氢氧化钙应用于根管封药的临床疗效观察

笔者在2001年5月至2002年9月间将氢氧化钙甘油糊剂用于根管封药治疗慢性根尖周炎，取得良好效果。     

地塞米松-氢氧化钙糊剂用于根管封药的临床研究

目的 观察地塞米松-氢氧化钙糊剂应用于根管封药的临床疗效。方法 选择240例根尖周炎病例，随机分观察组(地塞米松-氢氧化钙糊剂组)对照组(甲醛甲酚组)各120例，观察封药一周后的临床疗效。结果 两组效果有显著差异，地塞米松-氢氧化钙糊剂根管封药显效率(90．8％)优于甲醛甲酚根管封药(66．7％)。结论 地塞米松-氢氧化钙糊剂应用于根管封药能有效预防和降低根管治疗期间疼痛和水肿的发生。     

氢氧化钙碘仿糊剂治疗根管封药疼痛的临床观察

目的 评价氢氧化钙碘仿糊剂治疗根管封药后的根尖周炎的疗效。方法 在扩管封药后疼痛的根管内置人氢氧化钙碘仿糊剂棉捻，评价其疗效。结果 37例疼痛消失或减轻，有效率达94．9％。结论 在治疗根管封药后的根尖周炎中，氢氧化钙碘仿糊剂是一种有效的治疗手段。     

氢氧化钙-碘仿糊剂用于乳牙根管封药的临床研究

目的:观察氢氧化钙-碘仿糊剂应用于乳牙感染根管封药的临床疗效。方法:选择320例乳牙根尖周炎病例,随机分为治疗组(氢氧化钙-碘仿糊剂组)和对照组(甲醛甲酚组)各160例,观察封药后48h,1周的临床疗效。结果:1周后两组疗效有显著差异,氢氧化钙-碘仿糊剂根管封药显效率(91.25%)优于甲醛甲酚组(66.25%)。结论:氢氧化钙-碘仿糊剂应用于乳牙根管封药可有效减少治疗期间的肿痛。     

氢氧化钙甘油在根管封药中的应用

根管治疗期间常规采用如樟脑对氯酚、甲醛甲酚等药物,约诊期间经常发生疼痛和肿胀,是治疗难点之一。我们自2002年开始在根管治疗术中采用氢氧化钙甘油糊剂根管内封药,并与传统药物进行对比。报告如下。1材料和方法1.1临床资料慢性根尖周炎120例,120个牙,每位病人仅涉及1个牙,X线检查:根尖周区可见大小不等的稀疏区(0.5~6.5mm)。诊断明确,从未进行根管治疗术,扩根管时根管锉可达根尖部位。1周内未使用抗生素。男68例,女52例,年龄15~60岁,前牙43例,前磨牙62例,磨牙15例。随机分成3组,甲组:氢氧化钙甘油;乙组:樟脑对氯酚;丙组:甲醛甲酚。1.2治…     

氢氧化钙和FC用于根管封药后的临床观察

根管预备术后疼痛是指在根管预备后出现的疼痛和肿胀,发生率为4%～20%[1].其发生与多种因素有关,包括病人的体质,根管解剖、细菌感染程度及创伤等.     

氢氧化钙和FC根管封药的临床效果比较

甲醛甲酚 (ＦＣ)是目前应用最广泛的根管消毒药物 ,但由于副作用较大 ,也不尽理想。作者于 1996～ 1998年在临床选择了 196例患者 2 0 4个前牙 ,随机分别用氢氧化钙和ＦＣ作为消毒剂 ,用于根管封药进行临床对比观察。1　材料和方法1.1　病例选择从门诊患者中随机选择 196例患者 ,2 0 4个患慢性尖周炎的前牙 (男性 116例 12 0个牙 ;女性 80例 84牙 ) ,11、2 1有 6 0个 ;12、2 2有 4 6个 ;13、2 3有 16个 ;4 1、31有 33个 ;4 2、32有 38个 ;4 3、33有 11个。年龄 18～ 5 2岁。1.2　方法1.2 .1　根管预备按常规清理根管内残留的坏死、坏疽牙髓…     

氢氧化钙用于根管内封药的疗效观察

氢氧化钙作为一种根管内封药，近年来在临床治疗中得以广泛应用。本组用氢氧化钙甘油糊剂和传统的根管消毒药FC进行根管内封药，对其治疗结果进行评价。发现氢氧化钙在减少治疗期间疼痛和降低对根尖周组织刺激方面效果较好。     

氢氧化钙根管封药172例疗效观察

近年来氢氧化钙作为新的根管消毒药物，其疗效及安全性已越来越受到临床专家的肯定。我们自2000年应用氢氧化钙作为根管封药，并系统观察172例，与传统根管消毒药物甲醛甲酚(FC)相比较，疗效满意，现报道如下。     

氢氧化钙治疗乳牙根尖周炎的疗效观察

乳牙根尖周炎临床大多表现为根分叉处相应的牙龈黏膜脓肿或长期不愈的窦道。氢氧化钙作为一种根管治疗药物，在恒牙牙髓及根尖周疾病的治疗中得到了广泛应用。自2000年以来，笔者将氢氧化钙应用于乳牙根尖周炎根管封药及根管治疗，并与临床常用药物做对照，观察其疗效。     

Effects of Calcium Hydroxide Paste in Different Vehicles on Bacterial Reduction during Treatment of Teeth with Apical Periodontitis

IntroductionThis clinical study evaluated the antibacterial effects of calcium hydroxide associated with different vehicles during the treatment of infected teeth with apical periodontitis.MethodsBacteriologic samples were taken from 90 necrotic root canals of teeth with apical periodontitis before (S1) and after preparation with a rotary nickel-titanium instrument system and 2.5% sodium hypochlorite irrigation (S2). The teeth were distributed in 3 groups according to the intracanal medication used, which consisted of a calcium hydroxide paste in glycerin, camphorated paramonochlorophenol/glycerin (CHPG), or 2% chlorhexidine for 1 week, and then another sample was taken (S3). The frequency of bacteria-positive cases and the reduction of bacterial counts were evaluated by quantitative real-time polymerase chain reaction.ResultsSubstantial intracanal bacterial reduction was observed after preparation in the 3 groups (P < .001). After calcium hydroxide paste in glycerin medication, the number of bacteria-positive cases decreased from 20/29 (69%) to 17/29 (59%); however, the mean bacterial counts increased 8.4% from S2 to S3. Medication with CHPG reduced the number of bacteria-positive cases from 17/29 (59%) to 15/29 (52%), with a significant mean S2–S3 reduction of 71% (P < .05). In the chlorhexidine group, the number of bacteria-positive cases decreased from 21/30 (70%) to 17/30 (57%) after medication, with a mean S2–S3 reduction of 55%, which, however, was not statistically significant (P > .05). Intergroup comparisons showed no significant differences (P > .05).ConclusionComparison between the 3 calcium hydroxide pastes showed no significant differences in antibacterial effectiveness in the main root canal. However, only the CHPG paste showed a significant reduction in bacterial counts when postpreparation and postmedication samples were compared.     

Effect of the Association of Nonsteroidal Anti-inflammatory and Antibiotic Drugs on Antibiofilm Activity and pH of Calcium Hydroxide Pastes

Introduction

The objective of the present study was to evaluate the in vitro antibiofilm activity and pH of calcium hydroxide associated with different nonsteroidal anti-inflammatory drugs (NSAIDs).

对氢氧化钙根管消毒作用的再认识

氢氧化钙是临床上常用的根管消毒药物之一,其消毒效果得到广泛认同.但近年来的研究表明,氢氧化钙的抗菌作用并非全能,特别是对于一些难治性根尖周病的病原菌抗菌效果不佳,其药物剂型和临床操作也存在着一定的局限性.本文就氢氧化钙的抗菌作用、临床操作等作一综述.     

Calcium release and pH-characteristics of calcium hydroxide plus points

AIM: To evaluate calcium ion release and pH-characteristics of calcium hydroxide plus points (CHPP), conventional calcium hydroxide points (CHP, both Coltène/Whaledent, Langenau, Germany) and aqueous calcium hydroxide suspension (CHS) (Calxyl, OCO, Dirmstein, Germany). METHODOLOGY: Ten CHPP or CHP of size 50 were immersed into 5 mL isotonic sodium chloride solution. Conventional Ca(OH)2-free gutta-percha points served as negative control. Calcium release was measured up to 44 days by means of complexometric titration. Time dependent pH behaviour of all points in comparison with CHS was determined immersing 30 points of size 50 into 2.3 mL 0.9% wt NaCl-solution at time intervals of 0.5-72 h by a microelectrode measuring chain and a pH-meter. The surface morphologies of new and used gutta-percha points were evaluated qualitatively under a scanning electron microscope. Statistical evaluation was carried out using Kolmogorov-Smirnov-tests, Mann-Whitney-tests and multifactorial anova. RESULTS: For CHPP, a threefold greater calcium release was measured compared with CHP. Both types of points as well as CHS showed a maximum pH of approximately 12. Differences between groups were statistically significant for calcium release and pH (multifactorial anova; P < 0.001). Both types of points showed porous surfaces after usage, with a rougher surface for CHPP. CONCLUSIONS: CHPP and CHP increased the pH of isotonic sodium chloride >11 within 3 min. CHPP had a greater release of Ca2+ compared with CHP.     

氢氧化钙用于根管消毒作用的临床研究

目的观察氢氧化钙对感染根管的临床疗效和细菌学改变。方法采用随机分组对照实验,以樟脑对氯酚为对照,分别记录两组封药前后的临床和实验室指标,并进行统计学分析。结果氢氧化钙组显效率为83.33%,一次封药即可进行根管充填。樟脑对氯酚组显效率为56.67%,两组差异有统计学意义(P<0.05)。细菌培养结果显示两组在厌氧菌、链球菌和乳杆菌阳性率的差异有统计学意义(P<0.05)。结论氢氧化钙是一种高效、广谱的抗菌药物,能很好地改善临床症状。     

Antibiofilm Efficacy of Silver Nanoparticles Alone or Mixed with Calcium Hydroxide as Intracanal Medicaments: An Ex-Vivo Analysis

IntroductionThis study aimed to determine the most effective antibiofilm concentration of silver nanoparticles (AgNPs) alone or in combination with calcium hydroxide (Ca[OH]₂) against Fusobacterium nucleatum biofilm.MethodsThe minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of AgNPs alone or with Ca(OH)₂ were determined. Dentin slices were sterilized and inoculated with F. nucleatum for 3 weeks to establish a biofilm. Samples were randomly assigned to determine the MIC and MBC for AgNPs alone or mixed with Ca(OH)₂. A higher concentration of AgNPs for both preparations was also used. Triple antibiotic paste, Ca(OH)₂, and saline were used as controls. Specimens in each group were subdivided over 2 observation periods: 7 and 14 days. At the end of each period, specimens were analyzed with 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) to determine the metabolic activity. Also, samples from each group were assessed by scanning electron microscopy.ResultsThe MIC and MBC of AgNPs alone against F. nucleatum coincided at 0.04%. The combination of AgNPs + Ca(OH)₂ exhibited a lower MIC and MBC of 0.03%. MTT analysis showed a significant reduction in bacterial viability in all groups compared with negative controls (P < .05). A more substantial reduction in bacterial cells was observed with increasing concentrations of AgNPs at both periods. The combination (AgNPs [0.06%] + Ca[OH]₂) was the most potent against F. nucleatum.ConclusionsThe findings demonstrated that combining AgNPs with Ca(OH)₂ was more effective on the F. nucleatum biofilm than either material alone, suggesting a combined effect.     

Effectiveness of the proton pump inhibitor omeprazole associated with calcium hydroxide as intracanal medication: an in vivo study

Introduction

The objective of this study was to evaluate the efficacy of the association of a proton pump inhibitor (omeprazole) with Ca(OH)₂ as intracanal medication in a rat model of periapical lesions.

Methods

Periapical lesions were induced on the first right mandibular molar tooth of 36 male Wistar rats (6 per group). After 28 days, the distal canal of each tooth was prepared, filled with the respective dressing (negative control group, PEG 400; positive control group, Ca(OH)₂ + PEG400; test group, Ca(OH)₂ + omeprazole + PEG 400), and sealed with amalgam for 15 or 28 days. Microbiological samples were taken in 3 periods: S1, after 28 days of lesion induction; S2, after the biomechanical preparation; and S3, after the medication (15 and 28 days).

Results

The radiographic and histologic analysis revealed that either Ca(OH)₂ or Ca(OH)₂ plus omeprazole dressings produced a reduction of periapical lesions at 28 days, when compared with the negative control group. The reduction of periapical lesions and inflammatory cell infiltration was visibly improved by associating omeprazole with Ca(OH)₂, with an increase of reparative bone areas. The microbiological assessment showed a significant decrease of colony-forming units count from S1 to S2 or S3 collecting times, but no differences were observed between the S2 and the S3 time-periods or among the experimental groups within the S3 period. Further bacterial characterization showed a possible selective activity of the medications.

Conclusions

Our data showed that association of omeprazole with Ca(OH)₂ favored a superior repair of rat periapical lesions and seemed to display different selective activity over endodontic microbiota, in comparison with the conventional Ca(OH)₂ dressing.     

Cellular and Molecular Tissue Response to Triple Antibiotic Intracanal Dressing

Introduction

The aim of this study was to characterize the response of mouse subcutaneous tissue to triple antibiotic paste (TAP) using conventional light microscopy and real-time PCR (qRT-PCR).

Methods

Polyethylene tubes containing TAP or calcium hydroxide (CH) (ie, the control group) were implanted in mouse subcutaneous tissue. Animals that received empty tubes or no tubes were used as additional controls. After periods of 7, 21, and 63 days postimplantation, the specimens were removed and subjected to histologic processing. The number of inflammatory cells and vessels, vessel areas, vascular density, and relative percentage of collagen were evaluated. Gene expression of proinflammatory (interleukin-1 beta, tumor necrosis factor alpha, and interleukin 17) and anti-inflammatory (transforming growth factor beta) cytokines and angiogenic factors (vascular endothelial growth factor and hypoxia-inducible factor-1 alpha) was quantified by 7 and 21 days postimplantation. Results were analyzed using the Student t test, analysis of variance, and the Tukey test (α = 0.05).

Results

TAP induced an exuberant inflammatory and angiogenic response, with higher numbers of inflammatory cells, higher vascular area and density, and lower relative percentage of collagen compared with CH. In general, the expression of genes involved in inflammation and angiogenesis was higher in the TAP group compared with animals that received CH or empty tubes.

Conclusions

The response of mouse subcutaneous tissue to TAP was characterized by exuberant and persistent inflammatory and angiogenic responses with no repair and high gene expression of biomarkers associated with inflammation and angiogenesis.     

Effect of calcium hydroxide as an intracanal dressing on apical leakage

In this in vitro study, we investigated the effects of the use of two different calcium hydroxide (Ca(OH)2) preparations as an intracanal dressing on the sealing ability of two different sealers were investigated. Eighty-eight freshly extracted, single-rooted maxillary anterior teeth were used. After the root canals were hand-instrumented, they were divided into six groups of 10 each. The root canals were dressed with Ca(OH)2 paste, either mixed with sterile water (in groups 1 and 2) or with glycerine (in groups 3 and 4). The dressed root canals were incubated in 100% humidity at 37 degrees C for 7 days. In groups 5 and 6, the root canals were not dressed. After the root canal dressings were removed by irrigation with 5.25% NaOCl and reaming with a K-type file, all canals of the experimental groups were obturated with sealer and gutta-percha using a cold lateral condensation technique. Calciobiotric Root Canal Sealer, (CRCS), (in groups 1, 3 and 5) and Diaket (in groups 2, 4 and 6) were used as sealers. All specimens were placed in India ink for 7 days, and the amount of apical leakage was scored. Eight further prepared specimens were dressed with Ca(OH)2 plus water or Ca(OH)2 plus glycerine and examined with scanning electron microscopy (SEM) following the removal of dressings. There was a statistical difference in the leakage patterns amongst the 6 experimental groups (P < 0.05). Specimens in group 2 exhibited less leakage than the other experimental groups, except group 4 (P < 0.05). There were no other significant interactions. SEM examination revealed that Ca(OH)2 crystals were present on the surface of smear layer in both groups where Ca(OH)2 paste had been placed, but they did not penetrate into the dentinal tubules.