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。     

METAPEX糊剂防治根管治疗期间疼痛的临床评价

目的:评价采用METAPEX(氢氧化钙碘仿)糊剂根管封药预防根管治疗期间急症疼痛的临床效果。方法:218例根管治疗分为METAPEX氢氧化钙碘仿糊剂封药实验组(109例)和使用甲醛甲酚(FC)根管消毒的对照组(109例),评价其疗效。结果:METAPEX糊剂根管治疗期间疼痛的发生率4.59%,明显低于对照组16.51%。结论:METAPEX糊剂能有效预防根管治疗期间疼痛的发生。     

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。     

地塞米松-氢氧化钙糊剂用于根管封药的临床研究

目的 观察地塞米松-氢氧化钙糊剂应用于根管封药的临床疗效。方法 选择240例根尖周炎病例，随机分观察组(地塞米松-氢氧化钙糊剂组)对照组(甲醛甲酚组)各120例，观察封药一周后的临床疗效。结果 两组效果有显著差异，地塞米松-氢氧化钙糊剂根管封药显效率(90．8％)优于甲醛甲酚根管封药(66．7％)。结论 地塞米松-氢氧化钙糊剂应用于根管封药能有效预防和降低根管治疗期间疼痛和水肿的发生。     

氢氧化钙预防根管治疗期间急症的临床应用

目的通过对比氢氧化钙与甲醛甲酚(FC)根管封药后对诊间痛的控制及影响情况,评价氢氧化钙作为根管消毒剂的临床效果。方法收集慢性根尖周炎病例200例,随机分入实验组和对照组。实验组使用氢氧化钙糊剂封药,对照组使用FC封药。根管充填时评价约诊间急症情况。结果实验组与对照组的IAE(根管治疗期间急症)发生率无显著差异。实验组的症状指数小于对照组(P<0.05)。结论氢氧化钙比甲醛甲酚能更有效降低根管治疗期间疼痛和肿胀的程度。     

根管治疗期间急症的防治

目的:探讨根管治疗期间急症的防治.方法:将患牙髓炎、牙髓坏死、根尖周炎,需接受根管治疗的348例(348颗患牙)随机分成4组,分别在根管内封甲醛甲酚(FC)、奥硝唑、氢氧化钙、地塞米松-氢氧化钙,观察其根管治疗期间急性疼痛发作率.结果:奥硝唑与氢氧化钙组比较,差异无显著性(P>0.05).地塞米松-氢氧化钙组与奥硝唑组、氢氧化钙组比较,各组之间有显著差异(P<0.05),地塞米松-氢氧化钙糊剂同FC组比较具有非常显著差异(P<0.01).结论:根管内封地塞米松-氢氧化钙能较好预防和降低EIAE的发生率,并能减轻疼痛程度.     

碘仿氢氧化钙糊剂防治根管治疗期间急症临床研究

目的 :观察碘仿氢氧化钙糊剂 (ICH)用于根管封药后对死髓牙根管治疗期间急症发生的影响及防治效果。方法 :将 2 0 7例 2 3 6个死髓牙根管预备后随机分为二组 ,每组各 118个牙 ,实验组用ICH封药 ,对照组用甲醛甲酚 (FC)封药 ,观察临床效果。结果 :实验组Ⅱ -Ⅲ级疼痛发生 12个牙 ,发生率 10 .17% ,对照组发生 40个牙 ,发生率 3 3 .90 %。结论 :ICH作为防治根管治疗期间急症的根管封药具有较理想的药理作用。     

根管治疗期间急症23例

目的：探讨根管治疗期间急症的产生原因和治疗方法。方法：对23例31个发生根管治疗期间急症的患牙,进行封入常用的根管消毒剂及地塞米松糊剂,对临床治疗效果进行观察和分析。结果：活髓牙、根尖无阴影的死髓牙较易发生根管治疗期间急症;地塞米松注射液＋抗菌素糊剂根管内封药是治疗顽固性根管治疗期间急症的有效方法。结论：顽固性根管治疗期间急症的病因可能与酚类根管消毒药物引起的变态反应有关。     

氢氧化钙预防根管治疗期间急症的临床观察

目的 观察氢氧化钙根管内封药对预防根管治疗期间急症的临床疗效。方法 使用氢氧化钙及传统根管内消毒药物樟脑对氯酚、甲醛甲酚根管内封药，观察疼痛指数并比较其根管治疗期间急症的发生率。结果 氢氧化钙封药后根管治疗期间急症的发生率最低，与传统药物相比，其差异有统计学意义。结论 氢氧化钙根管内封药。对预防根管治疗期间的急症有较好的作用。     

Vitapex糊剂根管封药对老年糖尿病患者根管治疗期间疼痛的影响

目的：观察比较Vitapex糊剂根管封药和传统的根管消毒剂甲醛甲酚封药对老年糖尿病患者根管治疗期间疼痛的影响。方法：选择154例老年人慢性根尖周炎伴糖尿病患者,随机分为两组,常规根管预备后,实验组根管内封入Vitapex糊剂,对照组用甲醛甲酚髓腔封药,一周后观察比较两组患牙根管封药期间疼痛的发生率。结果：实验组的疼痛发生率明显低于对照组,有显著性差异（P〈0．05）。结论：Vitapex糊剂根管封药能有效减少老年糖尿病患者根管治疗期间疼痛的发生率。     

Er、Cr:YSGG激光根管内照射对根管封闭效果的影响

目的:探讨常规根管预备后使用不同能量的Er、Cr:YSGG激光进行根管内照射对根充后根管封闭效果的影响。方法:选择新拔除的单根管牙105颗,分成7组,每组15颗牙。切除牙冠后,常规进行根管预备。第1组不进行任何处理,作为阳性对照组;第2组为1W、有水激光照射;第3组为1W、无水激光照射;第4组为2W、有水激光照射;第5组为2W、无水激光照射;第6组为3W、有水激光照射;第7组为3W、无水激光照射。根充后进行根尖微渗漏检测,评估根管封闭效果。采用单因素方差分析(Anova)进行多组间总体均数比较,q检验进行组间比较。结果:除3W无水组外,其他各激光组与对照组相比,根尖微渗漏深度均有显著性差异(P<0.05);其中1W无水组与对照组相比具有高度显著性差异(P<0.01)。结论:较低能量(除外3W、无水)Er、Cr:YSGG激光进行根管内照射,能够有效提高根管充填后的封闭效果,其中1W、无水激光照射时根管封闭效果最好。     

Nd:YAG激光照射根管后的形态学观察

目的：了解感染根管管壁牙本质的病变特点，根管预备及Nd：YAG激光照射对感染根管的作用。方法：选用单根患牙60颗，随机分为5组：对照组（治疗前感染根管）、根管预备组（用手用器械根管预备）、3个激光组（在常规根管预备后，采用3种不同能量参数照射1min），做扫描电镜观察。结果：对照组：感染根管牙本质小管形态不规则，排列紊乱。根管预备组：能去除病变的牙本质层，形成玷污层。50mj 10Hz激光组不能封闭牙本质小管。100mj 10Hz、150mj 10Hz激光照射1min根管壁呈熔融状态，去除了玷污层，牙本质小管封闭和半封闭。结论：激光剂量在100mj 10Hz或在此以上时，能有效清洁根管壁玷污层和封闭牙本质小管。     

不同预备方法对根管治疗诊间急症和充填效果的影响

目的： 比较不同根管预备方法对根管治疗诊间急症(interappointment emergencies,IAE)发生率和根管充填效果的影响。方法： 2018年8月—2021年8月因牙髓炎或根尖周炎需要做根管治疗的恒磨牙96颗,随机分为2组（n=48）颗,MT组使用 Mtwo机用镍钛锉改良 Mtwo根管预备法,同步组使用改良 Mtwo预备技术加同步根管长度测量根管预备法。根管预备完成后拍摄根尖片,根管内封入氢氧化钙,复诊时行常规热牙胶根管充填。采用 SPSS 22.0 软件包分析IAE的发生情况及术后充填效果。结果： 术后即刻及术后第3 天、1周,2组IAE发生率无显著差异（P>0.05）;术后第1、2 天,同步组IAE发生率显著低于MT组（P<0.05）,同步组根管充填的合格率显著高于MT组（P<0.05）。结论： 同步法能减少根管预备过程中根尖区的机械刺激,严格控制根管的工作长度,维持根尖区屏障,从而降低IAE发生率并有效提高根管充填合格率。     

Improving the seal of amalgam cores with cemented dowels: a comparative in vitro radioactive tracer study

Amalgam cores with cemented dowels are commonly used to restore endodontically treated teeth. These restorations were widely studied for their mechanical properties; however, less is known about their sealing ability. The effect of the cement type used for the dowel and that of a bonding agent application were studied in a radioactive tracer coronal leakage study. The sealing ability of posts and cores was also compared with that of 5 mm remaining root canal fillings. Composite luting cement provided a better seal than zinc phosphate cement. The seal provided by 5 mm root canal fillings was poorer than that provided by posts and cores. High variability in seal quality was found among all types of posts and cores studied. This may indicate that the seal provided by cemented dowels with amalgam cores is unpredictable. Because neither the remaining root canal filling nor the post and core may be trusted alone for a seal, each should be performed with the greatest care and both covered with a crown as soon as possible.     

根管治疗术后冠渗漏的实验研究

目的:为临床上采用不同的根管充填材料提供理论依据。方法:分别用Vitapex(V组)、Cor tisomol(C组)和Sealiteultra(S组)作根管封闭剂进行根管充填,通过葡萄糖微渗漏试验检测冠渗漏情况,比较其封闭性能。结果:采用Sealiteultra做根管封闭剂时根管充填出现的冠渗漏时间较其他两组晚,微渗漏的量也明显低于其他两组。结论:Sealiteultra根管封闭性能较好,值得推荐;如果用Cortisomol和Vitapex作根管封闭剂进行根管充填,建议尽快进行窝洞或人工冠修复。     

The effect of immediate vs. delayed post space preparation on the apical seal of a root canal filling: a study in an increased-sensitivity pressure-driven system

A 5 mm remaining length of root canal filling, after post space preparation, is commonly assumed to maintain sealing ability similar to that of the intact filling. Post spaces were prepared either immediately using hot pluggers, or later, using drills. The sealing ability of the fillings, 5 mm remaining length, were compared with each other and with an intact root canal filling control, using radioactive tracer in a pressure-driven system. When no pressure was applied, no differences could be detected between either of the groups and the control. When a pressure of 120 mm Hg was applied to the same teeth, the control group clearly maintained a better seal than each of the experimental groups, which did not significantly differ from each other. These results suggest that (a) the pressure-driven system was more sensitive than the passive leakage assay that failed to detect differences even at 14 days; (b) a remaining root canal filling of 5 mm was inferior to the intact root canal filling; and (c) the immediate post space preparation with hot pluggers did not differ from a delayed preparation with drills.     

Correlation between remaining length of root canal fillings after immediate post space preparation and coronal leakage

The seal provided by root canal fillings after post space preparation was studied using a pressure-driven radioactive tracer assay. The coronal part of root canal fillings was immediately removed, using a hot plugger, to a remaining length of either 3, 5, 7, or 9 mm. Intact root canal fillings of 14 mm served as control. Application of air pressure of 130 mm Hg to the tracer solution drove it through the fillings and into phosphate-buffered saline surrounding the apex. Leakage gradually increased for 28 days, and differences in the leakage through 3 to 9 mm fillings were demonstrated. In a passive system by which an additional group of teeth were tested none of these differences could be detected. It was concluded that: (a) root canal fillings of 3, 5, and 7 mm have an inferior seal, compared with that of an intact filling; (b) the sealing is proportional to the length of the remaining filling; and (c) a passive system is unable to detect these differences, even when conducted for as long as 28 days.     

Does cold burnishing gutta-percha create a better apical seal?

This study investigated the seal created by cold burnishing the gutta-percha exposed after apical root resection of endodontically treated teeth. Sixty single-rooted extracted human teeth with a single straight canal were divided into four experimental groups of 15 teeth each. In two of the experimental groups the canals were instrumented and obturated well with laterally condensed gutta-percha and sealer. The remaining two groups were instrumented and poorly obturated with laterally condensed gutta-percha and sealer. The apical 2 mm of all the teeth were then resected and the effect of cold burnishing the exposed gutta-percha was investigated using a linear dye penetration technique. Under the condition of this study, cold burnishing gutta-percha after apical root resection of a well-obturated root canal resulted in a poorer apical seal than if no burnishing were performed. Cold burnishing the exposed gutta-percha after apical root resection of poorly obturated root canals improved the apical seal as compared with nonburnished poorly obturated canals.     

Dye leakage and SEM study of roots obturated with Thermafill and dentin bonding agent

Abstract— The apical seal of roots obturated with a dentin bonding agent and Thermafill with and without the use of sodium hypo-chlorite as an irrigating solution was compared by a dye leakage test. Roots obturated with Thermafill and a zinc oxide eugenol sealer were used as controls. Thirty-eight roots were prepared chemomech-anically and divided into three experimental groups. The teeth of group 1 were filled with Thermafill and the dentin bonding agent using sodium hypochlorite as the irrigant. The teeth of group 2 were filled in the same way, but saline solution was used as the irrigant. Before the root canal was filled the smear layer was removed from the root canal walls of both groups by rinsing the root canal with a 17% EDTA solution. The teeth of group 3 were filled with Thermafill and a zinc oxide eugenol sealer. The teeth were immersed in 2% methylene blue solution. The root fillings of groups 1 and 2 leaked significantly more than those of group 3. The resin-dentin-guttaper-cha interface of group 1 was observed by scanning electron microscopy and showed a typical hybrid layer. An intimate contact between resin and dentin was present in group 2, but a resin-dentin inter-diffusion zone was only occasionally observed. The use of dental adhesives and the hybrid layer formation did not improve the seal of Thermafill root canal Wings.     

Dye leakage and SEM study of roots obturated with Thermafill and dentin bonding agent.

The apical seal of roots obturated with a dentin bonding agent and Thermafill with and without the use of sodium hypochlorite as an irrigating solution was compared by a dye leakage test. Roots obturated with Thermafill and a zinc oxide eugenol sealer were used as controls. Thirty-eight roots were prepared chemomechanically and divided into three experimental groups. The teeth of group 1 were filled with Thermafill and the dentin bonding agent using sodium hypochlorite as the irrigant. The teeth of group 2 were filled in the same way, but saline solution was used as the irrigant. Before the root canal was filled the smear layer was removed from the root canal walls of both groups by rinsing the root canal with a 17% EDTA solution. The teeth of group 3 were filled with Thermafill and a zinc oxide eugenol sealer. The teeth were immersed in 2% methylene blue solution. The root fillings of groups 1 and 2 leaked significantly more than those of group 3. The resin-dentin-guttapercha interface of group 1 was observed by scanning electron microscopy and showed a typical hybrid layer. An intimate contact between resin and dentin was present in group 2, but a resin-dentin interdiffusion zone was only occasionally observed. The use of dental adhesives and the hybrid layer formation did not improve the seal of Thermafill root canal fillings.