Carisolv在根管机械化学预备过程中对根管清洁能力的影响

目的:探讨Carisolv作为根管预备的化学制剂对根管清洁度的影响.方法:将60例经亚甲蓝染色符合纳入标准的离体牙随机分为3组,分别采用Carisolv、2%氯亚明 3%过氧化氢和2.5%次氯酸钠不同的化学制剂处理根管.使用紫外可见分光光度仪测量荡洗液中亚甲蓝的吸光度值,并使用扫描电镜观察根管清洁度.采用SPSS11.5软件包对结果进行双因素方差分析及Kruskal-Wallis秩和检验.结果:经Carisolv处理过的根管,其荡洗液中亚甲蓝的吸光度值显著高于2%氯亚明 3%过氧化氢组(P＜0.05),与25%次氯酸钠组之间的差异不具有统计学意义(P＞0.05).扫描电镜结果与亚甲蓝吸光度的化学检测结果相吻合.结论:Carisolv作为根管预备化学制剂,对根管的清洁能力与2.5%次氯酸钠相近,可以去除玷污层及感染物质,又不引起过度脱矿.     

液体转移法评价3 种根管充填剂的封闭性能

采用液体转移法评价3 种根管充填剂(Endométhasone、AH-Plus、GuttaFlow)的根管微渗漏,通过扫描电镜观察根管壁与充填剂之间的结合特征.结果表明GuttaFlow组的微渗漏值最小,Endométhasone组的微渗漏值最大.3 种材料间比较均有统计学差异(P<0.05).扫描电镜下不同根管充填剂与根管壁的结合情况不同.GuttaFlow的根管封闭性能较其他2 组更佳.     

不同根管预备器械对根管充填后冠方微渗漏影响的实验研究

目的:比较不同根管预备器械对根管充填后冠方微渗漏的影响。方法:选择60个单根管前磨牙(弯曲度为10～20°)随机分为6组,分别以不锈钢K锉、VDW K锉、手动Protaper、机用Protaper、Hero642、Mtwo预备根管。采用冷侧压法进行根管充填,染色法比较不同根管预备器械对根管冠方封闭性能的影响。结果:不同根管预备器械对充填后根管冠方微渗漏影响不同,其中Hero 642预备组、Protaper预备组、VDWK锉组冠渗漏长度少于不锈钢K锉组,且差异有统计学意义(P<0.05),Hero 642预备组产生的冠方微渗漏最小。结论:不同根管预备器械预备根管后对冠渗漏影响不同,镍钛旋转器械预备根管后产生的冠方微渗漏较小,不锈钢K锉根管预备后产生的冠方微渗漏较大。     

Carisolv应用于根管冲洗对根管内粪肠球菌抗菌作用的体外研究

目的：分析Carisolv祛龋凝胶作为根管冲洗剂对粪肠球菌（E．faecalis）离体牙根管感染模型的抗菌效果。方法：60颗牙体完整、发育正常的人单根管前磨牙,用ProTaper手用器械将建立根管感染模型的离体牙根管预备至F2后,建立粪肠球菌体外根管感染模型。随机分为5组,分别使用Carisolv凝胶、5．25％次氯酸钠溶液、EDTA凝胶、2％氯亚明溶液、0．9％氯化钠溶液进行根管冲洗,对根管冲洗前后的根管进行菌落计数,比较各种冲洗剂的抗菌作用。结果：5种冲洗剂在根管预备冲洗后细菌数量都显著性低于冲洗前（P＜0．001）。Carisolv组、氯亚明组、次氯酸钠组冲洗后根管的细菌数量没有显著性差异（P＞0．05）,低于EDTA组和氯化钠组（P＜0．01）。结论：Carisolv凝胶作为根管冲洗剂具备抗菌作用,其抗菌作用强于EDTA凝胶和0．9％氯化钠溶液。     

Carisolv对根管微渗漏的影响

目的:建立以亚硝酸钠为示踪物的流体输送模型,探讨Carisolv对根管微渗漏的影响。方法:将70颗离体牙随机分为5组,分别采用Carisolv、2%氯亚明+3%H2O2、2.5%NaclO、5%NaclO(阴性对照)、蒸馏水(阳性对照)预备根管,对根管侧方加压充填后进行桩腔预备,置于模型上,分别于第1、2、4、7、10、15、20、25、30、35、40、45、50、55、60天利用重氮反应检测由冠方向根尖方渗出的亚硝酸钠浓度。采用SPSS11.5软件包对数据进行多因素方差分析。结果:阴性对照组从第1天到第60天均未检测到亚硝酸钠。阳性对照组从第1天就检测到较高浓度的亚硝酸钠,从第1天到第60天亚硝酸钠渗出量显著高于其余4组(P<0.01)。Carisolv组亚硝酸钠渗出量显著低于2%氯亚明+3%H2O2组(P<0.01),与2.5%NaclO组相比,除第25、30、35、40天外,其渗出量均较低(P<0.05)。结论:Carisolv可有效去除玷污层,减少根管微渗漏的发生,达到良好的根管封闭目的。以亚硝酸钠作为示踪物的流体输送模型,可客观、灵敏、准确地评价根管微渗漏。     

连续波热塑充填和冷牙胶侧压充填根尖封闭效果的比较研究

目的:比较连续波热塑充填和冷牙胶侧压充填的根尖封闭效果.方法:收集完整离体单根管恒牙44个,统一用ProTaper预备,随机分为A,B两组,每组20个牙,另4个分别为阳性和阴性对照组.A组用E&Q Plus热牙胶充填系统做连续波热塑充填,B组用冷牙胶侧压充填法.染料渗透法染色后测量根尖微渗漏长度;扫描电镜观测根管壁与充填物间微缝隙宽度.结果:A组根尖微渗漏长度均值为(1.26±0.44)mm,微缝隙均值为(2.87±1.07)μm;B组根尖微渗漏长度均值为(2.35±0.67)mm,微缝隙均值为(5.80±0.74)μm.微渗漏和微缝隙在连续波热塑充填和冷牙胶侧方加压法充填之间存在显著性差异(P<0.05).结论:在离体实验条件下,连续波热塑充填具有较好的根管壁适应性和密合度,充填效果优于冷牙胶侧压充填方法.     

氢氧化钙类根管糊剂的微渗漏研究及扫描电镜观察

目的 液体转移法评价氢氧化钙类根管糊剂的根管微渗漏,扫描电镜观察糊剂在根管内的微观特征.方法 22颗人上颌前牙随机分为2组:A组(Vitapex)和B组(国产根管充填剂),逐部后退法根管预备后根管侧压充填.每组8个样本装入液体转移法装置进行微渗漏实验,3个样本用于扫描电镜观察.结果 A组微渗漏值为(9.878±1.688)×10-4μl/cmH2O/min-1;B组微渗漏值为(11.253±3.205)×10-4μl/cmH2O/min-1.两组间无统计学差异.A组牙本质和根充物间存在间隙;B组根充物颗粒之间存在缝隙.结论 两种氢氧化钙类根管糊剂的根管微渗漏无明显差异.     

液体转移法评价桩道预备对根管充填后封闭性的影响

目的：液体转移法评价桩道预备对4种根管充填材料根管充填后微渗漏的影响。方法：32颗人上颌前牙截冠后统一工作长度为16ram,样本随机分组为Endoln~thasone组、AH—Plus组、Vitapex组和国产组,每组8个样本。根据充填材料不同进行根管预备及根管充填。一周后液体转移法测量桩道预备前根管微渗漏。桩道预备后,再测量根管微渗漏。实验数值采用SPss13．0统计学软件进行分析,取α=0．05。结果：Endom6thasone组、AH-Plus组的桩道预备前和桩道预备后无统计学差别。Vitapex组、国产组的桩道预备后微渗漏下降,与桩道预备前有统计学差别（P〈0．05）。结论：桩道预备不影响Endom6thasone、AH—Plus根管充填后的微渗漏;桩道预备使Vitapex、国产充填剂根管充填后的微渗漏下降。     

老年人部分闭锁根管的预备

目的:总结对老年人部分闭锁的根管进行根管预备的特点.方法:对50例根管闭锁需进行根管治疗的牙齿,经常规手持器械预备辅助以化学预备——乙二胺四乙酸(EDTA)液,双氧水及氯亚明反复冲洗根管,同时相应增加复诊次数,对根管进行多次预备.结果:50例患牙最终获得满意的根管预备.结论:对于老年人部分闭锁的根管,通过手持器械加化学预备多次根管扩大,可以获得满意的根管预备.     

桩道预备对不同根管糊剂充填后根尖封闭性的影响

目的 液体转移法评价根管桩道预备对三种根管糊剂充填后根尖封闭性的影响。方法24颗人上颌前牙截冠后统一工作长度为16 mm,进行根管预备及根管充填。样本随机分组为Endométhasone组、AH-P lus组和GuttaF low组,每组8个样本。1周后液体转移法测量桩道预备前根管微渗漏。随后1~6#G钻逐步桩道预备,保留根尖4 mm充填物。再测量桩道预备后的根管微渗漏。实验数值采用SPSS 13.0统计学软件进行霍特林T2检验,取α=0.05。结果 桩道预备对各实验组的影响无统计学意义(P>0.05)。GuttaF low组桩道预备后的微渗漏值最小为(4.393±2.052)×10-3μl/(kPa.m in)。结论 桩道预备不影响根管糊剂充填后的根尖封闭性。GuttaF low是值得推广的新型根管充填剂。     

Preliminary in vitro evaluation of Carisolv as a root canal irrigant

AIM: To test the null hypothesis that Carisolv is no better than PBS in removing organic debris from uninstrumented root canals. METHODOLOGY: The pulps of two uniform groups of 36 immature, sheep mandibular incisors were grossly removed with barbed broaches immediately prior to the study. Roots in group 1 were irrigated with phosphate buffered saline (PBS), strong sodium hypochlorite (4.5%) or Carisolv without ultrasonic agitation, whilst in group 2 the same irrigants were activated with ultrasound. Canal walls were exposed to irrigants for 10, 20 or 30 min at 37 degree C. In group 2, ultrasound was applied for 30 s at 2, 5 and 7 min within each 10 min incubation period. After washing irrigants free and immersion in fixative, all teeth were split longitudinally, critical point dried and sputter coated for SEM analysis. SEM photomicrographs were recorded of representative areas in the coronal, middle and apical canal thirds and debris scored by a single assessor against a five-point scale. Intraobserver reliability was assessed by Cohens kappa scores and debris scores analysed by the non-parametric Kruskal-Wallis test at P < 0.05. RESULTS: Sodium hypochlorite was significantly better than Carisolv and PBS in cleaning root canals (P < 0.0001), whether or not ultrasound was applied. Carisolv was shown to clean canals better than PBS, again whether or not ultrasound was applied (P = 0.01). Both incubation time and ultrasound enhanced the action of Carisolv (P < 0.001) whilst the activity of PBS was not significantly improved by exposure time or the application of ultrasound. Kappa scores of 0.90-0.95 indicated excellent consistency in debris scoring. CONCLUSIONS: Within the limitations of this preliminary study (i). Carisolv cleaned root canals better than PBS and shows promise as an adjunct to root canal preparation; (ii). the action of Carisolv was enhanced by incubation times beyond 20 min whether or not ultrasound was applied; (iii). sodium hypochlorite solution remains the gold standard endodontic irrigant, provided that it is used with care and is contained in the canal system.     

采用葡萄糖定量分析法评价连续波热牙胶充填技术的根管封闭性能的研究

目的采用葡萄糖定量法检测根管微渗漏模型评价连续波热牙胶充填技术的根管封闭性。方法选取30颗离体单直根管下颌前磨牙,机用镍钛ProTaper根管预备后随机分成连续波热牙胶充填组和冷牙胶侧方加压充填组(每组10例)和2个对照组(阳性对照和阴性对照各5例),根充后建立微渗漏葡萄糖定量分析法模型,通过在第1、4、7、20天用葡萄糖氧化酶法检测从冠方向根方渗出的葡萄糖的量,观察其微渗漏情况。结果第1天2组微渗漏值无显著性差异(P>0.05),第4、7天,连续波充填组的微渗漏小于冷侧压充填组(P<0.05),第20天时,2组无显著性差异(P>0.05)。结论尽管冷侧压充填发生微渗漏快于连续波充填,但是两者的根管封闭性无显著差异。     

CarisolvTM: an alternative to NaOCl in immature root canals?

AIM: To test the null hypothesis that Carisolv is no more effective than 1% sodium hypochlorite in cleaning uninstrumented, immature root canals. METHODOLOGY: A total of 240 uniform, immature ovine incisors were decoronated at the CEJ level and randomly divided into four groups of 60. After gross pulp extirpation, canals were flooded with normal saline (negative control), 1% NaOCl, Carisolv or 5% NaOCl (positive control) and incubated for 10 min (group 1), 20 min (group 2), 30 min (group 3) or 30 min, refreshing irrigant at 10 and 20 min (group 4). SEM photomicrographs of canal wall debris in the apical, middle and coronal thirds were scored against a 5-point scale. Internal consistency was assessed by kappa statistics. Debris scores for different irrigant regimes at different canal levels were analysed by non-parametric tests (P < 0.05). RESULTS: Canals were consistently cleaner in the coronal and middle than apical thirds. NaOCl (5%) was consistently most effective. Carisolv and NaOCl (1%) were no more effective than normal saline in group 1 (P > 0.05), but significantly more effective than normal saline in groups 2 (middle and apical 1/3), 3 and 4 (P < 0.05). Carisolv and NaOCl (1%) had comparable activity in groups 1, 2 (middle and apical thirds) and 3, but NaOCl (1%) was significantly more effective than Carisolv in group 4 (coronal and middle thirds). CONCLUSIONS: 1.The ovine incisor model presents opportunities to investigate irrigation regimes under controlled ex-vivo conditions. 2.NaOCl (5%) remains the most effective irrigant for rapid debris removal in immature root canals. 3.Carisolv cleans pulp debris from the walls of immature root canals as effectively as NaOCl (1%) during static, unrefreshed wall contact for between 20 and 30 min. 4. Refreshment of NaOCl (1%) enhances its cleaning ability above that of Carisolv.     

Extent of microleakage in relation to root canal morphology

The purpose of this study was to study with standardized methods the length and extent of the microleakage developing around the root canal fillings. The preparational errors were evaluated in twenty straight and curved root canal using computer graphic analysis. The step back technique was used for root canal preparation. The shape of the instrumented root canals were analyzed macroradiographically in order to evaluate unwanted procedural root canal deformities. The root canals were obturated with lateral condensation technique using AH-26 sealer and guttapercha points. After the teeth having been made transparent a silver nitrate penetration test was performed in vacuum and both the linear dye penetration and the extent of dye penetration surface area were measured from four directions with computer assisted digitized method. The linear dye penetration values were higher in straight root canals than in curved ones: 2.22 + 1.17 mm and 1.81 + 1.24 mm respectively. The dye penetration surface area was slightly also larger in straight than in curved root canals: 1.3 +/- 0.71 mm2 vs. 1.06 +/- 0.5 mm2. Nevertheless the differences were statistically non significant. In curved root canals the highest dye penetration values were measured at the inner curvature of the canals. This findings was also corroborated by a coincidence test.     

即刻桩腔预备对三种根管预备方法预备的直根管根尖封闭性的影响

目的 研究三种不同根管预备方法根管预备、根管充填后即刺桩腔预备对直根管根尖封闭性的影响.方法 离体直单根管上前牙124个,其中120个随机平均分为3组(n=40),A组:不锈钢根管锉常规法;B组:G 型钻根管冠部预处理 不锈钢根管锉常规法;C组:手用Pr01raper镍钛根管锉冠向下法,刺余4个随机平均分为阴性对照组和阳性对照组.所有根管均用侧方加压法充填,即刻手持垂直加压器去除部分充填材料,然后P型钻桩腔预备.用染料渗透法评价各组根尖封闭能力.结果 B组G型钻根管冠部预处理 不锈钢根管锉常规法预备的根管和C组手用ProTaper镍钛根管锉冠向下法预备的根管即刻桩腔预备后,其根尖微渗漏较A组常规法预备的轻(P<0.05).结论 大锥度根管预备,根管充填后即刻桩腔预备的根尖封闭性较好.     

23例27个粗大根管的根管治疗及修复临床观察

目的 :观察 2 3例 2 7个粗大根管的根管治疗及修复效果并总结治疗经验。方法 :对 2 7个根管未完全发育成形的残根、残冠进行根管治疗及修复 ,随访 2年观察治疗效果。结果 :2 7个粗大根管在根管治疗过程中 ,2 3个牙经化学根管预备后即产生良好的根充效果 ,3个牙仅作机械根管预备而未作化学预备的患牙首次根管治疗失败 ,采用化学预备重新根充效果良好 ,1个牙反复出现瘘管而拔除。自制牙胶尖未发生超充情况。修复后有 7个牙出现根折 ,其余均修复效果良好。结论 :利用化学方法对粗大根管进行预备是必须的 ,采用自制牙胶尖进行根管充填能形成良好的根尖封闭。修复的关键在于尽量保留牙体组织。牙颈部需形成“颈箍” ,肩台必须位于正常牙体组织上。     

碘仿氢氧化钙糊剂注射根管充填的微渗漏实验研究

目的 :了解碘仿氢氧化钙糊剂 (iodoform -calciumhydroxideICH)注射根管充填对根尖孔的封闭性能。方法 :5 0颗离体单根牙随机分为实验组和对照组。两组分别用注射型ICH和氧化锌丁香油糊剂组单尖充填根管 ,采取染料渗入法检查根尖孔微渗漏 ,在解剖显微镜下测量染料渗入距离。结果 :ICH组微渗漏值平均 0 .60 2mm ,氧化锌丁香油糊剂组微渗漏值平均 1.2 3 6mm ,经t检验 ,P <0 .0 5 ,两组渗漏值具有显著性差异。结论 :注射型碘仿氢氧化钙糊剂对根尖孔的封闭性优于氧化锌丁香油糊剂     

Coronal microleakage of endodontically treated teeth with intracanal post exposed to fresh human saliva

Objective

The aim of this study was to investigate the coronal microleakage of endodontically treated teeth prepared to receive an intracanal post and teeth with an intracanal post but without a prosthetic crown and exposed to contamination by fresh human saliva.

Material and Methods

A mechanical-chemical preparation following the step-back technique was carried out in 35 extracted single-rooted human teeth. The teeth were randomly divided into five groups: G1=root canals instrumented, obturated, and prepared to receive an intracanal post (N=10); G2=root canals with cemented posts but without coronal sealing (N=10); PC1=positive control root canals instrumented and open (N=5); PC2=positive control 2 root canals without instrumentation and open (N=5); and NC=negative control healthy teeth (N=5). The crowns were removed except for the control group of intact teeth. The root canals were obturated and sterilized with cobalt 60 gamma irradiation and were then adapted in an apparatus using a Brain Heart Infusion (BHI) medium and fresh human saliva for contamination. Microbial growth was indicated by the presence of turbidity in the BHI liquid medium.

Results

Data were submitted to the Kaplan-Meier Survival Analysis and the Holm-Sidak statistic method, which observed an index of 90% of microleakage in root canals after 24 hours for G1 and 70% of microleakage in samples at the end of 40 days for G2.

Conclusion

The results show that root canals with an intracanal post but without a prosthetic crown can be recontaminated when exposed to fresh human saliva in a short period.