甲硝唑-地塞米松糊剂预防根管治疗术期间急症的临床研究

目的探讨在急性牙髓炎患牙中,根管内封入甲硝唑-地塞米松糊剂对根管治疗期间急症发生的影响。方法162个急性牙髓炎患牙随机分为两组,实验组经根管预备用甲硝唑-地塞米松糊剂封药,对照组经根管预备用FC封药。用flare-upindex(FUI)定量的方法评价两种药物对根管治疗期间急症的影响,并根据急症引起的疼痛程度不同评价两种药物的临床疗效。结果甲硝唑-地塞米松组急症发生率为3.7%,显著低于对照组23.45%(P<0.01)。甲硝唑-地塞米松组急症的FUI均值为3.00,显著低于对照组5.47(P<0.05)。结论甲硝唑-地塞米松糊剂用于急性牙髓炎根管内封药能有效降低根管治疗间期急症的发生和疼痛程度。     

3种根充材料在一次法根管治疗中临床疗效观察

目的:比较三种根管充填材料一次法根充的临床疗效。方法:5 0 2个需根管治疗的患牙随机分为3组;分别采用Cortisomol糊剂加牙胶尖、Vitapex糊剂加牙胶尖、氧化锌糊剂加牙胶尖充填根管。观察术后1周内疼痛发生情况及1年后的疗效。结果:Cortisomol组和Vitapex组疼痛发生率较氧化锌组低,有显著性差异(P <0 .0 5 ) ;术后一年复查,Cortisomol组和Vitapex组总疗效好于氧化锌组,但无显著性差异(P >0 .0 5 )。根尖有暗影患牙的疗效Vitapex组好于Cortisomol组和氧化锌组,有显著性差异(P <0 .0 5 )。结论:Cortisomol糊剂和Vitapex糊剂充填根管可以有效减少一次性根管充填术后急症的发生,对根尖有暗影患牙的治疗Vitapex糊剂更有效。     

Vitapex糊剂在根管充填的应用观察

目的　观察Vitapex糊剂在根管治疗术后急性反应情况和治疗效果。方法　将患牙分为两组进行根管治疗 ,试验组用Vitapex糊剂加牙胶尖充填根管 ,对照组用氧化锌丁香油糊剂加牙胶尖充填根管 ,统计 16 0颗患牙根管治疗术后急性反应的发生率和治疗效果。结果　术后急性反应的发生率试验组为 3.75 % ,对照组为 13.75 % ,2组比较差异有显著性 (P <0 .0 1) ;术后追踪观察 2年成功率 ,试验组为 93.75 % ,对照组为 88.75 % ,2组比较差异无显著性 (P >0 .0 5 )。结论　用Vitapex糊剂充填根管术后急性反应少 ,疗效与氧化锌丁香油糊剂加牙胶尖充填根管相似。     

不同材料根管充填后近期疼痛发生情况分析

目的比较活髓牙经不同材料根管充填后的疼痛发生情况。方法288颗需要进行根管治疗的活髓牙分为4组,2组分别采用Cortisomol糊剂+牙胶尖和Vitapex糊剂+牙胶尖一次性根管充填;2组经引流24～48h后,分别用Cortisomol糊剂+牙胶尖和Vitapex+牙胶尖根管充填;观察术后1周内的疼痛发生情况。结果所有患牙中,根充后可自愈性疼痛的发生率为22.6%,非自愈性疼痛的发生率为2.08%;一次性根充组中,Cortisomol糊剂组较Vitapex糊剂组的可自愈性疼痛发生率低,有显著性差异(P<0.01);引流后根充组中,Cortisomol糊剂组较Vitapex糊剂组的可自愈性疼痛发生率低,但无显著性差异(P>0.05);各组间非自愈性疼痛的发生率均无显著性差异(P>0.05);大多数患牙根充后的疼痛发生在72h之内。结论Cortisomol糊剂+牙胶尖根管充填可以减少根充后疼痛的发生。     

不同根充材料在根管治疗术一次法中的临床疗效观察

目的比较四种根管充填材料一次法根充的临床疗效。方法752个需根管治疗的患牙随机分为4组：分别采用AHPlus糊剂加牙胶尖。Cortisomol糊剂加牙胶尖，Vitapex糊剂加牙胶尖，氧化锌糊剂加牙胶尖充填根管．观察术后1周内疼痛发生情况及1年后的疗效。结果各组在根管充填后7d出现急性后应的例数和反应发生率比较，AHplus组充填后急症发生率有显著性差异（P〈0．05），Cortisonol组，Vitapex组与氧化锌组组间充填后急症发生率有显在根管充填后7d出现急性后应的例数和反应发生率比较，AHplus组充填后急症发生率有显著性差异（P〈0．05），Cortisonol组，Vitapex组与氧化锌组组间充填后急症发生率有显著性差异fP〈0．05），氧化锌组术后疼痛发生率高于其它组，且差异显著（P〈0．05）：术后一后复查，AHPlus组总有效率最高，且与其它组有显著性差异（P〈0．05），Cortisonl组和Vitapex组总有效率相差不大，但高于氧化锌组，且有显著性差异（P〈0．05）。结论能有效减少一次性根管充填术后急症发生的根充材料由高到低的是：AHplus糊剂，Cortisomo糊剂，Vitapex糊剂和氧化锌糊剂。     

地塞米松-氢氧化钙糊剂根管内封药的临床观察

目的：观察地塞米松-氢氧化钙糊剂用于根管封药的临床疗效以及对根管治疗期间急症的预防效果。方法：分别用甲醛甲酚（FC）、氢氧化钙糊剂和地塞米松-氢氧化钙糊剂对患急、慢性根尖周炎、牙髓坏死等需接受根管治疗的206例273个患牙进行根管内封药，观察其近期疗效和治疗期间急性疼痛发作率。结果：FC、氢氧化钙及地塞米松-氢氧化钙糊剂根管内封药疗效呈递增趋势，其根管治疗期间急症发生率呈递减趋势，各组之间在统计学上有显著差异（P〈0．05）。结论：氢氧化钙糊剂、地塞米松-氢氧化钙糊剂根管内封药均可提高疗效和减少根管治疗期间急症的发生，地塞米松-氢氧化钙糊剂效果更佳。     

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目的分析Vitapex糊剂和抗生素糊剂用于乳牙根尖周病根管消毒的临床疗效。方法选择2004—2007年来济宁口腔医院儿童牙病科就诊的96例乳牙根尖周炎患儿的108颗患牙,随机分为Va组(充填Vitapex糊剂,口服抗生素3d)、Vb组(单纯充填Vitapex糊剂)和抗生素糊剂组(单纯充填抗生素糊剂),于封药后2周复诊,评价其临床疗效。结果 Va组患牙痊愈率为96.3%,Vb组患牙痊愈率为88.0%,抗生素糊剂组患牙痊愈率为92.9%,三组患牙痊愈率比较,差异均无统计学意义(P>0.05)。结论 Vitapex糊剂和抗生素糊剂用于根管内封药均能取得较好的根管消毒效果。     

Cortisomol与Vitapex糊剂用于根尖周炎根充治疗的临床疗效比较

目的 比较Cortisomol糊剂和Vitapex糊剂充填根管治疗根尖周炎的术后反应及临床疗效,以帮助临床医师进行根充材料的选择。方法 选择205例215颗根尖周炎患牙,随机分为实验组(Cortisomol组)110颗牙和对照组(Vitapex组)105颗牙。常规根管预备后,分别采用Cortisomol糊剂、Vitapex糊剂加牙胶尖充填根管。观察术后1周内急症反应及2年的疗效。结果 二者1周内急症反应较轻,两组差异无显著性(P>0.05),术后2年复查,实验组成功率为93.6%,对照组成功率为84.8%,实验组疗效明显高于对照组,两组差异有显著性(P<0.05)。结论 Cortisomol糊剂疗效优于Vitapex糊剂,是目前根管治疗中较为理想的一种永久性根管充填材料。     

Vitapex根管充填材料的短期疗效观察

目的 :比较氧化锌丁香油糊剂加牙胶尖、Vitapex糊剂加牙胶尖两种根管充填材料的短期疗效。方法 :131例门诊就诊患者的 16 1个患牙随机分为 2组 ,其中 82个牙用氧化锌丁香油糊剂加牙胶尖进行根管充填 ,79个牙用Vitapex糊剂加牙胶尖进行根管充填 ,术后 3、6个月随访观察。结果 :术后 3个月复查 ,发现氧化锌丁香油糊剂加牙胶尖组和Vitapex糊剂加牙胶尖组的有效率分别为 80 .3%和 93.1% ,有显著统计学差异(P <0 .0 5 )。术后 6个月复查 ,发现氧化锌丁香油糊剂加牙胶尖组和Vitapex糊剂加牙胶尖组的有效率分别为82 %和 95 % ,也有显著统计学差异 (P <0 .0 5 )。结论 :Vitapex根管充填糊剂是一种短期疗效较好的根管充填材料     

Vitapex糊剂治疗根尖周炎疗效观察

目的探讨Vitapex糊剂治疗慢性根尖周炎疗效与氧化锌丁香性糊剂疗效观察。方法将255例根尖患牙随机分成2组。Vitapex实验组135例。根管内注入Vitapex糊剂后加牙胶尖致密充填;常规治疗组氧化锌丁香油糊剂 牙胶尖致密充填。结果治疗总有效率实验组91.85%,对照组82.5%。两组疗效有显著差异(P<0.05)。结论Vitapex糊剂在治疗慢性根尖周炎患牙疗效优于氧化锌丁香油糊剂     

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。     

比塔派克斯糊剂治疗感染根管的临床观察

目的：观察比塔派克斯（Vitapex）糊剂在感染根管治疗中疗效。方法：选择患慢性根周炎的恒牙159个,随机分为3组,分别充填Vitapex糊剂、氧化锌丁香油糊剂及氧化锌丁香油加碘仿糊剂,观察其临床近期疗效。结果：Vitapex糊剂充填组术后反应明显轻于其它两组（P＜0.005）,超充糊剂3个月复查时吸收率高于其它两组（P＜0.01）,而一年愈合率3组间无明显差别（P＞0.05）。结论：Vitapex糊剂应用于感染根管的充填近期疗效优于氧化锌丁香油糊剂,而一年复查效果无明显差别。     

Assessment of leakage in the restored pulp chamber of endodontically treated multirooted teeth

The leakage associated with restorative materials placed within the pulp chamber of maxillary and mandibular molars was studied in vitro. The root canals and pulp chambers of 69 extracted teeth were prepared chemomechanically and sealed with gutta-percha and Tubliseal using cold lateral condensation. The teeth were divided into five groups. Gutta-percha was removed from the pulp chambers of three of the groups of 15 teeth and filled with one of three materials, a glass ionomer cement, a cermet cement or an amalgam. The gutta-percha was removed from the pulp chamber in the fourth group of nine teeth, which were left unfilled. The gutta-percha in the pulp chambers of the fifth group of teeth was left intact. The teeth were suspended in Indian ink, thermocycled for 24 hours and stored for a further 48 hours at 37 degrees C. They were then demineralized and cleared and the degree of coronal leakage was assessed. Those teeth with no filling in the pulp chamber showed extensive leakage. The gutta-percha-filled group demonstrated greater leakage than did the groups in which other restorative materials had been employed (P less than 0.01). No significant differences in leakage occurred between the other groups (P less than 0.05). It is recommended that the pulp chamber of molars should be restored with a filling material following root canal treatment.     

应用Hero642镍钛系统对老年人磨牙根管治疗期间急症发生的影响

目的：探讨Hero642旋转镍钛系统对老年人磨牙根管预备术后，根管冶疗期间急症（EIAE）发生的影响。方法：临眯选取老年人磨牙138颗，随机分为2组，分别采用Hero642旋转镍钛器械（蛮验组）和手动不锈钢K锉（对照组）进行根箭预备，比较向组根管预备后，患牙EIAE发生的情况。结果：Hero642旋转镍钛器械组在老年人磨牙根管预备后EIAE发生率为16．46％，对照组为37．29%，2组间差异有显著性（P〈0．01）。结论：应用Hero642旋转镍钛器械颅告老年八磨牙根管，能够显著降低EIAE的发生。     

医师操作水平对根管预备疗效的影响

目的：观察医师操作水平对根管预备疗效的影响.方法：选择164颗患牙,其中活髓牙66颗,感染根管牙98颗,随机分为2组,分别由2位不同年资的医师用ProTaper机用镍钛锉行根管预备,采用SAS6.2软件包进行统计学处理,x2检验比较2组患牙的器械折断率、根管治疗期间痛（EIP）发生率及根管充填成功率,分析医师操作水平对根管预备疗效的影响.结果：2组磨牙间的根管预备器械折断率有显著性差异（P＜0.05）;2组EIP发生率有高度显著性差异（P＜0.01）;在低年资医师组中,活髓牙和感染根管牙间有显著性差异（P＜0.05）;2组根管充填成功率有显著性差异（P＜0.05）,尤其是在感染根管磨牙组.结论：熟练、精确的操作能提高根管预备的疗效.     

Vitapex治疗成年患者根尖孔闭合不全并发慢性根尖周炎的疗效观察

目的：观察Vitapex对成年患者根尖孔闭合不全并发慢性根尖周炎患牙的临床疗效.方法：选择成年患者根尖孔发育不全并发慢性根尖周炎患牙36例,完成根管预备、消毒后,用氢氧化钙类糊剂Vitapex行根尖诱导术.经随访1～3a,在确认根尖有硬组织形成时,行注射式热牙胶根管充填,术后定期复查.结果：根尖发育完成者7例,占19.4%;根尖处有钙化桥形成者27例,占75%;失败2例,占5.6%.总有效率为94.4%,平均治疗周期为13.0周.结论：Vitapex对成年患者根尖孔发育不全并发慢性根尖周炎的患牙具有良好的临床疗效,值得临床推广应用.     

5种根管充填糊剂的根管封闭能力的比较

目的：比较5种根管充填糊剂的根管封闭能力。方法：选择75个直根管的恒牙,经开髓拔髓,Mtwo镍钛根管器械预备后反复冲洗后随机分为5组,分别采用实验组1：氧化锌丁香油糊剂,实验组2：Endomethasone根管充填糊剂,实验组3：Cortisomol根管充填糊剂,实验组4：Vitapex糊剂,实验组5：AH-plus糊剂,加牙胶尖严密充填。将所有离体牙置于37℃,100%湿度的恒温箱3d后选用透明牙染色法测量微渗漏深度。结果：实验组1：（2.35±0.768）mm,实验组2：（1.78±0.548）mm,实验组3：（1.54±0.322）mm,实验组4：（3.22±0.452）mm,实验组5：（0.98±0.536）mm。各组微渗漏深度值差异有显著性（P〈0.05）。其中实验组4的微渗漏值显著高于其他各组（P〈0.05）,实验组5的微渗漏值显著低于其他各组（P〈0.05）,实验组2的微渗漏值稍高于实验组3,结果无显著差异。结论：在Mtwo镍钛器械预备下,AH-Plus糊剂充填根管可有效的减少根管微渗漏的发生,但长远疗效有待进一步的观察。     

Evaluation of the apical seal in root canals prepared with a new rotary system and obturated with a methacrylate based endodontic sealer: an in vitro study

The purpose of this study was to evaluate in vitro the apical seal of root canals prepared with a new rotary system, Anatomic Endodontic Technology (AET) and filled with a methacrylate based endodontic sealer and a single gutta-percha cone and a lateral condensation technique, using the methacrylate based endodontic sealer/filler or Grossman's cement. The root canals of 45 freshly extracted human maxillary anterior teeth were prepared and then randomly assigned to three groups of 15 teeth each. After cleaning and shaping the teeth were obturated as follows: in group 1 the canals were filled with a methacrylate based sealer and a single gutta-percha cone; in group 2 the canals were filled using a lateral condensation technique with gutta-percha and the methacrylate based sealer; and in group 3, the canals were filled by means of lateral condensation of gutta-percha and Grossman's cement (control group). The specimens were stored in 100% relative humidity at 37 degrees C for 72 h, after which the coronal portion and the root surface of each tooth was covered with three layers of nail varnish and a final layer of sticky wax. After immersion in 2% methylene blue dye for 7 days, the specimens were imbedded in clear orthodontic resin and sectioned. Dye penetration was evaluated by an independent investigator using a stereo microscope. The results demonstrated that more pronounced leakage occurred in root canals obturated with the lateral condensation technique and Grossman's cement (p < 0.05). The least amount of dye leakage was observed for group 1 and 2 in which the methacrylate based sealer was used, either with a single gutta-percha cone or with lateral condensation of gutta-percha.     

ASSOCIATION OF CALCIUM HYDROXIDE AND METRONIDAZOLE IN THE TREATMENT OF DOG'S TEETH WITH CHRONIC PERIAPICAL LESION

One of the primary objectives of endodontic treatment of teeth with pulp necrosis is the elimination of microorganisms from the root canal system, as effectively as possible, especially in cases with chronic periapical lesions. AIM: The purpose of this study was to analyze the response of the periapical tissue of dogs'' teeth with chronic periapical lesions to endodontic treatment performed with utilization of metronidazole, calcium hydroxide, and an association of both as root canal dressings. METHODOLOGY: Forty root canals were submitted to pulpectomy and the root canals were kept exposed to the oral environment for 6 months. Then, they were submitted to biomechanical preparation and divided into 4 study groups with 10 specimens: group I – no root canal dressing; group II – calcium hydroxide; group III – metronidazole; group IV – calcium hydroxide associated to metronidazole. After 15 days, the root canals were filled with Fill Canal sealer. After 90 days, the animals were killed and the especimens processed for histological analysis. RESULTS: Calcium hydroxide dressing provided a significantly better outcome compared to other experimental groups (α = 0.01). Also, the results of the association of metronidazole and calcium hydroxide were similar to those observed for the metronidazole group. The worst results were obtained by the no root canal dressing group. CONCLUSION: The use of metronidazole alone or associated with Calcium hydroxide, did not improve periapical healing when compared to Calcium hydroxide dressing.     

Differences in the confluence of mesial canals in mandibular molar teeth with three or four root canals

Aim  To investigate the correlation between number of root canals and their confluence in mandibular molar teeth.
Methodology  A total of 553 first and 383 second mandibular molars were root filled between the beginning of 1997 and the end of 2006. Access cavities were prepared and the pulp chamber floors were carefully inspected with an endodontic explorer under magnification of 4×. After negotiating the root canal system, the 'straightest' canal of each root was instrumented. A gutta-percha cone was placed in the canal and a small file (08 or 10) was inserted to working length and then removed in all other canals. The gutta-percha cone was removed and inspected for notches indicating the presence of confluences. If it was not possible to probe completely one or more canals, the canal confluences were classified as 'not determined' (ND) if there was no sign of confluence; if a notch was present canals were considered confluent. For each tooth, the number of root canals and the presence of confluences were recorded. To test whether there was a difference in frequency of confluences between teeth with three and four root canals the chi-squared analysis with Yates' continuity correction was performed.
Results  The frequency of a confluence in mesial canals of first molars was 56% in teeth with three root canals and 34% in teeth with four canals. In second molars, it was 67 and 41%, respectively. Differences in the frequency of confluences in teeth with three and four root canals were statistically significant both in first and in second molars.
Conclusions  A greater incidence of confluent canals occurred in teeth with three rather than with four root canals both in first and second mandibular molars.