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。     

超声冲洗功率和时间对清除感染根管内毒素作用的影响

目的 探讨超声冲洗功率、时间对清除感染根管内毒素的作用的影响。方法 选择20颗患慢性根尖周炎的单根管前牙,随机分为根管治疗范围最小功率组和最大功率组,分别于治疗前、常规根管预备后附加超声冲洗1 min和延长超声冲洗1 min后根管内取样,测量内毒素含量的变化。结果 2组根管治疗前的内毒素含量无显著差异(P>0.05),2组经超声冲洗后的内毒素含量也无明显差异(P>0.05)。但每组的治疗前、超声冲洗1 min后、延长超声冲洗1 min后的内毒素含量两两比较均有显著差异(P<0.05)。结论 一定范围内的超声冲洗功率对清除感染根管内毒素作用无明显影响,适当延长超声冲洗时间可加强感染根管内毒素的清除作用。     

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。     

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.     

超声冲洗对感染根管内毒素的灭活及清除作用

目的探讨超声冲洗对感染根管内毒素的灭活及清除作用。方法选择因严重慢性根尖周炎拔除的具有双根管的离体上颌前磨牙10颗,常规开髓,用改良双敞法预备根管,将3％过氧化氢溶液30 μL注入根管,行超声振荡,每根管振荡2 min,分别于根管预备后和超声振荡后取样,测量内毒素活性。另外在临床患者中选择患有慢性根尖周炎的双根管上颌前磨牙10颗,采用相同的方法进行根管预备,预备后以无菌蒸馏水为介质进行超声冲洗,每根管均冲洗2 min,分别于根管预备前、根管预备后和超声冲洗2 min后根管取样,测量内毒素活性。内毒素活性的测定采用动态浊度法鲎试验,并对超声处理前后根管内毒素活性的差异进行分析。结果离体牙超声振荡前,根管内毒素的活性平均为4.069 EU·mL-1,超声振荡后为16.410 EU·mL-1,二者差异有统计学意义（P<0.01）,超声振荡后内毒素活性明显升高。临床样本中,根管预备前、根管预备后和超声冲洗后根管内毒素的平均活性分别为44.860、4.099、0.116 EU·mL-1,根管预备前与根管预备后内毒素活性的差异有统计学意义（P<0.01）,根管预备后内毒素活性明显下降;根管预备后与超声冲洗后内毒素活性的差异也有统计学意义（P<0.01）,超声冲洗后内毒素活性明显下降。结论在模拟临床操作的条件下,采用口腔科超声根管治疗仪进行超声冲洗可以明显增强根管冲洗液清除感染根管内毒素的作用,但不能增强根管冲洗液灭活感染根管内毒素的作用。     

金栀含漱液冲洗消毒根管的临床疗效观察

目的：评价金栀含漱液冲洗消毒根管的临床疗效。方法：选择需作根管治疗术患牙240个，随机分为两组，试验组和对照组各120个。试验组采用金栀2倍稀释液冲洗根管，浓缩液作为根管消毒药物。对照组采用15g／L氯亚明液冲洗根管，氢氧化钙药捻消毒根管。分别对患牙根管治疗的临床疗效、疗程及根管预备封药前后临床症状的变化进行评价。结果：金栀含漱液组与氢氧化钙组冲洗消毒根管的临床疗效无统计学差异。结论：金栀含漱液用于根管冲洗消毒有良好的临床疗效。     

根管治疗中应用空管药物消毒根管的临床效果观察

目的 :用空管药物消毒根管 ,观察其对根管的消毒效果。方法 :随机选择患急慢性根尖周炎、牙髓坏死需接受根管治疗的 3 6例患者共 3 6颗患牙为受试对象 ,随机分成实验组 18人 18颗患牙和对照组 18人 18颗患牙 ,2组均行 2次法完成根管治疗术 ,实验组于根管口暂封空管药物 ,对照组暂封甲醛甲酚合剂(formaldehydecresylol,FC) ,分别在封药前后采集细菌标本进行细菌培养鉴定。 结果 :从根管内采集并培养细菌 ,封药前 ,2组患牙根管内细菌检出率均为 10 0 % ,均包含需氧菌和厌氧菌 ;封药 1周 ,2组患牙中各有 1颗患牙检出细菌 ,其余患牙根管内未检测到细菌。结论 :根管口暂封空管药物可以有效杀灭根管系统的细菌 ,达到根管消毒的目的。     

HY-CALMT氢氧化钙糊剂与传统根管消毒剂的临床疗效比较

目的 评价HY-CALMT氢氧化钙糊剂消毒根管的临床疗效。方法 选择207颗患有慢性根尖周炎的患牙随机分为HY-CALMT氢氧化钙组、传统氢氧化钙组、甲醛甲酚组进行根管消毒。封药后1周评价临床疗效并比较。结果 氢氧化钙根管消毒剂的临床疗效要比甲醛甲酚要好(P<0.05),HY-CALMT氢氧化钙和传统氢氧化钙相比无统计学差异。结论 HY-CALMT氢氧化钙糊剂能有效地起到根管内杀菌效果。     

金栀含漱液用于感染根管冲洗消毒的细菌学观察

目的:观察金栀含漱液对感染根管冲洗消毒的抗菌效果。方法:选择27例患者的感染根管患牙30颗,随机分为实验组和对照组,每组15颗。实验组采用金栀2倍稀释液冲洗根管,浓缩液作为根管消毒药物。对照组采用氯亚明冲洗根管,氢氧化钙药尖消毒根管。根管预备冲洗前、预备冲洗后、封药后分别取细菌样本进行厌氧培养、分离和鉴定,计算并采用重复测量的方差分析比较2组细菌检出率、CFU随时间的变化趋势。结果:实验组专性厌氧菌的检出率由73.3%下降到预备冲洗后的46.7%和封药后的13.3%,对照组厌氧菌的检出率由73.3%下降到预备冲洗后的20.0%和封药后的26.7%,2组细菌检出率无统计学差异(P=0.9721)。实验组专性厌氧菌CFU由1462.9下降为预备冲洗后的27.9和封药后的15.7,对照组厌氧菌CFU由1402.8下降到预备冲洗后的14.0和封药后的45.1,2组细菌检出量无统计学差异(P=0.688)。结论:金栀含漱液对感染根管内厌氧菌有良好的抗菌效果。     

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。     

Spreading of root canal irrigants on root dentine

The purpose of this study was to evaluate the spreading of root canal irrigants on human root dentine. The spreading of various solutions on dentine surfaces was measured after pre-treatment with various conditional solutions. Seven experimental groups were set based on the combination of conditioning solution-test solution: none-distilled water; none-6% sodium hypochlorite (NaOCl); none-14.3% ethylenediaminetetraacetic acid containing surfactant 0.084% cetrimide (Morhonine); NaOCl-NaOCl; NaOCl-Morhonine; Morhonine-Morhonine and Morhonine-NaOCl. After application of 0.1 mL of conditioning solution for 60 s, 0.5 microL of test solution was placed on dentine surfaces. Spreading of test solution was measured for 480 s to examine the size of the contact area ratio. Those at 300 s were compared among groups using Fisher's Protected Least Significant Difference (P < 0.05). It was concluded that the contact area ratio of Morhonine-NaOCl increased the most significantly among all the experimental groups.     

钙化根管的根管显微镜治疗

目的:探讨应用根管显微镜治疗钙化根管的方法,并对其疗效进行评价.方法:因根管钙化进行根管治疗的患牙33个,在根管显微镜引导下,将超声预备、手动NiTi器械预备以及EDTA化学预备相结合进行治疗,记录预备时间,术后1周进行根管充填,半年后复查并进行疗效评价.结果:根管显微镜下钙化根管的治疗成功率为88.9%,平均每根根管耗时25.8 min.结论:在根管显微镜引导下,将超声预备、手动NiTi器械预备以及EDTA化学预备相结合可提高钙化根管治疗的成功率.     

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牙髓根尖周病是一类主要因细菌感染引起的、发生于牙髓及根尖周围组织的炎症性疾病,发病率高,是口腔常见病、多发病,占口腔内科门诊的60%,也是导致牙痛、失牙的主要原因.     

Quadrant root planing versus same-day full-mouth root planing

OBJECTIVES: The aim of this study was to determine whether same-day full-mouth scaling and root planing (FM-SRP) and quadrant scaling and root planing (Q-SRP) resulted in variations in the systemic humoral immune response dynamics (antibody titres and avidity) during active treatment and 3 and 6 months post-therapy. MATERIALS AND METHODS: Forty patients with chronic periodontitis were recruited into this study. Subjects were randomised into two groups and received either scaling and root planing quadrant by quadrant at 2-weekly intervals (Q-SRP group) or same-day full-mouth scaling and root planing (FM-SRP group). Clinical measurements and serum samples were obtained at baseline and approximately 6 weeks after the last clinical intervention (R1) and 6 months after the initiation of therapy (R2). Furthermore, serum samples were obtained from each patient undergoing therapy (Q-SRP and FM-SRP) at 3 bi-weekly instances so as to determine the short-term effects of each session of scaling and root planing on the dynamics of the humoral immune response. Serum antibody titre was assayed by enzyme-linked immunosorbent assay (ELISA) and antibody avidity was measured by thiocyanate dissociation against five putative periodontal pathogens: Porphyromonas gingivalis; Actinobacillus actinomycetemcomitans; Prevotella intermedia; Treponema denticola and Bacteroides forsythus. RESULTS: Both therapies resulted in similar antibody titre reductions against the majority of the organisms tested and although there was a distinct trend for antibody avidity to increase following therapy, this was not found to be statistically significant, reflecting marked inter-individual variation. In addition, no evidence emerged from this study to support increased antibody titres following the active phases of both treatment approaches due to an inoculation effect. Nevertheless, significant short-term increases in antibody avidity to most test bacteria were noted for both treatment strategies. CONCLUSION: Both therapies were associated with a reduction in antibody titres and an increase in the binding ability or avidity of antibodies, but there was a marked inter-subject variability and statistical significance was reached for only some of the test bacteria. No significant differences in the humoral antibody dynamics were found between the two treatment approaches.     

Treatment of a horizontal root fracture by vital root submergence

Abstract Cervical third horizontal root fractures in immature permanent teeth often present complicated and unpredictable treatment options. This case report describes the successful management of a horizontal root fracture in an open apex tooth by vital root submergence and subsequent nonsurgical root canal therapy.     

Clinical outcomes of quadrant root planing versus full-mouth root planing

OBJECTIVES: To determine the clinical effects of full mouth compared with quadrant wise scaling and root planing. METHOD: Twenty patients with chronic periodontitis (> or = 2 teeth per quadrant with probing pocket depths (PPD) > or = 5 mm and bleeding on probing (BOP) were randomized into a test group treated in two sessions with subgingival scaling and root planing within 24 h (full-mouth root planing (FMRP)) and a control group treated quadrant by quadrant in four sessions in intervals of 1 week (quadrant root planing (QRP)). PPD, relative attachment level (RAL) and BOP were recorded at baseline, 3 and 6 months. RESULTS: Analysing first quadrant data, in moderately deep pockets (5 mm < or = PPD < 7 mm) there was no evidence for a difference (FMRP-QRP) between both groups for PPD reduction (mean: -0.128 mm; CI: [-0.949, 0.693]; p=0.747), RAL gain (mean: 0.118 mm; CI: [-0.763, 1.000]; p=0.781), and BOP reduction (mean: -20.1%; CI: [-44.3, 4.2]; p=0.099). Likewise, no significant differences between treatments were found for initially deep pockets (PPD > or = 7 mm), neither for first quadrant nor for whole mouth data. CONCLUSION: The results of the present study demonstrated equally favourable clinical results following both treatment modalities.