氢氧化钙一次乳磨牙根管治疗的临床分析

随着儿童口腔医学的发展,对乳牙牙髓病及根尖周病的咬合诱导保存治疗,越来越受到人们的关注.本文介绍用氢氧化钙一次乳磨牙根管治疗67个患牙,获得了较好的临床效果,报告如下.临床资料1　一般资料:本组男性20例,女性25例,年龄4～10岁,平均年龄7.8岁,共治疗67个患牙12例为窦道型.第一乳磨牙22个,第二乳磨牙45个.病例选择:乳磨牙牙髓坏死及根尖周病,近期无急性发作,患儿及家长合作.2　治疗方法:2.1　根管制备:　常规去龋备窝洞,去全髓,根管内稍作扩大清理,扩锉时应严格掌握牙根管的操作长度,注意勿穿出根尖孔外,用3%双氧水和生理盐水交替冲洗,…     

253例乳磨牙活髓切断术临床疗效

采用ＦＣ糊剂作为乳磨牙活髓切断术的盖髓剂 ,治疗乳磨牙牙髓炎 ,以维持乳牙至替换期 ,共计 2 5 3个患牙 ,临床追踪观察 0 .5～ 2年 ,效果满意 ,现报告如下。1　临床资料和方法门诊诊断为急、慢性牙髓炎的乳磨牙 ,Ｘ线片示根尖及根分叉区无病变。 4～ 7周岁患者的第一乳磨牙 ;4～ 9周岁患者的第二乳磨牙 ,共 2 5 3个患牙 ,男 137个 ,女 116个。下颌牙 15 9个 ,上颌牙 94个。局麻下开髓 ,去冠髓 ,生理盐水冲洗 ,隔湿 ,ＦＣ棉球髓室内消毒 5ｍｉｎ。用ＦＣ液、丁香油各 1滴与适量氧化锌粉调拌为糊剂 ,覆盖于根管口 ,使之与切髓面密切接触 ,垫…     

穿髓底法治疗乳磨牙根周炎的临床疗效观察

探讨病变主要发生在乳牙根分叉处的根尖周炎的治疗方法。方法 采用人为磨穿髓 根管空管疗法进行治疗。经临床观察和术前术后Ｘ光片对比。结果 消除病变区的炎症快，有效地保存患牙到替换期。结论该法简便易行，是治疗乳牙根尖周炎的有效方法。     

248例乳磨牙改良干髓术与常规干髓术临床疗效观察

２４８例乳磨牙改良干髓术与常规干髓术临床疗效观察厦门市妇幼保健院口腔科徐美玉牙髓病是乳牙常见病，干髓术在乳磨牙治疗中是一种主要治疗手段．但是牙髓部分坏死或根管部分感染的牙齿，干髓术后易引起根尖周炎．据乳磨牙的特点，笔者用改良干髓剂充填牙齿，操作方法简...     

乳磨牙FC冠髓切断术125例临床分析

乳牙活髓切断术是近年治疗儿童牙病较为先进的方法,作者自1994年5月－1998年5月采用FC活髓切断术治疗乳磨牙125颗,并行一年的追踪观察,疗效较为满意。     

乳磨牙戊二醛冠髓切断术远期疗效观察

本文报道了一组临床连续追踪４年的乳磨牙冠髓切断术远期效果病例,共２２人,３８颗牙,其中男性１２人,女性１０人,年龄在第一乳磨牙３～５岁,第二乳磨牙４～６岁。选择病例为乳磨牙深龋近髓。根据术中情况又进一步分为深龋组和牙髓炎组。结果发现１～４年深龋组与牙髓炎组临床有效率无显著差养（ｐ＞０．０５）,牙髓炎组的有效率下降明显。Ｘ线像成功率,在第１年深龋组与牙髓炎组差异极显著（ｐ＜０．０１）,但呈下降趋势。术后第２年,牙根内外吸收开始出现,并逐渐增多。     

乳磨牙慢性牙髓炎伴髓底穿的保存治疗

乳磨牙慢性牙髓炎伴髓底穿的保存治疗湖北省襄樊市口腔医院儿童牙科（４４１００３）董雄生乳磨牙慢性牙髓炎，多由龋齿所致，同时也常常引起乳磨牙髓底病理性穿通，以往传统的观点认为髓底穿通的患牙都应拔除，者对乳磨牙牙根处于稳定期的患牙试作保存治疗，经３个月～２...     

乳磨牙根管治疗失败原因分析

目的探讨乳磨牙根管治疗失败的原因。方法收集2004年1月~2006年6月在广东省口腔医院儿童牙科就诊的乳磨牙根管治疗失败的病例128例,共136颗患牙,分析治疗失败的原因。结果失败患牙中因充填物脱落根管系统暴露再感染53颗(38.97%);遗漏根管52颗(38.24%);根管充填不密合、欠填21颗(15.44%);其它原因10颗(7.35%)。结论因充填物脱落造成髓腔暴露发生再感染和遗漏根管是造成乳磨牙根管治疗失败的主要原因。     

磨牙去髓术的疗效观察

磨牙去髓术的疗效观察吴敏陈志洪李翠琴沈阳市沈阳军区总医院（１１００１５）去髓术是去除全部牙髓的治疗方法，效果肯定，国内外应用广泛。但由于磨牙根较多，管腔细且时有弯曲，去除全部牙髓有一定困难。国内大多将此法用于前牙，用于后牙者报道很少。１９８０年陈志洪...     

氢氧化钙两种不同制剂用于乳牙活髓切断的临床评价

目的 比较两种不同的氢氧化钙制剂用于乳牙活髓切断的临床疗效。方法 选择 5～7岁 28例患儿 62颗诊断为深龋或早期牙髓炎的乳磨牙,随机分成 2组行活髓切断,根髓断面分别覆盖 Calvital（C组）和 Dycal（D组）,定期复查。结果C组临床成功率为83.9％,X线成功率为74.2％。D组临床成功率为90.3％,X线成功率为77.4％。两者在统计学上均无显著性差异。结论 这两种氢氧化钙复合制剂作为乳牙活髓切断的盖髓剂均有较好的疗效。     

部分活髓切断术在年轻恒磨牙龋源性露髓治疗中的应用

目的：应用部分活髓切断术治疗年轻恒磨牙龋源性露髓并评价其临床效果。方法：对35例41颗因龋病引起的年轻恒磨牙露髓的病例采用部分活髓切断术治疗并定期观察。结果：采用部分活髓切断术治疗年轻恒磨牙龋源性露髓成功率为92.68%。结论：对于龋源性露髓的年轻恒磨牙,部分活髓切断术是成功而有效的治疗方法。     

Evaluation of Complete Pulpotomy With Biodentine on Mature Permanent Molars With Signs and Symptoms of Symptomatic Irreversible Pulpitis: 12-months Follow-up

IntroductionComplete pulpotomy is the removal of the coronal portion of a vital pulp and is a means of preserving the vitality of the remaining root portion. The objective of this study was to evaluate the 12-months success rate of complete pulpotomy with Biodentine on mature permanent molars with signs and symptoms of symptomatic irreversible pulpitis.Materials and methodsA total of 68 molars diagnosed with symptomatic irreversible pulpitis in 68 patients aged 20 years and older were included in this study. The exclusion criteria were intraoperative clinical signs of pulp necrosis on the molar to be treated such as no bleeding, or uncontrollable pulp hemorrhage (more than 5 minutes of hemostasis) on at least 1 canal. A complete pulpotomy with Biodentine was performed on molars with symptomatic irreversible pulpitis by the same operator and with the same protocol. A 12-months postoperative follow-up was conducted to evaluate clinical and radiologic success.ResultsA total of 66 patients received complete pulpotomy; 52 could be examined 12 months postoperatively. Clinical and radiologic analysis at 12 months postoperatively revealed a success rate of 87% (45 of 52 molars) and a failure rate of 13% (7 of 52 molars). There was a relationship between age, tooth type, and preoperative periapical condition and treatment success with P < .05.ConclusionCompliance with the indications and protocol for complete pulpotomy with Biodentine on mature permanent molars with symptomatic irreversible pulpitis gives positive results at the 12-month follow-up.     

Long-term Outcomes of Full Pulpotomy in Permanent Molars for Patients Treated in a Single,Short Session under Special Conditions

IntroductionEndodontic procedures for patients requiring treatment in a single, short session need to be validated. This study aimed at evaluating the long-term outcome of full pulpotomy in permanent molars performed with reinforced zinc oxide–eugenol cement (Intermediate Restorative Material [IRM], Dentsply Sirona, Versailles, France) immediately restored using stainless steel crowns under general anesthesia.MethodsThe absence of clinical signs and symptoms and the evolution of the periapical index between the treatment date and the longest follow-up time were used to grade the pulpotomy outcome as “effective,” “uncertain,” or “ineffective.” The impact of different criteria on the pulpotomy outcome was tested (ie, the etiology of the lesion, tooth maturity, endodontic difficulty related to the coronal shape and the root canal shape, and endodontic difficulty related to the radiographic root canal appearance).ResultsAmong the 608 teeth (338 patients) treated in a single session with IRM full pulpotomy and stainless steel preformed crowns, 263 (143 patients) were evaluated after a median follow-up period of 24 months. Overall, 89% of the pulpotomies were effective, 7.6% were of uncertain outcome, and 3.4% were ineffective. No tested criteria influenced the rate of effectiveness.ConclusionsLong-term outcomes of IRM pulpotomy are similar to those of calcium silicate–based cement pulpotomy observed in the literature. This procedure should not be restricted to patients treated under general anesthesia because it is relevant for all special conditions that impose the provision of endodontic treatment in a single, short session, such as dental care emergencies during humanitarian crises or pandemic periods.     

MTA用于龋源性露髓年轻恒牙部分活髓切断治疗的初步研究

目的：应用三氧化矿化聚合物（MTA）对龋源性露髓的年轻恒牙进行部分活髓切断术治疗并评价临床效果。方法：采用MTA作活髓保存剂,对26例29颗因龋露髓的年轻恒磨牙采用部分活髓切断术治疗,随访18个月,评价其疗效。结果：MTA部分活髓切断术治疗龋源性露髓年轻恒磨牙成功率为96.55%,67.85%治疗成功患牙有牙本质桥形成。结论：部分活髓切断术是治疗龋源性露髓年轻恒牙的有效方法,MTA是可供选用的较为理想的活髓保存剂。     

Hall技术治疗乳磨牙龋坏疗效的系统评价

目的: 评价Hall技术用于治疗乳磨牙龋坏的疗效。方法: 计算机检索Cochrane图书馆(Cochrane Library)、PUBMED、荷兰医学文摘数据库(Excerpta Medical Database,Embase)、中国知网(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(China Biology Medicine disc,CBM)、维普数据库(VIP database,VIP)、万方数据库(Wanfang Database),同时对检索结果的参考文献进行检索,检索时间均为建库至2018年3月20日,搜集Hall技术和其他技术对比治疗乳磨牙龋坏的随机对照试验(randomized controlled trials,RCTs)。两位研究者对检索结果进行独立质量评估和数据提取,用RevMan 5.3软件进行分析,并采用GRADEpro 3.6软件对证据质量进行评价。结果: 共纳入6个RCTs涉及Hall技术与其他4种方法的对比。结果显示,Hall技术与传统金属预成冠技术和改良Hall技术(Carisolv去龋+Hall技术)治疗乳磨牙龋坏疗效比较差异无统计学意义(P>0.05);Hall技术与常规充填和非修复方式治疗乳磨牙龋坏疗效比较差异有统计学意义(P<0.05)。定量证据质量评价分级(The Grading of Recommendations Assessment,Development and Evaluation,GRADE)显示,4组Meta分析结局质量为中或低。结论: Hall技术无需局部麻醉、不去龋、不备牙的方法治疗儿童乳磨牙龋坏疗效好,在临床应用中有一定优势,但还需更多高质量RCTs支持。     

STA髓腔麻醉法在乳磨牙牙髓摘除术中的应用

目的:探讨STA髓腔麻醉法在乳磨牙牙髓炎无痛治疗中的可行性.方法:将就诊的3～9岁儿童中,同颌对称同名乳磨牙明确诊断为乳磨牙牙髓炎的患儿22名(4～7岁),共44颗患牙.每个患儿的2颗乳磨牙中,选取1颗采用STA髓腔麻醉,作为第1组(n=22);另1颗采用STA常规麻醉,其中上颌采用颊侧骨膜上浸润麻醉,下颌采用牙周膜(PDL)麻醉作为第2组(n=22).结果:髓腔麻醉注射时患儿的疼痛程度明显低于常规麻醉(P＜0.05);1 min内开髓揭顶时的麻醉效果较高于常规麻醉.髓腔麻醉下治疗结束后均无软组织麻木感及无自伤性溃疡的发生,患儿对髓腔麻醉更易接受.结论:乳磨牙STA髓腔麻醉法镇痛效果优于传统浸润麻醉.     

乳磨牙硫酸铁牙髓切断术临床疗效观察

目的：探讨硫酸铁溶液作为儿童磨牙牙髓切断术药物的可行性。方法：选择3-5岁儿童的第一乳磨牙、4～6岁儿童的第二乳磨牙共45人，80颗乳磨牙深龋近髓的病例，随机分为两组，分别行甲醛甲酚（FC）和硫酸铁溶液牙髓切断，术后6个月及1年复查，分别统计两组成功率，比较两组的疗效差异。结果：FC组和硫酸铁溶液组6月及1年的成功率无显著性差异（P〉0．05）。结论：从临床疗效看硫酸铁溶液是一种较好的牙髓切断药物。     

Primary and Secondary Closure of the Surgical Wound After Removal of Impacted Mandibular Third Molars

Aim  

The present study attempted the evaluation of Primary and secondary closure techniques after removal of impacted third molars in terms of healing, post-operative pain and swelling.