2种根充糊剂一次性根充治疗慢性根尖周炎的疗效比较

目的 观察Cortisomol糊剂和Vitapex糊剂用于磨牙慢性根尖周炎的一次性根管治疗术后的反应及远期疗效。方法 选择慢性根尖周炎需做根管治疗的磨牙107颗,随机分成A、B二组,分别以Cortisomol糊剂和Vitapex糊剂加牙胶尖进行根充,并对二组术后1～7d、1年的临床疗效进行比较分析。结果 治疗后1～7dA组术后反应率较B组要低(P<0.05),远期疗效两组无明显差异(P>0.05)。结论 Cortisomol糊剂用于一次性根管治疗术后反应较少,且疗效可靠。     

乳牙根尖周炎根管治疗术常用药物的研究进展

乳牙根尖周炎是儿童口腔科常见疾病之一，根管治疗术是其首选治疗方法，而根管充填材料的质量是治疗预后的重要因素。近年来出现大量根管充填新材料，为乳牙根尖周炎治疗提供了更丰富的选择，本文就目前临床乳牙根管充填的常用材料作一综述。     

2种糊剂对慢性根尖炎患牙侧副根管封闭性的效果比较

目的:观察2 种根管充填糊剂充填慢性根尖炎侧副根管的治疗效果.方法:选择术后X 线片显示有侧副根管的慢性根尖炎病例54 例, 随机分为AH-plus 组和赛普敦组,每组27 例.开髓、揭顶、去除牙本质肩领,应用逐步后退法进行根管预备,氢氧化钙糊剂根管封药消毒,分别选用AH-plus 糊剂和赛普敦(SEPTODONT)美松根管充填糊剂, 热牙胶连续波垂直加压充填技术进行根管充填.比较根尖1/3侧副根管充填率、治疗一年后根管治疗成功率和感染控制率.结果:AH-plus 组根尖1/3 侧副根管充填率为62.96%,根管治疗成功率为88.89%,感染控制率为96.30%,分别高于赛普敦组的37.04%、66.67% 和74.07%,差异有统计学意义(P<0.05).结论:AH-plus 糊剂较赛普敦美松糊剂对侧副根管充填的疗效好.     

超声冲洗联合镍钛器械一次性根管治疗慢性根尖周炎的临床疗效评价

目的 对超声冲洗与镍钛机动器械联合应用于慢性根尖周炎一次性根管治疗的临床疗效进行评价。方法 对77例患者81颗牙按就诊顺序随机分为实验组和对照组。2组均采用镍钛根管预备后,实验组:43颗患牙进行超声根管冲洗,一次法完成根管充填治疗。对照组:38颗患牙进行注射器冲洗,一次法完成根管充填治疗。冲洗液均为0.9%生理盐水。观察根管充填1周后的术后疼痛反应及1年后的根管充填疗效。结果 1周后复诊2组术后疼痛反应有显著性差异(P<0.05)。术后1年复诊,2组疗效无明显差异(P>0.05)。结论 超声冲洗与镍钛器械联合应用,对于治疗慢性根尖周炎一次法完成根管充填,可减少患者复诊次数,缩短疗程,同时提高根管充填质量,值得临床推广使用。     

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目的 观察联合应用不同根管充填糊剂治疗慢性根尖周炎的临床疗效.方法 选取2007-2009年山东大学口腔医学院综合科门诊诊治的慢性根尖周炎患者298例(422颗牙),按患者就诊先后顺序随机分为4组.A组(AH Plus糊剂+Vitapex糊剂+牙胶尖)75例患者108颗牙,B组(AH Plus糊剂+牙胶尖)75例患者105颗牙,C组(Vitapex糊剂+牙胶尖)74例患者105颗牙,D组[氧化锌丁香油糊剂(ZOE)糊剂+牙胶尖]74例患者104颗牙.对4组术后7 d、6个月、1年的临床疗效进行比较、分析.结果 298例患者根管充填7 d后复查,A、C组术后反应轻,与B组比较,差异具有统计学差异(P＜0.05);D组术后反应最重,与其他3组比较,差异均有统计学意义(均P＜0.05).根管充填6个月、1年后复查的结果没有差异(P＞0.05),A组有效率最高,与其他3组比较,差异有统计学意义(P＜0.05);D组有效率最低,与其他3组比较,差异有统计学意义(P＜0.05).结论 AH Plus糊剂+Vitapex糊剂+牙胶尖治疗慢性根尖周炎,既诱导了根尖周阴影区的骨质增生修复,又能使根尖孔形成完善的封闭,达到治愈根尖周炎、防止继发感染或复发的目的 .     

根管消毒药物缓解乳磨牙根尖周炎临床症状的疗效分析

目的：对比四种临床常用的根管消毒药物缓解乳磨牙根尖周炎临床症状的效果。方法 选择根尖周炎乳磨牙160颗,随机分为四组,每组40颗,根管预备超声荡洗后,A组封入抗生素糊剂,B组封入Vitapex糊剂,C组封入氢氧化钙糊剂,D组封入樟脑酚棉球,10 d后复诊,对四种根管消毒药物缓解乳牙根尖周炎临床症状的效果进行评价。结果 在10d后脓肿消除方面抗生素糊剂组效果优于其他三组（P=0.005）,Vitapex组与氢氧化钙组效果,均优于樟脑酚组（P＜0.05）。术后24h内疼痛的发生率抗生素糊剂组术后24 h内疼痛发生率低于Vitapex组（P=0.014）和氢氧化钙组（P=0.045）。10 d后疼痛的比例各组之间无统计学差异。结论 抗生素糊剂能够有效缓解乳牙根尖周炎的临床症状。     

Vitapex和碘仿氧化锌丁香油糊剂治疗乳牙尖周炎的疗效对比观察

目的:比较V itapex和碘仿氧化锌丁香油糊剂对乳牙尖周炎的疗效。方法:在心理疏导争取患儿配合的前提下,行常规根管治疗术,采用两种不同的根管糊剂根充,进行疗效对比分析。结果:注射式V itapex根充糊剂与碘仿氧化锌丁香油根充糊剂远期治疗效果有显著差异;乳磨牙的治疗效果差异更为显著。结论:注射式V itapex根充糊剂优于碘仿氧化锌丁香油根充糊剂,更适合作为临床常规乳牙根管充填剂。     

窦道型根尖周炎根管治疗术一次法临床观察

目的：观察窦道型根尖周炎根管治疗术一次法的临床疗效。方法：用钙维他(Calvital)糊剂对窦道型根尖周炎进行根管治疗术一次法治疗，治疗后2—3周和6个月后随访，通过临床和X线检查评价其疗效。结果：经根管治疗术一次法治疗的298例窦道型根尖周炎，265例2d后牙齿功能恢复正常，2—3周窦道消失，6个月后X线片检查可见到根尖周稀疏区消失。23例失败牙经再次治疗后治愈。12例失败将患牙拔除(两个以上窦道，牙齿松动Ⅲ度)。成功率达88．33％。结论：窦道型根尖周炎经根管治疗术一次法临床观察，不受年龄限制，疗效满意。     

前牙髓腔完全钙化的临床研究

目的：探讨完全钙化根管行根管治疗术的可行性。方法：对26例完全钙化前牙根管行根管治疗术，进行术前术后X线片对比研究。结果：24例顺利完成根管治疗术，2例因根管口完全钙化行根尖手术。结论：完全钙化的前牙根管X线片上显示为根管闭锁，临床上可通过寻找根管口，逐步扩大根管完成根管治疗术，以避免根尖手术或牙拔除术。     

Toxicity of root canal sealers on rat bone cells in primary culture

Abstract The cytotoxic effects on cultured rat bone cells of newly-developed root canal sealers and commercially available sealers were compared. Various root canal sealers were applied to cultured bone cells obtained from rat calvaria by the enzyme digestion method. Measurement of [3H]-thymidine incorporation, alkaline phosphatase activity, and calcium release were performed after 24 and 48 h. No significant difference was found in cellular DNA synthesis and alkaline phosphatase activity between cells exposed to New B-l, New B-5 and controls after exposure for 24 and 48 h. Cells in contact with Tubliseal, Diaket and AH-26 demonstrated a significant difference from controls in DNA synthesis and alkaline phosphatase activity. Calcium release at 24 h was significantly different in the cells treated with New B-1 and New B-5 than in controls. No appreciable difference was found, however, between New B-6, Sealapex and controls. At 48 h, cells treated with New B-l, New B-5 and New B-6 showed differed significantly difference from controls, but the cells exposed to Sealapex did not. The newly-developed root canal sealers had lower toxicity in vitro than five types of commercially available root canal sealers.     

Reaction of inflamed periapical tissue to intracanal medicaments and root canal sealers

Abstract The effects of different intracanal medicaments and zinc oxide-eugenol based root canal sealers on an experimentally induced apical periodontitis were studied histologically in mesial roots of lower molars of Wistar rats. After root canal instrumentation each canal was filled either with an intracanal medicament twice for 3 days each time or with a sealer for 21 days. The intracanal medicament chlorophenol caused periapical tissue damage. P-chloroxylenol-camphor lead to periapical improvement as did 5% sodium-hypochlorite. 12% sodium-hypochlorite gave tissue damage. After intracanal medication with an aqueous suspension of calcium hydroxide periapical repair was clearly visible. A combination of a corticoid and an antibiotic appeared to induce damage of the periapical tissues. The root canal sealers Endomethasone and N2 essentially impaired periapical repair. The results were acceptable for Aptal-Zink-Harz root canal fillings after 21 days as well as after 56 days.     

三种根管糊剂一次法根管治疗慢性根尖周炎疗效比较

目的：分别使用氧化锌丁香油糊剂、Vitapex糊剂、Cortisomol糊剂一次法根管治疗慢性根尖周炎,比较其术后反应及远期疗效。方法：选取慢性根尖周炎病例196例,225个恒牙,随机分成A、B、C三组,分别以氧化锌丁香油糊剂（A组）、Vitapex糊剂（B组）、Cortisomol糊剂（C组）加牙胶尖作为根充材料,采取一次法根管治疗,观察术后7d内的反应及1年内临床疗效。结果：治疗后1～7d B组和C组术后反应率较A组低,差异有统计学意义（P＆lt;0.05）,B组与C组术后反应率差异无统计学意义（P＆lt;0.05）,远期疗效3组间无明显差异（P＆gt;0.05）。结论：Vitapex糊剂与Cortisomol糊剂用于一次法根管治疗,术后反应较轻,疗效可靠。氧化锌丁香油糊剂术后反应较重,但远期效果与其它两种糊剂无明显差异。     

Vitapex糊剂治疗恒牙根尖周病的临床效果观察

目的观察Vitapex对一些治疗困难或失败的根尖周病的消毒效果。方法共治疗54个牙,包括根管治疗期间出现的行多次常规根管消毒后,患牙仍有持续的根尖周症状;或根管内有较多的渗液,不能短期内完成根管治疗;或治疗失败,均用Vitapex糊剂充填根管。结果Vitapex糊剂用于根管消毒(充填),术后患牙自觉症状消失,根管内的渗液减少,窦道封闭。结论Vitapex糊剂有较长作用时间的抗菌性以及组织吸收性,Vitapex可作为解决根管治疗效果不佳的一种有效药物。     

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目的对比观察氢氧化钙和甲醛甲酚用于根尖周炎患牙根管内封药的疗效。方法选择2008年1月到2009年12月在中国医学科学院整形外科医院口腔中心就诊的135例牙根尖周炎患者的156颗患牙,随机分为A组(81颗)和B组(75颗)。步退法根管预备后分别于根管内封入氢氧化钙(A组)和甲醛甲酚(B组)进行消毒。于封药后1周、根充后1周和治疗后3个月对两组疗效进行观察并作出相应评价。结果根管封药后1周A组的有效率为92.59%,B组的有效率为78.67%,两组间差异有统计学意义(P<0.05);根管充填后1周,A、B两组的急症发生率(3.70%对12.0%)差异有统计学意义(P<0.05)。治疗后3个月A组的成功率为91.36%;B组为84.00%,两组间差异有统计学意义(P<0.05)。结论氢氧化钙用于根尖周炎患牙根管内消毒的疗效优于甲醛甲酚。     

Solubility and biocompatibility of calcium hydroxide-containing root canal sealers

Abstract The solubility and biocompatibility of 2 commercially available calcium hydroxide-containing root canal sealers, CRGS and Sealapex, were studied. Four dogs were anesthetized and a sulcular incision was made to expose the vestibular surface of the mandble. Two rows of holes, 2 mm deep, 2 mm wide and 10 mm apart, were drilled into the mandible. Teflon cups with the same dimensions as the holes were filled with the experimental materials and placed in the cavities. For the purpose of comparison, Teflon cups filled with a traditional zinc oxide-eugenol sealer and a paste of calcium hydroxide and saline were implanted as well. After 90 days the animals were killed. The mandibles were dissected free, fixed in formalin and demineralized. Bone specimens containing 1 Teflon cup were then embedded in paraffin, sectioned longitudinally, and the sections were stained with hematoxylin and eosin and examined in the light microscope. The cups which originally contained the paste of calcium hydroxide and saline were completely filled with bone. Sealapex was partly missing from the cups and was generally replaced by ingrowth of connective tissue. Large amounts of the material were seen in macrophages and tissue outside the cups. CRCS and the traditional zinc oxide-eugenol sealer generally filled the cups well after 3 months. Tissue fluids were seen in the superficial layers of these materials, but ingrowth of tissue had not occurred. No macrophage reaction was seen with either of these materials, but a stronger inflammatory reaction was caused by CRCS than by the traditional zinc oxide-eugenol cement. CRCS appeared to be the most stable of the calcium hydroxide-containing sealers tested.     

Survival of Enterococcus faecalis in infected dentinal tubules after root canal filling with different root canal sealers in vitro

AIM: To investigate the ability of different endodontic sealers and calcium hydroxide to kill bacteria in experimentally infected dentinal tubules. METHODOLOGY: Fifty-six human root segments were enlarged to size 2 (ISO size 090) Largo Peeso Reamer. After treatment with 17% EDTA and 5% NaOCl for 4 min each, the specimens were infected with Enterococcus faecalis for 3 weeks. The roots were divided into eight groups and filled with gutta-percha and AH Plus (AH); Grossman's sealer (GS); Ketac-Endo (KE); Apexit (AP); RoekoSeal Automix (RSA); or RoekoSeal Automix with an experimental primer (RP), or calcium hydroxide (CH) only. One group of specimens was left unfilled for control (CT). Following storage in humid conditions at 37 degrees C for 7 days, the root canals were re-established with new sterile Largo size 2. Dentine samples from each canal were then collected using a sterile size 5 (ISO size 150) Largo Peeso Reamer. The number of colony-forming units (CFU) was determined for each sample. RESULTS: The mean log10 CFU in all test groups was significantly lower (P < 0.05) than that in the CT group. Root filling with AH and GS killed bacteria (mean CFU = 0) in the dentinal tubules. The mean log10 CFU for the CH group (0.53) was lower than that of RSA, AP, RP and KE (1.36, 1.40, 1.46 and 1.94, respectively), but only the difference between the CH and the KE groups was statistically significant (P < 0.05). CONCLUSION: Root fillings in vitro with gutta-percha and AH or GS were effective in killing E. faecalis in dentinal tubules. Other endodontic sealers, as well as CH, were less effective.     

反复发作性根尖周炎根管消毒处理

目的 观察短期内反复发作性根尖周炎的不同根管消毒封药的临床疗效。方法 选择116例多次根管治疗无效的根尖周炎病例，根据治疗前封药次数及其他相关因素，分为根管内封药为樟脑酚(A)组、丁香油酚(B)组、干棉絮(C)组进行临床疗效观察。结果 A组有效率94．12％，B组有效率98．48％，C组有效率93．74％，减少了封药次数，仅需1～2次复诊即能达到满意疗效。结论 本文强调使用根管消毒药物前应分析每个病例使用后的临床效果。     

不同根管封闭糊剂在一次性根管治疗中的临床疗效研究

目的评价3种不同的根管封闭剂在一次性根管治疗中的术后反应和疗效。方法 163例共179颗患牙随机分组分成3组。A组为iRoot SP糊剂组(60颗),B组为AH Plus糊剂组(60颗),C组为碘仿糊剂组(59颗)。常规根管预备后即刻根充。采用SPSS 19.0统计软件对数据进行分析。结果统计分析结果显示3组根管糊剂根管充填术后7 d疼痛发生率:i Root SP糊剂组低于AH Plus糊剂组和碘仿糊剂组,差异有统计学意义(P<0.05)。术后1年和2年的临床疗效进行比较,结果显示iRoot SP糊剂组和AH Plus糊剂组的成功率均高于碘仿糊剂组,差异有统计学意义(P<0.05)。iRoot SP糊剂组成功率略高于AH Plus糊剂组,差异无统计学意义(P>0.05)。结论在一次性根管治疗中iRoot SP糊剂疗效略优于AH Plus糊剂和碘仿糊剂,是理想的根管充填材料。     

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目的    观察美松永久根管充填糊剂治疗慢性根尖周炎的临床疗效。方法    选择2006年１月至2008年12月濮阳市第三人民医院口腔病防治中心就诊的慢性根尖周炎患者368例（370颗患牙）,按就诊顺序随机分为2组。试验组186例（187颗患牙）应用美松永久根管充填糊剂进行根管充填;对照组182例（183颗患牙）应用常规根管充填糊剂与牙胶尖进行根管侧方加压充填。根管充填后1周和1年随访观察近期临床反应和远期疗效。结果    根管充填后1周复诊,试验组中163颗牙无不良反应,对照组142颗牙无不良反应,组间差异有统计学意义（P < 0.05）。根管充填后1年,试验组随访170例（170颗牙）,失访17颗牙;对照组随访163例（163颗牙）,失访20颗牙。试验组的成功率为98.82％,对照组的成功率为88.96％,试验组疗效优于对照组,且组间差异有统计学意义（P < 0.05）。结论    美松永久根管充填糊剂优于根管充填糊剂,是一种良好的根管充填材料。     

In vivo sealing ability of calcium hydroxide-containing root canal sealers

Abstract It was the purpose of this study to determine the sealing ability of 2 commercially available calcium hydroxide-containing root canal sealers, CRCS and Sealapex. One hundred sixty single-rooted human teeth were used. The clinical crowns were removed and the roots were cleaned mechanically and by immersion for 24 h in 5% sodium hypochlorite. The root canals were then instrumented to size 80 at the apical foramen and the roots were sterilized by γ-radiation. Under aseptic conditions the root canals were filled with a gutta-percha master cone size 70 and Sealapex (48 roots), CRCS (48 roots), and a zinc oxide-eugenol type sealer, Roth 801 (50 roots). The coronal aspects of the root canals were then sealed with zinc oxide-eugenol cement. In order to bring the roots and root filling materials in contact with tissue and tissue fluids, the roots were implanted subcutaneously in rabbits for 90 days and 1 year. Leakage as demonstrated by penetration of India ink was evaluated using a stereomicroscope. The best results were obtained with CRCS. Significantly less leakage occurred with both calcium hydroxide-containing sealers than with the traditional zinc oxide-eugenol sealer.