不同根管处理方法对根管壁抗折力影响的研究

目的　比较预备与不预备的根管以及预备后充填与不充填的根管抗折力。方法　将 30颗人尖牙随机分为 2个实验组和 1个对照组 ,每组 10颗。实验组从牙颈部截去牙冠后进行根管预备。第 1组以Ultra为封闭剂 ,采用冷侧压方法充填 ;第2组根管预备后不充填 ;第 3组根管不作任何处理。所有标本进行抗剪切强度试验。结果　第 2组与其他 2组间差异有显著性 (P <0 .0 0 1) ,抗折应力值最低 (12 6 .182MPa) ;第 1组抗折应力值最大 (15 3.4 97MPa) ;第 1组和第 3组之间无统计学差异 (P>0 .0 5 )。结论　预备后不充填的根管抗折力低于未处理组和完善根管治疗组。使用封闭剂根充后的管壁抗折力增强。     

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。     

327例根管治疗临床疗效观察

根管治疗是对牙髓炎及根尖周炎的一种较好的治疗方法。临床上已得到广泛的应用。本文对327例根管治疗的临床疗效进行了观察。现报道如下: 1 临床资料及方法 1.1 临床资料:随机选择327颗做根管治疗的牙。男176、女151颗;用三组材料充填:第一组为上海第二军医大学生产的根管糊剂加牙胶尖充填;第二组为桉叶油的牙胶溶液加牙胶尖充填;第三组为金霉素粉加丁香油粘固粉液及甲醛甲酚调成糊。其它资料见表1—5。 1.2 方法:按常规根管预备和消毒、适时根充。其中一次性根充42颗;后牙根充时选择较粗大根管,因此一颗牙往往采取根管加干尸或根管加空管联合治疗。根管治疗充填程度的标准:“超填”指治疗后X线片显示充填材料与根管壁密合,牙胶尖超出根尖孔;“适填”指充填料与根管壁密合,牙胶尖长度达距离根尖1mm以内;“欠填”指充填料与根管壁有间     

根管长度测量仪在根管预备中的应用

目的评价RootZX电子根管长度测量仪测量根管工作长度的准确性和实用性。方法选择门诊患者180颗牙共320个根管,随机分为2组。试验组90颗牙164个根管,用根管长度测量仪测量其工作长度,进行根管预备和充填,术后拍片;对照组90颗牙共156个根管,用X线牙片法确定根管的工作长度,进行根管预备和充填,术后拍片。结果RootZX组和X线组两组间比较根充结果差异有统计学意义(P<0.05)。结论ZootZX根管长度测量仪在根管预备中能准确、快速的测量出根管长度。     

ProTaper和K3预备对上颌前磨牙根管形态影响的研究

目的比较Pro Taper和K3预备对根管形态的影响。方法选取正畸减数拔除含颊舌双根管的上颌前磨牙40颗,把80个根管随机分为2组,分别采用机用镍钛器械Pro Taper和K3预备根管,预备前后分别三维成像,记录预先设立的根管横断面、颊舌向切面、近远中向切面三个位点的三维数据,根据预备前后的三维图像评价根管预备的效果。结果 K3组相对于Pro Taper组对牙本质的切削量少,对根管形态的影响较小,Pro Taper组和K3组有显著性差异(P<0.01)。结论 K3组预备后的根管形态优于Pro Taper组。K3预备后能较好的保持根管形态,对根管壁牙本质的切削量少,较少地削弱了余留牙体组织的抗折力。     

不同根管预备法对根管壁清洁度影响的扫描电镜观察

目的 比较常规根管预备法、回旋手机根管预备法、超声根管预备法和Profile根管预备法的根管壁清洁度,以提高根管治疗的效果.方法 选用40颗单根管离体牙,随机分成常规组、回旋手机组、超声扩大组和Profile组,分别进行根管预备后纵劈根管,用扫描电镜观察根管壁的清洁度,并进行比较.结果 经Kruskal-Wallis秩和检验,超声组和Profile组比较(P＜0.05)差异有显著性;Profile组和常规组、回旋组比较(P＜0.05)差异有显著性;常规组和回旋组比较(P＞0.05)差异无显著性.结论 超声组的根管壁清洁度优于Profile组,Profile组根管壁洁度优于回旋组和常规组,回旋组和常规组的根管壁清洁度相似.     

Cortisomol一次性根管充填的临床应用

目的：探讨Cortisomol永久性根管充填材料在预备根管后一次性根充的临床疗效。方法：对280颗患牙分别使用Cortisomol和常用根充材料在根管预备后进行根管充填,并分为Cortisomol组和对照组比较术后反应。结果：经1年的应用,Cortisomol组疗效显著,其术后疼痛反应比对照组大大减轻。结论：使用Cortisomol根充材料一次性根管充填大大减轻病人术后疼痛和减少复诊次数。     

不同材料根管充填后近期疼痛发生情况分析

目的比较活髓牙经不同材料根管充填后的疼痛发生情况。方法288颗需要进行根管治疗的活髓牙分为4组,2组分别采用Cortisomol糊剂+牙胶尖和Vitapex糊剂+牙胶尖一次性根管充填;2组经引流24～48h后,分别用Cortisomol糊剂+牙胶尖和Vitapex+牙胶尖根管充填;观察术后1周内的疼痛发生情况。结果所有患牙中,根充后可自愈性疼痛的发生率为22.6%,非自愈性疼痛的发生率为2.08%;一次性根充组中,Cortisomol糊剂组较Vitapex糊剂组的可自愈性疼痛发生率低,有显著性差异(P<0.01);引流后根充组中,Cortisomol糊剂组较Vitapex糊剂组的可自愈性疼痛发生率低,但无显著性差异(P>0.05);各组间非自愈性疼痛的发生率均无显著性差异(P>0.05);大多数患牙根充后的疼痛发生在72h之内。结论Cortisomol糊剂+牙胶尖根管充填可以减少根充后疼痛的发生。     

碧兰糊剂和碘仿糊剂根管充填后疼痛的比较

目的比较碧兰糊剂和碘仿糊剂根管充填后疼痛的发生率与持续时间。方法将根管预备后行根管充填的260颗患牙随机分成2组,碧兰糊剂组130颗患牙,用碧兰糊剂加牙胶尖充填,碘仿糊剂组130颗患牙,用碘仿糊剂加牙胶尖充填,观察术后疼痛的发生率及持续时间。结果碧兰糊剂组的根充后疼痛发生率为10.8%(14/130),碘仿糊剂组为32.3%(42/130),两组间差异具有统计学意义(χ2=4.90,P<0.05)。碧兰糊剂组根充后疼痛持续1～2 d 10颗,3～4 d 3颗,5～6 d 1颗;而碘仿糊剂组根充后疼痛持续1～2 d 6颗,3～4 d 20颗,5～6 d 14颗,7 d以上2颗。两组疼痛持续时间差异具有统计学意义(χ2=73.11,P<0.01)。结论碧兰糊剂根充后疼痛的发生率明显低于碘仿糊剂,且疼痛持续的时间较短。     

碘仿自固化磷酸钙根管糊剂封闭性的体外研究

目的:观察注射型碘仿自固化磷酸钙(CPC)根管糊剂在体外充填根管的封闭性能。方法:62颗离体单根管牙用K锉常规法预备至40#,其中58颗随机分为2个实验组,分别用注射型碘仿CPC糊剂和氧化锌丁香油碘仿糊剂作为根管封闭剂,牙胶尖侧压法充填根管。另外4颗作为对照组。根充材料凝固后,将牙的根尖部分浸泡于2%亚甲蓝染料中6d,沿牙体长轴纵向劈开,测量根管内壁染料渗漏长度。采用团体t检验进行统计学分析。结果:注射型碘仿CPC充填组平均渗漏8.400mm,氧化锌丁香油碘仿糊剂组平均渗漏5.300mm,2组的渗漏值有显著性差异(P<0.05)。结论:碘仿CPC的体外根管封闭性不及氧化锌丁香油碘仿糊剂。     

A comparison of root fracture resistance using two root canal sealers

AIM: The aim of this study was to compare in vitro root fracture resistance following root canal filling with either Ketac-Endo or Roth's root canal sealer. METHODOLOGY: The roots of 40 teeth with single canals were instrumented and placed randomly into four groups of 10 teeth. The prepared canals were obturated with lateral compaction using gutta-percha and Roth's 801 sealer, lateral compaction and Ketac-Endo sealer or with a single cone and Ketac-Endo sealer; the fourth group acted as unfilled controls. The roots were stored for 2 weeks in 100% humidity prior to being mounted in acrylic resin blocks. A steel tipped rod attached to an Instron testing machine was positioned against the canal opening and a slowly increasing force was applied until root fracture occurred. The results were subjected to statistical analysis using Kruskal-Wallis one-way ANOVA. RESULTS: There were no significant differences between the groups in terms of force required to vertically fracture the roots. CONCLUSIONS: Under the conditions of this study, the use of Ketac-Endo sealer in conjunction with lateral compaction or single-cone obturation techniques does not increase the fracture resistance of root-filled teeth.     

Sealing ability of thermoplasticized gutta-percha in root canal obturation using a sectional vs. a single-phase technique

Abstract Properly prepared straight root canals of freshly extracted maxillary canines and central incisors were used to evaluate the sealing ability of the sectional thermoplasticized gutta-percha obturation technique, with or without sealer and the single-phase thermoplasticized gutta-percha filling technique. The teeth were divided into 3 groups (A, B, C) of 20 teeth and were obturated using the 3 thermoplasticized gutta-percha techniques. Group A: single phase with sealer; group B: sectional technique without sealer; and group C: sectional technique with sealer. The obturated teeth were immersed in India ink for 3 days followed by clearing procedures. The teeth were then examined under a stereo microscope and the linear leakage was recorded. Statistical unpaired Student's t-tests showed significantly less dye penetration in teeth obturated using the sectional technique with sealer (group C) than in teeth obturated with the single-phase technique with sealer (group A) or the sectional technique without sealer (group B).     

In vivo performance of the new non-instrumentation technology (NIT) for root canal obturation

AIM: The aim of this in vivo study was to compare the radiographic quality of root fillings performed by the NIT-obturation method versus conventional mechanical obturation. METHODOLOGY: Sixty-six patients needing root canal treatment participated in this study. The treatments were performed by three private practitioners. The root canals were instrumented with K-Flexofiles to a master apical file between sizes 25 and 60, followed by step-back flaring up to size 70. Copious irrigation was used throughout the instrumentation procedure with NaOCl (3%). The teeth were obturated either by lateral condensation, the McSpadden technique (control) or by the new non-instrumentation technology (NIT) with and without using gutta-percha points. In the NIT method, a low pressure was created within the tooth, and AH 26 sealer was sucked into the root canal system. Radiographs of the root-filled teeth were analysed and the length of the root filling, the presence of voids and the area of any other fillings determined. RESULTS: The root canal fillings of the control group (0.1 +/- 0.1 mm) and those of the NIT/gutta-percha group (0.3 +/- 0.1 mm) were both overextended when taking the apical constriction as a reference point. Root canal fillings of the NIT/gutta-percha group were statistically (P < 0.05) significantly longer than those of the NIT without gutta-percha group. The latter showed slightly underextended root canal fillings (-0.14 +/- 0.1 mm). CONCLUSIONS: The present investigation demonstrated the performance of the NIT-obturation method in vivo. Root canals filled by the reduced-pressure-method using sealer combined with gutta-percha cones exhibited equivalent radiographic quality compared to conventionally filled canals.     

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.     

GuttaFlow充填系统进行根管充填的临床疗效观察

目的：观察GuttaFlow充填系统充填根管的临床疗效。方法：将急、慢性根尖周炎或急、慢性牙髓炎患者的120个患牙,随机分成两组。根管预备后分别用氧化锌丁香油糊剂加牙胶尖的冷侧压法（对照组）或GuttaFlow充填技术加牙胶尖（实验组）进行根管充填。根充后即刻拍X线牙片评价根充效果,术后1周及半年评价其临床疗效。结果：两组病例根充后X线显示充填效果有统计学差异（P〈0.05）,随访半年的临床成功率无统计学差异（P〉0.05）。结论：GuttaFlow充填系统是一种高效、简便的根管充填技术,但是远期疗效还有待于进一步观察。     

An evaluation of .06 tapered gutta-percha cones for filling of .06 taper prepared curved root canals

AIM: To compare the area occupied by gutta-percha, sealer, or void in standardized .06 tapered prepared simulated curved canals and in mesio-buccal canals of extracted maxillary first molars filled with a single .06 gutta-percha point and sealer or lateral condensation of multiple .02 gutta-percha points and sealer. METHODOLOGY: Simulated canals in resin blocks with either a 30 degrees curve and radius of 10.5 mm (n = 20) or a 58 degrees curve and 4.7 mm radius (n = 20) and curved mesio-buccal canals of extracted maxillary first molars (n = 20) were prepared using .06 ProFiles in a variable tip crown-down sequence to an apical size 35 at 0.5 mm from the canal terminus or apical foramen. Ten 30 degrees and 58 degrees curved resin canals and 10 canals in the extracted teeth group were obturated with .02 taper gutta-percha cones and AH 26 sealer using lateral condensation. The time required to obturate was recorded. The remaining canals were obturated with a single .06 taper gutta-percha cone and AH 26 sealer. Excess gutta-percha was removed from the specimens using heat and the warm mass vertically condensed. Horizontal sections were cut at 0.5, 1.5, 2.5, 4.5, 7.5 and 11.5 mm from the canal terminus or apical foramen. Colour photographs were taken using an Olympus 35 mm camera attached to a stereomicroscope set at x40 magnification, and then digitized using a flatbed scanner. The cross-sectional area of the canal contents was analysed using Adobe PhotoShop. The percentage of gutta-percha, sealer or voids to the total root canal area were derived and data analysed using unpaired Student's t-test and the Mann-Whitney U-test. RESULTS: In the 30 degrees curved canals the levels had between 94 and 100% of the area filled with gutta-percha with no significant difference (P > 0.05) between the lateral condensation and single cone techniques. In the 58 degrees curved canals the levels had 92-99% of the area filled with gutta-percha, with the single cone technique having significantly (P < 0.05) more gutta-percha fill at the 2.5 mm level only. In the mesio-buccal canals of the teeth the levels had between 72 and 96% of the area filled with gutta-percha with no significant difference (P > 0.05) between the lateral condensation and single cone technique. The time for obturation was significantly (P < 0.05) greater for lateral condensation compared with the single cone technique in all groups. CONCLUSIONS: The .06 taper single cone technique was comparable with lateral condensation in the amount of gutta-percha occupying a prepared .06 tapered canal. The .06 single cone technique was faster than lateral condensation.     

Does cold burnishing gutta-percha create a better apical seal?

This study investigated the seal created by cold burnishing the gutta-percha exposed after apical root resection of endodontically treated teeth. Sixty single-rooted extracted human teeth with a single straight canal were divided into four experimental groups of 15 teeth each. In two of the experimental groups the canals were instrumented and obturated well with laterally condensed gutta-percha and sealer. The remaining two groups were instrumented and poorly obturated with laterally condensed gutta-percha and sealer. The apical 2 mm of all the teeth were then resected and the effect of cold burnishing the exposed gutta-percha was investigated using a linear dye penetration technique. Under the condition of this study, cold burnishing gutta-percha after apical root resection of a well-obturated root canal resulted in a poorer apical seal than if no burnishing were performed. Cold burnishing the exposed gutta-percha after apical root resection of poorly obturated root canals improved the apical seal as compared with nonburnished poorly obturated canals.     

An evaluation of sealing ability of endodontic materials as root canal sealers

An in vitro dye leakage study was carried out to compare the apical microleakage of vitapex (calcium hydroxide based paste) when used with single gutta percha cone with that of dentalis KEZ (calcium hydroxide and zincoxide eugenol based sealer) and zincoxide-eugenol sealer when used with laterally condensed gutta percha obturation technique. One hundred single rooted human anterior teeth were instrumented and randomly divided into three experimental groups of 30 teeth each and two control groups of 5 teeth each. Teeth in the first group were obturated using a single master gutta percha cone and vitapex as root canal sealer and those of second group were obturated with laterally condensed gutta percha using dentalis KEZ as sealer. Third experimental group was filled with laterally condensed gutta-percha using zinc-oxide eugenol as sealer. Teeth were then suspended in 2% methylene blue. After this, teeth were demineralized dehydrated and cleared. Linear dye penetration was determined under stereomicroscope (x10) with calibrated eye piece. Results of this study showed that calcium hydroxide based endodontic material leaked comparatively less as compared to zinc oxide Eugenol sealer. Vitapex with single gutta-percha cone provided an adequate apical Seal against dye penetration.     

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.