不同盖髓材料用于盖髓术的临床研究

目的 比较可乐丽菲露SE3 BOND和Dycal氢氧化钙盖髓的临床效果。方法 将79例患者的84颗患牙分成2组,乐丽菲露SE3 BOND 组62颗患牙,Dycal氢氧化钙组22颗患牙。2组病例分别用Dycal氢氧化钙以及可乐丽菲露SE3 BOND盖髓,光固化玻璃离子垫底,光固化复合树脂充填。结果 盖髓治疗8个月后追踪观察,深龋近髓的患牙用Dycal氢氧化钙盖髓的成功率93.5%,与用可乐丽菲露SE3 BOND盖髓（87.1%）比较,差异无统计学意义(P>0.05）;深龋穿髓的患牙用Dycal氢氧化钙盖髓的成功率（75%）明显高于可乐丽菲露SE3 BOND（50% ）,差异有统计学意义（P<0.05）。结论 在深龋近髓患牙盖髓术治疗中,可乐丽菲露SE3 BOND和Dycal氢氧化钙的疗效均佳,但在深龋穿髓患牙盖髓术治疗的病例中,Dycal氢氧化钙对深龋穿髓疗效明显优于可乐丽菲露SE3 BOND。     

MTA修补髓底穿孔的临床疗效观察

目的评价三氧化物多聚体(mineral trioxide aggregate,MTA)、磷酸锌水门汀(ZPC)和银汞合金(amalgam)应用于髓室底穿孔修补的临床疗效。方法选取髓底穿孔的患牙50颗,随机分成3组,均做严密的根管治疗,之后分别用MTA、ZPC、银汞合金修补髓空底,3组均定期复查,观察临床效果及X线片结果。结果经过1年后复查,MTA修补髓室底穿孔效果明显高于ZPC和银汞合金(P<0.05)。结论 MTA作为一种新型生物材料,具有良好的封闭性,组织相容性和生物活性,是修补髓室底穿孔良好修复材料,同时提高牙齿保存率,在临床广泛应用。     

四种牙充填材料修复根分叉穿孔渗漏的比较

为临床选择有交的根分叉（髓室底）穿孔修复材料，采用２％次要液，作四种牙充填材料修复根分叉穿孔的渗漏测试。结果显示光固化玻璃离子渗漏最小，银汞合金次之；羟基磷灰石渗漏最大，染液充满髓腔，而应用羟基磷灰石与光因化玻璃离子夹层技术，能显著减少羟基磷灰石的渗漏。结论：羟基磷灰石与光固化玻璃离子夹层技术修复根分叉穿孔优于单独使用羟基磷灰石。     

可乐丽菲露SEBOND应用于Beagles犬直接盖髓术的组织学评价

目的　将可乐丽菲露SE BOND用于beagles犬直接盖髓术后,进行组织学分级评价。方法　选择6只bea- gles犬共130颗健康牙齿,在颊面制备Ⅴ类洞并在洞底作人工穿髓孔,然后分为2组,实验组以可乐丽菲露SE BOND 盖髓,对照组以氢氧化钙盖髓。所有实验牙齿分别在盖髓后的第7、30、90天拔除,并进行组织学评价。结果　病理 学评价显示,在7 d的观察期内2组的牙髓均呈轻度到中度的炎性反应,可乐丽菲露SE BOND组的炎性反应较氢氧 化钙组轻,但其差别没有统计学意义。在30 d和90 d的观察期内2组均无明显的炎性反应,而牙本质桥的形成在 氢氧化钙组显著多于可乐丽菲露SE BOND组,其差别有统计学意义(P<0·05)。结论　可乐丽菲露SE BOND对牙 髓的刺激性较小,但诱导牙本质形成的能力较氢氧化钙弱。     

可乐丽菲露SE BOND用于直接盖髓术的组织学评价

目的:对可乐丽菲露SEBOND在人体用于直接盖髓术进行组织学评价。方法:选择24名志愿者共45颗健康人第三磨牙,41颗在牙合面制备Ⅰ类洞并在洞底作人工穿髓孔,然后分为2组,实验组以可乐丽菲露SEBOND盖髓,对照组以氢氧化钙盖髓。4颗作为空白对照。所有实验牙齿分别在盖髓后的7、30、90d后拔除并进行组织学检测。结果:实验组和对照组志愿者均未出现术后实验牙齿敏感症状。病理检测显示,在7d和30d的观察期内2组均有轻度到中度的炎性反应,但可乐丽菲露SEBOND组的炎性反应较氢氧化钙组轻,其组织学评价分级上的差别有统计学意义(P<0.05)。在90d的观察期内2组均无明显的炎性反应,而牙本质桥的形成在氢氧化钙组显著多于可乐丽菲露SEBOND组,氢氧化钙组7例标本中有6例标本有牙本质桥的形成,可乐丽菲露SEBOND组7例标本中有3例形成,其差别有统计学意义(P<0.05)。结论:可乐丽菲露SEBOND对牙髓的刺激性较小,但诱导牙本质形成的能力较氢氧化钙弱。     

MTA用于修补髓底及根管穿孔的临床疗效观察

目的观察采用MTA修补髓底及根管穿孔的临床效果。方法14颗髓底穿孔或根管侧穿的患牙采用根管显微镜下MTA修补,定期随访,观察治疗效果。结果复诊时14颗患牙中有13颗无不适主诉,临床检查无牙龈病变及牙周袋;1颗患牙因修补4d后疼痛加重,于外院拔除。修补前后临床检查及X线片对照显示,11颗患牙穿孔处牙槽骨无明显吸收。结论MTA是较为理想的髓底及根管穿孔的修补材料,短期临床疗效良好。     

钴铬合金嵌体修复磨牙髓室底穿孔的体外研究

目的 探讨钴铬合金嵌体修复髓室底穿孔的操作步骤及修复效果.方法 收集新鲜拔除的人恒磨牙42颗:其中38颗用8号球钻在髓底中央制备直径2.1 mm的穿孔洞型,随机均分为A、B两个实验组;另外4颗为C组,只开髓不制备髓底穿孔,作阴性对照.A、B两组分别用钴铬合金嵌体和间接树脂嵌体修复髓底穿孔,并使用树脂加强型玻璃离子进行粘接.从2个实验组中各随机选4个用扫描电子显微镜观察粘接界面,其余15个样本用葡萄糖氧化酶-过氧化物酶法检测微渗漏.结果 A组微渗漏值在任意时间点均高于B组,但差异无统计学意义(P＞0.05),A、B组均对根分叉的外形进行了良好的修复,但扫描电镜下,钴铬合金嵌体的界面宽度小于树脂嵌体.结论 在形态学和封闭性方面,钴铬合金嵌体修复磨牙髓室底穿孔效果良好.     

可乐丽菲露SE BOND防治固定义齿基牙牙本质过敏的疗效观察

目的 探讨评价可乐丽菲露SE BOND对活髓基牙预备后牙本质过敏症的防治效果。方法 将118例(共238颗基牙)行冠桥固定修复的患者随机分为可乐丽菲露SE BOND组、Gluma脱敏剂组(对照组)、75%NaF组(对照组)3组,所有基牙采用暂时冠修复、氧化锌丁香油酚粘固剂粘固。7～10d后试戴修复体,观察治疗效果,并进行统计学分析。结果 经3种药物处理过的基牙过敏症状均有明显改善,可乐丽菲露SE BOND组(有效率95.18%)的疗效优于75%NaF组(有效率56.58%,P<0.05),而可乐丽菲露SE BOND组和Gluma脱敏剂组(有效率92.41%)间则无统计学差异(P>0.05)。结论 可乐丽菲露SE BOND可以有效防治全冠活髓基牙预备后牙本质过敏症的发生。     

恒磨牙邻面龋充填治疗的疗效评价

目的：评价用银汞合会、町乐丽菲露AP-X复合树脂及Beautifil氟化玻璃聚合体对恒磨牙邻面龋进行充填治疗的临床效果。方法：选择58-71岁门诊患者176例416颗恒磨牙邻面龋患牙，按龋损部位分为龈缘组和龈上组，每组随机分为3组，分别用银汞合金、可乐丽菲露AP-X及Beautifil氟化玻璃聚合体按各闩洞型制备要求备涧后进行充填。银汞合金组深龋用聚羧酸锌水门汀垫底后充填；可乐丽菲露AP-X组及Beautifil氟化玻璃聚合体组深龋用Ionosit-Baseliiler垫底后充填。随访18-24个月观察治疗效果。结果：患者复查回访率为86．93％。龈缘组中，银汞合金组成功率92．31％；可乐丽菲露AP-X组成功率92．65％；Beautifil氟化玻璃聚合体组成功率87．76％。经χ2检验，3组差异均兀显著性。龈上组中，银汞合金组成功率91．30％；町乐丽菲露AP—X组成功率97．44％；Beautifil氟化玻璃聚合体组成功率95．77％。经χ2检验，3组差异均无显著性。结论：银汞合金、可乐丽菲露AP-X及Beautifil氟化玻璃聚合体修复恒磨牙邻面龋的临床嫂果良好，3组之间无明显茺异。     

无机三氧化物聚合体与树脂嵌体修复大面积磨牙髓室底穿孔封闭性能比较研究

目的 评价无机三氧化物聚合体（MTA）与树脂嵌体修复磨牙大面积髓室底穿孔的封闭性能。方法 收集2013年3—6月在福建省立医院口腔科新鲜拔除的人恒磨牙70颗,分为A、B、C组,其中A、B组各30颗,C组（作为对照）10颗。A、B组制备直径≥ 3 mm的髓室底穿孔,其中A组采用MTA修复髓室底穿孔,B组采用树脂嵌体修复;C组只开髓不制备穿孔。显微镜下观察各组的根分叉形态,采用葡萄糖氧化酶-蒽酮法检测各组的微渗漏情况,评价修复效果。结果 A组修复髓室底穿孔的形态恢复优良率为36.7%,B组为83.3%,两组差异有统计学意义（χ2 = 6.79,P < 0.05）;不同时间点A、B组的日均葡萄糖渗漏量差异均有统计学意义（均P < 0.05）。结论 树脂嵌体对磨牙大面积髓室底穿孔的修补效果优于MTA直接充填。     

树脂嵌体修复磨牙髓室底穿孔的形态学及微渗漏研究

目的研究树脂嵌体修复离体人恒磨牙髓室底穿孔的形态学及封闭效果。方法将50颗新鲜拔除的离体人恒磨牙随机分为A、B、C 3个实验组（每组15颗牙）和1个对照组（5颗牙）。制备髓室底穿孔后,A组采用树脂嵌体和AH Plus糊剂修复髓室底穿孔,B组采用树脂嵌体和玻璃离子修复髓室底穿孔,C组采用光固化复合树脂直接充填修复髓室底穿孔。对照组5颗离体牙,只开髓不制备髓室底穿孔。体视显微镜下观察髓室底穿孔修复后的外形恢复情况,葡萄糖氧化酶－蒽酮法测定微渗漏情况。结果嵌体法修复髓室底穿孔的形态恢复优良率为83.3%,直接充填法修复髓室底穿孔的形态恢复优良率为46.7%,两种方法修复的形态恢复优良率之间的差异有统计学意义（P<0.05）。3组在各个时间点上任意2组的日均葡萄糖浓度差异都有统计学意义,A组相似文献   

Effect of matrix placement on furcation perforation repair.

Furcation perforations are a serious complication during endodontic treatment, and a matrix to aid placement of repair material has been recommended. This study tested the sealing ability of amalgam and Ketac silver placed with and without plaster of Paris as a matrix. A bacterial penetration technique was used to test the seal. Perforations created in the pulpal floor of extracted human mandibular molars were repaired as follows: group 1, amalgam; group 2, amalgam plus plaster as a matrix; group 3, Ketac silver; and group 4, Ketac silver plus plaster (17 teeth/group). Leakage was measured by placing bacteria (Streptococcus sobrinus) in the pulp chamber, and recording the time taken for bacterial growth in a medium bathing the root surface. A plaster of Paris matrix improved the seal with amalgam, but not with Ketac silver. Ketac silver provided the best seal, but all materials showed complete leakage within 22 days.     

Effect of placement of calcium sulphate when used for the repair of furcation perforations on the seal produced by a resin-based material

AIM: To evaluate the sealing ability of calcium sulphate when used under composite resin for the repair of furcation perforations having different diameters. METHODOLOGY: Perforations of different diameter were created in the floors of pulp chambers in 60 extracted human molar teeth with either a number 3 (1 mm diameter) or 5 (1.5 mm diameter) round bur. The specimens of each group were divided into four sub-groups which were repaired with composite resin either alone or in combination with calcium sulphate that created an artificial floor (15 teeth group(-1)). Eight teeth without furcation perforations served as negative controls. In the leakage detection device, 1 mol L(-1) glucose solution was forced under a pressure of 1.5 KPa from the crown towards the pulp chamber floor. The concentration of leaked glucose was measured at 1, 2, 4, 7, 10, 15 and 20 days using a glucose oxidase method and the data evaluated using the rank sum test. RESULTS: The specimens with larger perforations repaired with composite resin alone had significantly more leakage (P < 0.05). Using calcium sulphate as an artificial floor significantly decreased leakage of smaller perforations (P < 0.05). In groups repaired with calcium sulphate under composite resin, leakage in smaller perforations was markedly lower than that in larger ones (P < 0.05). No significant difference was found between the specimens with 1 or 1.5 mm perforations repaired with resin alone (P > 0.05). CONCLUSIONS: Calcium sulphate significantly improved the sealing ability of 1 mm perforations repaired with composite resin but not for 1.5 mm perforations.     

Sealing ability of composite resin placed over calcium hydroxide and calcium sulphate plugs in the repair of furcation perforations in mandibular molars: a study in vitro

The purpose of this study was to evaluate in vitro the sealing ability of various materials in the repair of furcation perforations in mandibular molars by measuring coronal microleakage with Indian ink. Ninety extracted mandibular molars were embedded individually into a plaster of Paris block, with the roots surrounded by a simulated periodontal ligament of silicone. Subsequently, a standard coronal access opening was prepared, the root canal orifices were located and a perforation was made with a size 012 round bur in a water-cooled high-speed handpiece directly into the centre of the floor of the pulp chamber. The perforations were repaired with amalgam, composite resin, calcium sulphate under composite resin and calcium hydroxide under composite resin. The teeth were coated with two layers of nail polish, leaving the access opening area uncovered, and immersed in Indian ink for 4 days at 37°C. The teeth were sectioned longitudinally and dye penetration measured from the coronal level of the repair material to the apical end of the perforation. All experimental groups revealed dye penetration in varying degrees, but there was no significant difference amongst them (Kruskal-Wallis test P < 0.05). Calcium sulphate and calcium hydroxide prevented overextrusion of composite resin when used under this repair material.     

Nonsurgical repair of furcal perforations: a literature review

The important steps in the management of a furcal perforation are immediate action, adequate isolation, debridement, and sealing of the defect. Studies have shown that repair materials or underlying matrix material such as amalgam, Cavit, calcium hydroxide, glass ionomers, hydroxylapatite, tricalcium phosphate, and demineralized freeze-dried bone have not been able to produce consistent results. However, current research on new materials such as mineral trioxide aggregate may advance treatment modalities significantly for furcation repair.     

An evaluation of plaster of Paris barriers used under various materials to repair furcation perforations (in vitro study).

The present study was undertaken to evaluate the effect of plaster of Paris barriers on the sealing ability of various materials when used to repair furcation perforations. The study was conducted on 90 human permanent molars with well developed, nonfused roots. Access openings and furcation perforations were prepared in the pulp chamber floor. The teeth were divided into one control and five experimental groups of 15 teeth each. In the experimental group, plaster of Paris barriers were created in the perforations and then sealed with silver amalgam, glass ionomer (GI), self-cured composite resin, IRM, or AH26. Access openings were filled with composite resin. The teeth were submerged in a solution of 2% methylene blue dye for 2 wk. Finally, the samples were sectioned and evaluated for linear dye leakage and analyzed statistically. Maximum dye penetration was observed in amalgam followed in a decreasing order by GI, composite, IRM, and AH26. AH26 showed the best sealing ability in the presence of plaster of Paris barriers followed by IRM, composite resin, and GI. Amalgam showed the poorest sealing ability when used to repair furcation perforations.     

The comparison of MTA,Geristore® and Amalgam with or without Bioglass as a matrix in sealing the furcal perforations (in vitro study)

Aim

The objective of this in vitro was to assess the sealing ability of MTA, Geristore®, and amalgam with and without Bioglass as a matrix used to repair furcation perforations in mandibular molars by using dye penetration.

Materials and methods

One hundred mandibular molars were randomly divided into six experimental groups. Five teeth with perforation were used as positive control while five teeth without perforation were used as negative control group. Furcal perforations were made in the teeth. Perforations were repaired with amalgam in group 1, amalgam and Bioglass in group 2, MTA in group 3, MTA and Bioglass in group 4, Geristore® in group 5, and Geristore® and Bioglass in group 6. All repairing materials were allowed to set for 72 h. Leakage at the repaired sites was then evaluated using dye penetration and clearing technique under stereomicroscope.

Results

The perforations repaired with MTA and Geristore® leaked significantly less than amalgam (p = 0.000). Bioglass reduced sealing ability of MTA and Geristore® significantly (p = 0.000, p = 0.019), while reduced the sealing ability of amalgam insignificantly (p = 0.78).

Conclusion

MTA and Geristore® have shown acceptable sealing ability in furcal perforation in comparison to amalgam while Bioglass as a matrix beneath them has reduced their sealing ability.     

Pulpal response to a newly developed MMA based resin cement for bonding tooth-colored indirect restorations

PURPOSE: To evaluate the pulpal responses to a newly-developed MMA-based self-etch resin cement, when used as a luting agent for indirect resin composite restoration, and to compare the results with those obtained from a total-etch luting agent, glass-ionomer cement, and amalgam restoration. METHODS: 120 cervical cavities were prepared in monkey teeth and divided into four equal groups according to the restorative materials used: (1) the cavities were restored with resin composite inlays using a self-etch resin cement as a luting agent (M-Bond); (2) the cavities were also restored with resin composite inlays but using a total-etch resin cement as a luting agent (Super-Bond C & B); (3) the cavities were directly restored with glass-ionomer cement (Fuji II); or (4) the cavities were directly restored with amalgam (Dispersalloy). The restored teeth were extracted at 3, 30, or 90 days after restoration, then fixed in 10% neutral buffered formalin. The specimens were prepared using routine histopathological procedures. Five microm-thick sections were stained with hematoxylin and eosin or Brown & Brenn gram stain for bacterial observations. Histological responses in the pulpal tissue and bacterial penetration were observed under a light microscope and evaluated using standard scores. The results were statistically analyzed using the Kruskal-Wallis test (P< 0.05). RESULTS: At all time intervals, no significant differences of pulpal inflammatory responses between M-Bond and Super-Bond C&B were observed (P> 0.05). Both resin cements showed no serious pulpal responses, such as necrosis or abscess formation. In general, both MMA-based resin cements showed similar pulpal responses to those of glass-ionomer cement except for congestion of pulpal blood vessels at 3 days after restoration in which glass-ionomer cement exhibited a lower level than that of the MMA-based resin cements. For the group restored with amalgam, at 3 days after restoration, severe odontoblastic disorders and blood vessel congestions with a large infiltration of inflammatory cells were detected. At 30 and 90 days after restoration, slightly inflammatory irritations were observed irrespective of the materials used. Reparative dentin formation and bacterial penetration were found mostly in the group restored with amalgam.     

Retentive strength of an amalgam bonding agent: chemical vs light vs dual curing

Dentin bonding agents have been shown to enhance retention of amalgam restorations by mechanical means. Little research is available on which mode of curing may optimize amalgam bonding. This in vitro study compared the bond strengths exhibited by three variations of a bonding agent, each using a different curing mode, with two earlier versions of amalgam resin liners and cavity varnish. The six test groups of lining agents for amalgam restorations included [C] chemical-cured, [L] light-cured and [D] dual-cured versions of one filled adhesive resin (Clearfil Liner Bond 2V), [LF] Light-cured, Filled resin (Clearfil Liner Bond 2, Kuraray Co.); [LCF] Light- and Chemical-cured, Filled resin Clearfil Liner Bond + Protect Liner, Kuraray Co) and [V] Varnish (Copalite, Cooley & Cooley, Ltd). For each group, 20 Class V cavity preparations were cut in human molars. The preparations were 2.5 mm deep and 3 mm wide at the pulpal floor, with a slightly divergent taper. After treating the preparation with the bonding agent, a 3/4 inch, 18 gauge flat-headed wire nail was seated in the cavity with its head at the pulpal floor of the preparation, and Tytin amalgam (Kerr Corp, Romulus, MI) was condensed into the preparation around the nail. All restorations were stored for 24 hours in distilled water at 37 degrees C, then subjected to 2500 thermal cycles (8 degrees C to 58 degrees C). After one week the samples were tested to failure in tension using an Instron Universal Testing Machine (crosshead speed = 2 mm/min) and peak load (kg) was recorded. Significant differences in retention were found using ANOVA and the Games & Howell post hoc test (p = 0.05). The mean loads at failure (+/- SD) were C 13.1 (+/- 2.4), L 21.8 (+/- 6.1), D 26.8 (+/- 7.4), LCF 23.8 (+/- 7.4), LF 21.4 (+/- 3.3) and V 2.0 (+/- 1.8). All dentin-bonding agents exhibited significantly greater retention than the varnish. While the bond strengths of the dual cured (D) and the light-cured (L) liners were not significantly different from one another, both were significantly higher than the chemically-cured (C) resin liner in terms of retention.     

Intracoronal sealing ability of two dental cements

The purpose of this study was to compare the efficacy of sealing the coronal 2-mm of the root canals versus covering the entire pulpal floor with one of two dental-resin cements (Principle or C&B Metabond). Sixty-two molars with the occlusal half of the crowns and the apical half of the roots removed were used. Each canal was enlarged by using a #3 Gates Glidden bur and obturated with unsealed gutta-percha cones. The teeth were randomly assigned to four groups, each containing 15 teeth, plus a negative and a positive control. In group 1, 2 mm of Principle were placed over the entire pulpal floor. In group 2, Principle was placed 2 mm into each canal orifice. Groups 3 and 4 were the same as groups 1 and 2, except C&B Metabond cement was used. After the cement set, the gutta-percha was removed and the integrity of the seal was tested by fluid filtration at a pressure of 20 cm H2O at 1 h and at 1, 2, and 4 weeks. The data were analyzed by a three-way ANOVA and the Student-Newman-Keuls tests at alpha = 0.05. The controls behaved as expected. Results showed that there were no statistically significant differences among the materials used or the location (p > 0.05), but there was a significant difference with respect to time. Principle leaked significantly more than C&B Metabond at 1 h (p < 0.05), but the seal became tighter over time. C&B Metabond leaked less early (p < 0.05) but increased in leakage at 4 weeks. Both materials sealed well over the 4-week study. Principle was easier to use, and sealing the entire pulpal floor was easier than sealing only the canal orifice.