4种根管充填技术的根尖微渗漏评价

目的采用葡萄糖定量微渗漏模型,评价不同根管充填技术封闭根尖的能力。方法选取72颗直的单根管牙,沿釉牙骨质界截冠,镍钛旋转器械进行冠向下法根管预备。随机分为4个实验组,每组15例,阳性和阴性对照组各6例。实验A组采用热牙胶垂直加压充填法,B组用固体核心载体充填法,C组用常温流动牙胶充填法,D组用冷牙胶侧压充填法进行根管充填。对照组只用牙胶尖充填,不用封闭剂。实验组和阳性对照组除根尖孔外均涂布2层指甲油,阴性对照组所有牙面均涂布2层指甲油。将牙齿连接于葡萄糖定量检测微渗漏模型,检测1、2、7、14、21、30d从冠方向根方渗漏的葡萄糖含量。通过渗漏葡萄糖的浓度（体积）推算微渗漏的大小。结果阴性对照组l～30d的渗漏值为0,阳性对照组则于ld即检测到较高浓度的葡萄糖。实验A、B、C组最大渗漏量均小于0.18μl/24h即无微渗漏发生,经秩和检验A、B、C3组间无显著差异（P〉0.05）。D组2d开始出现微渗漏,微渗漏量明显多于其它3组（P〈0.05）。结论 GuttaFlow常温流动牙胶法、热牙胶垂直加压充填法和固体核心载体充填法在观察期内,具有较好的根尖封闭能力。     

GuttaFlow根管充填系统根尖封闭的微渗漏研究

目的评价GuttaFlow常温流动牙胶根管充填系统的根尖封闭性能。方法实验牙沿釉牙骨质界截冠,逐步后退法根管预备,2.5%次氯酸钠冲洗,分别以GuttaFlow常温流动牙胶和SystemB联合ObturaⅡ热牙胶充填系统充填根管。采用改良葡萄糖定量检测微渗漏模型测定第1、2、4、7、10、15、20、30d从冠方向根方渗漏的葡萄糖量。结果GuttaFlow常温流动牙胶和SystemB联合ObturaⅡ热牙胶充填系统的根尖封闭性能均较好,第7d起,GuttaFlow常温流动牙胶的封闭能力显著优于SystemB联合ObturaⅡ热牙胶充填系统(P<0.05)。结论GuttaFlow常温流动牙胶根管充填系统观察期内具有较好的根尖封闭能力。     

3种根管充填糊剂对根管冠渗漏的影响

目的:评价3种根充糊剂的冠封闭性能.方法:收集新鲜拔除的单根管前磨牙34颗,随机分为AH-plus糊剂加牙胶尖侧压组、Cortisomol糊剂加牙胶尖侧压组、纳米羟基磷灰石(HAP)糊剂加牙胶尖侧压组(每组10颗牙齿)、阴性对照组和阳性对照组(每组2颗牙齿).牙齿用2%亚甲基蓝溶液浸泡,脱矿使牙齿透明,在体视显微镜下测量染料渗入根管的长度.结果:实验组染料渗入长度分别为(1.15±0.31) mm、(2.50±0.30) mm、(3.65±0.59) mm,阳性对照组染料渗入根管全长,阴性对照组无染料渗入.3组之间统计学上均有显著性差异(P<0.01).结论:AH-plus糊剂冠封闭性优于Costimol糊剂;而Costimol糊剂冠封闭性优于HAP糊剂.     

3种根充糊剂根尖封闭性能的实验研究

目的评价3种根充糊剂的根尖封闭能力。方法30颗离体单根管前牙随机分为国产根充糊剂、Vitapex糊剂和AHPlus糊剂3组,每组10颗,分别用加牙胶尖以冷侧压法充填根管,用染料渗透法和透明标本法在立体显微镜下测量根尖微渗漏。结果3组根尖微渗漏的均值分别为:国产根充糊剂组(2.555±1.129)mm,Vitapex糊剂组(1.212±0.625)mm,AH Plus糊剂组(0.919±0.427)mm,3组间差异有显著性(P<0.01),Vitapex组和AH Plus组的微渗漏无明显差异(P>0.05)。结论Vi-tapex糊剂和AH Plus糊剂的根尖封闭性能均优于国产根充糊剂。     

根管糊剂在ObturaⅡ充填技术中对根尖微渗漏的影响

目的:探讨在Obtura Ⅱ注射式热熔牙胶充填中,不同根管糊剂对根尖微渗漏的影响。方法:40颗单根管牙随机分为4组,采用Obtura Ⅱ注射式热熔牙胶进行根管充填,A、B、C组分别以ZOE、Vitapex、AHplus作为根管糊剂,D组未用糊剂。充填后行墨汁渗透实验,制作透明标本,使用体视显微镜和显微照相系统观测染料渗透的长度。结果:染料自根尖孔渗入根管的长度,D组最长,为4.56±2.72mm,与A、B、C组间差异均有显著性(P<0.05)。在使用糊剂的实验组中,染色线的长度由小到大依次是AHplus1.70±0.82mm、Vitapex1.87±0.56mm和ZOE2.02±0.40mm,但3组之间没有统计学差异(P>0.05)。结论:根管糊剂的使用能显著降低Obtura Ⅱ根管充填后根尖的微渗漏。     

热牙胶连续波根充与冷侧压根充后根尖微渗漏的研究

目的：比较不同根管预备方法下,热胶牙连续波根充与冷侧压根充术后,根尖微渗漏的情况。方法：将100颗单根离体恒牙,随机分为2组,A组50颗牙采用ProTaper预备,B组50颗牙采用不锈钢K型锉预备。根管预备完成后,A组牙齿随机分为A1组25颗牙齿,A2组25颗牙齿,分别使用连续波热牙胶垂直根管充填以及冷侧压根管充填。B组做相同处理。染料渗透法染色后测量根尖微渗漏长度并进行统计学分析。结果：A1组的染色线长度为（1.28±0.39）mm,A2组的染色线长度为（1.36±0.42）mm,B1组的染色线长度为（1.68±0.44）mm,B2组的染色线长度为（1.96±0.41）mm。其中A、B组间在统计学上无显著性差异,即不同的根管预备方法下,根尖的微渗漏无明显不同。A1、B1,A2、B2组间在统计学上有差异（P〈0.05）,说明不同的根管充填方法下,根尖微渗漏不同。结论：在离体实验条件下,连续波热塑充填具有较好的根管壁适应性和密合度,充填效果优于冷牙胶侧压充填方法。而根管预备方法的选择对根尖微渗漏的影响尚未发现明显差异。     

氟离子导入降低根充微渗漏的实验研究

目的：探讨氟离子导入对根充后微渗漏发生的影响。方法：选择粗细相近的离体单根管牙18颗,随机分为氟离子导入组、氟离子导入＋自固化磷酸钙（CPC）组和对照组。氟离子导入组,即根管预备后采用氟离子导入再根充;氟离子导入＋CPC组,即除氟离子导入外采用自固化磷酸钙涂壁后再根充;对照组,即根管预备后直接根充。以透明牙染料渗透长度为指标,实验数据采用SPSS17.0软件包进行方差分析。结果：微渗漏长度：氟离子导入组为（2.6±1.6）mm,氟离子导入＋CPC涂壁组为（2.1±1.6）mm,对照组为（5.8±3.6）mm。氟离子导入组〈对照组（P〈0.05）,差异有显著性;氟离子导入＋CPC组〈对照组（P〈0.05）,差异有显著性;氟离子导入组〈氟离子导入＋CPC组（P〉0.05）,差异无显著性。结论：①氟离子导入技术可以降低根充后微渗漏发生。②氟离子导入加自固化磷酸钙根管涂壁能降低根充后的微渗漏发生,但与单纯氟离子导入无差别。     

根管治疗牙冠方渗漏的研究现状

根管治疗是目前治疗牙髓病和根尖周病最有效和最根本的方法，评价其成败的关键因素是根管系统的三维严密充填，而根管充填后存在的微渗漏是导致充填失败的重要原因。根管微渗漏包括冠方渗漏和根尖渗漏，它们均可导致细菌及其产物通过冠方渗漏进入牙髓腔，又经根尖渗漏再次进入根尖周组织，引起治疗的失败。一直以来，根尖渗漏是研究的重点，而近年来，冠方渗漏也愈来愈引起广大学者的注意。本文从研究冠方渗漏的重要性、冠方渗漏的影响因素、冠方渗漏的体外实验及冠方渗漏与根尖渗漏的关系等几方面入手，对根管治疗牙冠方渗漏的研究状况作一综述。     

根管糊剂在热塑载体牙胶充填法中应用评价

目的：探讨用热塑载体牙胶法充填根管时，应用根管糊剂的必要性，方法：用离体牙根管充填材料微渗漏的体外试验，比较用热塑载体牙胶加糊剂充填法与不用糊剂的热塑载体牙胶充填法的根尖封闭性能。结果：实验证明热塑载体牙胶加糊剂充填法与不用糊剂的热塑载体牙胶充填法在根尖封闭性能方面无明显差异。结论：用热塑载体牙胶充填根管时，没有用根管糊剂的必要性。     

Can Radiotherapy Affect the Apical Sealing Ability of Resin-Based Root Canal Sealers?

BackgroundThe authors conducted a study to assess the influence of radiotherapy on the apical sealing ability of one recently introduced resin-based root canal sealer and two sealers that have been in use for several years.MethodsThe authors divided 90 human maxillary anterior teeth into three groups according to the type of root canal sealer used and, using lateral condensation, obturated the roots with gutta-percha. They randomly divided all roots into two main groups according to the presence or absence of radiotherapy. For the groups that received irradiation, a dose of 60 gray was delivered in fractions of 1.8 Gy per day, five days a week for seven weeks. The authors then performed the centrifuging dye penetration test to determine apical leakage for each specimen.ResultsThe authors compared the specimens in the groups that received radiotherapy after endodontic treatment with the specimens in the groups that did not undergo radiotherapy after endodontic treatment. They found that mean apical leakage was slightly higher in the radiotherapy groups, but they did not observe any statistical difference between the groups (P > .05). In the groups that did not undergo radiotherapy, the mean apical leakage for the specimens in the MM-Seal (MicroMega, Besançon, France [not marketed in the United States]), AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany) and AH 26 (Dentsply DeTrey GmbH) groups was 2.52 ± 0.42 millimeters, 2.85 ± 0.52 mm and 3.73 ± 0.41 mm, respectively. In the groups that underwent radiotherapy, the mean apical leakage for the specimens in the MM-Seal, AH Plus and AH 26 groups was 2.72 ± 0.55 mm, 2.96 ± 0.47 mm and 3.93 ± 0.61 mm, respectively.ConclusionThe apical sealing ability of the resin-based root canal sealers decreased slightly when radiotherapy was administered, although there was no statistically significant difference.Clinical ImplicationsClinicians can safely use a resin-based root canal sealer in patients receiving radiotherapy.     

葡萄糖定量法检测3种根管封闭剂的封闭性能

目的 :用葡萄糖定量法检测根管微渗漏的模型评价 3种根管封闭剂封闭根管的能力。方法 :选取 72颗直根管的上前牙 ,随机分为 3个试验组 (每组各 2 0例 )和 2个对照组 (阳性对照和阴性对照各 6例 ) ,用侧向加压充填技术充填根管 ,试验组所用根管封闭剂分别为PulpCanalSealerEWT、Sealapex和AHPlus,置于微渗漏模型 ,于第1、2、4、7、10、15、2 0、30天检测从冠方向根方漏出的葡萄糖的量 ,检测方法为葡萄糖氧化酶法。结果 :第 1、2、4、7天3种根管封闭剂的微渗漏值无显著性差异 (P >0 .0 5 ) ,从第 10天起 ,PulpCanalSealerEWT组的微渗漏明显高于AHPlus、Sealapex组 (P <0 .0 0 1) ,后 2种封闭剂的微渗漏无显著性差异 (P >0 .0 5 )。 结论 :根管封闭剂AHPlus、Sealapex封闭根管的能力好于PulpCanalSealerEWT。     

不同根管封闭剂对根管充填封闭性能的比较研究

目的:评价3种根管封闭剂的根尖和冠方封闭性能.方法:收集新鲜拔除的人恒前牙60颗,用手用镍钛锉预备后随机分为A、B、C 3个实验组即为Cortisomol封闭剂、AHplus封闭剂加牙胶尖侧压充填,GattaFlow加主尖充填(每组20颗).根充后用印度墨汁染色、脱矿、脱水、制成透明,在体视显微镜下测量染料渗入根管的长...     

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目的    评价不同根管充填材料的根管封闭性能。方法    将2005—2007年黑龙江省森工总医院口腔科门诊拔除的40颗离体单根牙随机分为A、B、C、D 4个组,分别用塑化液、Vitapex糊剂、氧化锌丁香油（ZOE）糊剂加牙胶尖、氢氧化钙糊剂侧压充填根管。采用染液渗入法检查根尖孔微渗漏,在体式显微镜下用游标卡尺测量染液渗入根管的长度。结果    4个组染液渗入根管的长度分别为（2.02±0.92）mm、（0.94±0.50）mm、（3.21±0.87）mm和 （3.97±1.66）mm。除C组与D组间差异无统计学意义 （P ＞ 0.05） ,其余各组间差异均有统计学意义（P＜0.05）。结论    Vitapex糊剂对根尖孔的封闭性能优于塑化液、ZOE糊剂和氢氧化钙糊剂。     

5种根管充填糊剂的根管封闭能力的比较

目的：比较5种根管充填糊剂的根管封闭能力。方法：选择75个直根管的恒牙,经开髓拔髓,Mtwo镍钛根管器械预备后反复冲洗后随机分为5组,分别采用实验组1：氧化锌丁香油糊剂,实验组2：Endomethasone根管充填糊剂,实验组3：Cortisomol根管充填糊剂,实验组4：Vitapex糊剂,实验组5：AH-plus糊剂,加牙胶尖严密充填。将所有离体牙置于37℃,100%湿度的恒温箱3d后选用透明牙染色法测量微渗漏深度。结果：实验组1：（2.35±0.768）mm,实验组2：（1.78±0.548）mm,实验组3：（1.54±0.322）mm,实验组4：（3.22±0.452）mm,实验组5：（0.98±0.536）mm。各组微渗漏深度值差异有显著性（P〈0.05）。其中实验组4的微渗漏值显著高于其他各组（P〈0.05）,实验组5的微渗漏值显著低于其他各组（P〈0.05）,实验组2的微渗漏值稍高于实验组3,结果无显著差异。结论：在Mtwo镍钛器械预备下,AH-Plus糊剂充填根管可有效的减少根管微渗漏的发生,但长远疗效有待进一步的观察。     

Impact of Contracted Endodontic Cavities on Root Canal Disinfection and Shaping

IntroductionThe impact of minimally invasive endodontic procedures on root canal disinfection has not been determined. This ex vivo study compared root canal disinfection and shaping in teeth with contracted or conventional endodontic cavities.MethodsMandibular incisors with oval-shaped canals were selected and anatomically matched based on micro–computed tomographic (micro-CT) analysis and distributed into 2 groups. Conservative and conventional access cavities were prepared, and the canals were contaminated with a pure culture of Enterococcus faecalis for 30 days. Root canal preparation in both groups was performed using the XP-endo Shaper instrument (FKG Dentaire, La Chaux-de-Fonds, Switzerland) and 2.5% sodium hypochlorite irrigation. Intracanal bacteriologic samples were taken before and after preparation, and DNA was extracted and subjected to quantitative polymerase chain reaction. Micro-CT scans taken before and after preparation were used for shaping evaluation. Bacteriologic data were analyzed by the Poisson regression model and the chi-square test with Yates correction. Micro-CT data were analyzed by the Wilcoxon, Mann-Whitney, and Student t tests with the significance level set at 5%.ResultsAll initial samples were positive for E. faecalis. After preparation, the number of bacteria-positive samples was significantly higher in the contracted cavity group (25/29, 86%) than in the conventional cavity group (14/28, 50%) (P < .01). Intergroup quantitative comparison showed that the reduction in bacterial counts was also significantly higher in the group of conventional cavities (P < .01). Micro-CT data revealed no significant difference in the amount of unprepared areas between groups.ConclusionsOur findings showed that although shaping using an adjustable instrument was similar between groups, disinfection was significantly compromised after root canal preparation of teeth with contracted endodontic cavities.     

氧化锌丁香油基质根管封闭剂的根尖封闭性能研究

目的:比较几种氧化锌丁香油基质根管封闭剂的根尖微渗漏情况,评价其封闭性能。方法:选择因正畸原因拔除的健康单根管前磨牙60颗,随机分成7个实验组(每组8颗)和2个对照组(每组2颗)。实验组分别采用6种氧化锌基质根管封闭剂(武汉大学口腔医院材料厂研制的1、2、3、4号氧化锌类糊剂,Pulp canal sealer糊剂及Endomethasone ivory糊剂)和一种树脂类封闭剂(Ah-Plus)作为根充糊剂,各组均采用冷牙胶侧方加压法充填根管。充填后采用印度墨汁染色处理,体式显微镜观察染料渗入的深度,进行统计分析比较。结果:7个实验组之间微渗漏情况无显著性差异,但Endomethasone ivory的微渗漏情况明显大于Ah-Plus。结论:在本实验条件下,研制的氧化锌基质根管封闭剂具有其他几种封闭剂同样的根尖封闭效果。     

AHPlus和EndoREZ根管充填糊剂根尖封闭性能的体外研究

目的：采用体外离体牙实验,研究根管充填糊剂EndoREZ、AHPlus的根尖封闭性能。方法：收集60颗离体前牙,用镍钛旋转器械Protaper预备根管后,依据根管充填糊剂的不同,随机分为3组,每组20颗,A、B两组为实验组,分别用EndoREZ、AHPlus作为根管充填糊剂;C组为对照组,用氧化锌丁香油糊剂（ZOE）作为根管充填糊剂,3组均采用冷牙胶侧方加压法恰充填根管。将根管充填后的全部标本置于IndiaInk染料中进行根尖微渗漏实验,用染料渗透法结合透明牙体标本制作技术,检测染料渗透线长度,评价3种糊剂的根尖封闭性能。结果：A、B、C3组均有染料渗入根尖,渗透线长度分别为（1.13±0.24）mm,（0.94±0.18）mm,（1.79±0.12）mm;A、B、C3组间的染料渗透长度有显著性差异（P（0.01）,A、B两组与对照组间差异有统计学意义（P（0.05）,A组与B组间的差异无统计学意义。结论：树脂类根管充填糊剂AHPlus、EndoREZ的根尖封闭性能均优于氧化锌丁香油糊剂。     

Effect of Ultrasonic Activation of Endodontic Sealers on Intratubular Penetration and Bond Strength to Root Dentin

IntroductionThis study aimed to evaluate the effect of ultrasonic activation (UA) of endodontic sealers on dentin tubule penetration and the bond strength to root dentin.MethodOne hundred single-rooted teeth were prepared with 40.06 nickel-titanium instruments and divided into 2 groups: with or without UA. Three resin-based sealers (MTA Fillapex [Angelus Dental Solutions, Londrina, PR, Brazil], Sealer Plus [MK Life Medical and Dental Products, Porto Alegre, RS, Brazil], and AH Plus [Dentsply, DeTrey GmbH, Konstanz, Germany]; n = 20) and 2 calcium silicate–based sealers (Sealer Plus BC [MK Life Medical and Dental Products] and EndoSequence BC [Brasseler, Savannah, GA], n = 20) were used and subdivided (n = 10) according to the protocols. Fluo-3 (Thermo Fisher Scientific, Waltham, MA) and rhodamine B dyes were added to the calcium silicate- and resin-based sealers, respectively. In the UA groups, the activation was performed for 40 seconds followed by lateral compaction. Samples were transversely sectioned to evaluate the dentin tubule penetration and the bond strength to root dentin. The penetration data were analyzed with the Student t test, 1-factor analysis of variance, and Bonferroni tests. Bond strength was evaluated using the Student t test, Kruskal-Wallis, and Dunn post hoc test.ResultsResin-based sealers showed the highest tubule penetration without UA (P < .05). UA significantly enhanced MTA Fillapex and Endosequence BC dentin tubule penetration (P < .05). AH Plus and Sealer Plus BC improved their bond strength to root dentin after UA (P < .05). AH Plus/UA, Sealer Plus/UA, and Sealer Plus BC/UA presented the highest bond strength values (P < .05). Adhesive failures were predominant in all groups regardless of the use of ultrasound.ConclusionsUA interferes with tubule penetration and the bond strength to root dentin of resin- and calcium silicate–based sealers.     

Characterization of Leachates from 6 Root Canal Sealers

Introduction

The aim of this study was to evaluate 6 different endodontic sealers by characterizing their leachates and comparing their solubility in water over a 4-week period.