银汞合金桩用于后牙残根残冠的修复

笔者自1993年起对后牙残根残冠采取完善根管治疗后,进行银汞合金与全冠联合修复,并对150例患者152颗牙进行了随访观察,取得了满意的效果。1.临床资料和方法1.1 临床资料:随访观察的患者中,男性85例,女性65例,年龄12-60岁。病例选择为经过完善根管治疗的后牙残根残冠,牙周组织健康无松动,髓室底牙体组织完整。去净龋坏组织后,残根残冠边缘最低处位于龈上2mm以上,完成根管治疗2周后无临床症状,X线片显示根充为适充,根尖及周围牙槽骨组织正常。1.2 修复方法:去除根充物2/3,保留根端1/3牙胶尖,并略扩大根管;选择成形圈,使成形圈的颈缘与牙颈部…     

用铸造桩核修复后牙残冠残根的探讨

材料与方法1 临床资料　 30例 36颗后牙残冠残根 ,其中双尖牙 14颗 ,上颌第一磨牙 8颗 ,下颌第一磨牙 12颗 ,下颌第二磨牙 2颗 ,在根管治疗基础上采用铸造桩核修补牙体缺损 ,后用铸造全冠修复。2 材料　嵌体蜡或自凝塑料、藻酸盐弹性印模材料、钴铬合金等。3 方法(1)死髓牙牙体剩余 1/ 2以上 ,为防止牙体折裂 ,用高嵌体修复牙齿。精确备牙 ,消除倒凹 ,必要时增加髓室固位。直接法或间接法制作蜡型 ,送技工室包埋 ,铸造 ,临床调磨 ,磷酸锌水门汀粘固。(2 )牙体剩余 1/ 2以下 ,去尽腐质及薄弱边缘 ,常规预备牙体。根管预备 :双尖牙扁形单根者…     

后牙残冠残根修复的体会

后牙残冠残根修复的体会广东省口腔医院（５１０２６０）王险峰作者采用螺纹根管桩固位，银粉玻璃离子粘固剂作桩核，在桩核上行金属烤瓷冠或铸造金属全冠修复。临床操作简捷，患者就诊二次即可完成全部修复工作，临床效果良好。材料与方法临床资料：本文８３例，共１０６...     

老年人后牙残根残冠的铸造桩核冠修复

目的:本文旨在探寻和评价老年人后牙残根残冠的铸造桩核冠修复的临床效果.方法:对老年人可保留的后牙残根残冠,经过完善的根管治疗以后进行牙体预备,取印模、灌制模型,制作铸造桩核(多根牙时,加斜插式移动钉),临床粘结.在铸造桩核上进行全冠制备,取印模,完成全冠的制作,临床试戴、抛光、粘结,完成桩核冠修复.结果:1～3年随访观察,铸造桩核冠与牙体组织密合度良好,修复体无松动,冠周牙龈未见异常反应,X线片示无可见继发龋.结论:铸造桩核冠可以视为一种有效的方法,修复老年人残根残冠,以维持他们的正常咀嚼功能和口腔健康.     

后牙残根残冠的利用与修复

目的探讨后牙残根残冠修复的临床效果。方法对185例210颗后牙残根残冠经过完善的根管治疗后进行铸造桩核修复,再根据缺牙情况作为全冠或者固定桥,附着体、套筒冠的基牙利用,临床观察2年。结果185例210颗患牙修复后成功202颗,失败8颗,成功率96.1%。结论经过完善的根管治疗后铸造桩核冠修复可使后牙残根残冠得以保留并发挥功能。     

残根残冠牙的桩核冠保存修复

残根残冠牙的桩核冠保存修复上海第二军医大学长征医院口腔科何玉林综述陈必胜审阅残根残冠牙是临床上常见的大面积牙体缺损，以往大多数被拔除．１９７０年以来，许多学者开始使用牙本质固位钉（Ｐｉｎ）和根管桩（Ｐｏｓｔ）加银汞或复合树脂对残根残冠牙进行修复［１～...     

后牙残根残冠保留修复临床远期疗效浅析

随着根管治疗技术和固定修复技术日臻完善,临床上多数残根、残冠得到保留,并加以修复,达到恢复牙体外形和功能的目的。我们观察１４０例后牙残根、残冠保留修复治疗３年以上病例,分析影响后牙残根、残冠保留疗效的因素,指导临床实际操作。材料与方法１ 临床病例 修复科１９９２～１９９５年后牙残根、残冠保留修复治疗１４０例,修复年限最少为３年,最长７年。其中双尖牙６２例,磨牙７８例。２ 治疗方法 所有保留的残根、残冠经过完善根管治疗（１２７例）或塑化治疗（１３例）。固位桩采用成品桩（３８例）、铸造桩（１０２例）两种…     

残根残冠保存修复与口腔健康

残根残冠保存修复与口腔健康中国医学科学院血液学研究所（３０００２０）刘丽琴天津市河西区口腔医院王维军我们自１９８７年～１９９５年，接诊了一些要求对残根残冠保存治疗的患者。现资料记载完整的有３８例患者的６４颗残根残冠，其中２８例患者的５７颗残根残冠得到...     

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根管治疗牙齿的修复并保存终生是一项具有挑战性的工作,有几个关键性因素影响根管治疗牙和修复体长期保存,本文的目的是阐述这些基本原则,另外还涉及桩核的设计、桩道的预备和黏结等相关内容。     

根管治疗后牙体修复的治疗方案选择

冠部修复的质量是影响根管治疗后患牙预后的重要因素之一。如何根据患牙的具体情况选择最适合的修复方式,一直以来存在争议。本文介绍了根管治疗后冠部修复的目的与时机,选择修复方式需考虑的因素及具体修复方案的选择等,对近年来关于根管治疗后牙齿修复的研究进展进行分析,旨在为临床决策提供指导。     

Iatrogenic vertical root fractures in endodontically treated teeth

Abstract A survey of 31 published cases and 11 original cases of vertical root fractures due to iatrogenic reasons revealed that most of the vertical root fractures in endodontically treated teeth occurred in mandibular bicuspids and molars in patients aged 41–60 years. The diagnosis of vertical root fracture is difficult because of the late appearance of the signs and the appearance of pure endodontic or periodontal problems. This survey revealed that the most common cause of vertical root fracture in endodontically treated teeth is the excessive force used during lateral condensation of gutta-percha. Widening of the periodontal ligament along one or both sides of the root, or bone loss in solitary tooth are the major radiographic findings. Mild pain or discomfort and swelling are the major clinical symptoms, and solitary pocket around one aspect of the suspect tooth is the major clinical sign.     

根管治疗牙最终被拔除的原因分析

目的 :以最终被拔除的根管治疗牙为研究对象 ,来评判其失败的原因。方法 :收集分析 77例拔除的根管治疗牙资料 ,进行分类研究。结果 :与修复有关的失败占 6 1.0 % ,其中主要是冠折。与牙周疾病有关的失败占 2 9.9% ,根管治疗的失败仅占 9.1%。结论 :根管治疗自身的失败比较少见 ,但一旦发生 ,后果严重 ,平均寿命较短。冠修复的根管治疗牙比未冠修复的根管治疗牙平均寿命长。     

Prevalence of vertical root fractures in extracted endodontically treated teeth

AIM: The aim of this study was to evaluate the prevalence of vertical root fractures (VRF) in extracted endodontically treated teeth and to correlate the findings to previous studies and surveys. METHODOLOGY: Root-canal-treated teeth were referred for extraction from a public dental clinic. The endodontic therapy had been completed by a variety of dentists. Each tooth was evaluated following extraction by the oral surgeon who performed the procedure: the exact aetiology for the clinical diagnosis that led to the extraction was recorded. RESULTS: The major reasons for extraction were restorative (43.5%) and endodontic (21.1%), followed by vertical root fractures (10.9%). CONCLUSIONS: The relatively high prevalence of vertical root fractures in this survey compared with previous clinical and radiographic surveys was probably related to the difficulties in making a clinical diagnosis of vertical fractures before extraction.     

Resistance to fracture of restored endodontically treated teeth

Abstract Endodontically treated teeth were restored by 8 different methods. Copper rings were filled with commercial hard setting cement and the teeth were placed into the cement to the level of the cemento-enamel junction. The teeth were grouped according to restorative methods, mounted in an Instron T.T. machine and subjected to a slowly increasing compressive force until fracture occurred. The force of fracture for each tooth was recorded and the results in the various groups compared. All teeth fractured in a similar manner, irrespective of restorative method used. Preparation of a post space in the roots significantly weakened the teeth. Cementation of a steel parapost with zinc oxyphosphate cement did not significantly strengthen the teeth. Filling the post space and the access cavity with a composite resin following acid etching of the root canal and cavity walls strengthened the teeth more than other methods used to restore them. This finding may be of clinical importance, for instance in the restoration of endodontically treated young teeth with incomplete root formation and wide root canals.     

桩核对根管治疗牙修复后强度的影响

目的　比较不同修复方法对根管治疗牙修复后强度的影响。方法　 6 0个完整拔除的人上中切牙 ,根管治疗后随机分为 5组 ,每组 12个。A组 :完整的根管治疗牙 ;B组 :根管治疗后烤瓷熔附金属 (PFM)全冠修复 ;C组 :牙体预备保留 2 0mm高的牙本质套圈 ,铸造金属桩核及PFM全冠修复 ;D组 :牙体预备无牙本质套圈 ,铸造金属桩核及PFM全冠修复 ;E组 :牙体预备保留 2 0mm高的牙本质套圈 ,Parapost预成桩、复合树脂核及PFM全冠修复。在MTS 810材料试验机上沿与牙长轴成 135度方向加载 ,测试折裂强度。结果采用方差分析。结果　牙体预备保留 2 0mm高的牙本质套圈 ,铸造金属桩核及PFM全冠修复者折裂强度最高 ,为 (1793 5 9± 387 93)N ;完整的根管治疗牙次之 ,为(146 6 6 8± 2 40 11)N ;其余 3组的折裂强度 (95 8 49± 2 86 0 2 )N、(992 98± 2 91 0 0 )N、(994 94± 2 85 0 4)N之间 ,差异无显著性。修复牙有无牙本质套圈 ,其折裂强度间差异有高度显著性 (P <0 0 1)。结论　桩核能否增强根管治疗牙的抗折裂强度与其修复设计有关 ,牙本质套圈可明显增强根管治疗牙的抗折裂能力。     

The influence of indirect bonded restorations on clinical prognosis of endodontically treated teeth: A systematic review and meta-analysis

ObjectiveThe loss of the dental coronal portion following carious lesions or fractures leads to endodontic treatment with subsequent restoration to ensure correct anatomy and function. Recently, partial adhesive restorations have been widely proposed to increase the survival rate of endodontically treated teeth. The primary purpose of this review is to assess the failure rate of indirect partial adhesive restorations on endodontically treated teeth (ETT), considering the follow-up period.MethodsThe indications reported in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) were used to draft the present review. The study was constructed on PICO questions: population (patients who need indirect adhesive restorative treatment on endodontically treated teeth with onlay and overlay), intervention (onlay and overlay), control (patients with onlay and overlay on endodontically treated teeth) and outcome (failure rate and types of failure for onlay and overlay). The asked scientific question was: what are the failure rate and types of failure for adhesive indirect partial restorations on ETT?ResultsThe overall failure rate that emerges is 0.087 with a ratio of 121/1254, I² 80 % p-value< 0.001. Moreover, by meta-regression with covariates the follow-up period reports a coefficient of 0.013 with a P-value< 0.001. In conclusion, the indirect partial restorations on endodontically treated teeth displayed overall acceptable outcomes in terms of success from 2 to 4 years after their placement with only 4.32 % of failure. Failures increase after 7 years up to 12–30 years with failure rates of approximatively 10.65 % and 20.94 %. The analysis of the included articles reporting the causes of restorations failures showed that 15.51 % of cases were related to the loss of dental element.SignificanceBesides the survival rates of indirect adhesive restorations on endodontically treated posterior teeth, it was highlighted that the majority of failures appeared restorable. Thus, partial restorations seemed able to prevent the ETT tooth loss.     

Microleakage of self-etch primer/adhesives in endodontically treated teeth

BACKGROUND: The authors evaluated the coronal marginal leakage of endodontically treated teeth bonded with four self-etching adhesives and one total-etch adhesive system. MATERIALS AND METHODS: The investigators prepared Class II cavities in 60 extracted human premolars. They performed conventional endodontic therapy using a resin-based sealer and gutta-percha points. They randomly assigned each tooth to a group receiving one of the following adhesives: Adper Prompt L-Pop (3M ESPE, Seefeld, Germany), Clearfil SE Bond (Kuraray, Osaka, Japan), FL Bond (Shofu, Kyoto, Japan), Single Bond (3M ESPE) or Xeno III (Dentsply De Trey, Konstanz, Germany). They restored all teeth with resin-based composite material (Z250, 3M ESPE). Specimens underwent thermocycling and dye penetration and were sectioned longitudinally. The authors photographed the sections under a stereomicroscope. They transferred the images to an IBM-compatible personal computer for quantitative assessment of dye penetration using image analysis software. They analyzed data by means of Kruskal-Wallis and Mann-Whitney U tests (P = .05) and evaluated two specimens from each group under scanning electron microscopy. RESULTS: None of the tested self-etch adhesives completely eliminated microleakage. Dye leakage was restricted to the coronal cavity walls; it did not migrate toward the pulp chamber or toward the root canal. Single Bond and Clearfil SE Bond showed significantly lower dye penetration values at occlusal and gingival margins. CONCLUSIONS: The coronal sealing performance of the tested self-etch adhesive systems in endodontically treated teeth was material-dependent. The use of Clearfil SE Bond in such teeth can help achieve a marginal seal comparable to that achieved with Single Bond.