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1.
阎黎 《口腔医学》2004,24(1):36-37
目的 寻求有效的充填根管及修复髓室底穿孔的材料。方法 将需要治疗的 2 88颗患牙随机分为实验组 15 6颗 (其中 18颗见髓室底穿孔 ) ,对照组 132颗。实验组用自固化磷酸钙糊剂充填根管 ,对照组用传统的酚醛糊剂加牙胶尖充填根管。结果 实验组有效率 96 .79% ,对照组 89.39%。经统计学检验 ,两组差异有显著性 (P <0 .0 5 )。髓室底穿孔修复率 83.33%。结论 自固化磷酸钙能有效地控制感染 ,可用于充填感染根管并修复髓室底穿孔  相似文献   

2.
目的 :研究CPC修复髓室底穿孔的临床效果。方法 :将 6 8颗髓室底穿孔患牙随机分为CPC组 (46颗 )和对照组 (2 2颗 ) ,均先行根管治疗 ,然后穿孔处分别采用CPC和氢氧化钙充填修复 ,并作永久性充填 ,所有治疗牙均随访观察 18~ 2 4月。结果 :CPC组成功 43颗 ,失败 3颗 ,其疗效明显优于对照组 (P <0 .0 5 ) ;医源性和龋源性穿孔之间 ,其疗效无显著性差异 (P >0 .0 5 )。结论 :CPC是修复髓室底穿孔较好的一种材料 ,其疗效与穿孔大小有关  相似文献   

3.
无机三氧化复合物修补髓室底和根管穿孔的临床效果   总被引:5,自引:0,他引:5  
目的:评价MTA用于髓室底和根管穿孔修补的临床价值。方法:髓室底穿孔12例,随机分为2组,分别用MTA和IRM(对照组)修补,进行根管治疗,术后3、6、12个月复查,拍平行投照x线片,双盲法评价穿孔处根周组织的变化。用,检验比较2组治疗效果。根管穿孔9例:用MTA修补并完成根管治疗。复查时间和方法同前。纵向观察MTA修补根管穿孔的效果。结果:MTA组和IRM组治疗髓室底穿孔的有效率12个月时分别为80%和75%,两者间无明显差异(P=0.722)。MTA修补根管穿孔的病例治疗均有效。结论:MTA治疗髓室底和根管穿孔时能取得很好的治疗效果,可提高穿孔牙齿预后。  相似文献   

4.
磷酸钙骨水泥修复髓室底穿孔的临床研究   总被引:7,自引:0,他引:7  
目的:研究CPC修复髓室底穿孔的临床效果。方法:将68颗髓室底穿孔患牙随机分为CPC组(46颗)和对照组(22颗),均先行根管治疗,然后穿孔处分别采用CPC和氢氧化钙充填修复,并作永久性充填,所有治疗牙均随访观察18-24月。结果:CPC组成功43颗,失败3颗,其疗效明显优于对照组(P<0.05);医源性和龋源性穿孔之间,其疗效无显著性差异(P>0.05)。结论:CPC是修复髓室底穿孔较好的一种材料,其疗效与穿孔大小有关。  相似文献   

5.
邹彤蔚 《口腔医学》2012,32(5):301-302,320
目的评价三氧化物多聚体(mineral trioxide aggregate,MTA)、磷酸锌水门汀(ZPC)和银汞合金(amalgam)应用于髓室底穿孔修补的临床疗效。方法选取髓底穿孔的患牙50颗,随机分成3组,均做严密的根管治疗,之后分别用MTA、ZPC、银汞合金修补髓空底,3组均定期复查,观察临床效果及X线片结果。结果经过1年后复查,MTA修补髓室底穿孔效果明显高于ZPC和银汞合金(P<0.05)。结论 MTA作为一种新型生物材料,具有良好的封闭性,组织相容性和生物活性,是修补髓室底穿孔良好修复材料,同时提高牙齿保存率,在临床广泛应用。  相似文献   

6.
用MTA修复髓室底较大穿孔的临床观察   总被引:1,自引:0,他引:1  
目的:髓室底较大穿孔在临床上常常导致牙齿丧失.为了保存和恢复受损牙的功能,采用MTA修复髓室底较大穿孔以观察其临床疗效.方法:选取7例临床上髓室底较大穿孔(>2mm)的病例,第一次就诊:清理髓腔和根管,髓腔内和根管内封入氢氧化钙类药物(Vitapex),1周后,常规根管充填,髓室底穿孔处置MTA,厚度约1~4 mm,上置一湿棉球,暂封5~7 d后常规充填窝洞,拍摄术前、术中、术后X线片.术后0.5、1、2年后根据临床症状和X线片观察疗效.结果:7个髓室底较大穿孔的患牙1年后5个获得成功,无临床症状,能正常行使咀嚼功能.X线检查骨破坏面积缩小.2个患牙失败.结论:MTA具有良好的生物相容性,边缘密封好,微渗漏小,可以用于髓室底较大穿孔的修复,但它的远期疗效尚需进一步观察.  相似文献   

7.
氢氧化钙碘仿糊剂修复髓室底穿孔的临床研究   总被引:5,自引:0,他引:5  
目的 观察氢氧化钙碘仿糊剂修复髓室底穿孔的临床疗效。方法 选择髓室底穿孔的患者65例,患牙68颗,随机分为两组,试验组采用氢氧化钙碘仿糊荆修复髓室底穿孔,再用玻璃离子水门汀垫底,对照组直接采用玻璃离子水门汀修复穿孔。一年后复查,观察其治疗效果。结果 试验组成功率(76.19%)明显高于对照组,两组间有显著性差异,并且其疗效与穿孔原因及穿孔直径有密切关系。结论 氢氧化钙碘仿糊剂是一种良好的髓室底穿孔的修复材料。  相似文献   

8.
目的:评价矿物三氧化物凝聚体( MTA)、玻璃离子水门汀和银汞合金在修补髓室底穿孔的临床疗效。方法:将78颗髓室底穿孔的患牙,进行根管治疗后随机分为3组,分别应用MTA、玻璃离子水门汀和银汞合金修补髓室底,1年后复查观察其临床疗效。结果:MTA治疗组成功率92.3%,玻璃离子水门汀治疗组成功率69.2%,银汞合金治疗组成功率53.8%。经统计学处理,MTA组与其余两组之间差异有统计学意义(P<0.05)。 MTA组的成功率高于玻璃离子组和银汞合金组。 MTA组成功率与穿孔原因有关,医源性穿孔治疗成功率高于龋源性穿孔,两者差异有统计学意义(P<0.05)。结论:MTA具有良好的生物活性和组织相容性,临床疗效良好,应用于修补髓室底穿孔可以提高患牙的保留率。  相似文献   

9.
目的 探讨iRoot BP直接修复髓室底穿孔的效果。方法 收集新鲜拔除的人恒磨牙40颗,其中36颗于髓室底中央制备直径2 mm的穿孔洞型,随机分为A、B组,每组18颗,分别用iRoot BP和矿物三氧化聚合体(MTA)修复髓室底穿孔;另外4颗为对照组,只开髓不制备髓室底穿孔。从A、B组中各随机选择3个样本用扫描电子显微镜观察材料和牙本质的结合界面;其余15个样本用葡萄糖氧化酶-蒽酮法检测微渗漏值。结果 A组中,iRoot BP与牙本质结合较为紧密,而B组中MTA和牙本质之间存在不均匀的微小间隙。在观察期内,B组的微渗漏值高于A组,其差异有统计学意义(P<0.05)。结论 iRoot BP修复髓室底穿孔的封闭效果优于MTA。  相似文献   

10.
复方五倍子作为髓室底穿孔屏障材料的微渗漏研究   总被引:1,自引:0,他引:1  
目的:探讨复方五倍子用作髓室底穿孔屏障材料对封闭性的影响.方法:在55个离体牙上制造髓室底穿孔模型后,分别用银汞合金(A组)、复合树脂(R组)、复方五倍子作屏障银汞合金修复(AM组)、复方五倍子作屏障复合树脂修复(RM组)及MTA(MTA组)修复,通过染料渗漏法测定各组渗漏情况.结果:阳性对照组(PC)为完全渗漏,阴性对照组(NC)无染料渗入.所有实验组均有不同程度的渗漏.微渗漏值由大到小依次为:A组、R组、AM组、MTA组、RM组,各组间两两比较,除AM组和R组、AM组和MTA组外,均有统计学差异(P<0.05).AM组和RM组无超填.结论:复方五倍子作为屏障材料来修补髓室底穿孔可以减轻微渗漏,并能有效防止修复材料的超填.  相似文献   

11.
The aim was to evaluate histologically the inflammatory reactions and tissue responses to an experimental tricalcium phosphate cement (TCP) and mineral trioxide aggregate (MTA) when used as repair materials in furcation perforations in dogs. Perforations were performed in 24 mandibular premolars of six anaesthetised dogs and filled either with ProRoot MTA (grey) or TCP. The root canals were subsequently shaped and filled, and the access cavities were closed with a bonded composite resin. The animals were killed at 12 weeks. After radiological examination, the teeth and surrounding structures were processed for light microscopy. Concerning the grades of inflammation, MTA exhibited significantly better results than TCP (chi-square test according to Pearson). No furcation was free of inflammatory cells. Mild inflammation was observed in nine of twelve cases with MTA and only twice in those with TCP. No significant differences were revealed between MTA and TCP in terms of bone reorganization or deposition of fibrous connective tissue (Mantel-Haenszel chi-square test). The grade of radiological examination corresponded with the grade of inflammation or differed by only one grade plus or minus. Perforations located in the furcation of teeth remain an endodontic and a periodontal problem with an uncertain prognosis, in spite of the promising modern materials applied.  相似文献   

12.
The purpose of this study was to evaluate the ability of gray and white ProRoot MTA to seal furcation perforations in mandibular molars using a dye extraction leakage model. Sixty-four mandibular molars were randomly divided into four experimental groups. Six teeth with perforations were used as positive controls and six teeth without perforations were used as negative controls. Perforations in groups 1 and 2 were repaired with white MTA. Groups 3 and 4 were repaired with gray MTA. Dye leakage was tested from an orthograde direction (groups 1 and 3) and a retrograde direction (groups 2 and 4). After dye extraction, absorbance was measured on a spectrophotometer at 550 nm. No statistically significant difference in leakage was found between gray and white MTA when used as a furcation perforation repair material. However, there was significantly more leakage when the perforations were challenged from the orthograde than the retrograde direction (p < 0.001).  相似文献   

13.
Ⅱ°根分叉病变动物模型构建的研究   总被引:12,自引:0,他引:12  
目的 观察杂种狗下颌前磨牙Ⅱ°根分叉病变自然修复过程及其病理状态下牙周组织的修复能力 ,探讨慢性根分叉病变动物模型的制备方法。方法 将 4只杂种狗的下颌双侧第 2、3、4前磨牙颊侧翻瓣后凿出6mm× 6mm× 3mm的牙槽骨缺损 ,对照组直接缝合牙龈 ,实验组于骨缺损区置入牙胶后缝合。分别于术后第 4、6、8、10周进行形态学和组织学观察。结果 对照组 4周就可观察到增大的牙骨质细胞出现在缺损部位的冠方 ,并有新生的类牙骨质形成。 6周时缺损部位冠方出现少量新生的牙槽骨。随着时间的推移 ,牙骨质的量逐渐增多 ,牙槽骨骨小梁变得细密 ,到 10周基本形成正常组织结构。实验组 4周时有炎症细胞浸润、牙周袋形成 ,在 8周时甚至有龈下脓肿形成 ;10周时牙龈仍有炎症、牙周袋 ,并出现骨吸收现象。结论 根分叉病变研究中 ,可以在急性损伤制备根分叉缺损的基础上结合局部因素诱导形成一个近似临床牙周根分叉病变表现的实验模型。  相似文献   

14.
The aim of this study was to compare the histologic response elicited by repairing furcal perforations with mineral trioxide aggregate (MTA) and a new endodontic material in the name of “calcium enriched mixture (CEM) cement” in dogs’ teeth. Thirty-four premolars were randomly divided into four groups: MTA (n = 15), CEM (n = 15), positive, and negative controls (n = 4). Root canal therapy were carried out; perforations were made, and the furcation areas were then repaired with MTA or CEM cement. The animals were sacrificed after 3 months. The teeth and their adjacent structures were processed and stained with hematoxylin and eosin stain for histological evaluation. Chi-square test was used to evaluate hard tissue formation, and Mann–Whitney U test was used for the histological evaluation of inflammation. Specimens in positive controls showed severe inflammatory infiltration, prominent granulation tissue, and epithelial proliferation; negative controls demonstrated normal periodontal ligament without inflammatory reactions. Hard tissue formation was observed in all the specimens of the two experimental groups. In inflammatory evaluation, mild inflammation was detected in the experimental groups, and no statistically significant differences were observed between them. MTA and CEM cement showed similar favorable biological response in furcation perforation repair, especially in inducing the formation of cementum-like hard tissue.  相似文献   

15.
MTA修复犬牙髓室底穿孔的组织学评价   总被引:10,自引:3,他引:10  
目的 用MTA、Dycal、GIC即时修复不同大小髓室底穿孔,从组织学角度评价三种材料对牙周组织的炎症反应和硬组织形成的影响。方法 选择3条成年杂种犬的42颗后牙,用随机法先将一侧牙分为小穿孔组,另一侧牙分为大穿孔组;每侧再分为三个亚组,分别用MTA、Dycal、GIC修复。4个月后处死动物,标本经处理,光学显微镜下观察材料下方牙周组织的炎症细胞及其程度、上皮增生以及硬组织形成情况。结果 MTA组的14例中5例无炎症反应,其余9例仅有轻度至中度的炎症反应,4例有牙骨质形成,周围可见成牙骨质细胞;Dycal组材料下方均引起牙周组织中度或重度的炎症反应,2例小穿孔处有不规则的钙化物沉积,同时伴有大量炎症细胞,上皮增生多见(6/14);GIC组除1例大穿孔标本有少量散在的炎症细胞及纤维组织包绕,其余标本均可见中度或重度的炎症反应,有的伴有上皮增生(4/14)。上皮增生与穿孔大小有一定关系。结论 MTA用于即时修复犬牙髓室底穿孔,能诱导硬组织形成,对组织的刺激小,效果优于GIC和Dycal。  相似文献   

16.
This study evaluated in vitro the effect of using the operating microscope on repairing furcation perforations using Vitrebond or mineral trioxide aggregate. Forty-six human molar teeth were mounted into a jig attached to a simulated jaw. The teeth were allocated randomly to four groups (n = 10). Furcal perforations were made in the teeth using an ISO 012 round bur in a slow-speed hand-piece. Each material was used to repair a group of teeth with and without the use of the operating microscope. The remaining six teeth provided positive and negative controls. All groups were stored in 100% humidity, and the repair materials were allowed to set for 72 h at room temperature before being assessed for the quality of placement under x26 magnification. Leakage at the repair was then tested using India ink; the teeth were demineralized, dehydrated in alcohol, and rendered transparent in methyl salicylate. Dye penetration into the furcation repair was evaluated at x26 magnification. There was no difference in the acceptability of the repair with either material whether or not the operating microscope was used. The perforations repaired with mineral trioxide aggregate leaked significantly less to the tracer dye than those repaired with Vitrebond (p < 0.001).  相似文献   

17.

Objective

The objective of this work was to evaluate, using radiographic images, the behavior of four materials used to repair root perforations in dogs'' teeth.

Material and Methods

Second and third premolars of 6 dogs were used. The 48 teeth were randomly divided into 4 groups (n=12) and the perforations were sealed with one of the following materials: MTA, AH Plus, Vitremer and gutta-percha. Dogs were submitted to general anesthesia, teeth were radiographed and pulp was accessed. Perforations were done, at the maximum curve of the pulp floor, sealed and the accessed coronal cavity was filled with glass ionomer cement (Vidrion R). After 90 days, the dogs were sacrificed and the last x-ray image was taken. Images were analyzed for the presence/absence of periodontal lesions at the perforation region. Data were analyzed statistically by chi-square test at 5% significance level.

Results

There were no statistically significant differences (p≥0.05) among AH Plus, Vitremer and gutta-percha groups. MTA produced the smallest number of periodontal lesions (p<0.05).

Conclusions

It may be concluded that none of the tested materials was able to preserve the integrity of the periodontal tissues in the furcation region, and the use of MTA resulted in the least formation of adjacent periodontal bone lesions revealed by the radiographic comparisons.  相似文献   

18.

Introduction

This histologic study aimed to measure the morphometric and morphologic changes in periodontal tissue after immediate and delayed mineral trioxide aggregate (MTA) repair of 2 sizes of furcal perforations.

Methods

There were 72 premolars from 12 beagle dogs that were divided equally into 4 experimental and 2 control groups (n = 12). Experimental groups included immediate small (0.6 mm in diameter), immediate large (1.8 mm in diameter), delayed (30 days) small, and delayed large furcal perforation MTA repair. The control groups included negative (no furcal perforation) and positive (nonrepaired small and large furcal perforations) controls. After 3 months, tissue blocks were harvested and processed for histologic assessment. Morphometric analysis measured the thickness of periodontal ligaments (average, maximum, and minimum) in millimeters, the area of interest in square millimeters, and the area of healing tissue at the perforation site in square millimeters. Morphologic assessment consisted of 7 parameters for tissue inflammation, resorption, and repair. Histologic assessment was completed by 2 calibrated examiners who were blinded to the study group.

Results

Morphometric and morphologic measurements showed no significant difference between immediate and delayed MTA repair of small perforations and the negative control. The average thickness of the periodontal ligaments in delayed large perforations was 0.467 mm, which was significantly different from 0.294 mm in the delayed small perforations repair. The area of healing tissue in the positive control was 0.473 mm2, which was significantly different from 0.311 mm2 in delayed large perforation repair.

Conclusions

Within the study limitations, periodontal tissue responded more favorably to MTA repair of furcal perforation when it was placed in smaller perforations. The time of treatment became more critical as the perforation size increased.  相似文献   

19.
The present study was performed to find out whether implants placed around periodontally involved teeth during reconstructive surgery would support replaced flaps and prolong gingival coverage of the treated root surfaces facilitating new attachment. Through-and-through furcation defects were made in the mandibular second, third, and fourth premolars of 10 beagle dogs. Bone was surgically removed from the furcation and from the circumference of each tooth to a level 3 to 4 mm apical to the cementoenamel junction. Steel wires were passed through the furcations and ligated to enhance plaque formation. At 6 weeks, the wires were removed. At 12 weeks, during reconstructive surgery, 4 dogs received implants of autogenous intraoral cancellous bone, 2 of autogenous iliac cancellous bone and marrow, 2 of Proplast, and 2 of Avitene. The results demonstrated that none of 12 teeth implanted with Avitene or Proplast showed new attachment. Only 2 of 6 teeth implanted with autogenous iliac bone showed new attachment, combined with extensive root resorption and ankylosis. Of 12 teeth implanted with autogenous intraoral bone, 6 showed new attachment. Our findings suggest that flap support by intraoral cancellous bone implants may facilitate new attachment. A more predictable technique, however, needs to be developed.  相似文献   

20.

Aim

The objective of this in vitro was to assess the sealing ability of MTA, Geristore®, and amalgam with and without Bioglass as a matrix used to repair furcation perforations in mandibular molars by using dye penetration.

Materials and methods

One hundred mandibular molars were randomly divided into six experimental groups. Five teeth with perforation were used as positive control while five teeth without perforation were used as negative control group. Furcal perforations were made in the teeth. Perforations were repaired with amalgam in group 1, amalgam and Bioglass in group 2, MTA in group 3, MTA and Bioglass in group 4, Geristore® in group 5, and Geristore® and Bioglass in group 6. All repairing materials were allowed to set for 72 h. Leakage at the repaired sites was then evaluated using dye penetration and clearing technique under stereomicroscope.

Results

The perforations repaired with MTA and Geristore® leaked significantly less than amalgam (p = 0.000). Bioglass reduced sealing ability of MTA and Geristore® significantly (p = 0.000, p = 0.019), while reduced the sealing ability of amalgam insignificantly (p = 0.78).

Conclusion

MTA and Geristore® have shown acceptable sealing ability in furcal perforation in comparison to amalgam while Bioglass as a matrix beneath them has reduced their sealing ability.  相似文献   

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