不同锥度牙胶尖热垂直加压法根尖封闭性的研究

目的对不同锥度牙胶尖热垂直加压法根管充填的根尖封闭性进行比较。方法将62颗下颌切牙经GG钻及Hero642锉根管预备至0.06锥度30号,然后随机分为0.02锥度组（ 30颗）、0.06锥度组（ 30颗）和阳性对照组（ 2颗）,0.02锥度组和0.06锥度组分别应用0.02锥度牙胶尖和0.06锥度牙胶尖加Cortisomol糊剂热垂直加压法进行根管充填,阳性对照组不进行根管充填。将0.02锥度组和0.06锥度组中的10颗牙置入印度墨水中浸泡24 h,10颗牙置入印度墨水中浸泡10 d,10颗牙置入Hank′s平衡盐溶液67 d后再置入印度墨水中浸泡90 h。阳性对照牙置入印度墨水中浸泡24 h。应用立体显微镜三维测量根尖渗漏的线性长度,对根尖封闭性进行评价。结果阳性对照牙根管全长均有墨水染色。0.02锥度组随浸泡时间延长其根尖渗漏明显增加,0.06锥度组随浸泡时间延长根尖渗漏无明显增加。在浸泡24 h和10 d时,0.02锥度组和0.06锥度组的根尖渗漏距离无显著性差异（ P=0.601,P=0.471）;浸泡67 d时,0.02锥度组和0.06锥度组的根尖渗漏距离有显著性差异（ P=0.041）。结论使用与根管锥度相一致的牙胶尖进行根管充填,能够得到更好的根尖封闭性。     

ProTaper简化预备法的根尖微渗漏实验研究

目的观察ProTaper简化预备法的根尖微渗漏,评价其根尖的封闭性能。方法 60颗离体成人患牙,分成2组。实验组30颗牙标本采用ProTaper机动系统简化预备和0.06锥度牙胶尖垂直加压充填根管,对照组30颗牙标本采用逐步后退法0.02锥度不锈钢锉预备和0.02锥度牙胶尖冷侧方加压充填根管,经透明标本染料渗透技术后,测量根尖部染料渗透的距离。结果实验组根尖染料的渗透距离均值0.60 mm,标准差0.29 mm,对照组根尖染料的渗透距离均值1.18 mm,标准差0.83 mm,2组根尖染料的渗透距离差异有统计学意义(P<0.05)。结论 ProTaper简化法预备根管配合相应锥度牙胶尖充填其根尖的封闭性能良好。     

机用镍钛器械与超声根管冲洗联合应用于慢性根尖周炎一次性根管治疗的临床研究

目的 应用机用镍钛器械、超声根管冲洗对上下颌前牙患有慢性根尖周炎者进行一次性根管治疗的术后疼痛反应及远期临床疗效进行评价。方法 将280颗患牙随机分成对照组、镍钛组、超声组、联合组4组,对照组患牙69颗,采用K锉预备根管,注射器冲洗;镍钛组患牙70颗,采用机用镍钛锉预备根管,注射器冲洗; 超声组患牙70颗,采用K锉预备根管,超声冲洗;联合组患牙71颗,采用机用镍钛锉预备根管,超声冲洗。4组患牙均行一次性根管治疗,充填1周后评价各组术后疼痛反应发生率,2年后评价其远期临床疗效。结果 术后1周,联合组术后反应最轻,疼痛发生率为9.86%;镍钛组与超声组次之,疼痛发生率分别为28.6%和27.1%;对照组术后反应最重,疼痛发生率为50.7%。术后2年,对照组与联合组间临床疗效有显著差异（P<0.02）,而其他各两组间临床疗效差异均无统计学意义（P>0.05）。结论 联合应用机用镍钛器械与超声根管冲洗对上下颌前牙患有慢性根尖周炎者行一次性根管治疗,能明显减少术后疼痛反应,提高患牙远期临床疗效,临床上值得推广。     

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目的评价ProTaper机用镍钛锉用于根管治疗术一次法的临床效果。方法选择2008年7月至2010年7月广州医学院第一附属医院口腔科就诊患者206例(206颗患牙),随机分为两组。试验组的106颗患牙用ProTaper机用镍钛锉预备根管,对照组的100颗患牙用不锈钢K型锉预备根管,两组均以常规侧方加压法进行根管充填。拍摄牙片以了解根管数目形态、确定根管工作长度及判断治疗效果,并观察根管预备及充填后1～2周的术后反应。结果试验组患牙根管充填成功率(88.7%)高于对照组患牙(64.0%),试验组患牙根管预备及充填术后急性反应发生率(1.9%)明显低于对照组(14.0%),差异均有统计学意义(P<0.05)。结论 ProTaper机用镍钛锉用于根管治疗术一次法的根管充填成功率较高,且能明显减少术后根尖不良反应的发生,近期疗效可靠。     

根管显微镜下应用连续波热垂直加压技术充填根管的疗效分析

目的:评价根管显微镜下应用连续波热牙胶垂直加压技术行根管充填的临床疗效。方法:选择上颌前牙单、直根管患牙50颗为研究对象,采用ProTaper机用镍钛锉预备至F3锉,随机分为2组,每组25颗患牙。分别采用常规方法和显微镜下连续波热垂直加压技术充填根管。应用术后即刻X线片和术后2年X线片分别进行2组患牙根管充填质量和术后2年的临床疗效比较,采用SPSS10.0软件包进行统计学分析,充填质量和临床疗效比较采用χ2检验。结果:根管显微镜下操作的充填质量高于常规充填操作(P<0.05)。术后2年复查显示,显微镜下操作的根管治疗成功率与常规操作组间无显著差异(P>0.05)。结论:应用显微镜进行连续波热牙胶垂直加压充填根管,能有效提高根管充填质量,值得临床推广使用。     

机用镍钛器械与手用不锈钢锉预备根管效果比较

目的评价机用ProTaper镍钛器械与手用K型不锈钢锉用于根管预备的临床效果。方法患者390例患牙407颗,以单双数字法随机分成2组,试验组患牙204颗414个根管采用机用ProTaper镍钛器械行冠向下技术预备根管,对照组患牙203颗416个根管采用手用K型不锈钢锉行逐步后退技术预备根管。2组均采用侧向加压法充填根管,治疗前后摄X线片。比较2组的根管预备时间、根管预备后充填效果。结果试验组每根管预备时间为（13.32±6.06）min,对照组每根管预备时间为（18.79±7.58）min,2组根管预备时间的差异有统计学意义（t=8.036,P〈0.001）。试验组与对照组相比,根管预备并发症发生率较低,根管预备后充填的根管形态好、适充率相对较高。结论机用ProTaper镍钛器械预备根管较手用K型不锈钢锉预备效果好。     

Lightspeed备根技术与手用器械备根后治疗效果的比较

目的观察Lightspeed备根和手用器械备根在根充后的临床疗效，选择较好的根管预备方法。方法选取210颗慢性根尖周炎患牙，随机分为两组，每组105颗，分别使用Lightspeed和手用镍钛锉进行根管预备，侧向加压法充填根管，比较术后临床疗效。结果经过2年临床观察，使用Lightspeed备根的根管治疗组，其临床疗效明显优于手用器械备根组。结论使用Lightspeed备根技术可提高根管治疗成功率。     

2种根管治疗方法的体内、外实验比较

目的将Twisted file与Guttaflow常温流动牙胶联合应用于根管治疗,与传统K锉预备+牙胶侧方加压的根管充填方法做体内、外实验比较。方法临床实验120例下颌前磨牙根管治疗病例,对照组(K锉)和实验组(TF)各60例。对照组用0.02锥度K锉行根管预备后,用Cortisomol糊剂+0.02锥度牙胶行侧方加压充填根管。实验组用TF预备根管,Guttaflow联合大锥度牙胶尖充填根管。记录2组患者术后疼痛情况,术后3、6、12个月复查患牙状况。体外实验52颗离体下颌前磨牙,对照(K锉)组和实验(TF)组各26例,根管治疗步骤同临床实验。染料渗透法行根尖微渗漏比较。结果临床实验中实验组术后1 d疼痛情况优于对照组;远期疗效术后3个月复查2组间无统计学差异,6、12个月复查实验组优于对照组。体外实验离体牙染料渗透法显示实验组根尖密闭性优于对照组。结论 TF联合Guttaflow根管治疗法优于传统K锉预备+牙胶侧方加压法,值得临床推广应用。     

Hero 642根管预备系统在弯曲根管应用中的比较研究

目的:比较研究机用镍钛器械Hero 642根管预备系统对弯曲根管采用不同预备方法的临床效果.方法:选取有弯曲根管的牙髓炎或根尖周炎患牙164个,分为3组,分别应用Hero 642根管预备系统和不锈钢K锉采用逐步深入法或逐步后退法预备根管,均采用侧方加压法充填根管,根据X线片评价根管预备效果和充填效果,术后随访半年评价临床疗效.结果:与传统的不锈钢K锉相比,Hero 642根管预备系统采用两种方法预备根管均能较好地维持根管的走向和弯曲度以及根管的锥度和流畅度,术后并发症少且程度轻,逐步后退法术后疼痛和器械折断的发生率较逐步深入法多.结论:机用镍钛器械Hero 642根管预备系统预备弯曲根管成形效果好;采用逐步深入法术后并发症少.     

两种机用镍钛器械预备老年人磨牙根管的临床效果比较

目的：比较两种机用镍钛系统Mtwo和ProTaper在老年人磨牙根管预备中的临床应用效果。方法：选择牙髓炎或根尖周炎老年患者磨牙60颗,分别用Mtwo、ProTaper和不锈钢K锉预备根管,全部患牙均采用侧向加压法充填根管。记录根管预备时间,根据术前术后X线片评价根管预备和充填的效果,回访患者术后反应。结果：Mtwo和ProTaper机用镍钛器械均能较好地保持根管的弯曲度和走向,根管预备的锥度和流畅度好,根管形态无改变,未见根管偏移、根尖阻塞、台阶形成等并发症发生;Mtwo和ProTaper机用镍钛器械的操作时间均比不锈钢K锉组短;使用ProTaper组有2例发生器械分离,Mtwo组未见器械分离。结论：Mtwo和ProTaper机用镍钛器械预备老年人磨牙根管均可获得较好的成形效果,均快速高效且较少有根管内并发症发生。     

Comparison of cold lateral condensation and a warm multiphase gutta-percha technique for obturating curved root canals

AIM: The aim of this project was to evaluate and compare the radiographic quality and sealability of root fillings in extracted human teeth using lateral condensation of gutta-percha or multiphase gutta-percha obturation (Alphaseal). METHODOLOGY: A total of 108 freshly extracted human, mature single-rooted teeth were divided into two identical groups of 54 teeth on the basis of root canal shape. The canals were prepared to a minimum 0.055 taper and enlarged to size 35 at the apex. All root canals were flushed with 17% EDTA solution and 2.5% NaOCl to remove the dentinal smear layer. The canals of one group were obturated using cold lateral condensation of gutta-percha and the canals of the other group were filled using a warm multiphase gutta-percha obturation technique. The extrusion of sealer and/or gutta-percha through the apex of the teeth was recorded using a simple yes/no scheme. The sealability of each technique was assessed by a dye penetration method. The radiographic quality of obturation was determined for each canal using a four-point scale. RESULTS: Root canals filled by multiphase obturation had significantly more extrusion of sealer (P < 0.001) and gutta-percha (P < 0.001) than canals filled by lateral condensation. Canals filled by multiphase gutta-percha obturation had significantly less apical dye leakage than those obturated by lateral condensation (P < 0.05). Lateral condensation achieved significantly better scores for radiographic quality than multiphase obturation from the bucco-lingual view (P < 0.01). CONCLUSIONS: Under laboratory conditions multiphase gutta-percha had better sealability but poorer radiographic quality than lateral condensation.     

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.     

Comparison of lateral condensation and thermomechanically compacted warm alpha-phase gutta-percha with a single cone for obturating curved root canals

OBJECTIVE: To evaluate and compare the sealability and radiographic quality of root fillings in extracted teeth by using lateral condensation of gutta-percha or alpha-phase gutta-percha in conjunction with a single gutta-percha cone. STUDY DESIGN: A total of 108 single-rooted teeth were divided into 2 groups of 54 teeth based on canal shape. Canals were prepared to a minimum 0.055 taper and enlarged to a size 35 at the working distance. Irrigation was done with 17% EDTA and 2.5% sodium hypochlorite (NaOCl) to remove smear layer. One group was obturated by using cold lateral condensation of gutta-percha; the other group was obturated with thermomechanically compacted alpha-phase gutta-percha and a single cone of gutta-percha. Apical extrusion of sealer or gutta-percha was recorded. Sealability of each technique was assessed by dye penetration. The radiographic quality of obturation was also determined. RESULTS: Root canals filled with alpha-phase gutta-percha and a single cone had significantly more extrusion of sealer than canals filled by lateral condensation. Lateral condensation achieved significantly better scores for radiographic quality. There was no significant difference between the 2 filling techniques in terms of apical or coronal leakage. CONCLUSIONS: Thermomechanically condensed alpha-phase gutta-percha used in conjunction with a single gutta-percha cone had poorer radiographic quality than laterally condensed gutta-percha.     

Evaluation of the Trifecta obturating technique

The aim of this project was to evaluate and compare the radiographic quality and sealability of root fillings in extracted human teeth using lateral condensation of gutta-percha or the Trifecta obturating system. One hundred freshly extracted human mature, single-rooted teeth were divided into four identical groups of 25 teeth on the basis of root canal shape. The root canals of two groups were prepared in such a way as to produce a relatively parallel canal shape with little or no flare towards the coronal orifice. The root canals of the other two groups were prepared in such a way as to produce a canal shape that was deliberately more flared to ensure that they were wider at the orifice than at the endpoint of the preparation. All root canals were flushed with 17% EDTA solution and 2.5% NaOCl to remove the dentinal smear layer. The canals of one flared and one parallel group were obturated using cold lateral condensation and the canals of the other two groups were obturated using the Trifecta system. The sealability of each technique was assessed by a dye penetration method. The radiographic quality of obturation was determined for each canal using a 4-point scale. Canals filled with thermoplasticised gutta-percha had significantly less apical dye penetration than those obturated by lateral condensation (P < 0.001). Lateral condensation achieved significantly better scores for radiographic quality than thermoplasticised gutta-percha from both the bucco-lingual (P < 0.001) and the mesio-distal views (P < 0.001). Root canals obturated using the Trifecta technique showed significantly more apical extrusion of sealer than those obturated by lateral condensation (P < 0.001). Under laboratory conditions the Trifecta technique had better sealability but poorer radiographic quality than lateral condensation.     

INFLUENCE OF SMEAR LAYER REMOVAL ON THE OBTURATION OF ROOT CANAL RAMIFICATIONS

Objective:

This study evaluated whether smear layer removal has any influence on the filling of the root canal system, by examining the obturation of lateral canals, secondary canals and apical deltas.

Material and Methods:

Eighty maxillary and mandibular canines were randomly divided into two groups, according to their irrigation regimen. Both groups were irrigated with 1% NaOCl during canal shaping, but only the teeth in Group II received a final irrigation with 17% EDTA for smear layer removal. The root canals were obturated with lateral condensation of gutta-percha and the specimens were cleared, allowing for observation under the microscope.

Results:

In Groups I and II, 42.5% and 37.5% of the teeth, respectively, presented at least one filled canal ramification. Although a larger number of obturated ramifications was found in Group I, there were no statistically significant differences between the two groups (p = 0.4957).

Conclusion:

Smear layer removal under the conditions tested in this study did not affect the obturation of root canal ramifications when lateral condensation of gutta-percha was the technique used for root canal filling.     

根尖止点阻止根充材料超充的效果研究

目的:研究根管治疗中制备根尖止点对阻止根管充填材料超充的影响。方法:选取80个单根管上、下颌尖牙,其中40个牙采用逐步后退技术,常规制备根尖止点进行根管预备至根尖孔上1mm,另40个牙亦采用逐步后退技术预备至根尖孔,不进行根尖止点的制备;再将以上各组牙随机平分为两组,分别采用冷牙胶侧方加压和热牙胶垂直加压方法充填根管,观察并记录每组中牙胶超出根尖的牙数,收集每个牙超出的充填材料(牙胶和糊剂)并称量,对实验结果进行统计学分析。结果:制备根尖止点的侧方加压组与不制备根尖止点的侧方加压组之间根充材料超出的量、制备根尖止点的垂直加压组与不制备根尖止点的垂直加压组之间根充材料超出的量均无统计学差异(P>0.05)。结论:通过在初尖锉的基础上扩大3#的方法制备根尖止点并不一定能起到减少根充材料超充的作用。     

Comparison of laterally condensed and low-temperature thermoplasticized gutta-percha root fillings

The aim of this study was to evaluate and compare the radiographic quality and sealability of root fillings in extracted human teeth using lateral condensation of gutta-percha or low-temperature thermoplasticized gutta-percha (Ultrafil). One hundred freshly extracted human, mature single-rooted teeth were divided into four identical groups of 25 teeth on the basis of root canal shape. The root canals of two groups were prepared in such a way to produce a relatively parallel shape with little or no flare toward the coronal orifice. The root canals of the other two groups were prepared in such a way as to produce a canal shape that was deliberately more flared to ensure that they were wider at the orifice than at the end point of the preparation. All root canals were flushed with 17% EDTA solution and 2.5% NaOCl to remove the dentinal smear layer. The canals of one flared group and one parallel group were obturated using cold lateral condensation, and the canals of the other two groups were obturated using low-temperature thermoplasticized gutta-percha. The sealability of each technique was assessed by a dye penetration method. The radiographic quality of obturation was determined for each canal using a 4-point scale. Canals filled with thermoplasticized gutta-percha had significantly less apical dye penetration than those obturated by lateral condensation (p < 0.001). Lateral condensation achieved significantly better scores for radiographic quality than thermoplasticized gutta-percha from both the buccolingual (p < 0.005) and mesiodistal views (p < 0.001). Low-temperature thermoplasticized gutta-percha root fillings were associated with significantly more apical extrusion of sealer (p < 0.001) and gutta-percha (p < 0.005). Under laboratory conditions the low-temperature thermoplasticized gutta-percha had better sealability but poorer radiographic quality than lateral condensation.     

Periodontal tissue reactions following root canal obturation with an injection-thermoplasticized gutta-percha technique

Abstract The thermoplasticized gutta-percha obturation technique is a relatively recent development in endodontics. In this study we evaluated the possible effects of heat transmitted to the periodontal tissues when the Obtura root canal filling device was used in dog teeth. Two 8-month-old beagle dogs were used; 56 root canals of 36 teeth (maxillary incisors and first, second and third premolars of both jaws) were divided into two groups. In Group A 26 root canals were obturated with the lateral condensation technique, while in Group B 30 root canals were obturated using the Obtura device, without sealer. Observation periods were 1, 3, 7, 28 and 56 days. After routine laboratory procedures, hematoxylin-eosin stained sections were examined under a light microscope. In this experimental model the thermoplasticized gutta-percha obturation technique caused a periapical inflammatory reaction at all observation periods. Inflammatory reaction and destruction of collagen fibers were localized in the area around the apical delta, while the alveolar founding bone, the roots of the teeth and the periodontal ligament at the side of the root surfaces remained normal.     

Periodontal tissue reactions following root canal obturation with an injection-thermoplasticized gutta-percha technique

The thermoplasticized gutta-percha obturation technique is a relatively recent development in endodontics. In this study we evaluated the possible effects of heat transmitted to the periodontal tissues when the Obtura root canal filling device was used in dog teeth. Two 8-month-old beagle dogs were used; 56 root canals of 36 teeth (maxillary incisors and first, second and third premolars of both jaws) were divided into two groups. In Group A 26 root canals were obturated with the lateral condensation technique, while in Group B 30 root canals were obturated using the Obtura device, without sealer. Observation periods were 1, 3, 7, 28 and 56 days. After routine laboratory procedures, hematoxylin-eosin stained sections were examined under a light microscope. In this experimental model the thermoplasticized gutta-percha obturation technique caused a periapical inflammatory reaction at all observation periods. Inflammatory reaction and destruction of collagen fibers were localized in the area around the apical delta, while the alveolar founding bone, the roots of the teeth and the periodontal ligament at the side of the root surfaces remained normal.     

Comparison of the obturation density of cold lateral compaction versus warm vertical compaction using the continuous wave of condensation technique

The purpose of this in vitro study was to compare quantitatively the density of standard cold lateral gutta-percha compaction and warm vertical compaction by using the continuous wave of condensation technique. Forty transparent acrylic blocks with 30-degree, curved root canals were instrumented using Gates Glidden burs and Profile 0.06 taper rotary nickel-titanium files in a crown-down manner. The blocks were weighed and randomly assigned to two evenly distributed groups. Group A was obturated with the cold lateral-compaction technique using medium-fine, gutta-percha accessory points until the canal was completely filled. Group B was obturated with the continuous wave of condensation technique until the canal was completely filled. The blocks were weighed again after obturation. Data were analyzed using a two-sample t test at the 5% significance level. Results demonstrated that the continuous wave of condensation technique resulted in a significantly greater density compared with cold lateral compaction. Warm vertical compaction using the continuous wave of condensation technique in acrylic blocks resulted in a greater gutta-percha fill by weight compared with standard cold lateral compaction.