ProTaper机动镍钛锉在乳牙根管预备中的应用

目的:比较ProTaper机动镍钛锉与手用不锈钢锉在乳牙根管预备中的效果.方法:选择42名4～7岁的儿童50个患有牙髓炎、根尖周炎的下颌第一乳磨牙.随机分成2组,分别用ProTaper机动镍钛锉(A组)与手用不锈钢锉(B组)进行根管预备,使用注射型根管充填剂(Matapex充填剂)进行根管充填.比较两组病例根管预备的时间,X线片观察两组根管充填效果.结果:A组根管预备的时间明显少于B组,差异有显著性(p＜0.01).根充效果观察,下颌第一乳磨牙近中根的恰填率A组高于B组,差异有显著性(P＜0.01).远中颊舌根恰填率A组与B组差异无显著性(P＞0.05).结论:ProTaper机动镍钛锉进行根管预备及使用注射型乳牙根管充填剂充填根管,能大大提高乳牙根管治疗的效率和效果.     

ProPex测量仪对磨牙根管工作长度准确性的临床评价

目的:评价ProPex根管测量仪测量磨牙根管工作长度的准确性.方法:选择50例根尖周病患者,共102个磨牙.患牙随机分为两组,实验组采用ProPex根管测量仪测量根管工作长度,对照组采用X线法计算根管工作长度,常规根管预备充填,摄X线牙片了解其准确性.结果:实验组根管充填适充率显著高于对照组(p＜0.05).结论:ProPex根管测量仪方便、快捷,能够准确测量根管长度.     

上颌第二乳磨牙根管数目的临床研究

目的 观察临床治疗中上颌第二乳磨牙根管数目.方法 选取需行上颌第二乳磨牙根管治疗的3~8岁患儿204例,共216颗患牙.常规方法开髓、制备开髓洞型,使髓室底完全暴露,用小号锉结合17%乙二胺四乙酸(ethylene diamine tetraacetic acid,EDTA)溶液探查各根管口的位置,确定并记录根管数目,根管预备完成后采用碘仿氧化锌糊剂进行根管充填.结果 216颗上颌第二乳磨牙中,122颗为3根管(占56.5%);94颗为4根管(占43.5%),根管数目变异以近中颊根第二根管(second mesiobuccal canal,MB2)出现频率较高,占比41.2%.上颌第二乳磨牙MB2的发现率在性别(X2=1.004,P=0.316)及牙位方面的差异(X2=0.072,P=0.788)没有统计学意义.结论 上颌第二乳磨牙根管数目存在较多变异,MB2发现率较高.     

Glyde凝胶联合次氯酸钠根管清理的疗效观察

目的 评价Glyde凝胶(含EDTA和过氧化脲)与次氯酸钠组合冲洗清理根管的临床疗效。方法 选择需要做根管治疗的牙髓坏死及慢性根尖周炎患牙160例,随机分为实验组和对照组,采用改良冠入法根管预备,实验组采用Glyde凝胶联合次氯酸钠辅助根管预备,对照组采用过氧化氢与生理盐水交替冲洗配合K锉根管预备。比较两组预备后并发症发生情况及疼痛的发生率。结果 实验组预备后并发症明显少于对照组,术后疼痛反应明显减少,2组间差异具有统计学意义。结论 Glyde凝胶联合次氯酸钠辅助根管预备,在控制有效使用时间以减少对牙本质腐蚀的前提下,能彻底清理根管,去除玷污层,协助扩大狭窄弯曲根管,减少术后并发症,提高根管治疗的成功率,具有较好的临床应用价值。     

乳磨牙根管治疗失败原因分析

目的探讨乳磨牙根管治疗失败的原因。方法收集2004年1月~2006年6月在广东省口腔医院儿童牙科就诊的乳磨牙根管治疗失败的病例128例,共136颗患牙,分析治疗失败的原因。结果失败患牙中因充填物脱落根管系统暴露再感染53颗(38.97%);遗漏根管52颗(38.24%);根管充填不密合、欠填21颗(15.44%);其它原因10颗(7.35%)。结论因充填物脱落造成髓腔暴露发生再感染和遗漏根管是造成乳磨牙根管治疗失败的主要原因。     

超声在下颌磨牙C形根管预备中的应用

目的:比较超声法与手动K锉预备下颌第二磨牙C形根管的临床效果.方法:选取临床上需行牙髓治疗的下颌第一二磨牙C形根管50例,随机分成两组.实验组25例,用Odontoson-M超声仪预备根管;对照组25例,用于动K型锉预备根管.记录并比较根管预备时间.侧压法根管充填后拍摄X线片,分析根管预备和根管允填的效果.比较两组间根管治疗期间急症的发生率.结果:超声法C形根管预备的平均时间为340 s,手动K型锉为620 s,两组问筹异非常显著;X线片示根管内台阶形成超声组2例,K锉组3例;手动K型锉组出现3例根尖阻塞,3例根火偏移.与对照组相比,实验组根管预备效果显著提高,同时治疗期间急症发生率(EIE)有所改善,但未见显著性差异.结论:超声法预备下颌第二磨牙C形根管操作简便、高效实用、安全,是临床上对下颌第二磨牙C形根管进行预备的有效工具.     

新型机动镍钛器械预备根管的疗效评价

目的:探讨新型机动镍钛器械Hero642预备根管的临床疗效。方法:选取患牙髓炎或根尖周炎的恒磨牙60例(60颗患牙),试验组用机动镍钛器械Hero642及根向预备技术预备根管,对照组用K锉及逐步后退技术预备根管,两组均采用侧向加压充填技术充填根管。根据治疗前后的X线片评价根管预备和充填效果,t检验比较两组根管弯曲度和操作时间,χ2检验比较根管内并发症和术后疼痛的发生率。结果:试验组能维持根管的原走向,无根尖阻塞、台阶、根管偏移及侧壁穿孔等并发症发生,对照组并发症的发生显著多于试验组(P<0.005);试验组操作时间短,术后疼痛发生少。结论:机动镍钛器械Hero642预备根管快速、有效,成形效果好,值得临床推广应用。     

根管显微镜下下颌磨牙C形根管的临床分型与治疗

目的:探讨显微根管治疗技术对下颌磨牙C形根管系统的临床诊治疗效.方法:选择临床上需行根管治疗术且为C形根管的下颌磨牙79例,机用镍钛根管锉冠向下法预备主根管,显微镜下使用超声与K锉双敞法预备峡区,热牙胶垂直加压充填根管.记录根管分型、根管预备过程中并发症的情况,通过临床症状和体征、术前后X线片,半年随访X线片评价疗效.结果:C形根管系统中C1型较少见(12.66%);C2型发生率较高(62.02%),C2、C3型的近舌根管易超填(超填发生率:C2型4.08%;C3型15%).治疗过程中未发生器械折断、管壁侧穿等并发症,半年回访率为72.15%,随访病例中治疗成功率为91.3%.结论:C1、C2型具有较大的弧形带状根管,是临床治疗的难点;显微根管治疗术可以获得理想的疗效,值得临床推广使用.     

微创器械联合单尖法在张口受限患者根管治疗中的应用

目的:评价M3微创镍钛器械联合单尖法在张口受限患者磨牙根管治疗中的临床效果。方法:选取2020年1～8月不能完全进行常规根管治疗的张口受限的牙髓疾病患者90例,随机分为两组。观察组采用M3微创镍钛器械预备根管结合单尖法充填,对照组采用Protaper Gold预备根管结合热牙胶垂直加压充填。对两组各项指标及治疗效果进行分析。结果:观察组根管治疗可行率高于对照组,但两组差异无统计学意义(P>0.05)。对照组根管根管预备时间、充填时间较短,两组差异有统计学意义(P<0.05)。成功率、适充率、疼痛发生率两组差异均无统计学意义(P>0.05)。结论:M3微创器械预备联合单尖法充填在张口受限患者磨牙根管治疗的可行率更高,更省时,是一种有效的治疗方法。     

手用ProTaper根管扩大系统联合镍钛K锉在老年人磨牙根管治疗术中的应用

目的：评估手用ProTaper根管扩大系统联合镍钛K锉对老年人磨牙根管治疗的效果。方法：110例118个慢性根尖周炎磨牙随机分为两组,实验组60个患牙,采用手用ProTaper根管扩大系统和镍钛K锉进行根管预备,对照组58个患牙,采用不锈钢K锉根管预备,两组均以常规侧方加压法进行根管充填,在治疗前、中、后应用X线牙片了解根管数目、形态、确定根管工作长度、判断治疗效果。结果：对118个磨牙根管充填后拍摄X线牙片及观察术后反应,实验组根管成形及充填满意率85%,术后急症反应率3.33%,对照组满意率62.07%,术后急性反应率为15.5%。经x2检验,两组根管成形及充填满意率有显著性差异（P〈0.01）,术后急症反应率有显著性差异（P〈0.01）,实验组明显优于对照组。结论：手用ProTaper根管扩大系统联合镍钛K锉可有效提高老年人根管治疗的效果。     

Light and scanning electron microscopic evaluation of Glyde File Prep in smear layer removal

AIM: To evaluate the effectiveness of Glyde File Prep used in conjunction with sodium hypochlorite irrigation in the removal of smear layer produced during root canal instrumentation. METHODOLOGY: Thirty-nine extracted human teeth with single root canals were used. Access cavities were prepared and the teeth divided into three groups of 13 teeth each. Each group was treated by one of the three different regimes of irrigation and conditioning during root canal instrumentation. Group A: 0.5 mL of 1% NaOCl irrigation after each file size with an additional final irrigation of 10 mL 1% NaOCl; group B: 0.5 mL of 1% NaOCl irrigation after each file size with an additional final irrigation of 10 mL 17% EDTA; group C: Glyde File Prep coated on each instrumentation file used in conjunction with 0.5 mL 1% NaOCl irrigation after each file size and an additional final irrigation of 10 mL 1% NaOCl. The teeth were then longitudinally grooved and sectioned. Root canal cleanliness was evaluated with the aid of a Nikon light microscope (x40 and x100) and scanning electron microscope (x1000 and x3000). The debris scores obtained at three canal regions were compared statistically within the same group and among different groups using repeated measurements of analysis of variance (anova) with Bonferroni adjustments and anova with posthoc Tukey HSD, respectively. RESULTS: The canals treated with EDTA and Glyde File Prep were significantly cleaner than those treated with NaOCl alone. The apical region of the root canals generally displayed more residual smear layer, but the difference was not significant. CONCLUSIONS: Used in conjunction with NaOCl irrigation, Glyde File Prep was effective in removing smear layer produced during root canal instrumentation.     

Assessment of a gel-type chelating preparation containing 1-hydroxyethylidene-1, 1-bisphosphonate

AIM: To test an aqueous gel containing 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) regarding its interactions with sodium hypochlorite, its calcium binding capacity, and its potential in preventing the formation of a smear layer when used in conjunction with rotary root canal preparation. METHODOLOGY: The experimental aqueous gel consisted of (w/v) 2% alginate, 3% aerosil, 10% Tween 80 and 18% HEBP. Interactions of gel components with hypochlorite were assessed using iodometric titration and monochromatic ultraviolet spectrometry. Two commercial paste-type chelators containing ethylenediaminetetraacetic acid (EDTA) and peroxide (RC-Prep and Glyde) served as controls. Calcium-binding capacities were measured in mixtures with a Ca2+ standard solution buffered at pH 10 using a calcium-selective measuring chain. Finally, root canals of 16 extracted single-rooted premolars per group were instrumented using ProFile instruments dipped in the experimental gel, RC-Prep, or nothing. Additionally, canals were rinsed with 10 mL of a 1% NaOCl solution during/after preparation. Smear scores in instrumented teeth were monitored using scanning electron microscopy. RESULTS: None of the experimental gel components showed short-term interactions with hypochlorite, whilst EDTA, peroxide, RC-Prep and Glyde immediately reduced the hypochlorite in solution. The experimental gel chelated 30 mg Ca2+ g-1, compared with 16 mg Ca2+ g-1 and 11 mg Ca2+ g-1 chelated by RC-Prep and Glyde respectively. Smear scores obtained with the experimental gel were significantly (P<0.05) lower than with RC-Prep in coronal and middle root thirds, whilst no differences were observed in apical root thirds. CONCLUSIONS: Under the conditions of this study, an HEBP gel appeared advantageous over currently available products.     

老年患者钙化根管的预备

目的：观察老年人根管钙化情况,总结高校社区医院对老年患者钙化根管的治疗方法。方法：选择60-72岁老年患者的148个钙化根管,在EyeMag放大镜下,分别采用低速球钻或超声器械去除髓室内钙化物, C型先锋锉蘸取Glyde凝胶进行根管疏通,术中记录根管钙化情况和疏通效果,最后完成根管预备、消毒和充填。结果：老年人钙化根管多见于上颌第一磨牙,前牙、前磨牙、磨牙疏通成功率分别为：91.67%,72.73%,60.80%,前牙组疏通成功率高于磨牙组（χ2=4.50, P＜0.05）;根管冠方1/3和根中1/3较易发生钙化,且钙化的疏通成功率明显高于根尖1/3（χ2=19.33, P＜0.05）。结论：针对老年人钙化根管的治疗,临床医生要有足够的细心、耐心和信心,灵活的综合运用现有的各种治疗器械和设备,能够取得较好的治疗效果。     

Debris Remaining in the Apical Third of Root Canals after Chemomechanical Preparation by Using Sodium Hypochlorite and Glyde: An In Vivo Study

Introduction

During chemomechanical instrumentation, several liquid or paste substances are used to ease the action of the files and to eliminate debris and the smear layer. The aim of this study was to evaluate whether the use of a paste containing EDTA during cleaning and shaping of the root canal helps to eliminate debris.

Methods

Twenty root canals in dog teeth were instrumented by a crown-down technique by using nickel-titanium rotary files. In 10 root canals (group A), sodium hypochlorite was used during instrumentation, followed by a final irrigation with 17% liquid EDTA. In another 10 canals (group B), sodium hypochlorite was again used as the irrigating solution, but Glyde File Prep paste was used with every instrument, and a final irrigation with EDTA was also carried out. Two additional teeth were used as positive and 2 as negative controls. The jaws were prepared for histologic evaluation.

Results

In group A where Glyde was not used during cleaning and shaping, little or no debris was found in the apical third of the instrumented root canals; however; in group B in which Glyde File Prep paste was used during chemomechanical instrumentation, moderate to high accumulation of debris was observed in the apical third.

Conclusions

The use of Glyde File Prep paste during rotary mechanical instrumentation favors the accumulation of debris in the apical third of the root canals. Irrigation with NaOCl and a final flush with EDTA by means of a small-gauge needle with simultaneous aspiration led to less accumulation of debris than in the Glyde File Prep group (P < .05).     

Removal of the smear layer from flattened canals using different chemical substances

This study used scanning electron microscopy to evaluate the flattened root canals of human mandibular incisors cleaned with nickel-titanium instruments and different chemical substances. Teeth were selected and divided randomly into five groups (n = 10) according to the chemical substances used in the biomechanical preparation: 5.25% sodium hypochlorite (Group 1), 5.25% sodium hypochlorite plus a final irrigation with 17% EDTAC (Group 2), EDTA gel combined with 5.25% sodium hypochlorite (Group 3), 2% chlorhexidine gel (Group 4), and 5.25% sodium hypochlorite combined with Glyde File Prep gel (Group 5). Data analysis showed a statistically significant difference (p < 0.001) among groups. Groups 1 and 5 were similar statistically (p > 0.001) and displayed a higher amount of smear layer on canal walls. Samples from Groups 2, 3, and 4 revealed root canal walls without smear layer and exposed dentin tubules. Among the associations tested in this study, 5.25% sodium hypochlorite solution combined with 17% EDTAC, 5.25% sodium hypochlorite combined with EDTA gel, and 2% chlorhexidine gel all were effective substances for removing the smear layer from flattened root canals.     

In vitro evaluation of the effectiveness of the chemomechanical preparation against Enterococcus faecalis after single- or multiple-visit root canal treatment

The purpose was to assess the elimination of Enterococcus faecalis in vitro in human mandibular premolars after chemomechanical preparation with or without the use of a calcium hydroxide dressing. After 60 days of contamination with E. faecalis, the root canals were prepared using the Crown-Down technique combined with 2% chlorhexidine gel irrigation. Then, the specimens were divided into two experimental groups, treated in a single visit or in multiple visits, and two control groups. The multiple-visit group received a dressing with calcium hydroxide for 14 days (Calen) and the single-visit group did not receive any medication. In the two control groups, the canals were filled with BHI after chemomechanical preparation with 2% chlorhexidine gel or distilled water. Microbial samples were taken from the root canals for colony forming unit count for each phase of the treatment using sterile paper points inside the root canal lumen. Data were ranked and analyzed by the Kruskal-Wallis statistical test. The residual microbial colonies were then assessed. The results showed that chemomechanical preparation using 2% chlorhexidine gel with no intra-canal dressing reduced by 100% the E. faecalis contamination of the root canal lumen. The calcium-hydroxide group that received the 14-day intra-canal dressing allowed a small number of bacteria to grow between visits, but without statistical differences between groups.     

下颌第二磨牙C形根管预备方法的临床探讨

目的 探索预备下颌第二磨牙C形根管的有效方法.方法 对下颌第二磨牙C形根管初诊或根管再治疗的患牙,采用"拉网法"进行根管预备,完成根管充填后拍X线片检查充填效果.结果 C形根管的峡区被充分预备和成形,根充后峡区有均匀稀薄的X线阻射影像.结论 该根管预备方法能有效地预备C形根管的峡区,且不易发生根管侧穿.     

三种因素对根管桩道预备后根尖封闭性影响的研究

目的:评价根管形态、根管充填方法、根管封闭剂三种因素对桩道预备后根管的根尖封闭性的影响.方法:本实验共选取45颗规则的直根管牙根及40颗椭圆形根管牙根,分为9组.其中实验组A组为规则的直根管,A1.iRoot SP+热牙胶(n=10),A2.iRoot SP+单尖法(n=10),A3:GuttaFlow2+热牙胶(n=...     

即刻桩腔预备对三种根管预备方法预备的直根管根尖封闭性的影响

目的 研究三种不同根管预备方法根管预备、根管充填后即刺桩腔预备对直根管根尖封闭性的影响.方法 离体直单根管上前牙124个,其中120个随机平均分为3组(n=40),A组:不锈钢根管锉常规法;B组:G 型钻根管冠部预处理 不锈钢根管锉常规法;C组:手用Pr01raper镍钛根管锉冠向下法,刺余4个随机平均分为阴性对照组和阳性对照组.所有根管均用侧方加压法充填,即刻手持垂直加压器去除部分充填材料,然后P型钻桩腔预备.用染料渗透法评价各组根尖封闭能力.结果 B组G型钻根管冠部预处理 不锈钢根管锉常规法预备的根管和C组手用ProTaper镍钛根管锉冠向下法预备的根管即刻桩腔预备后,其根尖微渗漏较A组常规法预备的轻(P<0.05).结论 大锥度根管预备,根管充填后即刻桩腔预备的根尖封闭性较好.     

不同根管预备方法对直根管即刻桩腔预备根尖封闭性影响的研究

目的观察直根管不同根管预备方法根管充填后即刻桩腔预备对根尖封闭性的影响。方法离体直单根管上前牙84个,其中80个按根管预备方法随机平均分为2组(n=40),A组:不锈钢根管锉常规法;B组:G型钻根管冠部预处理+不锈钢根管锉常规法,其余4个随机平均分配为阴性对照组和阳性对照组。所有根管均用侧方加压法充填,即刻垂直加压器去除部分充填材料,然后P型钻桩腔预备。用染料渗透法评价各组根尖封闭能力。结果B组的根管进行即刻桩腔预备后,其根尖微渗漏较A组轻(P<0.05)。结论大锥度根管预备,根管充填后即刻桩腔预备根尖封闭性较好。