根管治疗牙正畸加力后根吸收的相关因素研究

目的研究固定正畸治疗对根管治疗牙牙根吸收的影响和相关因素分析。方法选择正畸治疗前口腔内已完善根管治疗牙45例,利用治疗前后的全口曲面断层片,以改良根吸收分级法评估患者治疗前后牙根形态变化,分析正畸治疗对根管治疗后牙根吸收的影响。结果①正畸治疗后根管治疗牙牙根吸收有所增加,差异具有统计学意义（P〈0．001）;②性别是影响正畸治疗后根管治疗牙牙根吸收方程最为显著的因素（P〈0．05）,提示女性发生根吸收的风险大于男性;③正畸治疗后根管治疗牙与对侧活髓牙比较牙根吸收程度的改变差异没有统计学意义（P〉0．05）;④在所观察的样本中,无论根管治疗牙齿与活髓牙均未见3级根吸收。结论根管治疗牙在固定正畸治疗后可能发生一定程度的根吸收改变,但并不比活髓牙的风险更高。     

正畸矫治对根管治疗牙齿牙根吸收程度影响的CBCT研究

目的利用CBCT评价正畸治疗对根管治疗牙齿牙根吸收程度的影响。方法选择上下颌牙齿轻中度拥挤的成年患者16例,患者上颌前牙中至少有一颗已行根管治疗。使用0.558 8 mm槽沟的MBT托槽进行非拔牙矫治。于治疗前、后分别拍摄头颅CBCT,并分别测量根管治疗牙齿以及对侧同名牙齿的长度。采用配对t检验进行统计分析。结果 16例患者一共有18颗上颌前牙接受过根管治疗,其中包括6颗中切牙,8颗侧切牙,4颗尖牙。平均治疗时间为(18.3±2.6)个月。治疗前,已行根管治疗牙齿牙根平均长度(22.68±2.14)mm;治疗后,牙根平均长度为(21.98±2.05)mm。治疗前,对侧同名活髓牙牙根平均长度(22.61±2.01)mm;治疗后,牙根平均长度为(22.01±2.37)mm。两组差别无统计学意义。按照牙位单独分析,亦无统计学差异。结论利用CBCT能够很好地观察正畸治疗后牙根吸收的情况。在轻中度拥挤非拔牙的病例中,正畸治疗并不会增加上颌前牙已行根管治疗牙齿牙根吸收的风险。     

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目的    评价上中切牙正畸治疗后根吸收状况,探讨影响根吸收的相关因素。方法    从大连大学附属口腔医院正畸科2名资深医生2007年5月至2009年12月所完成的正畸病例中,随机选择233例（男85例,女148例）。分为成人组90例,平均年龄（21.73 ± 3.68）岁;青少年组143例,平均年龄（13.37 ± 1.81）岁。通过分析治疗前后的头颅侧位片观察上中切牙牙根形态与长度变化,评价上中切牙根吸收状况。结果    233例患者中的13例上中切牙发生了不同程度的根吸收,根吸收发生率为5.58%。成人女性拔牙矫治组的上中切牙根吸收程度高于青少年女性拔牙矫治组,差异有统计学意义（P < 0.05）。青少年组中,女性拔牙矫治患者的根吸收程度较男性拔牙矫治患者明显,差异有统计学意义（P < 0.05）。而是否拔牙,其上中切牙根吸收程度差异无统计学意义（P > 0.05）。结论    女性拔牙矫治患者治疗后的上中切牙根吸收发生率较高。正畸根吸收原因复杂,治疗前应详细分析各种根吸收易发因素,以减小正畸根吸收的发生和程度,维持正畸牙齿的健康。     

根管充填牙在直丝弓技术矫治中根吸收观察

目的 探讨直丝弓技术治疗中根管充填牙的根吸收情况.方法 观察31例经直丝弓矫正器治疗的根管充填牙,并与对侧未经牙髓治疗同名牙进行比较.结果 矫治前后X线片测量表明,直丝弓技术治疗后根管充填牙牙根长度有减小,但与正常牙的牙根长度变化量相比差异无统计学意义(P＞0.05).结论 经完善牙髓治疗的无髓牙在直丝弓技术治疗中牙根吸收量与正常牙无差异.     

猫下颌尖牙根管治疗对牙正畸移动的影响

目的：探讨经根管治疗牙的正畸移动可行性及牙根吸收的风险.方法：建立对经根管治疗牙进行正畸移动的动物模型,采用石膏模型测量、病理学和放射学方法评估正畸移动的距离及牙根吸收的程度.16只成年家猫的一侧下颌尖牙在全麻下开髓、拔髓,一次完成根管充填治疗术,随后在正畸弹簧的作用力（100～120 g）下向远中作倾斜移动.8周后测量石膏模型上牙移动的距离,以及根管治疗牙与正常牙的组织学和放射学牙根长度.应用SPSS11.0软件包进行数据分析,均数比较采用配对t检验.结果：实验结果显示,在相同正畸力作用下,根管治疗牙与正常牙移动距离相近（P＞0.05）;组织病理学显示,根管治疗牙牙根的长度比正常牙小（P＜0.05）,但在放射学上,两者的长度无统计学差异（P＞0.05）.结论：在本实验条件下,经根管治疗牙在正畸力作用下能与正常牙同样快速移动,组织学观察显示其根吸收的程度比后者略大.     

无髓牙与活髓牙正畸治疗后牙根吸收的比较

正畸治疗中最常见的副作用之一是牙根吸收,学者们对这种现象做了大量的研究,但对牙根吸收的机理并未完全掌握.尽管无髓牙对正畸力的反应与活髓牙相似,有学者认为无髓牙的根吸收较活髓牙为重,相反,也有学者认为死髓牙与活髓牙正畸后根吸收在程度上无显著差异.本文的目的就是对死髓与活髓牙正畸后根吸收的情况进行比较研究。材料和方法本研究共选用43名患者(男性21名,女性22名),平均年龄13岁。在接受正畸治疗前,患者均有一侧上颌切牙做过根管治疗,对侧同名切牙牙髓活力     

青少年正畸治疗中影响牙根吸收的因素探讨

目的：探讨影响青少年错[牙合]畸形患者正畸矫治后牙根吸收的相关因素。方法：选择已完成正畸固定矫治的青少年患者78例．在其矫治前后的曲面断层片上,对4个上切牙进行根尖形态的分析,以获得正畸矫治后牙根吸收的定性数据。在对受试者按年龄、性别、牙位、牙龄、拔牙与否及疗程分组后,利用SPSS12．0软件对所得数据进行非参数检验分析。结果：所有正畸患者都存在一定程度的牙根吸收,根尖形态分析显示：①牙龄ⅣA期患者比ⅢC期的患者存在更严重的牙根吸收（P〈0．01）,但按年龄比较不存在显著差异;②拔牙组比不拔牙组有更加严重的牙根吸收（P〈0．01）;③疗程越长,牙根吸收也越明显（P〈0．05）;④牙根吸收的严重程度与性别及上切牙牙位之间无相关性。结论：在第二恒磨牙完全建验前（ⅣA期前）进行正畸治疗、不拔牙矫治、缩短矫治疗程,均可以减少正畸治疗中的牙根吸收。     

青少年安氏Ⅰ类固定矫治牙根吸收的临床研究

目的探讨青少年安氏Ⅰ类患者固定正畸治疗后牙根吸收的影响因素。方法选择100例年龄小于18岁的安氏Ⅰ类患者分成牙根发育完成组与牙根发育未完成组，均采用MBT技术矫治，矫正前后拍摄全口曲面断层片，以改良根吸收分级法评估治疗前后牙根吸收情况，探讨牙根吸收与性别、牙根发育、拔牙与否的相关性。结果①牙根发育完成组矫治后根吸收加重，差异有统计学意义（P〈0．01）；牙根发育未完成组矫治前后牙根吸收差异无统计学意义（P〉0．05）。②青少年男、女组间的根吸收差异无统计学意义（P〉0．05）。③拔牙组根吸收者多于未拔牙组，差异有统计学意义（P〈0．05）。结论拔牙与否、牙根发育完成与否是影响安氏Ⅰ类患者固定矫治后牙根吸收的部分因素，而性别因素与根吸收无明显的关系。     

正畸牵引（牙合）向移动龈下残根的临床应用正畸牵引（牙合）向移动龈下残根的临床应用正畸牵引（牙合）向移动龈下残根的临床应用

目的 探讨一种采用正畸方法（牙合）向牵引龈下牙根后再修复的方法.方法 选择龈下牙折患者8名,共10颗患牙,断端最低处距牙槽嵴顶的距离为1.5~2.0mm.经完善的根管治疗4周后,采用正畸固定矫治技术（牙合）向牵引龈下牙根,平均疗程4~6个月,然后桩冠修复治疗.采用临床检查评价正畸前后牙齿松动度、牙龈形态和牙周状况,并通过X线片测量比较正畸前后断根根尖区相对骨密度的变化、断根倾斜度的变化和修复后冠根比.结果 10颗患牙经正畸治疗后（牙合）向移动距离平均为3.99 mm,牵引后的牙根唇倾度减小,但与治疗前比较无统计学意义（P〉0.05）.修复后患牙冠根比与对侧同名牙相比无统计学差异（P〉0.05）.结论 对于伤及牙槽嵴顶下的前牙牙根,在一定条件下可通过正畸方法（牙合）向牵引龈下牙根,经修复治疗后,可达到美观和功能的效果.     

正畸治疗导致牙根外吸收的临床分析

目的：调查正畸治疗导致牙根外吸收的发病情况,分析其临床特征及相关因素。方法：随机选择经直丝弓矫治技术完成的病例230例,以Levander根吸收分级法对患者全颌曲面断层片进行分析,评估矫治前后中切牙至第一磨牙的根吸收情况。结果：正畸治疗后根吸收发生率明显升高,根吸收均值（root resorption after treatment,RRAT）及根吸收增加量均值（increment of root resorption,IRR）表现为上切牙最高,拔牙组高于未拔牙组,异常根形态组高于正常根形态组。结论：正畸治疗可提高根吸收发生几率,并加重根吸收程度,此可能与拔牙与否、牙位、根形态及治疗前牙根吸收程度有关。     

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study

Introduction: The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. Methodology: The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student’s t-test, chi-square test and logistic regression analysis were used to determine statistical significance. Results: There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. Conclusions: There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps. Key words:Endodontics, orthodontics, root canal treatment, root resorption.     

Orthodontic root resorption of endodontically treated teeth

The purpose of this study was to evaluate, radiographically, whether there is similarity in the apical root resorption found in endodontically treated teeth and untreated teeth when they are submitted to orthodontic treatment. From 2,500 treatment records examined, 16 patients were selected who had a maxillary central incisor treated endodontically before initiation of the orthodontic movement, and a vital homologous tooth (for control). Measurements were made by comparing the periapical radiographs taken before and after the orthodontic treatment. There was no statistically significant difference (p>0.05) in apical root resorption found in the endodontically treated teeth compared to the group of vital teeth.     

埋伏阻生牙导致牙根外吸收邻牙的预后的临床观察

目的 探讨埋伏阻生牙导致邻牙（恒牙）牙根外吸收（ERR）时,阻生牙拔除术后邻牙的预后。方法 以埋伏阻生牙导致邻牙（恒牙）ERR但可以正常行使功能的63例患者的75颗ERR邻牙作为研究对象,微创拔除埋伏阻生牙后,术后随访6月,观察ERR邻牙的预后情况,并分析预后与患者年龄、性别、牙根数量、牙根吸收类型、牙根吸收程度的关系。结果 在75颗ERR邻牙中,67颗（89.3%）为无症状活髓牙。ERR邻牙的预后与患者的年龄相关（r=0.330,P<0.05）,年龄低于30岁者ERR邻牙均保持了无症状活髓。ERR邻牙的预后与性别、牙根数量、牙根吸收类型、牙根吸收程度无相关性（P>0.05）。结论 对于因相邻埋伏阻生牙导致的牙根外吸收而无临床症状的恒牙,有较大概率在阻生牙拔除术后保存活髓,建议密切随访观察,不必行预防性根管治疗。     

埋伏阻生牙导致牙根外吸收邻牙的预后的临床观察

目的 探讨埋伏阻生牙导致邻牙（恒牙）牙根外吸收（ERR）时,阻生牙拔除术后邻牙的预后。方法 以埋伏阻生牙导致邻牙（恒牙）ERR但可以正常行使功能的63例患者的75颗ERR邻牙作为研究对象,微创拔除埋伏阻生牙后,术后随访6月,观察ERR邻牙的预后情况,并分析预后与患者年龄、性别、牙根数量、牙根吸收类型、牙根吸收程度的关系。结果 在75颗ERR邻牙中,67颗（89.3%）为无症状活髓牙。ERR邻牙的预后与患者的年龄相关（r=0.330,P<0.05）,年龄低于30岁者ERR邻牙均保持了无症状活髓。ERR邻牙的预后与性别、牙根数量、牙根吸收类型、牙根吸收程度无相关性（P>0.05）。结论 对于因相邻埋伏阻生牙导致的牙根外吸收而无临床症状的恒牙,有较大概率在阻生牙拔除术后保存活髓,建议密切随访观察,不必行预防性根管治疗。     

牙根发育对正畸牵引后埋伏前牙牙根及牙周组织的影响

目的:基于锥形束CT(CBCT)研究牙根发育对正畸牵引后埋伏前牙牙根及牙周组织的影响.方法:选择2018年7月-2019年3月西南医科大学附属口腔医院收治的需行上颌埋伏前牙正畸牵引治疗患者34例,共34颗上颌埋伏阻生前牙.根据牙根发育情况,分为未完全发育组和完全发育组,每组各17例.所有患者均行正畸牵引治疗.比较2组患...     

3种封闭剂在一次性根管治疗术后的近期疼痛比较

目的 观察3种根管封闭剂在活髓牙一次性根管治疗术后1周内发生疼痛的情况。方法 将需要行根管治疗的162颗活髓恒牙随机分为3组,分别以Roekoseal封闭剂(A组)、Cortisomol封闭剂(B组),Vitapex封闭剂(C组)结合牙胶尖作为根充材料进行冷测压充填。对术后1、3、7d的疼痛发生情况用VAS评价标尺记录并分析比较。结果 3组术后3d疼痛发生有显著性差异(P<0.01),A、B组术后反应较轻,C组较重。1d、7d时均无显著差异。术后7d疼痛均基本缓解消退。结论 以Roekoseal或Cortisomol作为根管封闭剂进行根管充填可减少活髓牙一次性根管治疗术后近期疼痛的发生。     

Comparison of orthodontic root resorption of root-filled and vital teeth: A meta-analysis

BackgroundIn this systematic review, the authors aimed to answer the following question: Do vital teeth differ in the level of external root resorption induced by means of orthodontic treatment compared with root-filled teeth?Types of Studies ReviewedThe search strategy was performed in 6 electronic databases and in gray literature for articles published until July 29, 2021. Two reviewers independently assessed potentially eligible studies according to the following criteria: studies that evaluated patients undergoing fixed orthodontic therapy and compared the mean difference in millimeters of orthodontically induced external root resorption in endodontically treated teeth with the vital contralateral tooth. Only randomized, quasi-randomized, nonrandomized, cohort, case–control, or cross-sectional studies were considered eligible. There were no restrictions on language or publication time. Two reviewers also independently extracted data on the characteristics of the included studies, methods, and results, and performed risk-of-bias analysis using the Meta-Analysis of Statistics Assessment and Review instrument. Estimates of interest were calculated using random-effects meta-analyses. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.ResultsEleven studies were included in the quantitative synthesis. Endodontically treated teeth had a lower level of root resorption (mean difference, 0.45 mm; 95% CI, –0.69 to –0.21 mm). However, the level of certainty of the evidence was considered very low owing to confounding factors.Conclusions and Practical ImplicationsEndodontically treated teeth may have a lower level of orthodontically induced root resorption than vital teeth, but the evidence is still uncertain about this outcome. Furthermore, owing to the small effect size, this difference might not be clinically significant (up to 1 mm).     

Contribution of cone beam computed tomography to the detection of apical root resorption after orthodontic treatment in root-filled and vital teeth

Objective:To investigate whether root-filled teeth are similar to vital pulp teeth in terms of apical root resorption (ARR) after orthodontic treatment.Materials and Methods:An original sample of cone beam computed tomography (CBCT) images of 1256 roots from 30 orthodontic patients were analyzed. The inclusion criteria demanded root-filled teeth and their contralateral vital teeth, while teeth with history of trauma had to be excluded to comply with exclusion criteria. CBCT images of root-filled teeth were compared before and after orthodontic treatment in a split-mouth design study. Tooth measurements were made with multiplanar reconstruction using axial-guided navigation. The statistical difference between the treatment effects was compared using the paired t-test.Results:Twenty posterior root-filled teeth and their contralaterals with vital pulp were selected before orthodontic treatment from six adolescents (two boys and four girls; mean [SD] age 12.8 [1.8] years). No differences were detected between filled and vital root lengths before treatment (P  =  .4364). The mean differences in root length between preorthodontic and postorthodontic treatment in filled- and vital roots were −0.30 mm and −0.16 mm, respectively, without any statistical difference (P  =  .4197) between them.Conclusion:There appears to be no increase in ARR after orthodontic treatment in root-filled teeth with no earlier ARR.