氢氧化钙-地塞米松糊剂预防根管治疗期间急症的临床研究

目的：评价采用氢氧化钙-地塞米松糊剂根管封药预防根管治疗期间急症的临床效果。方法：200例慢性根尖周炎、牙髓坏死、残根、残冠,需行根管治疗的患者,随机分为两组,实验组用氢氧化钙-地塞米松糊剂封药,对照组用FC封药,每组100例。结果：实验组急症发生率（4％）,显著低于对照组（28％）。结论：氢氧化钙-地塞米松糊剂能有效预防根管治疗期间急症的发生和降低约诊间疼痛程度。     

地塞米松用于预防根管治疗期间急症的疗效

我们自2002-10～2003-05月对117例患者132个患牙，采用地塞米松氢氧化钙碘仿糊剂作为暂封药于根备预备后封人根管内，并对80例患者92个牙采用无地塞米松的氢氧化钙碘仿糊剂封人为对照。结果报告如下。     

地塞米松治疗根管治疗期间急症的疗效观察

目的：观察地塞米松治疗根管治疗期间急症的疗效。方法：针对根管治疗期间急症反应,采用与不同地塞米松的疗效进行分析,结果：治疗组和对照组比较经统计学检验3日、7日疗效,P值分别小于0．01和0．05,有显著性差异。结论：地塞米松可明显降低根管治疗期间急症的发生。     

地塞米松和替硝唑预防根管治疗术期急症

根管治疗术期急症是指根管治疗术期间发生的急性反应 ,主要表现为疼痛和肿胀 ,其发生率较高 ,约 2 5%～ 4 0 % [1,2 ] 。使治疗次数增多 ,患者痛苦加大 ,我们在根管治疗术 (ｒｏｏｔｃａｎａｌｔｈｅｒａｐｙ ,ＲＣＴ)中配合地塞米松 (ｄｅｘａｍｅｔｈａｓｓｏｎｅＤＭ)、替硝唑(ｔｉｎｉｄａｚｏｌ,ＴＮＺ)进行根管冲洗 ,封药消毒 ,发现根管治疗术期急症的发生率明显降低。1　材料和方法1.1　临床病例共 16 2例 16 2个牙 ,其中男 92例 ,女 70例 ,年龄 18～ 5 3岁。疾病类型 :急、慢性牙髓炎 44牙 ,牙髓坏死 88牙 ,急、慢性尖周炎 40牙。纳…     

根管治疗期间急症的发生原因和处理

目的探讨根管治疗期间急症的发生原因及其治疗方法。方法对55例根管治疗期间急症的患牙进行临床分析。用地塞米松和甲硝唑行根管内封药,1周后用Vitapex糊剂加牙胶尖行根管充填;术后随访1a,评价其疗效。结果根管治疗期间急症的发生率为12.59%(55/437)。牙髓炎组(5.13%)与牙髓坏死、根尖周炎组(16.73%)的急症发生率差异有显著性(P<0.01),前牙组与后牙组发生率差异有显著性(P<0.01)。随访1年时疗效评定为成功者达92.7%。结论根管治疗期间急症的发生与术前患牙的牙髓状况、牙位等有关;用地塞米松和甲硝唑行根管内封药及用Vitapex糊剂加牙胶尖行根管充填治疗,效果可靠。     

地塞米松在防治根管治疗期间急症中的应用

目的：评价地塞米松对根管治疗中急症发生情况的影响。方法：对需根管治疗的176例,208个患牙随机分为2组,分别应用地塞米松＋氢氧化钙及单用氢氧化钙,观察不同时段各组急症发生情况,并进行统计分析。结果：24h、48h及48h以后地塞米松组107个患牙急症发生率分别为10．28％,6．54％,1．86％;氢氧化钙组101个患牙急症发生率分别为27．72％,12．84％,5．94％。结论：地塞米松氢氧化钙作为根管消毒剂,能明显降低根管治疗中急症的发生率。     

不同药物预防根管治疗期间急症的临床研究

目的:通过在根管治疗期间使用不同药物进行根管内封药,比较其对预防根管治疗期间急症(EIAE)的临床效果. 方法:选择因牙髓坏死、慢性根尖周炎、牙髓治疗失败而需要进行根管治疗或再治疗的患牙146颗,根据用药不同随机分为3组:甲醛甲酚(FC)、氢氧化钙(CH)及奥硝唑-地塞米松(OD),7天后复诊由同一名医师记录患者在约诊期间出现的疼痛肿胀情况, 并计算急性发作指数(FUI). 结果:FC组、CH组及OD组预防EIAE的有效率分别为61.2%、79.6%和85.4%,3组FUI均值分别为3.52±1.39、2.30±0.95和1.43±0.53. 经x2检验和秩和检验:FC组与另外两组的差异均有统计学意义(P<0.05),CH组与OD组差异无统计学意义(P>0.05). 结论:氢氧化钙和奥硝唑-地塞米松糊剂较甲醛甲酚更能有效预防EIAE的发生并可降低EIAE的疼痛程度.     

地塞米松在根管治疗术中的应用

目的：观察地塞米松在根管治疗术中的临床疗效。方法：186例需根管治疗的牙髓和根尖周病患者随机分为治疗组和对照组。在根管封药、根管充填、根管治疗期急症中分别使用地塞米松和甲硝唑。治疗1周后对咀嚼功能及肿胀疼痛程度等临床指标进行观察。结果：治疗组同对照组比,上述3个指标明显减轻。疗效具有显著性差异。结论：地塞米松用于辅助根管治疗术可减少或减轻根管治疗期间急症的发生。     

根管治疗期间急症的防治

目的:探讨根管治疗期间急症的防治.方法:将患牙髓炎、牙髓坏死、根尖周炎,需接受根管治疗的348例(348颗患牙)随机分成4组,分别在根管内封甲醛甲酚(FC)、奥硝唑、氢氧化钙、地塞米松-氢氧化钙,观察其根管治疗期间急性疼痛发作率.结果:奥硝唑与氢氧化钙组比较,差异无显著性(P>0.05).地塞米松-氢氧化钙组与奥硝唑组、氢氧化钙组比较,各组之间有显著差异(P<0.05),地塞米松-氢氧化钙糊剂同FC组比较具有非常显著差异(P<0.01).结论:根管内封地塞米松-氢氧化钙能较好预防和降低EIAE的发生率,并能减轻疼痛程度.     

戊二醛在预防根管治疗术期间急症发生中的作用

患牙进行根管治疗期间发生急性蜂窝织炎,出现疼痛肿胀的情况,临床上被称为根管治疗期间急症(interap-pointm ent em ergenc ies,IAE)。本无明显症状的患牙,经治疗后反而出现肿痛,除了增加患者的痛苦和就诊次数外,也常使临床医生陷于尴尬境地,因而已经引起不少学者重视。本文选择238例需做根管治疗的患者,选用戊二醛做为根管消毒剂,观察IAE的发生情况,从而为预防IAE措施的选择提供临床依据。1临床资料和方法1.1病例选择标准前牙和前磨牙牙髓已坏死的牙或经临床和X线片确诊的根尖周炎患牙,均为单根管,黏膜或皮肤无窦道,近2月内无明显肿痛…     

根管预备及根管消毒期间诊间疼痛的临床观察

目的:通过临床观察根管预备及根管消毒期间诊间疼痛的发生及归转,为根管治疗术疼痛的管理提供依据.方法:选择临床需要做根管治疗的患牙324颗,采用ProTaper机用镍钛器械根管预备后封入氢氧化钙做根管消毒,术后疼痛标准参照Negm分为4级,使用MATLAB及SPSS19.0软件包分析数据,观察患者术前和术后不同时间点疼痛发生的情况及归转.结果:术后即刻所有病例均出现疼痛,根管治疗约诊间痛(endodontic interappointment emergencies,EIAE)发生率为1.54％;1 d后EIAE达到峰值(25.62％),3d后趋于缓解(3.71％).通过MATLAB拟合数据,EIAE百分比随时间变化的函数关系式为P(t)=100％×0.066t exp[-0.076t](其中t以小时为单位,拟合RMSE为3.91);术后6h开始出现完全无痛的患者,2周时达82.72％.术前及术后2周完全无痛的水平有显著差异(P＜0.01).结论:随着术后时间的延长,疼痛病例数和程度相应增加,3d后趋于缓解;术后2周,完全无痛的患者明显增加.     

Protaper手动镍钛锉对老年人磨牙根管治疗期间急症发生率的影响

目的：评价ProTaper手动镍钛锉对老年人磨牙根管预备术后，根管治疗期间急症（EIAE）发生率的影响。方法：临床选取老年人磨牙108个，随机分为2组，分别采用ProTaper手动镍钛锉（实验组）和手动不锈钢K锉（对照组）进行根管预备，比较2组根管预备后，患牙EIAE发生的情况。结果：实验组在老年人磨牙根管预备后EIAE发生率为14．29％，对照组为32．69％，2组间差异有显著性（P〈0．05）。结论：应用ProTaper手动镍钛锉预备老年人磨牙根管，能够显著降低EIAE的发生。     

The relationship of intracanal medicaments to postoperative pain in endodontics

AIM: To investigate the relationship of postoperative pain to three different medicaments placed in the root canal after a complete biomechanical debridement of the root canal system in patients presenting for emergency relief of pain. METHODOLOGY: Two hundred and twenty-three teeth belonging to 221 patients presenting as emergencies to the Royal Dental Hospital of Melbourne were included in the study. Inclusion was limited to patients with a diagnosis of pulp necrosis and acute apical periodontitis. All teeth underwent conventional root canal treatment, which involved the instrumentation to the apices of each canal at the first visit. Canals were instrumented using a stepback technique and hand-files along with irrigants using Milton's (1% sodium hypochlorite) solution followed by 15% EDTAC. The canals were dried and one of the following three medicaments was inserted into the canal in random sequence: Group 1: Ledermix paste (Lederle Pharmaceuticals, Division of Cyanamid, Wolfratshausen, Germany); Group 2: calcium hydroxide paste (Calcipulpe, Septodont, France); and Group 3: no dressing. Before dismissal, the preoperative pain experienced on the previous night was recorded using a visual analogue pain scale. Patients were then instructed to record the degree of pain experienced 4 h after treatment and daily for a further 4 days. RESULTS: The mean score pain for all three groups was between 42 and 48 prior to treatment being commenced. After 4 days, the pain score for Group 2 was 10, for Group 3 was 7 and for Group 1 was 4. Mean preoperative pain level was 44.4 (of a maximum 100) for all groups, and declined by 50% (to 22.1) after 24 h. Patients in Group 1 (Ledermix) experienced significantly less (P = 0.04) postoperative pain than those in the other two groups. There was no significant difference between Group 2 (calcium hydroxide) and Group 3 (no dressing). CONCLUSION: Under the conditions of this study, painful teeth with acute apical periodontitis that had been dressed with Ledermix paste gave rise to less pain than that experienced by patients who had a dressing of calcium hydroxide or no dressing at all. Ledermix is an effective intracanal medicament for the control of postoperative pain associated with acute apical periodontitis, with a rapid onset of pain reduction.     

The effect of endodontic solutions on resorcinol-formalin paste in teeth

This study determined if any of six endodontic solutions would have a softening effect on resorcinol-formalin paste in extracted teeth, and if there were any differences in the solvent action between these solutions. Forty-nine single-rooted extracted teeth were decoronated 2 mm coronal to the CEJ, and the roots sectioned apically to a standard length of 15 mm. Canals were prepared to a 12 mm WL and a uniform size with a #7 Parapost drill. Teeth were then mounted in a cylinder ring with acrylic. The resorcinol-formalin mixture was placed into the canals and was allowed to set for 60 days in a humidor. The solutions tested were 0.9% sodium chloride, 5.25% sodium hypochlorite, chloroform, Endosolv R (Endosolv R), 3% hydrogen peroxide, and 70% isopropyl alcohol. Seven samples per solution were tested and seven samples using water served as controls. One drop of the solution was placed over the set mixture in the canal, and the depth of penetration of a 1.5-mm probe was measured at 2, 5, 10, and 20 min using a dial micrometer gauge. A repeated-measures ANOVA showed a difference in penetration between the solutions at 10 min (p = 0.04) and at 20 min (p = 0.0004). At 20 min, Endosolv R, had significantly greater penetration than 5.25% sodium hypochlorite (p = 0.0033) and chloroform (p = 0.0018); however, it was not significantly better than the control (p = 0.0812). Although Endosolv R, had statistically superior probe penetration at 20 min, the softening effect could not be detected clinically at this time.     

根管治疗期间急性发作与慢性根尖周炎患牙根管细菌组成比较

目的:比较根管治疗期间炎症急性发作及慢性根尖周炎患牙根管内8种厌氧菌检出情况,分析急性发作时根管内定植细菌种类及其相关性。方法:分别提取26例根管预备后约诊期间炎症急性发作患牙根管样本和23例慢性根尖周炎患牙根管样本,提取样本细菌DNA,利用细菌16S rRNA引物通过PCR扩增方法鉴定细菌。结果:慢性根尖周炎样本根管细菌检出率达100%(23/23),根管治疗期间急性发作样本细菌检出率为92.31%(24/26);产黑普氏菌、齿垢密螺旋体和直肠弯曲杆菌在急性发作样本中的检出率较慢性根尖周炎样本显著增高(P<0.05)。急性发作样本中牙龈卟啉菌与福赛氏类杆菌的检出显著相关(OR>2,P<0.05)。结论:根管内感染是根管治疗期间炎症急性发作的重要原因,厌氧菌在急性发作的发生中起重要作用。     

Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesions

AIM: This prospective clinical study explored the influence of calcium hydroxide as an interappointment dressing on the healing of periapical lesions associated with pulpless teeth that had not been endodontically treated previously. This was achieved by comparing the prognosis after a two-visit root canal treatment with that following a one-visit treatment. METHODOLOGY: Seventy-three patients were recruited having one tooth with an endodontically induced lesion. Of these patients, 67 could be re-examined. Calcium hydroxide was placed in the instrumented root canals of 31 teeth for at least one week and the treatment finished at the second visit. Thirty-six teeth were root canal treated at one visit. The criteria for success were the absence of signs and symptoms indicating an acute phase of periapical periodontitis and radiographically a periodontal ligament space of normal width. Methods for event time analysis were used to evaluate and compare the prognosis of both treatment approaches. RESULTS: The probability that complete periapical healing will take place increased continuously with the length of the observation period. In both treatment groups the likelihood that the root canal treatment yields a success within an observation time of five years exceeded 90%. A statistically significant difference between the two treatment groups could not be detected. CONCLUSIONS: From a microbiological perspective, one-visit root canal treatment created favourable environmental conditions for periapical repair similar to the two-visit therapy when calcium hydroxide was used as antimicrobial dressing. One-visit root canal treatment is an acceptable alternative to two-visit treatment for pulpless teeth associated with an endodontically induced lesion.     

������ϴ�Ը�������Լ�����ʹ��Ӱ��

目的探讨超声冲洗技术对根管治疗约诊间疼痛（endodontic interappointment pain,EIAP）的影响。方法选择2012年7—8月中国医科大学口腔医学院综合急诊科收治的50例根尖周炎患者（64颗患牙）,按照就诊顺序随机分为超声冲洗组和注射器冲洗组,比较两组患者EIAP的发生率。结果超声冲洗组患者EIAP发生率（12．5％）低于注射器冲洗组（37．5％）,差异有统计学意义（Х^2=5．33,P=0．021）。结论超声冲洗可减少EIAP的发生,值得在临床推广和应用。     

Surgical access for endodontic treatment of intruded teeth

Abstract This case report describes the first phase in the treatment of an 11-year-old patient with completely intruded maxillary central incisors. The intruded teeth were left to spontaneously re-erupt. After 10 days, the crowns of the teeth were exposed surgically for the initiation of endodontic therapy and an aqueous paste of calcium hydroxide was placed in the root canals. Eight wk after the injury and 6 wk after the endodontic treatment was initiated, the intruded incisors had re-erupted to about their original position before the displacement occurred.