垂直加压根管充填技术的临床评价

目的:对垂直加压根管充填技术进行临床疗效评价.方法:选择到本院牙体牙髓科就诊的牙髓病或根尖周病患者60例,按就诊顺序排列随机分为两组.分别采用垂直加压根管充填技术(VC组)和冷牙胶侧方加压充填技术(LC组)进行根管充填.对两组的根管充填时间、术中疼痛情况和根管充填效果进行比较.术后3个月和6个月进行复查.并拍摄X线片进行记录.结果:以牙为单位,VC组适充27例,超充2例,欠充1例;LC组中,适充25例,超充3例,欠充2例.VC组术中不适5例,LC组2例.以根管为单位,VC根管充填时间组平均62.6 s/根管,LC组平均198.9 s/根管(P<0.05).结论:垂直加压充填技术临床操作简便有效,操作时间短.     

Obtura Ⅱ热牙胶充填年轻恒牙根管的临床疗效评价

目的比较年轻恒牙采用两种不同根管充填术的临床疗效。方法将120颗患牙髓病或根尖周病的年轻恒磨牙随机分为两组,每组各60颗,对照组行冷牙胶侧压充填术,实验组行热牙胶垂直加压联合热塑牙胶充填术。观察术后疼痛发生情况、充填效果及1年后牙周膜的改变。结果根充后两组患牙能自行缓解的疼痛发生率分别为11.7%和10.0%。不能自行缓解的疼痛发生率分别为5.0%和3.3%,两组间差异无统计学意义(P>0.05)。对照组适充49颗,超充3颗,欠充8颗;实验组适充50颗,超充7颗,欠充3颗(P>0.05)。术后1年牙周膜增宽分别为2.35%和1.5%,两组间差异亦无统计学意义(P>0.05)。结论两种根管充填术均能达到良好的临床疗效,差异无统计学意义。     

根管治疗失败原因分析(附969例报告)

目的：探讨根管治疗失败的原因。方法：对512例根尖周病例，361例牙髓炎病例和106例外伤牙病例行根管治疗。结果：根尖周病组适充、欠充，超充失败率分别是20.7％、48.1％、17.0％，牙髓病组适充、欠充，超充失败率分别是11.6％、27.2％、42.3％，外伤牙组适充、欠充，超充失败率分别是0％、12.5％、60％。结论：根管治疗适充时疗效佳，欠充是根尖周病变治疗失败主要原因，超充是牙髓病、外伤牙治疗失败主要原因。     

试尖对根管充填质量的影响--附1500例Digora图像分析

目的 :利用计算机数字化图像系统 (Digora)能储存大量图像的特点 ,了解试尖对侧向加压法根管充填质量的影响。方法 :随机从Digora系统中提取我院从 1998年 10月至 1999年 4月所完成的根管充填病例 15 0 0例 ,按试尖与未试尖 ,分别对前牙、前磨牙和磨牙根管充填质量进行分析。结果 :在 75 2例未试尖根管充填病例中 ,前牙、前磨牙和磨牙的适充比例分别为 4 4%、3 5 %和 2 6% ,欠充为 2 2 %、3 2 %和 4 5 % ,超充为 3 4%、3 3 %和 2 9% ;在 74 8例试尖病例中 ,前牙、前磨牙和磨牙的适充比例分别为 62 %、64 %和 5 1% ,欠充为 7%、13 %和 19% ,超充为 3 1%、2 3 %和3 0 %。结论 :在侧向加压法根管充填中 ,试尖可明显改善充填质量     

上颌第三磨牙的根管治疗

目的：评估上颌第三磨牙根管治疗的临床技术特点及近期临床效果。方法：32例患牙髓炎症的上颌第三磨牙进行常规根管预备，标准牙胶尖侧向加压充填。术后x线评估根管充填质量。结果：32个病例中，适充25例，适充比例为78．12％，欠充7例，欠充比例为21．88％，没有超充病例。结论：常规根管治疗技术治疗上颌第三磨牙可以取得较好的临床效果。     

Thermafil充填技术体外实验研究

目的 :通过体外实验 ,研究Thermafil根管充填技术的效果 ,为新技术的使用和推广提供基础性资料和经验。方法 :4 0个离体单根管前磨牙 (根管弯曲度为 0°～ 10°)随机分为两组 ,分别采用Thermafil根管充填技术 (TC)和冷牙胶侧方加压充填技术 (LC)进行根管充填。比较上述两种根管充填方法的根尖封闭能力并进行分析。结果 :离体牙实验表明 ,Thermafil充填技术与冷牙胶侧方加压充填技术相比 ,根管微渗漏无统计学差异 (P >0 .0 5 )。结论 :与冷牙胶侧方加压充填技术相比 ,在直根管和轻度弯曲的根管中 ,Thermafil充填技术造成的根管微渗漏与冷牙胶侧方加压充填技术相比无显著性差异     

Root ZX根管长度测量仪的临床应用评价

目的评价Root ZX根管长度测量仪测量根管长度的准确性,分析出现偏差的可能因素。方法临床554个根管随机分为二组,分别用Root ZX和插针定位X线测量根管长度,根充后拍X线片检查充填效果,根据牙片上根管充填物和根尖平面关系定出三个等级。结果Root ZX组和X线组在根充超充方面比较有显著的统计学差异,P≤0．01;而在根充适充及欠充方面,二者比较无统计学差异。提示应用Root ZX根管长度测量仪所得到的工作长度比X线法准确。结论Root ZX根管长度测量仪可作为根管长度测量的一种方法。     

在根管充填前行根管长度再测量的临床评估

目的探讨根管充填前行根管长度再测量对根管充填效果的影响。方法选择需行根管治疗的恒前牙、双尖牙及磨牙共81颗,分为3组。A组根管充填前,再次用根管测量仪测量根管长度及试牙胶尖,调试出最适主牙胶尖后侧压法充填根管。B组根管充填前,插入主尖锉摄X线片获得印象长度,加试牙胶尖,侧压法充填根管。C组根管预备后按原来所测量的长度试牙胶尖,侧压法充填根管。所有患牙根管充填后拍摄X线片,评价充填效果并记录。结果 A组适充率88.10%,B组适充率89.74%,C组适充率64.45%,A、B组的适充率差异无统计学意义（χ2=0.056,P=0.815）;A、B组与C组的适充率差异均有统计学意义（P〈0.0125）。结论进行根管治疗时,根管预备完成后再次对根管长度进行校正测量,可获得较好的适充率。     

手用Protaper预备根管后注射式热塑牙胶充填系统充填效果的观察

目的观察Protaper手用法预备的后牙根管使用注射式热塑牙胶充填系统(Ultrafil-3D)充填的效果。方法10颗离体人上颌磨牙,开髓拔髓,截冠并截除腭根,按照Protaper的使用要求对颊根进行根管预备,均至F2(相当于主尖锉为25#K-file),测量根尖孔直径,干燥根管,涂布封闭剂(Roekoseal),Ultrafil-3D(Endoset)牙胶充填根管,记录注射针头进入的最大深度,直接观察超充情况,然后X线片评价整体的充填效果。结果①20个根管中有8个出现少量牙胶(伴封闭剂)超充,9个出现单纯的封闭剂超充;②根尖孔直径均≤0.25mm,注射针头距根尖孔的距离(L)均在8～10mm,牙胶超充组与无牙胶超充组差异无显著性(P>0.05)。③X线片显示牙胶未见欠充,与管壁未见明显空隙,可充填进入侧支根管。结论使用Protaper预备根管简便快速,根管形态好,有可能出现牙胶超充,但超出量较少,根管能获得整体良好的三维充填效果。     

联合侧向热垂直加压技术充填根管初探

目的:探索采用联合侧向热垂直加压技术充填根管以改良热连续波根充技术,通过增加根尖部的牙胶量克服该技术超充率较高,以及根尖部根管牙胶充盈率(PGFA)较低的缺点。方法:80颗离体尖牙牙根用改良双敞技术预备后,随机分为2组,分别用单纯热连续波法和侧向热垂直联合加压充填技术根充,超充样本计数;所有样本均在距根尖孔1.5mm水平截断,体视显微镜下数码拍照,计算机测定PGFA值,统计学分析。结果:实验组超充率低于对照组,差异有统计学意义(P<0.05);实验组距根尖孔1.5mm的PGFA高于对照组,差异有统计学意义(P<0.01)。结论:侧向热垂直联合加压充填技术,比单纯热连续波法具有更好的根充效果。     

热软化牙胶插入充填法磨牙多根管充填的临床研究

目的　分析热软化牙胶插入法充填磨牙多根管的方法和其特点。方法　选择门诊磨牙尖周炎和牙髓炎患者 5 8例 ,随机分成 2组 :对照组采用牙胶侧方加压法充填 ,实验组采用热软化牙胶插入法充填。摄X线牙片比较两组根管充填效果及充填操作时间。结果　经秩和检验 ,侧方加压法组和热软化牙胶插入法组在充填弯曲根管时 ,两者充填效果总体分布有差异 ,热软化牙胶插入法充填弯曲根管效果优于侧方加压法 (U =4 4 0 1,P <0 0 1) ;而两组在较直根管充填效果差异无统计学意义 (P >0 5 ) ,两组的充填时间经t检验统计差异有显著性。结论　热软化牙胶插入法较传统牙胶侧方加压法对根管三维具有更好的适应性 ,尤其适合于弯曲根管的充填 ,操作简捷、省时。     

E-Q根管充填系统的临床评价

目的:评价E Q根管充填系统的充填质量和近期疗效。方法:收集成人牙髓病及根尖周病患者75例,随机分为3组,每组25例;通过X线和临床观察比较E Q根管充填系统(包括A组:固核载体插入技术,B组:热牙胶旋转推入技术)和冷牙胶侧方加压充填技术(C组)的充填时间、充填质量和近期疗效。结果:根管充填时间以C组最多,B组次之,A组最少(P<0. 05);术后疼痛发生率,根充类型X线片评价和近期疗效评价各组的差别无统计学意义。结论:E Q根管充填系统可以快速、简便地完成根管充填,临床近期疗效与侧方加压技术相比拟。     

Leakage evaluation of three different root canal obturation techniques using electrochemical evaluation and dye penetration evaluation methods

The aim of this study was to compare the apical sealing ability of three different obturation techniques using an electrochemical evaluation and evaluating dye penetration. One hundred and thirty-two maxillary anterior teeth were randomly divided into six groups. There were 20 teeth in each group. The teeth were obturated as follows: Groups 1 and 4 with Thermafil, Groups 2 and 5 with System B, and Groups 3 and 6 with cold lateral condensation (CLC). The apical leakage in these groups was evaluated using an electrochemical method for Groups 1, 2, 3 and a dye penetration method for Groups 4, 5 and 6. In both methods, the lowest mean leakage values were observed for Thermafil and the highest were observed for the CLC groups. The difference between Thermafil and CLC was statistically significant (P < 0.05). In both groups, System B fillings showed moderate leakage and the difference was not significant with Thermafil and CLC groups.     

The evaluation of apical leakage for three endodontic fill systems

This study evaluated the apical leakage for three endodontic systems: (1) lateral condensation with Essential Dental System's epoxy adhesive: (2) Thermafil with Thermaseal adhesive; and (3) EZ-Fill Bi-directional spiral with EDS' epoxy adhesive. Five groups of 10 recently extracted single-rooted human teeth were used. Results showed that lateral condensation, and the EDS' EZ-Fill Bi-directional, and Thermafil techniques did not differ from each other, but differed from the no treatment group and the instrumented-unfilled group. In the current study, the EZ-Fill Bi-directional technique produced a tighter apical seal than either lateral condensation or Thermafil obturation techniques, but they all were not significantly different. EZ-Fill Bi-directional is a faster and more economical alternative to lateral condensation and Thermafil obturation.     

Comparative study of retreatment of Thermafil and lateral condensation endodontic fillings

The aim of the present study was to evaluate the possibility of retreating teeth obturated with: (i) Thermafil with plastic carrier, (ii) Thermafil with metallic carrier and (iii) laterally condensed gutta-percha. The following aspects were analysed: removal of obturation, time required for removal, remaining filling material and apical extrusion during reinstrumentation. Thirty human teeth with a single canal were instrumented up to a size 45 K-type file, divided into three groups of 10 teeth each and obturated with Thermafil with plastic carrier (group 1), Thermafil with metallic carrier (group 2), and laterally condensed gutta-percha (group 3) with AH26 as the sealer. Reinstrumentation was performed manually after 30 days storage using Hedstroem files and xylene as a solvent. The average time needed to remove the obturation was 12 min 1 s for group 1, 14 min 36 s for group 2 and 11 min 26 s for group 3. Although no statistically significant differences were observed between groups 1 and 2, and 1 and 3 ( P > 0.05), the differences between groups 2 and 3 were significant ( P < 0.05). The amount of remaining filling material was significantly higher in group 2 when compared with groups 1 and 2 ( P < 0.01). Although the lowest incidence of apical extrusion during reinstrumentation was found in group 3, the differences among groups were not statistically significant.     

The long-term sealing ability of an epoxy resin root canal sealer used with five gutta percha obturation techniques

AIM: The aim of the present study was to evaluate the long-term sealing ability (both apical and coronal) of an epoxy resin root canal sealer (AH26) when used with different gutta-percha obturation techniques. METHODOLOGY: Straight single-rooted teeth with mature apices were divided into 10 groups of 75 teeth and one group of 40 control teeth. Root canals were prepared according to the crown-down/step-back technique and using both 2.5% sodium hypochlorite and an EDTA paste. Root canals were obturated using cold lateral condensation, warm vertical condensation and hybrid condensation of gutta-percha; and with Thermafil and Soft-Core obturators. AH26 was used as the sealer in all cases. After root canal filling, each group was divided into five individual groups of 15 teeth. The first group of 15 teeth was kept for 1 day, the second for 1 week, the third for 4 months, the fourth for 6 months and the fifth for 12 months at 37 degrees C in vacutainers in 80% relative humidity. The teeth were immersed in India ink for 90 h, each root was split and sectioned longitudinally, and the maximum extent of leakage was measured using a stereomicroscope at x6 magnification. RESULTS: Leakage occurred whatever filling technique was combined with AH26. The number of teeth with gross leakage increased with time up to 4 months, but did not appear to increase between 6 and 12 months storage. The degree of apical leakage and the number of leaking teeth in the Soft-Core obturator groups was significantly higher than all four other gutta-percha obturation techniques. Up to 4 months the degree of coronal leakage and the number of leaking teeth in the Thermafil groups was significantly higher than the other gutta-percha obturation techniques, except for Soft-Core. In the Soft-Core obturator groups the degree of coronal leakage and the number of leaking teeth was significantly higher than the other gutta-percha obturation techniques, except for Thermafil at all evaluation times. CONCLUSION: The hybrid gutta-percha condensation technique was superior to the other four obturation techniques in respect of apical leakage. Coronal leakage was significantly greater during the first 4 months for the Thermafil system as compared to the three condensation techniques; coronal leakage was significantly greater at all time periods for the Soft-Core system. There were no significant differences between the Thermafil and the Soft-core system.     

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.     

Percentage of canals filled in apical cross sections - an in vitro study of seven obturation techniques

AIM: To compare the apical density of several obturation techniques when used in palatal roots of extracted maxillary molars. METHODOLOGY: Seventy extracted molars were randomly divided into seven groups with 10 teeth each. The palatal root canals were instrumented to size 60 MAF, coated with Kerr's Pulp Canal Sealer, and obturated using one of seven techniques. The palatal roots were separated from the crowns, decalcified, and sectioned horizontally at 2 and 4 mm from the apex. The cross-sections were photographed through a microscope, the photos were analysed, and the amount of area in the canal that was obturated with gutta-percha was measured. The means for the 20 sections per group were calculated and the means were compared using mixed analysis of variance test. RESULTS: Simplifill used in accordance with the manufacturer's directions and Thermafil had the greatest mean obturated area, but neither were statistically better than mechanical lateral or warm vertical compaction (WVC; Schilder Technique). Simplifill as recommended and Thermafil were statistically better than cold lateral (P = 0.0210 and 0.0433, respectively), WVC (continuous wave) (P = 0.0006 and 0.0015), and the modified Simplifill group (P = 0.0010 and 0.0012). In addition, mechanical lateral and WVC (Schilder) had statistically more obturated area than WVC (continuous wave) (P = 0.0054 and 0.0073) and modified Simplifill (P = 0.0015 and 0.0016). Cold lateral and WVC (continuous wave) had significantly more obturated area than modified Simplifill (P = 0.0040 and 0.0087). CONCLUSIONS: Simplifill as recommended, Thermafil, mechanical lateral and WVC (Schilder) obturation techniques created more complete obturation using gutta-percha at the 2 and 4 mm levels than cold lateral, WVC (continuous wave), and Simplifill not used as directed.     

两种镍钛机动器械预备根管的效果分析

目的　评价使用两种镍钛机动器械预备磨牙根管的临床疗效。方法　选取需行根管治疗的 10 0颗患有牙髓炎及根尖周炎的磨牙 ,分别使用机用镍钛器械Protaper、Hero6 4 2冠向下预备根管 ,两组均使用侧压充填法充填根管。记录根管预备时间及器械折断数量。根据治疗前、中、后的X线片计算弯曲根管的弯曲度变化 ,评价根管预备和充填的效果。结果　Protaper和Hero6 4 2预备根管时间短 ,根管锥度、流畅度好 ,术后疼痛发生少且程度轻。Protaper预备后根管弯曲度平均减小 4 0 2°,Hero6 4 2平均减小 1 72°,二者差异有统计学意义 (P <0 0 0 1)。Protaper器械折断 5支、Hero6 4 2未发生器械折断 (P <0 0 5 )。结论　镍钛机动器械Protaper、Hero6 4 2预备磨牙根管成形、根充效果好。Protaper减小根管弯曲度较Hero6 4 2明显 ,但易折断。Hero6 4 2操作简单 ,不易折断目的　评价使用两种镍钛机动器械预备磨牙根管的临床疗效。方法　选取需行根管治疗的 10 0颗患有牙髓炎及根尖周炎的磨牙 ,分别使用机用镍钛器械Protaper、Hero6 4 2冠向下预备根管 ,两组均使用侧压充填法充填根管。记录根管预备时间及器械折断数量。根据治疗前、中、后的X线片计算弯曲根管的弯曲度变化 ,评价根管预备和充填的效果。结果　Protaper和He