无机三氧化物聚合体用于年轻恒牙根尖封闭的短期疗效观察

目的 观察无机三氧化物聚合体(MTA)一次性封闭根尖开放年轻恒牙的疗效.方法 13颗年轻恒牙采用MTA一次性封闭根尖开放部位,形成硬组织屏障后行流动牙胶充填根管,冠部永久性充填,术后定期复诊.结果 所有患牙在治疗后的复诊期间均无不适症状,同时原根尖周透射区局限、缩小或消失.结论 MTA用于年轻恒牙根尖封闭的短期疗效确切.     

MTA和Vitapex糊剂治疗成人慢性根尖周炎伴根尖孔闭合不全的疗效比较

目的：比较三氧化物多聚体（mineral trioxide aggregate,MTA）和Vitapex糊剂应用于成人慢性根尖周炎伴根尖闭合不全恒牙的临床疗效。方法：选取成人慢性根尖周炎伴根尖孔闭合不全的恒牙共38颗,随机分为2组,实验组在根管显微镜下用MTA严密封闭根尖开放部位,硬固后根管行热牙胶充填;对照组用Vitapex糊剂行根尖诱导成形,在根尖部有硬组织形成后行根管充填。两组术后均定期复查,评价临床效果及X线片结果。结果：经过2年的复查,实验组所有病例在治疗后均无临床不适症状,X线片显示患牙11颗根尖阴影完全消失,8颗明显缩小,1颗无变化,有效率95%。对照组2颗磨牙因冠根折拔除,8颗根尖有硬组织形成,8颗根尖无硬组织形成,有效率为44.4%,两者差异有统计学意义。结论：MTA治疗成人根尖孔未闭合恒牙是一种较理想的根尖诱导成形材料,短期临床疗效好,长期效果有待于进一步观察。     

MTA再行治疗根部开放恒牙的疗效观察

目的：观察显微镜下MTA（mineral trioxide aggregate）再行治疗恒牙根部开放导致的牙髓根尖周炎的疗效.方法：选取转诊我院的根部开放合并根尖周炎、既往治疗失败的恒牙20例,在根管显微镜下用MTA严密封闭根部开放部位,形成屏障后行根管热牙胶充填,定期复诊观察.结果：所有病例在治疗后复诊期间无不适症状,原有窦道消失,牙龈恢复正常.6个月后X线片复查显示根部开放处MTA屏障封闭严密,原有根尖周稀疏区逐渐缩小.15个月后有9例患牙根尖稀疏区完全消失,呈骨性愈合.结论：MTA再行治疗根部开放恒牙的疗效确切,根管显微镜的应用使治疗更为方便和准确,提高根管再处理的成功率.     

MTA形成根尖屏障的疗效观察

目的:评价在手术显微镜下采用无机三氧化聚合物(mineraltrioxideaggregate,MTA)形成根尖屏障、治疗根尖孔未闭合患牙的临床疗效。方法:选取根尖孔未闭合的患牙23颗,完成根管预备后,在手术显微镜下将MTA充填于根尖1/3段,形成3～5㎜的根尖屏障,硬固后完成根管中、上段的充填及冠部修复,观察疗效。结果:所有病例在2～3周内完成根管充填,术后X线片显示16颗患牙适充,7颗超充约1～2㎜,根充致密;除失访及不能亲自前来复诊检查的患者外,其余19颗均达到成功要求,患牙无不适,瘘管闭合,无叩痛;复查X线片示根尖周病变明显缩小或消失,无新的暗影出现。结论:MTA治疗根尖孔未闭合的患牙治疗周期短,临床疗效好,少量超充不影响疗效。     

显微镜下三氧化矿物凝聚体修补侧穿根管和建立根尖屏障的护理配合

目的探讨显微镜下三氧化矿物凝聚体（mineral trioxide aggregate,MTA）修补侧穿根管和建立根尖屏障的护理配合要点。方法根管侧壁穿孔或拟行根尖成形术的患者52例,52颗患牙,在根管显微镜下,通过医护间熟练的无菌操作,平稳、迅速的器材传递,用MTA完成根管侧穿部位的严密封闭或建立根尖屏障。结果 52例患者1周复诊时无黏膜损伤等护理并发症,3个月后患牙无牙周袋和窦道,咀嚼功能良好。结论在根管显微镜下应用MTA修补根管侧穿或建立根尖屏障是一项精细操作,技术复杂、操作难度大,规范、娴熟的优质护理是治疗成功的保证。     

应用MTA封闭根尖和修补根管侧穿的临床疗效观察

目的:观察MTA(mineral trioxide aggregate)治疗根尖敞开和根管侧穿患牙的临床疗效.方法:病例选择于解放军第306医院牙体牙髓科门诊患者共计23 例,其中根尖部敞开7 例、根管内吸收、根折造成根管侧穿6 例、医源性根管侧穿10 例.病程0.5～24 个月, X线片显示23 例均有根部或根尖周透射影.常规根管清理消毒、封药,于根管显微镜下采用MTA封闭根尖开放部位,形成屏障后热胶垂直加压法充填根管, 6、 12 个月进行复查.结果:1 例失访, 6 个月复诊根尖周透射影增大1 例,根尖周透射影减小20 例,1 例无明显变化.12 个月复诊根尖区透射影消失9 例,根尖周透射影减小5 例,无明显变化2 例.结论:应用MTA封闭根尖和修补根管侧穿的临床短期疗效良好,在根管显微镜下实施有助于提高MTA充填的准确性和密合性.     

MTA治疗成年患者根尖孔未闭合患牙的疗效评价

目的 评价无机三氧化聚合物（MTA）治疗成年患者根尖孔未闭合患牙的临床疗效。方法 选取成年患者根尖孔未闭合的前牙及前磨牙共41颗,随机分为2组,试验组21颗牙,在完成根管预备和消毒后,在手术显微镜下将MTA充填于根尖孔及根管下段,厚约3-5 mm,硬固后采用热牙胶完成根管中上段的充填;对照组20颗牙,采用氢氧化钙类根管糊剂Vitapex行根尖诱导成形术,定期复查,在根尖部有硬组织形成后完成根管治疗。记录患者就诊次数、治疗周期及治疗效果。结果 试验组术后X线片显示15颗患牙适充,6颗牙超充约0.5-2 mm,根管内充填物致密;平均就诊次数3.5次,平均治疗周期11.8 d,复查时多数患牙窦道闭合,根尖周病变明显缩小或消失,无新的暗影出现;对照组11颗患牙诱导成功,根尖有硬组织形成,9颗牙无明显根尖屏障形成,平均就诊次数6次,平均治疗周期306.8 d。结论 与根尖诱导成形术比较,MTA治疗成年患者根尖孔未闭合患牙的周期短,疗效好。     

无机三氧化聚合物根尖屏障术治疗根尖孔未形成患牙的临床评价

目的评价无机三氧化聚合物(mineral trioxide aggregate,MTA)作为根尖屏障材料封闭根尖孔未形成患牙的临床疗效。方法选取根尖孔未形成的28颗患牙。施行标准根管预备程序、氢氧化钙消毒根管1周后在手术显微镜下将可吸收性胶原海绵和MTA放置于根尖区,制备人工根尖屏障。1 d后复诊,剩余根管空间AH plus糊剂和热牙胶回填及冠部修复,6个月、1年后临床检查、X线片评估疗效。结果 6个月成功率65.2%,1年成功率是91.3%,根尖周指数有所改善。卡方检验显示两组间统计学有显著性差异。结论 MTA根尖屏障术用于治疗根尖孔未形成的患牙临床疗效可靠。     

无机三氧化聚合物修补根管穿孔的疗效观察

目的:评价采用非手术方法以无机三氧化聚合物(mineral trioxide aggregate,MTA)修补根管侧壁穿孔的临床疗效。方法:选取因病理性或医源性因素造成的根管侧壁穿孔患牙18颗,彻底清理根管并预备根管,在手术显微镜下以MTA修补根管侧壁穿孔,完成根管充填及冠部修复。结果:仅1颗患牙因穿孔范围过大治疗失败,其余患牙术后X线片显示充填物致密,10颗有少量材料超充,但未引起临床症状;治疗后1～2a复查,16颗患牙无不适,X线片示根尖周或根侧暗影明显缩小或消失。结论:MTA治疗根管侧壁穿孔患牙临床疗效好,少量超充不影响其疗效。     

MTA应用于穿孔修补和根尖屏障的临床效果观察

目的:临床观察MTA(mineraltrioxideaggregate)用于根尖屏障术和根管或髓室穿孔修补的治疗效果。方法:收集临床上使用MTA治疗的病例11例,其中无髓恒牙根尖孔敞开病例7例( 7个患牙)行MTA根尖屏障术,在手术显微镜下完成MTA根尖屏障的制备,垂直加压充填根管。治疗过程仅需1 ~2次复诊。使用MTA进行根管或髓室穿孔修补病例4例共5个患牙。11例观察期0. 5 ~4年多不等。结果:经追踪观察, 11例患牙在临床症状的控制和获得骨愈合方面都有良好的效果。结论:本研究结果提示,MTA对穿孔修补和根尖屏障术方面是一种满意的材料。     

Apical plug technique using mineral trioxide aggregate: results from a case series

AIM: To examine the clinical and radiographic appearance of teeth that suffered premature interruption of root development and were treated by an mineral trioxide aggregate (MTA) apical plug technique. SUMMARY: Eleven teeth with immature root apices in 11 patients were treated nonsurgically by the manual application of MTA in the apical portion of the root canal under microscopic vision. Follow-up evaluations were performed at 1-2 years after treatment. KEY LEARNING POINTS: Mineral trioxide aggregate appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps. Ten out of 11 cases were associated with periradicular health at follow-up evaluation.     

Mineral trioxide aggregate in management of immature teeth with open apices – A report of clinical cases

Injuries to immature permanent teeth due to trauma may eventually result in pulpal necrosis and the subsequent arrest of root development. These teeth are often difficult to treat as the associated open root apex hinders the placement of the root filling material. To overcome this drawback, various materials have been introduced to induce apex closure prior to endodontic treatment. One of the currently popular material for apexification is mineral trioxide aggregate due to its superior biocompatibility, good sealing ability & excellent marginal adaptability. The presented clinical cases justifies the successful nonsurgical management of traumatized upper anterior teeth with mineral trioxide aggregate (MTA).     

Periapical tissue reactions to calcium hydroxide and MTA after external root resorption as a sequela of delayed tooth replantation

Clinical experience has shown that most avulsed teeth are replanted after a long extra-alveolar time and dry or inadequate wet storage, causing necrosis of periodontal ligament cells. This condition invariably leads to development of external root resorption, leaving the filling material in contact with the periapical connective tissues. In this study, the periapical tissue reactions to calcium hydroxide (CH) and mineral trioxide aggregate (MTA) were evaluated after occurrence of external root resorption as an expected sequela of delayed tooth replantation. Twenty male Wistar rats (Rattus norvegicus, albinus) had their right upper incisor extracted and maintained in dry storage for 60 min. Then, the dental papilla, enamel organ, pulp tissue, and periodontal ligament were removed, and the teeth were immersed in a 2% acidulated phosphate sodium fluoride solution, pH 5.5, for 10 min. The teeth were randomly assigned into two groups (n = 10), in which the canals were filled with either a CH and saline paste (CH group) or MTA (MTA group). The sockets were irrigated with saline, and the teeth were replanted. After 80 days, it was possible to observe large areas of replacement root resorption and some areas of inflammatory root resorption in both groups. More severe inflammatory tissue reaction was observed in contact with calcium hydroxide compared with the mineral trioxide aggregate. New bone formation was more intense at the bottom of the socket in the MTA group. In conclusion, as far as periapical tissue compatibility is concerned, intracanal MTA can be considered as a viable option for root canal filling in delayed tooth replantation, in which external root resorption is an expected sequela.     

Marginal adaptation of mineral trioxide aggregate (MTA) compared with amalgam as a root-end filling material: a low-vacuum (LV) versus high-vacuum (HV) SEM study

AIM: To compare the marginal adaptation of mineral trioxide aggregate (MTA) or amalgam root-end fillings in extracted teeth under low-vacuum (LV) versus high-vacuum (HV) scanning electron microscope (SEM) viewing conditions. METHODOLOGY: Root-end fillings were placed in 20 extracted single-rooted maxillary teeth. Ten root ends were filled with MTA and the other 10 root ends were filled with amalgam. Two 1 mm thick transverse sections of each root-end filling were cut 0.50 mm (top) and 1.50 mm (bottom) from the apex. Gap size was recorded at eight fixed points along the dentine-filling material interface on each section when uncoated wet (LV wet (LVW)) and dry under LV (0.3 Torr) in a JEOL JSM-5800 SEM and backscatter emission (LV dry uncoated (LVDU)). The sections were then air-dried, gold-coated and gap size was recorded once again at the fixed points under HV (10(-6) Torr; HV dry coated (HVDC)). Specimen cracking, and the size and extent of the crack were noted. RESULTS: Gap sizes at fixed points were smallest under LVW and largest under HVDC SEM conditions. Gaps were smallest in MTA root-end fillings. A General Linear Models Analysis, with gap size as the dependent variable, showed significant effects for extent of crack in dentine, material and viewing condition (P = 0.0001). CONCLUSIONS: This study showed that MTA produced a superior marginal adaptation to amalgam, and that LVW conditions showed the lowest gap size. Gap size was influenced by the method of SEM viewing. If only HV SEM viewing conditions are used for MTA and amalgam root-end fillings, a correction factor of 3.5 and 2.2, respectively, may be used to enable relative comparisons of gap size to LVW conditions.     

Mineral trioxide aggregate for obturation of maxillary central incisors with necrotic pulp and open apices

Abstract – There are few reports on treatment of necrotic pulps with mineral trioxide aggregate (MTA) for apexification. Five immature teeth with necrotic pulps were treated with the use of an apical plug of MTA for apexification. All teeth were central incisors that had premature interruption of root development caused by a previous trauma. According to the treatment protocol, the root canals were rinsed with 5% NaOCl; then calcium hydroxide paste was placed in the canals for 1–6 weeks. The apical portion of the canals were filled with MTA. The rest of the canals were obturated with lateral condensation of the gutta‐percha applied with a canal sealer. At 6 months, 1 year and 2 year follow‐up periods the clinical and radiographic appearance of the teeth showed the resolution of the periapical lesions and continued root end development in all except in the one case in which the MTA was extruded out the apex. MTA can be considered a very effective option for apexification with the advantage of reduced treatment time, good sealing ability and high biocompatibility.     

MTA用于根端囊肿根尖倒充填的临床评价

目的:观察根端囊肿术中应用MTA根尖倒充填的临床疗效。方法:临床确诊为根端囊肿病例共30例,病灶牙均为上颌前牙,术前常规根管治疗并超充填牙胶尖,术中刮除囊壁后去除病灶牙根尖3 mm,最后应用MTA根尖倒充填并封闭根尖孔区。结果:30例患牙均取得成功,术后3年无复发,且病灶牙与颌骨均愈合良好。结论:根端囊肿术中应用MTA根尖倒充填取得较好的临床疗效,且操作方便,无不良刺激反应,是一种较理想的治疗方法。