镍钛器械预备根管对根管充填根尖孔封闭性的影响

目的：研究临床常用镍钛根管预备器械ProTaper预备根管对根管充填根尖孔封闭性的影响。方法：选取仿真树脂根管34个，其中30个随机平均分为3组：不锈钢K锉预备组；手用镍钛ProTaper预备组；机用镍钛器械ProTaper预备组。剩余4个随机平均分为阴性对照组和阳性对照组。AH-PLUS根充糊剂加牙胶尖冷侧压法充填，染料渗透法评价，分别在第1，3，5，7，9，11d定时观察，记录渗漏的发生率、渗漏的程度以及染料渗漏的量。结果：3个实验组在染料渗漏程度方面无统计学差异（P〉0．05）；而在第5，7d不锈钢预备组染料渗漏的发生率要明显高于其余两个实验组（P〈0．05）；同时在第11d不锈钢预备组染料渗漏的量也要明显高于其余两个实验组。而两种镍钛器械预备组之间比较染料渗漏的发生率、染料渗漏程度以及染料渗漏的量均无明显差异（P〉0．05）。结论：短期内镍钛器械预备的根管相比不锈钢器械预备的根管更有利于根管充填后根尖孔的密封。     

根管充填糊剂根尖封闭性的体外研究

目的：体外评价3种根管充填糊剂的根尖封闭效果。方法选取人离体下颌前磨牙68颗,截冠后随机分为A、B、C、D、E、F 6个组,其中A、B、C、D为实验组（每组12颗牙齿）,E和F分别为阳性和阴性对照组（每组各10颗牙齿）,所有样本均使用K3镍钛器械采用冠向下法完成根管预备后按如下方法进行根管充填：A、B组分别用树脂类根管充填糊剂AH Plus和生物陶瓷类根管充填糊剂iRoot SP行冷牙胶侧方加压充填;C、D组分别用生物陶瓷类根管充填糊剂iRoot SP和硅酮类根管充填糊剂Guttaflow行单尖充填;E、F组不添加糊剂只用牙胶尖侧方加压充填。将完成根管充填的实验组（每组10颗）和对照组浸入印度墨水中染色,其中4个实验组和阳性对照组在根尖孔周围2mm以外的牙体表面涂布2层指甲油,阴性对照组则在整个牙根表面涂布2层指甲油,采用透明牙法观察根尖微渗漏情况,使用imageJ软件测量并记录染色长度,并进行统计学分析;将剩余的样本横切后用扫描电镜对其截面进行观察。结果4个实验组所获得的浸墨长度分别为：A（1.02±0.46）mm, B（1.05±0.42）mm, C（1.02±0.45）mm, D（1.16±0.43）mm。4组浸墨长度之间的差异均无统计学意义（P〉0.05）。扫描电镜观察各组根管充填糊剂和根管壁牙本质之间均有缝隙。结论3种根管充填糊剂均不能完全封闭根管,在根尖封闭效果上无明显差异。     

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。     

牙髓病及根尖周病

冠折年轻恒前牙活髓切断术后临床及X线研究；连续波热牙胶垂直充填术根尖微渗漏的研究；R-H糊剂超填对疗效的影响；根管治疗后冠部封闭材料的渗漏研究；手用ProTaper镍钛器械根管预备后不同充填方法的效果研究     

新型纳米羟基磷灰石(n-HA)糊剂封闭根尖性能及其对病原菌抗菌活性的体外实验

目的：研究新型纳米羟基磷灰石根管充填糊剂（n-HA）、AH-Plus根管封闭剂的根尖封闭性能以及二者对感染根管优势菌牙龈卟啉单胞菌（Porphyromonas gingivalis,Pg）、具核梭杆菌（Fusobacteria nu-cleatum,Fn）、中间普氏菌（Prevotalla intermedius,Pi）生长的影响。方法：实验一34个离体单根管牙随机分为4组,用镍钛旋转器械Protaper预备根管,阳性对照（2个）、阴性对照（2个）、2个实验组（各15个）,分别用新型n-HA、AH-plus根充糊剂加牙胶尖以冷侧压法根充恰填,染料渗入法检查根尖微渗漏。实验二选用Pg、Fn、Pi作为实验菌株,常规打孔法测定新型纳米羟基磷灰石根管充填料、AH-Plus根管封闭剂的抑菌效果。结果：所有根充糊剂充填后根尖部位均有微渗漏,AH-plus组的微渗漏值低于n-HA组,2组结果间无统计学意义（P〉0.05）。n-HA与AH-Plus糊剂对Pg、Fn、Pi均有一定的抑菌作用,但n-HA的抑菌作用明显强于AH-Plus。结论：2种根充糊剂充填后都不能完全封闭根尖孔,AH-plus根充糊剂的根尖封闭性优于n-HA组。n-HA根充糊剂具有较理想的抑菌效果。     

激光与镍钛器械在一次性根管治疗术的联合应用

目的：观察激光与镍钛器械联合应用于前牙慢性根尖周炎一次性根管治疗的临床效果,评价其临床应用的可行性。方法：对150例240颗慢性根尖周炎的前牙随机分为二组：实验组,123颗牙,采用镍钛旋转器械Hero642系统预备根管,Nd：YAG激光消毒,即刻完成根管充填;对照组,117颗牙,手用不锈钢器械预备根管,氢氧化钙糊剂根管封药消毒后再完成根充;对二组的结果：实验组较少发生糊剂超填（P〈0．05）;两组的急症发生率,各阶段疗效则无明显差别。结根管充填质量、治疗期间的急症、术后3个月、半年、1年、2年的疗效进行比较。论：激光与镍钛器械联合应用于前牙慢性根尖周炎一次性根管治疗,具有临床可行性及应用价值。     

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。     

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。     

微焦点CT技术评价镍钛再治疗器械去根管内充填材料的效果

目的：利用微焦点CT技术定量比较两种镍钛再治疗器械与手用不锈钢器械去根管内充填材料的效果。方法：30颗离体前牙经逐步后退法预备根管后行冷侧方加压充填,随机分为3组,分别使用K锉、ProTaper D和Mtwo R去根管内充填物。再治疗前后分别对实验牙进行微焦点CT扫描,CT图像处理软件处理图像,计算根管内中1/3段和尖1/3段充填材料体积并比较其残留充填材料体积百分数。结果：在根管中1/3段,Mtwo R组根管残留充填材料体积百分数均数最小,与其他两组根管中1/3段间存在显著性差异（P〈0.05）。结论：在本实验条件下,K锉、Mtwo R和ProTaper D这3种器械在去根管内充填材料时,Mtwo R组清理效果最好。     

Easyshape和Mtwo两种镍钛预备系统对后牙弯曲根管预备效果的比较

目的 比较Easyshape和Mtwo机动镍钛预备系统对后牙弯曲根管预备的效果.方法 将临床拔除完整的第一、二磨牙随机分成两组：A组用Mtwo镍钛系统,B组用Easyshape镍钛系统,两组统一采用全长预备法进行根管预备：Mtwo器械组预备由10#锉扩大至25#,Easyshape器械组预备由15#锉扩大至30#;比较预备时间、预备前后X线片上扩大锉尖偏移的距离,用SAS9.0软件进行Wilcoxon检验方法统计分析.结果 （1） Mtwo器械组预备平均用时145s; Easyshape器械组预备平均用时156s,两组比较,差异无统计学意义（P＞0.05）.（2）离体牙预备前后X线片比较,两组根管偏移,差异无统计学意义（P＞0.05）.结论 Easyshape镍钛系统与Mtwo镍钛系统对后牙弯曲根管的预备效果无明显差异.     

三种根管封闭剂根管封闭性能的实验研究

目的：比较三种根管封闭剂的根管封闭能力。方法：选择103颗单根离体牙,根管预备后随机分为3组,分别用AH-plus根管封闭剂＋牙胶（A组）、Cortisomol根管封闭剂＋牙胶（B组）、EndoREZ双固化UDMA树脂根管封闭剂＋牙胶（C组）侧方加压法充填根管,扫描电镜观察封闭剂与根管结合情况,并进行染色法微渗漏实验,观察3、7、30d染色线长度。结果：扫描电镜下观察,树脂类封闭剂与根管壁结合紧密,染色法发现Cortisomol组染色3、7、30d较其它两组微渗漏值高,3、7d无显著性差异（P〉0．05）,30d时有显著性差异（P〈0．05）。结论：树脂类根管封闭剂根管封闭性能较好。     

三种根管封闭剂的根尖封闭性能体外比较研究

目的    在体外环境下比较C-Root SP、iRoot SP、AH-Plus 3种根管封闭剂的根尖封闭性能,以评价新型生物陶瓷类根管封闭剂C-Root SP的应用效果。方法    将80颗离体单根管牙使用Reciproc Blue机用镍钛锉预备根管,随机分为3个实验组（AH-Plus组、C-Root SP组、iRoot SP 组,每组15颗）和3个对照组（单纯牙胶充填组、阳性对照组各15颗,阴性对照组5颗）。3个实验组分别使用单尖法充填AH-Plus、C-Root SP、iRoot SP根管封闭剂,单纯牙胶充填组仅充填牙胶尖,阳性对照组和阴性对照组不做任何充填。使用染料渗透法对所有样本处理后纵向剖开根管,体视显微镜下测量染料渗透长度,比较各组染料渗透长度差异。结果    AH-Plus组、C-Root SP组、iRoot SP组、单纯牙胶充填组、阳性对照组的根管内均有染料渗入,染料渗透长度依次为（1.41 ± 0.40）、（1.32 ± 0.36）、（1.25 ± 0.42）、（4.12 ± 0.97）、（5.82 ± 0.54）mm。3个实验组的染料渗透长度差异均无统计学意义（均P > 0.05）,此3组的染料渗透长度均明显小于单纯牙胶充填组和阳性对照组（均P < 0.05）。阴性对照组无染料渗入。结论    C-Root SP根尖封闭性能良好,与iRoot SP、AH-Plus两种根管封闭剂的根尖封闭性能相近。     

玷污层及封闭剂对Ultrafil-3D系统根尖封闭的影响

目的:观察有无玷污层及不同类型的封闭剂对Ultrafil-3D系统根管充填封闭性的影响。方法:64颗人离体单、直根管前牙预备后,将其中的60颗分为有玷污层与无玷污层组,各组分别采用3种封闭剂(AH-plus、Roekoseal、CRCS)并以Ultrafil-3D牙胶(Firmset)充填根管,其余4颗作为对照。所有标本在2%亚甲蓝中浸染5d,将牙体近远中向纵劈后,测量染料的线性染色长度。采用SAS6.04软件包进行方差分析及t检验。结果:(1)无论玷污层去除与否,CRCS组的微漏均显著大于AH-plus及Roekoseal组(P<0.05);(2)去除玷污层前后,使用3种封闭剂的染料微漏均无显著差异(P>0.05)。结论:AH-plus及Roekoseal与Ultrafil-3D牙胶联合使用,能增加根管充填的密合性,去除玷污层不能明显减少微漏的发生。     

Evaluation of the apical seal in root canals prepared with a new rotary system and obturated with a methacrylate based endodontic sealer: an in vitro study

The purpose of this study was to evaluate in vitro the apical seal of root canals prepared with a new rotary system, Anatomic Endodontic Technology (AET) and filled with a methacrylate based endodontic sealer and a single gutta-percha cone and a lateral condensation technique, using the methacrylate based endodontic sealer/filler or Grossman's cement. The root canals of 45 freshly extracted human maxillary anterior teeth were prepared and then randomly assigned to three groups of 15 teeth each. After cleaning and shaping the teeth were obturated as follows: in group 1 the canals were filled with a methacrylate based sealer and a single gutta-percha cone; in group 2 the canals were filled using a lateral condensation technique with gutta-percha and the methacrylate based sealer; and in group 3, the canals were filled by means of lateral condensation of gutta-percha and Grossman's cement (control group). The specimens were stored in 100% relative humidity at 37 degrees C for 72 h, after which the coronal portion and the root surface of each tooth was covered with three layers of nail varnish and a final layer of sticky wax. After immersion in 2% methylene blue dye for 7 days, the specimens were imbedded in clear orthodontic resin and sectioned. Dye penetration was evaluated by an independent investigator using a stereo microscope. The results demonstrated that more pronounced leakage occurred in root canals obturated with the lateral condensation technique and Grossman's cement (p < 0.05). The least amount of dye leakage was observed for group 1 and 2 in which the methacrylate based sealer was used, either with a single gutta-percha cone or with lateral condensation of gutta-percha.     

Qualitative evaluation of two endodontic obturation techniques: tapered single-cone method versus warm vertical condensation and injection system: an in vitro study

Forty two single-rooted teeth, prepared with the Mtwo system, were divided into three groups based on the filling method: control, "Single-cone" (n = 20) (Mtwo gutta-percha single-cone tapered according to the diameter, length and conicity of the preparation) and "Combined system" (n = 20) (BeeFill 2in1). The parameters studied were apical leakage, gutta-percha adjustment, number of voids, presence/absence of sealer, root canal morphology, residual fragments, and filling of lateral/accessory canals. A dye penetration test was carried out (methylene blue). The teeth were embedded in resin, cut transversally and observed. The data were analyzed with non-parametric Mann-Whitney and Spearman tests. Comparative tests between the two groups showed that the "Combined system" was superior in terms of apical leakage (P < 0.01), gutta-percha adjustment (P < 0.05) and filling of lateral/accessory canals (P < 0.05). There were statistically significant correlations between master cone adjustment and root canal morphology (P < 0.01) in the "Single-cone" group. In the "Combined system" group, a relation was observed between the voids and root canal morphology (P < 0.05) and between voids and residual fragments (P < 0.05). The quality of obturation with warm gutta-percha was better than that of the tapered single-cone technique. Root canal morphology influences gutta-percha adjustment. Residual fragments on the root canal reduce sealing ability.     

Apical leakage in canals filled with glass ionomer sealer and gutta-percha after dentin conditioning

Abstract This study assessed in vitro apical leakage in root canals filled with gutta-percha and Ketac-Endo using different dentin conditioning and filling techniques. The root canals of 63 single-rooted teeth were instrumented and randomly divided into the following four groups: group A – canals were irrigated with 25% tannic: acid and filled with Ketac-Endo and a standardized gutta-percha cone; group B – canals were irrigated with 1% NaOCl and filled as in group A; group C – canals were irrigated with 25% tannic acid and filled with Ketac-Endo and a chloroform-softened gutta-percha cone adapted to the canal walls; group D – canals were irrigated with 1 % NaOCl and filled with Grossman's sealer and laterally condensed gutta-percha. After storage for 72 hours at 37°C and 100% humidity, the gutta-percha was removed to a level 4 mm short of the working length, using a Peeso reamer. Teeth were immersed in India ink for 48 hours and cleared, and the coronal extent of dye penetration examined under a binocular dissecting microscope at × 15 magnification. The mean value of leakage for group A was 0.86 mm, for group B 2.23 mm, for group G 2.34 mm, and for group D 0.55 mm. Tukey's multiple comparison lest disclosed significant differences (P<0.05) between group A and groups B and C, and between group D and groups B and C. Differences between groups A and D, as well as between groups B and C, were not significant.     

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.     

A comparative study of the apical leakage of four root canal sealers and laterally condensed gutta-percha.

Previous studies have shown that lateral condensation of gutta-percha and sealer can provide an adequate apical seal. The purpose of this study was to compare the level of apical dye penetration when different sealers were used. One-hundred twenty-five teeth with single root canals were biomechanically prepared using the step-back technique and irrigation with EDTAC and 1% NaOCl solutions. The teeth were divided into five groups of 25 teeth each. The control group root canals were filled with laterally condensed gutta-percha and no sealer and the other four groups were filled with laterally condensed gutta-percha and either Apexit, Sealapex, Tubli-Seal, or AH26 sealer. After storage in 100% humidity at 37 degrees C for 48 h, the root surfaces were coated with nail varnish (except at the apex) and placed in 2% methylene blue dye solution and centrifuged at 3 x g for 3 min. The roots were sectioned transversely at 1-mm intervals to determine the following mean levels of dye penetrations: Apexit, 1.67 mm; Sealapex, 2.28 mm; Tubli-Seal, 1.95 mm; AH26, 0.82 mm; and gutta-percha alone, 8.37 mm. This study demonstrated that a root canal sealer should be used in conjunction with laterally condensed gutta-percha and that AH26 sealer provides a significantly better apical seal than the other sealers.     

碘仿氢氧化钙糊剂注射根管充填的微渗漏实验研究

目的 :了解碘仿氢氧化钙糊剂 (iodoform -calciumhydroxideICH)注射根管充填对根尖孔的封闭性能。方法 :5 0颗离体单根牙随机分为实验组和对照组。两组分别用注射型ICH和氧化锌丁香油糊剂组单尖充填根管 ,采取染料渗入法检查根尖孔微渗漏 ,在解剖显微镜下测量染料渗入距离。结果 :ICH组微渗漏值平均 0 .60 2mm ,氧化锌丁香油糊剂组微渗漏值平均 1.2 3 6mm ,经t检验 ,P <0 .0 5 ,两组渗漏值具有显著性差异。结论 :注射型碘仿氢氧化钙糊剂对根尖孔的封闭性优于氧化锌丁香油糊剂