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。     

Healing process of dog teeth after post space preparation and exposition of the filling material to the oral environment

The purpose of this study was to observe the influence of coronal leakage on the behavior of periapical tissues after root canal filling and post space preparation. Forty root canals of dogs' teeth were instrumented and filled by the lateral condensation technique with gutta percha points and the cements Sealer 26 and Roth. After post space preparation, the remaining filling material was either protected or not protected with a plug of the temporary cement Lumicon. After root canal exposition to the oral environment for 90 days, the animals were killed and specimens were removed and prepared for histomorphological analysis. The Brown and Brenn technique showed 70% of cases with microorganism leakage for Roth cement, and 20% with Sealer 26. When a plug of Lumicon was employed, there was 30% leakage for Roth cement and 0% for Sealer 26. A chronic inflammatory reaction was more frequently observed with Roth cement than with Sealer 26. It was concluded that a plug of Lumicon was efficient in controlling microorganism coronal leakage (p = 0.05), and that Sealer 26 was more biocompatible and sealed root canals better than Roth sealer (p = 0.01).     

碧兰糊剂和碘仿糊剂根管充填后疼痛的比较

目的比较碧兰糊剂和碘仿糊剂根管充填后疼痛的发生率与持续时间。方法将根管预备后行根管充填的260颗患牙随机分成2组,碧兰糊剂组130颗患牙,用碧兰糊剂加牙胶尖充填,碘仿糊剂组130颗患牙,用碘仿糊剂加牙胶尖充填,观察术后疼痛的发生率及持续时间。结果碧兰糊剂组的根充后疼痛发生率为10.8%(14/130),碘仿糊剂组为32.3%(42/130),两组间差异具有统计学意义(χ2=4.90,P<0.05)。碧兰糊剂组根充后疼痛持续1～2 d 10颗,3～4 d 3颗,5～6 d 1颗;而碘仿糊剂组根充后疼痛持续1～2 d 6颗,3～4 d 20颗,5～6 d 14颗,7 d以上2颗。两组疼痛持续时间差异具有统计学意义(χ2=73.11,P<0.01)。结论碧兰糊剂根充后疼痛的发生率明显低于碘仿糊剂,且疼痛持续的时间较短。     

Comparative in vivo analysis of the sealing ability of three endodontic sealers in post-prepared root canals

AIM: To compare the sealing ability of the endodontic sealers AH Plus, Sealer 26 and Endofill in premolar teeth of dogs exposed to the oral cavity after post-preparation. METHODOLOGY: Forty teeth with two canals each underwent root canal cleaning and shaping. Before filling, the canals were randomly distributed into three groups according to the sealer to be used: Group 1 - AH Plus; Group 2 - Sealer 26; and Group 3 - Endofill (Dentsply, Indústria e Comércio Ltda.). Immediately after filling, the gutta percha and sealer were partially removed from the canals, leaving material only in the apical third of the root. The teeth were temporarily sealed with glass ionomer sealer for 72 h to ensure setting. The coronal seal was then removed and the canals were exposed to the oral cavity for 45 days. The animals were euthanased and their mandibles and maxillae were removed. After abundant irrigation with distilled water, the canals were dried and filled with India ink. The teeth were sealed again for 96 h before extraction. The roots of the extracted premolars were separated and stored in labelled test tubes. The roots were cleared and the extent of dye penetration was measured with a 20x stereoscopic magnifying lens. RESULTS: Statistical analysis revealed that there were significant differences between the sealers studied (P < 0.001). Means for the extent of dye penetration for AH Plus, Endofill and Sealer 26 were, respectively, 0.13, 2.27 and 3.08 mm. CONCLUSIONS: After 45 days exposure to the oral cavity, none of the sealers was capable of preventing leakage and coronal dye penetration. There were significant differences between the sealers studied, in terms of mean dye penetration.     

Effectiveness of a silicon-based root canal sealer for filling of simulated lateral canals

The purpose of this in vitro study was to evaluate the ability of a silicon-based root canal sealer, compared to zinc oxide and eugenol and an epoxy resin-based sealers, for filling of simulated lateral canals. Thirty extracted single-rooted human teeth were selected, conventional access was made and the working length was established 1 mm from the apical foramen. Three simulated lateral canals, one in each root third (coronal, middle and apical) were prepared in both the mesial and distal surfaces of each tooth using a size 15 reamer adapted to a low-speed handpiece. Each root canal was instrumented using ProTaper rotary files up to file F3 at the working length, and then irrigated with 2.5% NaOCl followed by EDTA. The teeth were assigned to 3 groups (n=10), according to the root canal sealer: Roeko Seal (Group 1), Sealer 26 (group 2) and Grossman's sealer (Group 3). Gutta-percha cold lateral condensation technique was performed in all groups. Postoperative radiographs were taken and the images were projected for evaluation of the quality of lateral canal filling. Data were submitted to statistical analysis by Kruskal Wallis test at 5% significance level. The results showed that Grossman's sealer filled a larger number of lateral canals than Roeko Seal (p<0.05) and Sealer 26 (p<0.01). It may be concluded that Roeko Seal silicone-based root canal sealer was not as effective as the Grossman's sealer for filling of simulated lateral canals. The lateral canals localized in the apical third of the root were more difficult to be filled.     

H锉联合回旋手机与ProFile镍钛系统拆除根充牙胶能力的比较研究

目的比较H锉联合同旋手机与ProFile镍钛系统在进行根管再治疗时拆除根管充填物的能力。方法选取24颗离体下前牙常规根管治疗后随机分为2组(每组12颗),分别采用H锉联合回旋手机和ProFile镍钛系统进行根充物的拆除,每组都使用氯仿。记录到达工作长度牙数、到达工作长度用时、根充物推出根尖孔牙数、发生并发症牙数及器械损耗数。最后纵劈牙齿,统计根管内残余充填物量。实验结果采用t检验和卡方检验。结果H锉联合回旋手机组到达根尖工作长度用时较短,与ProFile组间存在显著性差异(P< 0．01);两组根管内都有充填物残余;PorFile组在拆充过程中较少发生根充物被推出根尖孔的情况;ProFik器械的损耗率较高。结论ProFile器械不适用于拆除根充牙胶。     

Vitapex药物糊剂充填乳牙根管的疗效观察

目的观察Vitapex糊剂充填乳牙根管的疗效.方法对120名儿童140个患牙进行根管治疗术,分为两组.实验组用Vitapex糊剂充填根管,对照组用氧化锌丁香油糊剂充填根管.结果术后追踪观察1～2年,实验组观察68个乳牙,成功65个(95.59%);对照组观察64个乳牙,成功52个(81.25%).结论用Vitapex糊剂充填乳牙感染根管疗效较好.     

Metapex糊剂治疗乳牙有窦型慢性根尖周炎的疗效观察

目的：对比Metapex糊剂与氧化锌碘仿糊剂在作为乳牙根充材料时的近期与远期效果。方法：选取2011年3月至2013年7月就诊于我院儿童口腔科且明确诊断为有窦型慢性根尖周炎的97例（108颗乳磨牙）患儿,将其随机分为实验组与对照组,实验组55颗患牙用Metapex糊剂进行根管充填,对照组53颗乳磨牙用氧化锌碘仿糊剂根充。对比2周、1年和2年后疗效,并进行分析。结果：2周成功率实验组显著高于对照组（P<0.05）,1年成功率无显著差异（P>0.05),2年成功率实验组优于对照组（P<0.05）。结论：Metapex糊剂治疗乳牙有窦型慢性根尖周炎疗效较好,是理想的根充材料。     

A preliminary analysis of the morphology of lateral canals after root canal filling using a tooth-clearing technique

AIM: This study used a modified tooth-clearing technique to allow observation of accessory canals following filling with a warm gutta-percha technique and one of two endodontic cements. METHODOLOGY: Ten extracted human maxillary molars with three roots were selected and divided into two equal groups of five teeth. Each group had 15 canals. Root canal preparation was performed with a modified double flared technique; irrigation with 5% NaOCl and lubrication with RC-Prep were used. The canals were then filled with gutta-percha and cement utilizing a warm vertical condensation technique in the apical third followed by thermo-mechanical compaction in the middle and coronal thirds. Pulp Canal Sealer or AH-Plus were used in the experimental groups. The teeth were demineralized with a modified buffered acid solution, cleared in methylsalicylate and examined under a stereomicroscope. Accessory canals were evaluated in the apical, middle and coronal thirds of each root canal and categorized as narrow or wide, following observation on four surfaces. The depth of penetration of gutta-percha and cement into lateral canals was scored using a 5-point system. RESULTS: Complete transparency of the roots was achieved. Accessory canals were detected in all specimens. In coronal ramifications, gutta-percha filled the empty spaces (coronal thirds, grades 3 and 4: 70.9% in AH-Plus group and 68.8% in Pulp Canal Sealer group). In the apical accessory canals, gutta-percha entered less frequently (apical thirds, grades 3 and 4: 17.9% in the AH-Plus group and 3.2% in the Pulp Canal Sealer group); cement without gutta-percha (grades 1 and 2) was present in 55.5% in the AH-Plus group and 38.7% of the Pulp Canal Sealer group. Analysis showed that AH-Plus cement resulted in significantly greater filling of the apical accessory canals compared to Pulp Canal Sealer. CONCLUSIONS: The modified tooth-clearing technique allowed observation of fine morphological details in all specimens. Effective gutta-percha filling was evident in most of the wide coronal lateral canals whilst the apical narrow ramifications were often incompletely filled by cement. Overall AH-Plus demonstrated better diffusion into lateral accessory canals compared to Pulp Canal Sealer.     

AH Plus与CCQ碘仿糊剂根管充填的疗效比较

目的比较AHPlus糊剂加牙胶尖、CCQ碘仿糊剂加牙胶尖充填根管后的患牙疼痛反应和疗效。方法将300颗患牙随机分为AHPlus糊剂组和CCQ碘仿糊剂组,在行常规根管治疗术的基础上分别采用AHPlus糊剂加牙胶尖和CCQ碘仿糊剂加牙胶尖充填根管,观察术后1周内患牙疼痛发生情况以及术后12个月的疗效。结果疼痛发生率AHPlus糊剂组术后较CCQ碘仿糊剂组低,差异有统计学意义(P<0.05);术后12个月疗效,AHPlus糊剂组高于CCQ碘仿糊剂组,差异有统计学意义(P<0.05)。结论AHPlus糊剂加牙胶尖充填根管可有效降低术后患牙的疼痛反应,与CCQ碘仿糊剂加牙胶尖比较,远期疗效有意义。     

比塔派克斯糊剂充填感染根管的疗效

目的：观察比塔派克斯糊剂充填感染根管的疗效。方法：对320例320个患牙进行根管治疗术,分为两组各160牙。实验组用比塔派克斯湖剂充填根管,对照组用氧化锌丁香油糊剂充填极管。结果：术后追踪观察2年,实验组观察158牙,成功154牙（97．47％）;对照组观察151牙,成功135牙（89．40％）。结论：用比塔派克斯糊剂充填根管疗效较好。     

Resistance to fracture of roots filled with three different techniques

AIM: To compare the fracture resistance of roots filled with different materials. METHODOLOGY: Thirty-four freshly extracted human maxillary central incisor teeth with similar dimension were selected. Crowns were sectioned at the cemento-enamel junction, and the length of the roots were adjusted to 13 mm. Following the preparation of the root canals and final irrigation with EDTA and saline, the 10 root canals in group 1 were filled with Resilon cones and Epiphany sealer, the 10 root canals in group 2 were filled with gutta-percha and AH 26 and the 10 root canals in group 3 were filled with gutta-percha and MCS Canal Sealer. All materials were used with a cold lateral condensation technique. Four root canals remained unfilled and were used as a control group. Tests for fracture strength were performed using a universal testing machine and a round tip that had a diameter of 4 mm. The force was applied vertically with a constant speed of 1 mm min(-1). For each root, the force at the time of fracture was recorded in Newtons. Results were evaluated statistically with ANOVA and Tukey Honestly Significant Difference (HSD) tests. RESULTS: The mean force of fracture values was 1043 N, 967 N, 859 N and 517.5 N for groups 3, 1 and 2 and the control group, respectively. There was a significant difference (P < 0.01) between the experimental groups and the control group. No significant differences were found between the three experimental groups. CONCLUSIONS: All the materials used in the present study reinforced the prepared root canals.     

氢氧化钙碘仿糊剂根管消毒治疗有窦型慢性根尖周脓肿的临床观察

目的:观察氢氧化钙碘仿糊剂运用于有窦型慢性根尖周脓肿根管内封药消毒的临床效果。方法:选择在同一牙列上有二颗磨牙均患有窦型慢性根尖周脓肿的病例50例,共100颗患牙。将同一病例的二颗患牙分别设为实验组和对照组,同时进行根管治疗。实验组(50颗牙)采用氢氧化钙碘仿糊剂根管内封药消毒,对照组(50颗牙)采用氢氧化钙糊剂根管内封药消毒,对两组根管消毒效果进行临床观察和比较。结果:实验组74%(37/50)封药1次后即可行根管充填术,对照组52%(26/50)封药1次后可行根管充填术,两组间封药1次的根管充填率存在显著性差异(P<0.05)。实验组平均封药次数为1.30次,对照组平均封药次数为1.56次。结论:用氢氧化钙碘仿糊剂根管内封药消毒能够减少有窦型慢性根尖周脓肿根管封药消毒的次数,有利于窦道的尽快愈合。     

The effect of extra-alveolar root filling with calcium hydroxide on periodontal healing after replantation of permanent incisors in monkeys

The effect of calcium hydroxide, used as an extra-alveolar root filling material, on periodontal healing was examined in green vervet monkeys (Cercopithecus aethiopa). Incisors were extracted and a root canal filling of calcium hydroxide paste was processed. Control teeth were replanted after either pulp extirpation or root filling with gutta-percha. In the experimental groups, the extra-alveolar period was either 18 or 120 minutes. The animals were killed eight weeks after replantation, and the replanted teeth were examined histologically. The histologic parameters recorded for each tooth were surface resorption, inflammatory resorption, replacement resorption (ankylosis), periapical inflammatory changes, and downgrowth of pocket epithelium. Teeth with canals filled with calcium hydroxide that had an extra-alveolar time period of 18 minutes, showed noticeably more replacement resorption than either the teeth with canals filled with gutta-percha or those with extirpated pulps. Calcium hydroxide paste may diffuse through the apical foramen, thus injuring the periodontal ligament in the apical region. Consequently, the use of calcium hydroxide does not seem justified in the initial treatment of avulsed teeth, but it can be used after some weeks when periodontal ligament healing has progressed.     

LYSANDA PASTE: A NEW OPTION FOR ROOT-END FILLING

This study aimed to compare the apical sealing of root-end fillings performed with Lysanda (zinc oxide-eugenol paste) with radiopacifiers (iodoform or zinc oxide) and calcium hydroxide. Root-end cavities were prepared and filled with different materials, as follows: Group I – Lysanda paste with iodoform; Group II – Lysanda paste with iodoform and calcium hydroxide; Group III – Lysanda paste with iodoform and zinc oxide; Group IV – Lysanda paste with zinc oxide; Group V – mineral trioxide aggregate (MTA). After filling, the teeth were immersed in 2% methylene blue for analysis of marginal leakage. It was observed that marginal leakage occurred in all groups. Lysanda paste with iodoform showed the lowest leakage, with no statistically significant difference compared to the other groups. All materials can be considered as good options for root-end filling.     

Vitapex用于乳牙根管充填的临床评价

目的探索适合乳牙根管充填治疗的材料.方法用两种根管充填材料对乳前牙进行根管治疗.实验组采用Vitapex糊剂充填,对照组采用常规碘仿氧化锌糊剂(简称碘仿糊剂)充填,均跟踪观察疗效.结果实验组平均有效率为93.4%,对照组平均有效率为69%.实验组疗效优于对照组(P<0.05).结论Vitapex糊剂适合作乳牙根管充填材料.     

IN VITRO STUDY OF THE EFFECT OF ER:YAG LASER IRRADIATION ON THE APICAL SEALING OF DIFFERENT ROOT CANAL SEALERS

Objectives:

The aim of this study was to determine the effect of Er:YAG laser irradiation used to clean dentinal walls on the apical sealing of root canals filled with different types of sealers.

Background Data:

Laser application to the dentinal walls removed debris, rendering the root canals free of smear layers and leaving the dentinal canaliculi open.

Methods:

Sixty-four maxillary canines obtained from laboratory files were instrumented with K-files (Dentsply, Maillefer, Ballaigues, Switzerland) using the crown-down technique, and irrigated with a 0.5% sodium hypochlorite solution. The specimens were divided into two groups of 32 teeth each. In group I, the teeth were instrumented and irrigated with sodium hypochlorite solution, and divided into four subgroups to be sealed with the different materials (Endofill, N-Rickert, Sealapex and Sealer 26). In group II, the root canals were subjected to Er:YAG laser irradiation (200 mJ, 7 Hz and 60 J total energy), followed by root canal sealing as in group I.

Results:

The data showed lower levels of apical microleakage in the teeth filled with N-Rickert, Sealapex and Sealer 26 cements than in those sealed with Endofill (p < 0.01). No significant difference in microleakage was observed between teeth irrigated only with 0.5% sodium hypochlorite and those submitted to Er:YAG laser application (p > 0.05).

Conclusions:

The Er:YAG laser irradiation applied to the root canal walls was not able to prevent apical microleakage.     

Coronal leakage of two root canal sealers containing calcium hydroxide after exposure to human saliva

This in vitro study evaluated the coronal leakage of human saliva into root canals filled by lateral condensation of gutta-percha using two root canal sealers containing calcium hydroxide. Obturated canals with gutta-percha and either Sealapex of Sealer 26 were mounted in an apparatus and then exposed to saliva. The number of days required for total recontamination of the root canal was recorded. Evaluation was conducted for 60 days. Thirty-five percent of the specimens of the Sealer 26 group showed entire recontamination at 60 days. Eighty percent of the root canals obturated with Sealapex showed complete recontamination at 60 days. Sealer 26 presented significantly less leakage than Sealapex (p < 0.01).     

3种根管糊剂的根管密封性能研究

目的比较Vitapex糊剂、AH-Plus糊剂和GuttaFlow常温流动牙胶根管充填的致密性。方法选择30颗单根管牙,随机分3组,每组10颗牙。分别用Vitapex糊剂(A组)、AH-Plus糊剂(B组)、GuttaFlow常温流动牙胶(C组)充填根管。分别对每颗牙在距根尖2、4、6、8 mm进行片切,MIAS-2000图像分析并计算各横断面的根管面积(area of canal,AC)以及其中的空隙面积百分比(perceentage of voild-filled area,PV)。记录结果,并进行统计学分析。结果各组根充材料在距离根尖相同处的根管面积(AC值)虽有所差异,但无统计学意义(P>0.05)。在距根尖2、4、6、8 mm处C组材料的PV值与其他各组均有统计学意义(P<0.05);在距根尖2、4 mm处A、B组的PV值有统计学意义(P<0.05),B、C组的PV值无统计学意义(P>0.05);在距根尖6、8 mm处3组间的PV值均有统计学意义(P<0.05)。结论 GuttaFlow常温流动牙胶和AH-Plus糊剂在距根尖不同部位均显示出较好的致密度;Vitapex糊剂的致密度欠佳。     

The impact of the addition of iodoform on the physicochemical properties of an epoxy-based endodontic sealer

Due to the low radiopacity of Sealer 26, iodoform is frequently empirically added to this sealer. Thus, the interference of this procedure with the physicochemical properties of Sealer 26 must be evaluated.

Objective

This study evaluated the influence of the addition of iodoform on setting time, flow, solubility, pH, and calcium release of an epoxy-based sealer.

Material and Methods

The control group was pure Sealer 26, and the experimental groups were Sealer 26 added with 1.1 g, 0.55 g or 0.275 g of iodoform. Setting time evaluation was performed in accordance with the ASTM C266-03 speciflcation. The analysis of flow and solubility was in accordance with the ISO 6876-2001 speciflcation. For the evaluation of pH and calcium ion release, polyethylene tubes were filled with the materials and immersed in flasks with 10 ml of deionized water. After 24 h, 7, 14, 21, 28, and 45 days pH was measured. In 45 days, the calcium released was evaluated with an atomic absorption spectrophotometer.

Results

The addition of iodoform increased setting time in comparison with pure sealer (P<0.05). As for flow, solubility, and calcium release, the mixtures presented results similar to pure sealer (p>0.05). In the 24 h period, the mixture with 1.1 g and 0.55 g of iodoform showed lower pH than pure sealer and than sealer added with 0.275 g of iodoform (P<0.05).

Conclusions

The iodoform added to Sealer 26 interferes with its setting time and solubility properties. Further studies are needed to address the clinical signiflcance of this interference.