金栀含漱液冲洗消毒根管的临床疗效观察

目的：评价金栀含漱液冲洗消毒根管的临床疗效。方法：选择需作根管治疗术患牙240个，随机分为两组，试验组和对照组各120个。试验组采用金栀2倍稀释液冲洗根管，浓缩液作为根管消毒药物。对照组采用15g／L氯亚明液冲洗根管，氢氧化钙药捻消毒根管。分别对患牙根管治疗的临床疗效、疗程及根管预备封药前后临床症状的变化进行评价。结果：金栀含漱液组与氢氧化钙组冲洗消毒根管的临床疗效无统计学差异。结论：金栀含漱液用于根管冲洗消毒有良好的临床疗效。     

根管治疗中应用空管药物消毒根管的临床效果观察

目的 :用空管药物消毒根管 ,观察其对根管的消毒效果。方法 :随机选择患急慢性根尖周炎、牙髓坏死需接受根管治疗的 3 6例患者共 3 6颗患牙为受试对象 ,随机分成实验组 18人 18颗患牙和对照组 18人 18颗患牙 ,2组均行 2次法完成根管治疗术 ,实验组于根管口暂封空管药物 ,对照组暂封甲醛甲酚合剂(formaldehydecresylol,FC) ,分别在封药前后采集细菌标本进行细菌培养鉴定。 结果 :从根管内采集并培养细菌 ,封药前 ,2组患牙根管内细菌检出率均为 10 0 % ,均包含需氧菌和厌氧菌 ;封药 1周 ,2组患牙中各有 1颗患牙检出细菌 ,其余患牙根管内未检测到细菌。结论 :根管口暂封空管药物可以有效杀灭根管系统的细菌 ,达到根管消毒的目的。     

碘复用于感染根管冲洗消毒的细菌学观察

目的：观察碘复冲洗消毒感染根管的抗菌效果。方法：共收集３５例感染根管标本,实验组２０例用０．５ｇ／Ｌ碘复冲洗根管然后封５ｇ／Ｌ碘复原液,对照组１５例用过氧化氢液和生理盐水冲洗根管,封ＦＣ于根管,分别在用药前后进行细菌标本采样、培养、分离与鉴定,观察ＣＦＵ变化及细菌检出情况。结果：使用０．５ｇ／Ｌ碘复冲洗根管的抗菌作用明显优于临床用Ｈ２Ｏ２和生理盐水联合冲洗的效果;用５ｇ／Ｌ碘复封药消毒根管的杀菌作用与ＦＣ相当。结论：碘复对感染根管内厌氧菌有良好的抗菌效果。     

Metapex糊剂用于感染根管消毒的临床疗效评价

目的:评价Metapex糊剂用于感染根管消毒的临床效果.方法:选择牙髓坏死或慢性根尖周炎的患牙218颗,随机分为两组,常规根管预备后,实验组在根管内封入Metapex糊剂、对照组根管内封入甲醛甲酚(FC)棉捻.1周后复诊,观察封药前后临床症状和体征的变化并完成根管充填;随访5~6个月,再观察根充后的临床疗效.结果:实验组根管内封药1周后的临床有效率为92.66%,对照组的86.24%,但差异无显著性;实验组封药后急症的发生率为4.59%,明显低于对照组的16.51%(P<0.01).随访观察5~6个月,实验组根管治疗后的临床有效率为89.72%,对照组为86.79%,两组间差异无显著性.结论:Metapex糊剂用于感染根管消毒不仅临床疗效肯定,而且与FC相比,也能有效减少根管封药期间急症的发生,是一种较理想的根管消毒剂.     

髓腔封药对根管预备后疼痛的影响

目的 :探讨根管预备后疼痛发生的原因和预防方法。方法 :临床 1 5 6例根管预备病例 ,随机分为实验组和对照组 ,实验组先行髓腔封FC 1周后再行根管预备 ,对照组直接根管预备 ,观察术后疼痛反应。结果 :预备前封药组与对照组疼痛发生率有统计学的显著性差异 ,其中感染根管有显著性差异 ,非感染根管无显著差异。结论 :根管预备前封药有助于减低感染根管预备后疼痛的发生。     

氢氧化钙及氯己定联合用于根管消毒的临床疗效观察

目的评价氯己定凝胶(CHX)、氢氧化钙糊剂(CH)和氢氧化钙联合氯己定(CHX+CH)作为根管消毒药物在根管治疗中的临床疗效。方法选取慢性根尖周炎患牙60颗,采用常规机械预备冲洗,随机数字表法均分为三组选择CHX、CH和CHX+CH进行根管内封药,分别在根管预备前,预备后及封药7 d后进行根管内细菌标本的采样,培养,测定需氧菌和厌氧菌细菌数量的变化,观察患牙封药7 d前后的临床疗效并进行评分,记录患牙达到可以充填的平均封药时间。结果三组患牙封药7 d后,每组患牙根管内的需氧菌和厌氧菌数量(取对数值)均较封药前明显降低(P<0.05);根管内需氧菌和厌氧菌的细菌数量差异有统计学意义(P<0.05);每组患牙封药前后临床评分的差异均有统计学意义(P<0.05);三组临床评分差值的差异有统计学意义(P<0.05)。三组患牙达到根管充填要求的封药时间差异有统计学意义(P<0.5)。结论 CHX、CH和CHX+CH作为根管消毒药物对慢性根尖周炎均有较好的疗效,CHX凝胶联合CH糊剂综合评估抑菌效果及临床疗效最佳。     

四种浓度次氯酸钠根管消毒效果的评价

目的 探讨4种浓度次氯酸钠对感染根管的消毒作用.方法 将100例慢性根尖周炎患者随机分为5组,分别使用0.25%、0.50%、1.00%、2.00%的次氯酸钠和生理盐水作为根管冲洗剂,根管预备前后,分离、培养根管内厌氧菌,观察并记录细菌形态及菌落数.结果 4种浓度次氯酸钠对感染根管均有消毒作用,生理盐水的根管消毒作用差.结论 在橡皮障未能普及的情况下,作为根管冲洗剂的次氯酸钠合适浓度为1.00%.     

Metapex糊剂根管封药方法的临床探讨

目的评价Metapex糊剂2种封药方法用于磨牙感染根管治疗的临床效果。方法慢性根尖周炎或牙髓坏死的下颌第一磨牙患者68例68颗患牙按就诊顺序随机分为2组。首诊时开髓、清洗,髓腔封Metapex糊剂;再诊时根管预备后封药。试验组选择小于根管预备完成锉锥度和号数的牙胶尖,将Metapex糊剂重复导入并蘸糊剂插入根管内封药;对照组注入式填充Metapex糊剂封药。观察2种方法封药的根管消毒效果。结果封Metapex糊剂1周后,试验组有效率为85．3％,对照组为79．4％,2组无重度疼痛发生。2组的临床疗效、疼痛发生率、疼痛和不适及持续时间差异无统计学意义。结论根管预备后牙胶尖蘸Metapex糊剂封药方法,使用方便,消毒效果可靠,具有临床可行性。     

氢氧化钙碘仿糊剂根管消毒治疗有窦型慢性根尖周脓肿的临床观察

目的:观察氢氧化钙碘仿糊剂运用于有窦型慢性根尖周脓肿根管内封药消毒的临床效果。方法:选择在同一牙列上有二颗磨牙均患有窦型慢性根尖周脓肿的病例50例,共100颗患牙。将同一病例的二颗患牙分别设为实验组和对照组,同时进行根管治疗。实验组(50颗牙)采用氢氧化钙碘仿糊剂根管内封药消毒,对照组(50颗牙)采用氢氧化钙糊剂根管内封药消毒,对两组根管消毒效果进行临床观察和比较。结果:实验组74%(37/50)封药1次后即可行根管充填术,对照组52%(26/50)封药1次后可行根管充填术,两组间封药1次的根管充填率存在显著性差异(P<0.05)。实验组平均封药次数为1.30次,对照组平均封药次数为1.56次。结论:用氢氧化钙碘仿糊剂根管内封药消毒能够减少有窦型慢性根尖周脓肿根管封药消毒的次数,有利于窦道的尽快愈合。     

几种根管冲洗液组合对粪肠球菌感染根管体外抗菌研究

目的：比较本实验室研制的根管润滑剂与不同浓度次氯酸钠组合用于粪肠球菌感染根管预备冲洗的抗菌效果。方法：将145颗单根管人离体牙消毒,随机选取5颗置于无菌培养基中培养作为阴性对照,其余140颗接种粪肠球菌4周,按照不同的冲洗组合随机分为14组,使用ProTaper器械按照冠根向深入法进行机械预备,分别在预备冲洗前、预备冲洗中和预备冲洗后进行细菌取样培养计数,并进行统计学分析。结果：与双氧水联合生理盐水组以及蒸馏水对照组相比,各处理组在冲洗过程中与冲洗结束后,均不同程度的降低了根管中的细菌的数量,其中含5.25%次氯酸钠的四种组合处理后菌数减少最为明显,较其它各组差异显著。结论：本实验室研制的根管润滑剂与5.25%次氯酸钠组合抗菌效果最佳,与G lyde凝胶配合次氯酸钠组没有显著差异。     

Bacteriologic status of the root canal after sonic, ultrasonic and hand instrumentation

Abstract The purpose of this study was to assess the bacteriologic status of the root canal after sonic, ultrasonic and hand instrumentation. Root canal infection was induced in 50 single-rooted teeth in young dogs by removing the pulp and filling the canals with dental plaque. After 7 clays the root canals were instrumented under aseptic conditions with conventional hand instruments, a sonic vibratory device or an ultrasonic device. Sterile saline or 2.5% sodium hypochlorite was used as irrigating solution. Following instrumentation a sterile paper point was sealed into the root canals. After 7 d the root canals were reopened under aseptic conditions and the paper points were incubated for the demonstration of bacteria, using pre-reduced thioglycolate culture medium and anaerobic chambers. The results obtained with the different instrumentation techniques and irrigating solutions were compared by means of the Chi-square test. The results indicated that the sonic and ultrasonic devices were not more effective in the elimination of bacteria from the root canal than conventional hand instrumentation. Irrigation with sodium hypochlorite appeared to be more effective than saline in producing bacteria-free root canals; however, this difference was not statistically significant. Thus, it appeared that more than one appointment and the supporting action of an antibacterial medicament between appointments would be necessary to achieve bacteria-free root canals in infected teeth in a predictable manner.     

三种冲洗液用于超声根管预备抗菌效果的对比研究

目的 探讨生理盐水、次氯酸钠、口泰与超声波联合应用杀灭感染根管内厌氧菌的效果。方法 将60例慢性根尖周炎患者共60颗患牙随机分为3组，每组各20颗患牙，三组均用超声法进行根管预备并分别以生理盐水、次氯酸钠、口泰作为超声冲洗液，根管预备前后分别取样进行厌氧培养。结果 次氯酸钠组和口泰组其厌氧菌减少程度均明显大于生理盐水组（P〈0．01）；次氯酸钠组和口泰组之间其厌氧菌减少程度无显著性差异（P〉0．05）。结论 口泰与超声波联合应用可有效杀灭感染根管内厌氧菌，其抗菌效果与次氯酸纳相近似，是一种较理想的根管超声冲洗液。     

二种氢氧化钙制剂消毒根管的临床疗效评价

目的 评价HY-CALTMMT氢氧化钙糊剂消毒根管的临床疗效.方法 选择76颗需做根管治疗的患牙随机分为两组,实验组使用HY-CALTMMT氢氧化钙糊剂进行根管内消毒,对照组使用Reoko氢氧化钙药尖消毒根管,分别对患牙根管封药后的临床疗效评价并比较.结果 两组根管消毒剂的临床疗效无统计学差异.结论 HY-CALTMMT氢氧化钙糊剂作为根管消毒剂疗效良好,能有效地起到杀菌效果,并且操作简便.     

中药制剂用于超声根管预备的初步研究

目的评价中药制剂洁尔阴与超声波联合应用杀灭感染根管内厌氧菌的效果。方法将临床诊断为慢性根尖周炎的60例患者的60颗患牙随机分为3组（每组20颗牙）,第1组为传统手持器械对照组,第2组为超声生理盐水对照组,第3组为超声洁尔阴实验组。根管清理前后分别取样进行厌氧培养。结果传统手持器械组与超声生理盐水组之间差异有显著性（P<0.05）;超声洁尔阴组与超声生理盐水组之间差异有极显著性（P<0.01）。结论超声波在根管杀菌方面有独特的优势,中药洁尔阴可有效地杀灭感染根管内的厌氧菌,是符合生物学原则、较理想的超声根管冲洗液。     

The antimicrobial effect of iodine-potassium iodide after cleaning and shaping procedures in mesial root canals of mandibular molars

The aim of this study was to evaluate the antibacterial activity of 2% iodine potassium iodide (IKI) used as a final rinse after the cleaning and shaping procedures in mesial root canals of mandibular molars infected with Enterococcus faecalis. Seventy two mandibular first molars were used. The root canals were infected with Enterococcus faecalisfor 30 days. After the infection procedures, the root canals were cleaned and shaped by using the Pro Taper rotary system and manual files. The teeth were randomly assigned to four experimental groups (N = 18). In group 1, the root canals were irrigated with sterile distilled water (control). In group 2, the root canals were irrigated with 1% Sodium hypochlorite (NaOCl) during instrumentation. In group 3, root canals were irrigated with 1% NaOCl during instrumentation and a five minute final irrigation using 2% IKI. In group 4, the root canals were irrigated with 1% NaOCl during instrumentation and a 15 minutes final irrigation with 2% IKI. Bacteria colony-forming units (CFU) from root canals were semi-quantified and the presence of negative cultures among the groups was compared using Fisher's test (p < 0.05). The order of effectiveness was: 1% NaOCI plus 2% IKl for 15 minutes (95%), 1% NaOCl plus 2% IKl for 5 minutes (44%), 1% NaOCl (17%) and sterile distilled water (0%). Fisher's exact test showed a significant difference among the groups (p < 0.05). It was concluded that under in vitro conditions, IKI was able to eliminate the Enterococcus faecalis from infected dentin significantly in a 15-minute time frame after the cleaning and shaping procedures.     

不同根管冲洗方式对粪肠球菌生物膜清除效果评价

目的 比较不同根管冲洗方式对粪肠球菌感染根管预备、冲洗的清除效果,评价不同根管冲洗液残余药量的抗菌效果,为临床上选择根管冲洗方法提供参考。方法 将32颗离体牙（前磨牙、单根管）消毒,接种粪肠球菌60 d,随机分为4组（第1组：生理盐水;第2组：生理盐水+超声1 min;第3组：1%NaOCl;第4组：1%NaOCl+超声1 min）,使用ProTaper器械按照冠向下法进行根管预备,并在预备冲洗前及预备至F2进行冲洗后分别取样、计数,进行统计学分析。将预备好的离体牙再次消毒,随机分为2组,分别浸泡生理盐水和1%NaOCl;浸泡30 min后取出,置于接种粪肠球菌标准菌株（ATCC33186）的培养液内,分别在培养2、6、24、48 h时取样、计数。采用SPSS19.0软件包对数据进行统计学分析。结果 4组在预备至F2冲洗结束后,根管中的细菌数量均不同程度降低,其中,使用1% NaOCl结合超声冲洗1 min,几乎可完全去除根管内的细菌。经1% NaOCl浸泡的牙根样本内的细菌,在培养48 h时后总量少于生理盐水。结论 1%NaOCl是有效的根管冲洗液,用于根管化学预备后的残余液体,也可发挥有效的抗菌效果。联合使用超声器械,可以使其抗菌效果最大化。     

ELIMINATION OF INTRACANAL INFECTION IN DOGS' TEETH WITH INDUCED PERIAPICAL LESIONS AFTER ROTARY INSTRUMENTATION: INFLUENCE OF DIFFERENT CALCIUM HYDROXIDE PASTES

The aim of this study was to evaluate the antiseptic efficacy of rotary instrumentation associated with calcium hydroxide-based pastes prepared with different vehicles and antiseptics. Chronic periapical lesions were experimentally induced in 72 premolar root canals of four dogs. Under controlled asepsis, after initial microbiological sampling (A1), the root canals were instrumented using the ProFile system in conjunction with 5.25% sodium hypochlorite and the intracanal medication was placed. Four experimental groups were formed according to the pastes used: group 1- Calen (n=18), group 2- Calen+CPMC (n=20), group 3- Ca(OH)₂ p.a.+ anaesthetic solution (n=16) and group 4- Ca(OH)₂ p.a.+ 2% chlorhexidine digluconate (n=18). After 21 days, the pastes were removed; the canals were emptied and 96 hours later a second microbiological sample was obtained (A2). The incidence of positive microbiological cultures and the number of cfus in stages A1 and A2 were compared statistically by the Wilcoxon test while the influence of the different treatments in intracanal infection was evaluated by Kruskal-Wallis test at 5% significance level (p<0.05). Large numbers of strict and facultative anaerobes, and viridans group streptococci were found in 100% of root canals of A1 samples. Among A2 samples, all treatments showed significant reduction of cfus and positive cultures (p<0.05), but only groups 3 and 4 showed 100% of root canals free of microorganisms. Rotary instrumentation plus NaOCl 5.25% associated with intracanal medication produced a drastic reduction or elimination of intracanal microbiota, whose performance was not influenced by the nature of the vehicle or the antiseptic added to the Ca(OH)₂ p.a.     

不锈钢K锉预备弯曲根管时根管不良形态形成的实验研究

目的:探讨弯曲根管预备时根管不良形态形成的特点与规律。方法:使用手用不锈钢K锉,按逐步后退法预备8个弯曲人工根管,根管预备过程中对根管及根尖孔进行微距摄影,用图像分析软件Image-ProPlus对根管的形态与位置变化进行测量、分析;实验数据采用SPSS10.0统计软件包进行统计学分析,选用配对t检验比较组间差异。结果:根管预备完毕,根管弯曲角度均值从预备前的36.21°(Schneider法)逐渐减小至21.98°,弯曲半径均值从6.28mm增大至11.35mm;根管长轴发生了偏移,与预备前原根管长轴形成2个交点,3个相交区。根管的连续锥度被破坏,并出现一系列预备缺陷。结论:弯曲根管预备时,根管器械在弯曲应力与切削力的共同作用下发生动态的根管偏移,是导致一系列根管不良形态的根本原因。