氢氧化钙樟脑对氯苯酚糊剂根管消毒的临床评价

目的 了解在氢氧化钙甘油糊剂中加入樟脑对氯苯酚后其临床疗效。方法 选择１８３颗慢性根尖周炎患牙、随机分为３组：氢氧化钙／樟脑对氯苯酚甘油（Ａ组,６３例）,氢氧化钙／甘油（Ｂ组,６０例）、樟脑对氢苯酚组（Ｃ组,６０例）,对照观察封药７天后的临床疗效及微生物培养结果。结果 Ａ组约８４％病例在封药后一次复诊即可完成根管充填;Ｂ组仅６３％成功,而Ｃ组为３８％,差异具有统计学意义。微生物学结果与此成正相关。     

氢氧化钙根管消毒药物在临床的应用

目的　观察对比氢氧化钙固化药尖和樟脑酚的根管消毒效果。方法　 6 5颗单根患牙 ,X线片明确诊断为慢性根尖炎或慢性根尖炎急性发作者 ,根管预备后分为两组 (氢氧化钙组 /樟脑酚组 ) ,观察封药前后根管细菌培养结果 ,记录临床检查结果。结果　患者不适症状封药前后都有明显减轻 (P <0 .0 5 ,Wilcoxon检验 ) ,氢氧化钙组比樟脑酚组的叩诊症状改善明显 (P <0 .0 5 ,Mann -Whitney检验 )。厌氧细菌培养两组间统计学结果无明显差异 (P >0 .0 5 ,Wilcoxon检验 ) ,不同试验组内封药后比封药前平均菌落计数明显降低 (P <0 .0 1,t检验 )。结论　氢氧化钙根管消毒药物缓解临床叩痛疗效明显 ,抗菌效果与樟脑酚无明显差异。此外 ,氢氧化钙具有消毒效果持久 ,不致敏 ,具收敛性 ,价廉实用方便的优点。建议临床推广使用 ,替代酚类消毒药物。     

氢氧化钙根管内封药的临床疗效观察

目的 观察氢氧化钙在根管内封药治疗慢性根尖脓肿的临床疗效。方法 选择58例慢性根脓肿的患牙，随机分成两组，根管治疗过程中分别采用氢氧化钙和传统的根管消毒药物樟脑对氯酚（CMCP）根管内封药，对疗效结果进行比较。结果 Ca（OH）2根管内封药组总有效率（93．10％）优于对照组CMCP根管封药（68．97％），两组疗效有统计学意义（P＜0．05）。结论 Ca(OH)2根管内封药对于病程长、长期渗出、疼痛、根尖区破坏较大的病例较CMCP能更有效地控制症状。     

氢氧化钙对乳牙感染根管作用的研究

目的 探讨氢氧化钙用作乳牙感染根管消毒剂的效果。方法 通过临床120例患者的对照观察，X线片以及实验细菌学检验，对氢氧化钙用于乳牙感染根管与常规使用的甲醛甲酚(FC)、樟脑酚消毒剂作对比，比较三种消毒剂消毒前后根管内细菌的变化以及治疗后的反应。结果 乳牙感染根管中的细菌与成人恒牙感染根管相似，是以厌氧菌为主的混合感染。氢氧化钙对乳牙感染根管有很强的杀菌、抑菌作用，优于樟脑酚，与FC相似，但氢氧化钙对根尖周组织无刺激性及不良作用；而且对儿童尤其安全、有效，临床效果肯定。结论 氢氧化钙是安全、有效而理想的乳牙感染根管的消毒药物。     

氢氧化钙及氯己定联合用于根管消毒的临床疗效观察

目的评价氯己定凝胶(CHX)、氢氧化钙糊剂(CH)和氢氧化钙联合氯己定(CHX+CH)作为根管消毒药物在根管治疗中的临床疗效。方法选取慢性根尖周炎患牙60颗,采用常规机械预备冲洗,随机数字表法均分为三组选择CHX、CH和CHX+CH进行根管内封药,分别在根管预备前,预备后及封药7 d后进行根管内细菌标本的采样,培养,测定需氧菌和厌氧菌细菌数量的变化,观察患牙封药7 d前后的临床疗效并进行评分,记录患牙达到可以充填的平均封药时间。结果三组患牙封药7 d后,每组患牙根管内的需氧菌和厌氧菌数量(取对数值)均较封药前明显降低(P<0.05);根管内需氧菌和厌氧菌的细菌数量差异有统计学意义(P<0.05);每组患牙封药前后临床评分的差异均有统计学意义(P<0.05);三组临床评分差值的差异有统计学意义(P<0.05)。三组患牙达到根管充填要求的封药时间差异有统计学意义(P<0.5)。结论 CHX、CH和CHX+CH作为根管消毒药物对慢性根尖周炎均有较好的疗效,CHX凝胶联合CH糊剂综合评估抑菌效果及临床疗效最佳。     

氢氧化钙在根管消毒中的作用机制

氢氧化钙因其特有的理化特性在临床根管消毒中得到越来越广泛的应用。许多研究表明,氢氧化钙具有良好的扩散性,并可以通过破坏细菌菌体、降解细菌脂多糖等途径发挥消毒作用。本文将对氢氧化钙在根管消毒中的主要作用机制做一综述。     

碘仿氢氧化钙用于根管消毒的临床疗效观察

目的：评价碘仿氢氧化钙糊剂和氢氧化钙糊剂根管内消毒效果的差异。方法：将340有瘘型慢性根尖周炎患牙,在常规根管预备成形后,随机分为2组：碘仿氢氧化钙组170颗患牙,将碘仿氢氧化钙糊剂导入根管内暂封1周;氢氧化钙组170颗患牙,将氢氧化钙置入根管内暂封1周,分别复查封药1周,根充2周,根充3月后各组牙的临床症状和体征,对比根管消毒效果及封药后疼痛反应情况。结果：慢性根尖周炎患牙碘仿氢氧化钙组封药1周,根充2周,根充3月有效率分别为84.4%;86.7%;85.6%,氢氧化钙组有效率分别为77.3%,68.2%,68.2%。两组有效率的差异有统计学意义（P〈0.05）。结论：对于慢性根尖周炎患牙根管内封碘仿氢氧化钙糊剂能发挥更好的根管消毒作用。     

复方氢氧化钙与甲醛甲酚根管消毒疗效的对比研究

目的 比较复方氢氧化钙糊剂与甲醛甲酚根管消毒剂的疗效.方法 将211颗窦道型慢性根尖周炎患牙,在常规根管彻底清理和根管成形的根管预备后,随机分2组:复方氢氧化钙组106颗患牙,将复方氢氧化钙糊剂导入根管内暂封2周;甲醛甲酚组105颗患牙,将甲醛甲酚棉捻置入根管内暂封1周.复查2组患牙根管内封药后临床症状和体征,对比根管消毒效果及封药后疼痛反应.结果 复方氢氧化钙组有101颗患牙临床症状和体征明显缓解或消除,有效率为95.28%;甲醛甲酚组有89颗患牙临床症状和体征有减轻或消除,有效率为84.76%.2组根管消毒有效率差异有统计学意义(P＜0.05).用复方氢氧化钙糊剂消毒根管很少发生疼痛反应且程度较轻,疼痛反应发生率为6.60%(7/106).用甲醛甲酚消毒根管较易发生疼痛反应且程度较重,疼痛发生率为30.48%(32/105).2组封药后疼痛反应发生率比较,差异有统计学意义(P＜0.01).结论 复方氢氧化钙糊剂根管消毒效果优于甲醛甲酚根管消毒剂,并可减少或减轻封药后的疼痛反应.     

不同赋形剂氢氧化钙根管消毒效果的临床研究

目的比较生理盐水、碘甘油、樟脑对氯苯酚、樟脑对氯苯酚/碘甘油等赋形剂对氢氧化钙消毒根管效果的影响,以期为临床工作提供参考。方法选择单根管慢性根尖周炎患牙80颗,随机分成氢氧化钙加生理盐水、氢氧化钙加碘甘油、氢氧化钙加樟脑对氯苯酚、氢氧化钙加樟脑对氯苯酚/碘甘油等4组,观察封药1周后的临床疗效、封药1周前后的细菌学培养菌落数变化以及达到临床可充填的封药时间等评价指标。结果氢氧化钙加樟脑对氯苯酚/碘甘油组明显优于氢氧化钙加生理盐水、氢氧化钙加碘甘油、氢氧化钙加樟脑对氯苯酚组(P<0.01);在封药1周的临床疗效(评分差值)方面,氢氧化钙加生理盐水组、氢氧化钙加樟脑对氯苯酚组差异无统计学意义(P>0.05);在达到临床可充填封药时间上,氢氧化钙加碘甘油组、氢氧化钙加樟脑对氯苯酚组差异无统计学意义(P>0.05)。结论在生理盐水、碘甘油、樟脑对氯苯酚、樟脑对氯苯酚/碘甘油等赋形剂中,樟脑对氯苯酚/碘甘油可能是最为有效的赋形剂。     

对氢氧化钙根管消毒作用的再认识

氢氧化钙是临床上常用的根管消毒药物之一,其消毒效果得到广泛认同.但近年来的研究表明,氢氧化钙的抗菌作用并非全能,特别是对于一些难治性根尖周病的病原菌抗菌效果不佳,其药物剂型和临床操作也存在着一定的局限性.本文就氢氧化钙的抗菌作用、临床操作等作一综述.     

氢氧化钙-碘仿糊剂用于乳牙根管封药的临床研究

目的:观察氢氧化钙-碘仿糊剂应用于乳牙感染根管封药的临床疗效。方法:选择320例乳牙根尖周炎病例,随机分为治疗组(氢氧化钙-碘仿糊剂组)和对照组(甲醛甲酚组)各160例,观察封药后48h,1周的临床疗效。结果:1周后两组疗效有显著差异,氢氧化钙-碘仿糊剂根管封药显效率(91.25%)优于甲醛甲酚组(66.25%)。结论:氢氧化钙-碘仿糊剂应用于乳牙根管封药可有效减少治疗期间的肿痛。     

氢氧化钙预防根管治疗术后疼痛的临床观察

目的评价氢氧化钙作为根管内药物预防根管治疗术后疼痛的效果。方法选择90颗牙髓坏死的前磨牙,将其随机分为A、B、C组,每组30颗牙。A组患牙1次完成根管治疗;B组患牙2次完成根管治疗,但约诊期间根管内不封任何药物;C组患牙2次完成根管治疗,但约诊期间根管内封Ca(OH)2糊剂。采用改良10点视觉模拟量表对患者根管治疗后疼痛的严重程度进行评价,比较3组患者根管治疗后的疼痛水平。结果A组与B组、B组与C组患者根管治疗术后疼痛的差异有统计学意义(P<0.05),A组与C组患者根管治疗术后疼痛的差异无统计学意义(P>0.05)。结论氢氧化钙作为根管内封药可有效预防根管充填后疼痛的发生。     

The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals

Abstract The bactericidal efficacy of calcium hydroxide, camphorated phenol and camphorated paramonochlorophenol as intracanal dressings was evaluated clinically when the root canals of 65 single-rooted teeth with periapical lesions were treated. A bacteriological technique that could detect even small numbers of anaerobic bacteria in the canals was used. After treatment, including intracanal dressing with calcium hydroxide paste (Calasept), bacteria were recovered from one of 35 treated root canals. After use of camphorated phenol or camphorated paramonochlorophenol as the dressing, bacteria were recovered from 10 of 30 treated root canals. The isolated bacteria were predominantly Gram-positive and anaerobic. There was no indication that specific bacteria were resistant to the treatment. The results indicate that the endodontic treatment of infected root canals can be completed in two appointments when calcium hydroxide paste is used as an intracanal dressing.     

地塞米松-氢氧化钙糊剂用于根管封药的临床研究

目的 观察地塞米松-氢氧化钙糊剂应用于根管封药的临床疗效。方法 选择240例根尖周炎病例，随机分观察组(地塞米松-氢氧化钙糊剂组)对照组(甲醛甲酚组)各120例，观察封药一周后的临床疗效。结果 两组效果有显著差异，地塞米松-氢氧化钙糊剂根管封药显效率(90．8％)优于甲醛甲酚根管封药(66．7％)。结论 地塞米松-氢氧化钙糊剂应用于根管封药能有效预防和降低根管治疗期间疼痛和水肿的发生。     

Influence of calcium hydroxide intracanal medication on apical seal

AIM: The aim of this study was to determine the influence of calcium hydroxide intracanal medication and various techniques for its removal on the sealing ability of gutta-percha root fillings with a zinc oxide-eugenol sealer. METHODOLOGY: Eighty extracted mature human mandibular molar roots were divided into three groups of similar root-canal configuration. Calcium hydroxide paste was made by mixing calcium hydroxide powder with distilled water at a powder to liquid ratio of 1:1.25. After root canals were prepared and enlarged to a minimum of size 30 with the Profile 0.06 system, calcium hydroxide paste was placed in the canals of two groups, but no medication was placed in the control group. The intracanal calcium hydroxide was removed with two different techniques, 1 week after medication: K-files one size larger than the master apical file (MAF) were used with 2.5% NaOCl and 15% EDTA solutions in one group, whilst K-files the same size as the MAF were used with 2.5% NaOCl solution in another group. Canals were obturated with gutta-percha and Tubli-Seal cement using the lateral condensation technique. The apical sealing-ability was assessed by dye leakage and cross-sections of the specimens were examined under a stereomicroscope. The dye-penetration level was measured and analyzed using Fisher's exact test and Duncan's multiple range test. RESULTS: The calcium hydroxide-medicated groups showed significantly more dye leakage than the non-medicated control group (P < 0.05). However, there was no significant difference between the two calcium hydroxide-medicated groups (P > 0.05). The stereomicroscopic views showed a relatively uneven and thicker layer of sealer in the calcium hydroxide-medicated groups. CONCLUSION: Calcium hydroxide intracanal medication may increase apical leakage of gutta-percha root fillings when a zinc oxide-eugenol sealer is used.     

Effect of calcium hydroxide as an intracanal dressing on apical leakage

In this in vitro study, we investigated the effects of the use of two different calcium hydroxide (Ca(OH)2) preparations as an intracanal dressing on the sealing ability of two different sealers were investigated. Eighty-eight freshly extracted, single-rooted maxillary anterior teeth were used. After the root canals were hand-instrumented, they were divided into six groups of 10 each. The root canals were dressed with Ca(OH)2 paste, either mixed with sterile water (in groups 1 and 2) or with glycerine (in groups 3 and 4). The dressed root canals were incubated in 100% humidity at 37 degrees C for 7 days. In groups 5 and 6, the root canals were not dressed. After the root canal dressings were removed by irrigation with 5.25% NaOCl and reaming with a K-type file, all canals of the experimental groups were obturated with sealer and gutta-percha using a cold lateral condensation technique. Calciobiotric Root Canal Sealer, (CRCS), (in groups 1, 3 and 5) and Diaket (in groups 2, 4 and 6) were used as sealers. All specimens were placed in India ink for 7 days, and the amount of apical leakage was scored. Eight further prepared specimens were dressed with Ca(OH)2 plus water or Ca(OH)2 plus glycerine and examined with scanning electron microscopy (SEM) following the removal of dressings. There was a statistical difference in the leakage patterns amongst the 6 experimental groups (P < 0.05). Specimens in group 2 exhibited less leakage than the other experimental groups, except group 4 (P < 0.05). There were no other significant interactions. SEM examination revealed that Ca(OH)2 crystals were present on the surface of smear layer in both groups where Ca(OH)2 paste had been placed, but they did not penetrate into the dentinal tubules.     

The pH changes of four different calcium hydroxide mixtures used for intracanal medication

The purpose of this study was to determine the pH values of calcium hydroxide mixtures in combination with either distilled water, two different local anaesthetic solutions or physiological saline solution, which are commonly used as a dressing materials during endodontic treatment. The pH of each vehicle prior to mix with calcium hydroxide and subsequently each prepared combination was determined using a digital pH meter. The pH measurements were determined at 3 min, 10 min, 1 h, 24 h, 48 h and 7 days. The results of this study indicated that four different water-based vehicles demonstrated similar pH changes range within pH 11-12 when mixed with calcium hydroxide.     

Effectiveness of the proton pump inhibitor omeprazole associated with calcium hydroxide as intracanal medication: an in vivo study

Introduction

The objective of this study was to evaluate the efficacy of the association of a proton pump inhibitor (omeprazole) with Ca(OH)₂ as intracanal medication in a rat model of periapical lesions.

Methods

Periapical lesions were induced on the first right mandibular molar tooth of 36 male Wistar rats (6 per group). After 28 days, the distal canal of each tooth was prepared, filled with the respective dressing (negative control group, PEG 400; positive control group, Ca(OH)₂ + PEG400; test group, Ca(OH)₂ + omeprazole + PEG 400), and sealed with amalgam for 15 or 28 days. Microbiological samples were taken in 3 periods: S1, after 28 days of lesion induction; S2, after the biomechanical preparation; and S3, after the medication (15 and 28 days).

Results

The radiographic and histologic analysis revealed that either Ca(OH)₂ or Ca(OH)₂ plus omeprazole dressings produced a reduction of periapical lesions at 28 days, when compared with the negative control group. The reduction of periapical lesions and inflammatory cell infiltration was visibly improved by associating omeprazole with Ca(OH)₂, with an increase of reparative bone areas. The microbiological assessment showed a significant decrease of colony-forming units count from S1 to S2 or S3 collecting times, but no differences were observed between the S2 and the S3 time-periods or among the experimental groups within the S3 period. Further bacterial characterization showed a possible selective activity of the medications.

Conclusions

Our data showed that association of omeprazole with Ca(OH)₂ favored a superior repair of rat periapical lesions and seemed to display different selective activity over endodontic microbiota, in comparison with the conventional Ca(OH)₂ dressing.