and 83% for FC (5 failures). Eight teeth presented internal resorption. In 4 of them (2 of each group), progress of the resorption process stopped and the pulp tissue was replaced by a radioopaque calcified tissue. Pulp canal obliteration was observed in 58% of the MTA group and in 52% of the FC group (total=55%). CONCLUSIONS: MTA showed a higher (though not statistically significant) long-term clinical and radiographic success rate than formocresol, and can be recommended as its replacement as, unlike FC, MTA does not induce undesirable responses.     

Radiographic and histologic periapical findings of root canal treated teeth in cadaver

The success of root canal treatment can be subjectively evaluated both clinically and radiographically. Normally, the recall radiograph is the main factor in evaluating success or failure.Objectives. This study evaluated periapical areas of root canal treated teeth by correlating radiographic and histologic findings.Study design. Jaws were resected from cadavers and radiographed. Those teeth that had received root canal treatment were evaluated for success or failure based on radiographic criteria. Teeth and surrounding bone were then removed en bloc and prepared for light microscopy. Untreated teeth without periapical pathosis were examined as controls.Results. Root canal treated teeth classified as failures were found to consistently have inflammatory resorptive lesions at the periapices. In contrast, those treated teeth classified as radiographically successful showed varying reactions ranging from normal uninflamed to mildly inflamed.Conclusions. Those classified as failure showed consistent inflammation. However, the majority of our examined treated teeth were radiographically normal and exhibited no periapical inflammation.