纤维桩修复前牙残根残冠25例临床报告

目的：观察纤维桩复合树脂材料修复前牙残冠残根的临床应用效果。方法：对25例30个前牙残冠残根,经完善根管治疗后,采用美国TENAX纤维桩及Permacem桩核树脂形成纤维桩树脂核,恢复基牙外形并进行全冠修复。结果：经过1～2年的随访观察,30个牙中有1例于修复后半年出现纤维桩的松动、脱落,无根折、桩折现象发生。结论：纤维桩树脂核修复技术是一种快捷、稳固和符合牙体生理的有效修复方法,且不易造成根管壁折裂,有利于前牙的美观,是金属桩核的良好替代品。     

Bis-Core复合树脂重塑薄弱根管的临床应用

目的评价Bis—Core复合树脂重塑薄弱根管的临床疗效。方法对29颗薄弱根管的残根先用Bis—Core复合树脂重塑成正常形态，再进行常规桩核冠修复，随访6～20个月，观察牙根的折裂情况及桩核松动情况。结果所有牙根均未发生折裂，其中28颗桩核无松动，冠修复情况良好，有效率达96．55％，仅有1颗桩核松动脱落，修复失败。结论用Bis—Core复合树脂重塑薄弱根管，再以常规桩核冠修复，可以提高牙根的抗折能力。     

玻璃纤维桩修复前牙残根的疗效观察

目的探讨玻璃纤维桩和树脂核联合全冠在前牙残根修复中的临床效果。方法以玻璃纤维桩和树脂核联合全冠修复前牙残根21颗,修复完成后两年进行随访检查。结果有1颗残根修复后一年玻璃纤维桩松动,失败率4．76％,其余病例义齿冠保持完好,纤维桩无松动、脱落,X线片示牙根和纤维桩无折断,牙周和根尖无阴影。结论应用玻璃纤维桩和树脂核联合全冠修复前牙残根是一种效果良好的修复方法。     

纤维桩树脂核在修复前牙残根残冠的应用观察

目的观察玻璃纤维桩树脂核修复前牙残根残冠的临床效果。方法选择35例患者的47颗已行完善根管治疗的上下前牙残根、残冠,采用玻璃纤维桩及树脂制作桩核,金合金烤瓷冠或全瓷冠修复,随访观察。结果随访1-5年,47颗修复体均无松动脱落,无根折,无龈缘变色。结论玻璃纤维桩树脂核修复前牙残根残冠的短期临床效果稳定,但仍需长期观察。     

粘固剂对桩核烤瓷全冠修复后抗折强度的影响

目的探讨树脂粘结系统对前牙桩核烤瓷全冠抗折强度是否具有增强作用。方法40个新鲜拔除大小一致的上颌中切牙,随机分成4组,每组10个,分别用钛合金预成桩和铸造桩核修复,同一种桩及烤瓷全冠分别用树脂粘结系统和玻璃离子粘固剂粘固。经温度循环疲劳试验,用万能力学试验机,测试抗折强度,并观测折裂型。结果钛合金预成桩树脂粘结组抗折强度为499.82±168.90N,玻璃离子粘固剂组为388.98±125.22N;铸造桩核树脂粘结组抗折强度为412.55±99.29N,玻璃离子粘固剂组为337.41±121.18N。可再修复折裂型标本比例分别为40%、20%和20%、30%。统计学分析表明,两种桩核冠修复树脂粘结组的抗折强度及可再修复折裂型标本比例与玻璃离子粘固剂组均无显著性差异(P>0.05)。结论树脂粘结系统对金属桩烤瓷全冠修复的前牙抗折强度无显著的增强作用,有待进一步研究。     

两种桩核在前牙修复中的临床观察

目的:比较两种桩-核-冠(预成螺纹型金属桩核和螺纹钉树脂桩核)修复方法的临床疗效。方法:对近3年修复的113例前牙残根残冠的单冠患者,采用两种不同的桩-核-冠修复治疗方法。并经过2年的随访观察。结果:两种桩-核-冠修复方法在核冠钉松动方面存在显著差异(P<0.05),在防止牙根折裂方面无显著差异(P<0.05)。结论:预成螺纹型金属桩核-冠组,在防止冠钉松动方面明显优于螺纹钉-复合树脂核-冠组(P<0.05)。     

ParaCore双固化树脂重塑前牙薄弱残根的临床效果

目的评价ParaCore双固化树脂重塑前牙薄弱残根的临床效果。方法 22例28颗已行根管治疗的前牙薄弱残根,采用ParaCore双固化树脂材料重塑根管,结合玻璃纤维桩制作桩核,再行金瓷冠修复。修复完成后随访6～30个月,观察修复效果。结果 28颗前牙修复后,均未发生根折,其中26颗桩核无松动,修复5个月后2颗桩核脱落,重新粘固后观察18个月,桩核均无松动。结论 ParaCore双固化树脂材料重塑前牙薄弱根管可提高牙根的固位和抗折能力。     

两种桩核系统在上颌前牙残冠残根修复中的临床研究

目的：比较铸造金属桩核与玻璃纤维桩核修复上颌前牙残冠残根的临床效果。方法：随机选取16～50岁的病例128例共150个上颌前牙残冠残根进行修复,其中64个牙制作铸造金属桩核,86个牙制作玻璃纤维桩核,桩核完成后均行烤瓷熔附金属全冠修复。结果：经过0.5～2.5年的随访观察,铸造金属桩组出现7个牙根折,3个牙修复体松动脱落,1个牙慢性尖周炎复发,成功率为82.81%。玻璃纤维桩组出现2个牙根折,1个牙修复体松动脱落,1个牙窦道溢脓,成功率为95.35%。经χ2检验,两组的差异有显著性。结论：玻璃纤维桩核修复上颌前牙残冠残根具有更好的临床效果。     

铸造桩核的临床应用体会

目的 评价铸造桩核修复残根残冠的临床效果.方法 213颗残根残冠实行铸造桩核修复后采用金属烤瓷冠修复.结果 所有病例经临床随诊观察6～26个月,修复成功206颗,修复失败牙中根管折裂2颗,其中下前牙1颗、下颌前磨牙1颗,桩核松动脱落5颗.结论 残根残冠在经过铸造桩核增强固位后全冠修复,不但保留了残根残冠也扩大固定修复的范围.     

不同材料修复喇叭型根管口的实验观察

目的观察不同材料修复喇叭型根管口后的抗折裂强度和破坏模式。方法将15颗离体上颌中切牙截除牙冠后进行常规根管治疗,形成喇叭型根管口,然后随机分为A、B、C组,分别用镍铬合金铸造桩核、预成玻璃纤维树脂桩核和可塑性纤维增强树脂桩核修复。在压力测试机上对试件进行抗折裂强度测试,并记录破坏模式。结果3组试件修复后的抗折裂强度无统计学差异（P＞0.05）,但破坏模式不同,其中A组铸造桩核试件主要表现为根折和粘接剂与牙体分离,B组预成玻璃纤维树脂桩核试件主要表现为桩与粘接剂分离,C组可塑性纤维增强树脂桩核试件主要表现为粘接剂与牙体组织分离。结论纤维树脂类修复材料修复喇叭型根管口有利于残根的保存和再次修复。     

上前牙薄弱根管重塑后桩核冠修复提高牙齿抗力的实验研究

目的　探讨桩核冠修复中提高薄弱根管抗力的方法。方法　选用成人离体牙 ,制备成喇叭口根管的实验样本 ,以BIS -CORE树脂材料对薄弱根管进行重塑 ,铸造桩核冠修复 ,在电子万能力学试验机上沿与牙长轴 135°方向静态加载 ,测试折裂强度。结果　用树脂加强薄弱根管后修复组折裂强度最高 ,与薄弱根管直接修复组差异有显著性。结论　利用BIS -CORE树脂材料对薄弱根管进行重塑后修复 ,可提高其抗力。     

根管重塑对薄弱根管抗折性能影响的实验室研究

目的探讨根管重塑对薄弱根管抗折能力的影响。方法收集成人离体牙30例作为样本,分为三组:实验组A、B和对照组每组各10例,实验组A、B组制备成喇叭口状根管,其中实验组B以复合树脂材料对薄弱根管进行重塑,三组样本分别铸造桩核冠修复,在电子万能力学试验机上沿与牙长轴135°方向静态加载,至牙体折裂,记录此时样本所承受的最大负荷,并对实验结果进行单因素方差分析两两比较。结果用复合树脂加强薄弱根管后修复组抗折裂强度与薄弱根管直接修复组差异有显著性,与对照组之间差异无显著性,薄弱根管直接桩核冠修复组与对照组之间的差异有显著性。结论利用复合树脂材料对薄弱根管进行根管重塑后修复,可提高其抗折能力。     

CAD/CAM一体化纤维桩核修复薄弱根管的冠向微渗漏研究

目的：观察计算机辅助设计与制作（CAD／CAM）一体化纤维桩核修复薄弱根管的冠向微渗漏大小。方法：选择单根管前磨牙60颗,完善根管治疗后制备成薄弱根管形态。分组制作粘接 CAD／CAM一体化纤维桩核（A 组）、预成单支纤维桩＋流体树脂核（B 组）和铸造金钯金属桩核（C 组）,每组20颗。印度墨水染色4周后脱矿脱水透明化处理,体视显微镜下观察染料渗入情况并分析统计学差异。再将标本完全脱矿,观察微渗漏产生的界面。结果：3种桩核修复薄弱根管后根管壁与桩核之间均存在微渗漏,A 组与 C 组冠方微渗漏无显著性差异（P ＞0．05）,均明显小于 B 组（P ＜0．05）。A 组、C 组微渗漏多产生在桩核与树脂水门汀之间,B 组则多出现于树脂水门汀与根管壁之间。结论：CAD／CAM一体化纤维桩核修复薄弱根管的冠方微渗漏多产生于桩核与粘接剂界面,大小与金属桩组相似且均明显小于单支纤维桩＋树脂核组。     

纤维桩主辅桩在喇叭口状根管桩核修复中的临床效果观察

目的：评价纤维桩主辅桩十全瓷冠修复喇叭口状残冠残根的临床效果。方法：选择28例患者37颗需修复的喇叭口状单根管残冠残根为研究对象。患牙经根管治疗后行纤维桩主辅桩＋复合树脂核及全瓷冠修复,于修复完成后随访18-26个月,评价修复体完整性、边缘适合性、牙周及根尖周组织健康状况等。结果：37个修复体完整,成功率100％;冠边缘适合性好达91．89％,可接受8．11％;色泽匹配好达75．68％;牙龈状况好达83．79％;纤维桩及树脂核无松动、折裂、缝隙等;根尖未见异常,无根折发生。结论：纤维桩主辅桩系统临床修复喇叭口状残冠残根取得良好的临床效果,可作为保存此类残冠残根简便有效的修复方式。     

Load capability of excessively flared teeth restored with fiber-reinforced composite posts and all-ceramic crowns

This investigation evaluated the stabilizing effect of glass fiber reinforced posts (FRP) luted with self-adhesive universal cement on the fracture resistance of excessively flared endodontically treated teeth (ETT). Values were compared to teeth with no ferrule, 2 mm ferrule and resin cement for luting with 2 mm ferrule. Thirty-two caries-free maxillary central incisors were randomly assigned to 4 groups (n=8) and endodontically treated. Two groups were flattened 2 mm above and 2 groups at the cemen-to-enamel junction (CEJ). The teeth received FRPs as follows: 1) post was cemented with self-adhesive cement (RelyX Unicem, 3M ESPE) (U), no ferrule (F) was prepared, root canal entrance was excessively flared with a remaining wall thickness of 0.5 - 0.75 mm (UNF/flared); 2) post was cemented with U, no F was prepared; 3) post was luted with U, F was prepared; 4) post was cemented with a resin cement (Panavia F, Kuraray, Japan), F was prepared. All specimens were built-up using a resin composite (Clearfil Core, Kuraray). All-ceramic crowns were adhesively luted (U). Specimens were exposed to thermo-mechanical loading and statically loaded until failure. The mean fracture load values [N](SD) were: UNF/flared=68 (126); UNF=315 (136); UF=488 (72); PF=860 (190). All groups exhibited statistically significant differences regarding maximum fracture load (p<0.05).     

Effect of post type and restorative techniques on the strain and fracture resistance of flared incisor roots

Restoring flared endodontically treated teeth continues to be a challenge for clinicians. This study evaluated the effect of post types and restorative techniques on the strain, fracture resistance, and fracture mode of incisors with weakened roots. One hundred five endodontically treated bovine incisors roots (15 mm) were divided into 7 groups (n=15). The two control groups were (C) intact roots restored with Cpc (cast posts and core) or Gfp (glass fiber posts). The five experimental groups were (F) flared roots restored with GfpAp (Gfp associated with accessory glass fiber posts), GfpRc (anatomic Gfp, relined with composite resin), and GfpRcAp (anatomized Gfp with resin and accessory glass fiber posts). All teeth were restored with metal crowns. Mechanical fatigue was performed with 3x10(5)/50 N. Specimens were loaded at 45o, and the strain values (μS) were obtained on root buccal and proximal surfaces. Following that, the fracture resistance (N) was measured. One-way ANOVA and Tukey's HSD tests (α=0.05) were applied, and failure mode was checked. No significant difference in strain values among the groups was found. Cpc presented lower fracture resistance and more catastrophic failures in flared roots. Gfp associated with composite resin or accessory glass fiber posts seems to be an effective method to improve the biomechanical behavior of flared roots.     

Weakened anterior roots--intraradicular rehabilitation

This paper highlights the fact that many anterior teeth requiring restoration are severely weakened having wide, flared canal spaces, and thin dentinal walls that are prone to fracture. Traditionally these teeth have been restored using metal posts and are often unsuccessful because of lack of retention or root fracture. This paper describes how mineral trioxide aggregate (MTA) can be used to form an immediate apical seal rather than waiting months for apexification. Weakened roots can be reinforced using dentine bonding agents and composite resin and if insufficient coronal tooth structure is present a quartz-fibre post can be placed to retain a composite core.     

漏斗状根管治疗牙重塑后不同桩核系统修复的抗折性研究

目的比较漏斗状根管治疗牙在根管重塑前后不同桩核系统修复的抗折强度及牙折形式。方法采用两因素三水平的析因设计。选择45颗近期拔除的上颌中切牙,随机分为9组,每组5颗。分别按照根管重塑因素和桩核系统因素的三个水平交互组合进行处理。样本进行破坏性力学试验,记录瞬间力值及牙折形式。结果根管重塑因素对抗折强度具有显著性影响（P〈0.05）,桩核系统因素对抗折强度不产生明显影响（P〉0.05）,两种因素之间无交互作用（P〉0.05）。结论根管重塑可显著提高漏斗状根管治疗牙桩核系统修复后的抗折强度。重塑后的漏斗状根管治疗牙,不同桩核系统修复后的抗折强度无显著性差异。     

Aesthetic restoration of the compromised root: a case report.

The amount of tooth structure that remains after endodontic therapy and post preparation is of prime importance as the strength and resistance to root fracture of an endodontically treated tooth is directly related to the amount of residual dentine. The desired post diameter is determined by tooth morphology and the endodontic procedures (for root canal debridement) with the aim being to avoid removing too much tooth structure. Increasing the diameter of the post does not provide a significant increase in the retention of the post; it only increases the stiffness of the post at the expense of the remaining dentine and the fracture resistance of the root. There is little indication for increasing the post width beyond the endodontic cleaning and shaping procedures for all post systems. The post diameter needs to be controlled to preserve the radicular dentine, reduce the potential for perforations, and permit the tooth to resist fracture. However, endodontic treatment often involves wide flared canals where cast posts are the standard method of treatment. These thin-walled canals are then further compromised by the placement of a tapered cast post--thus increasing its risk for fracturing. The Luminex light, transmitting posts provide an alternative treatment option by strengthening weakened, endodontically treated teeth by the combined bonding action of dentine bonding agents and composite resin restorative material. The paper reports on a case where a wide flared root canal was rehabilitated with composite resin using a light-transmitting post.