热牙胶根管充填技术研究进展

热牙胶根管充填技术是目前研究较多、运用较广的根管充填技术，其种类大致包括：热牙胶加压、机械热压、超声震动热压、热塑牙胶注射、固核载体插入等充填技术。本文对这些技术的原理、改良和优缺点作一综述，为临床选用提供参考。     

热牙胶注射根管充填法的研究

本文对100个离体牙作了根管充填研究,结果表明,热牙胶注射法与侧压法充填的效果在X线片上无明显差别,但染液渗漏检查和扫描电镜观察,前者的根尖封闭能力和边缘密合度显著优于后者。本文还对热牙胶注射充填的程度与一些因素的关系作了分析与讨论。     

热牙胶根管充填技术的研究进展

热牙胶根管充填技术是目前应用较多的根管充填技术,利用牙胶加热软化后具有流动性的特点,在压力的作用下能够顺应根管的复杂形态,可随根管形态灌注到管腔各个部分,最终达到较理想的三维根充效果。目前常用的技术大致包括：热牙胶垂直加压充填、连续波充填、固核载体充填、机械热压充填、超声震动热牙胶充填技术等。本文对这些技术的起源、优缺点、系统以及改良进行综述,为热牙胶在临床中的应用提供指导。     

不同根管充填方法和根管封闭剂根尖微渗漏的研究

目的：探讨不同根管充填方法和根管封闭剂的根尖封闭效果。方法：选择150颗近期拔除的单根管牙,选取140颗分为A、B、C、D4组（每组35颗）,其它10颗随机分为E组：阳性对照组（n=5）和F组：阴性对照组（n=5）,采用手用Pro-taper镍钛根管锉预备根管,分别采用Cortisomol根管封闭剂加冷牙胶侧方加压充填技术（A组）、AHplus根管封闭剂加冷牙胶侧方加压充填技术（B组）、Cortisomol根管封闭剂加Obtura-Ⅱ热牙胶充填技术（c组）、AHplus根管封闭剂加Obtura—II热牙胶充填技术（D组）进行根管充填,采用染料渗透法检测根尖微渗漏,对染料渗透的长度进行测量并对结果进行分析。结果：A组和B组、A组和C组、C组和D组的染料渗透长度有显著性差异@〈0．05）,B组和D组的染料渗透长度无显著性差异（P〉0．05）。结论：热牙胶垂直加压术的根尖封闭效果好于冷侧压充填术,AH-plus根管封闭剂的封闭性能好于Cortisomol根管封闭剂。     

热牙胶注射根管充填封闭性的研究

热牙胶注射根管充填封闭性的研究王青熊世江根管充填的封闭性是根管治疗成功的关键之一。近年来国外采用一种新技术，将加热后软化、流动性较好的牙胶用特制注射器注射充填根管。为探讨其根充封闭性，作者将这一方法与国内常用的根充方法进行对比观察，并探讨根管封闭的机...     

超声根管预备和根管封闭剂对根尖微渗漏的影响

目的 了解超声根管预备和根管封闭剂对根管治疗后根尖微渗漏的影响。方法 将79颗离体牙随机分为5个实验组和2个对照组。实验组分别用超声波，回旋手机和手法备根后分别用AH plus^TM，根充I号，氧化锌糊剂作根管封闭剂并用牙胶法作侧压充填。用2％亚甲蓝浸泡1周后纵剖牙体，体视镜下观测染料渗透长度。数据行统计学分析。结果 三种备根方法中，超声备根组根尖微渗漏最少。三种根管封闭剂中，AH plus^TM组微渗漏最少。结论 超声根管预备后根充术，同时采用AH plus^TM根管封闭剂，能有效地减少根充术后微渗漏，提高根管治疗效果。     

单尖法和热牙胶法根管充填根尖封闭性能的比较研究

目的 比较3种封闭剂AH-Plus, iRoot SP和GuttaFlow2分别配合单尖法充填和热牙胶充填的根尖封闭性能。方法 选取近期拔除的70颗单根管前磨牙,截冠后采用Waveone gold系统预备至P#,随机分为6个实验组(每组10颗)和2个对照组(每组5颗)。分别行单尖法充填和热牙胶充填,即AH-Plus单尖法组(A1组),AH-Plus热牙胶组(A2组),iRoot SP单尖法组(B1组),iRoot SP热牙胶组(B2组),GuttaFlow2单尖法组(C1组),GuttaFlow2热牙胶组(C2组),阳性对照组(D组)和阴性对照组(E组)。将充填完成的牙齿进行染料渗透实验后,通过纵切片法检测根尖的微渗漏情况。结果 A1组微渗漏值最大,B2组微渗漏值最小,同种封闭剂下单尖法充填和热牙胶充填根尖封闭性差异无统计学意义(P>0.05),同种充填技术下3种封闭剂的封闭性差异无统计学意义(P>0.05)。结论 3种根管封闭剂均不能完全封闭根管,单尖法充填和热牙胶充填在根尖封闭效果上无显著差异。     

连续波热牙胶垂直充填术根尖微渗漏的研究

目的 评价连续波热牙胶垂直充填术在根充后3、7、30d的根尖微渗漏情况,并与根管冷侧压充填做比较.方法 将87颗单根人离体牙,常规根管预备,随机分为2组,S组43颗牙采用连续波热牙胶垂直根管充填术;L组44颗牙选用冷侧压根管充填术.2组根管充填后进行染色,分别在3、7、30d纵向劈开牙后,测量染色线长度并进行统计学分析.结果 S3d组,L3d组,S7d组,L7d组的染色线长度分别为2.13±2.13mm,3.50±2.05mm,5.36±3.58mm,3.58±2.95mm,统计学无显著性差异(P＞0.05).S30d组和L30d组的染色线长度分别为4.73±3.90mm,7.33±5.05mm,S30d比L30d短,但统计学没有差异(P＞0.05).结论 连续波热牙胶垂直充填术在根尖微渗漏方面,短期内与冷牙胶侧压充填术无明显差异.长期(1个月以上)优于冷牙胶侧压充填术,但统计学无差异.     

高温注射式热牙胶充填根管时牙根表面温度的变化

目的:评估Obtura Ⅱ热牙胶系统牙胶加热温度在160、180、200 ℃进行根管充填时根管外表面温度的变化是否会对牙周组织造成热损伤,及使用封闭剂对温度变化的影响.方法:42颗离体单根管恒牙根管预备后,用Obtura Ⅱ热牙胶系统以不同温度加热牙胶及是否使用封闭剂分组充填根管.测定根管充填前后根管外表面温度的变化.结果:在3种温度设定下充填时,根管外表面温度的升高值平均都未超过10℃阈值.充填前使用封闭剂对根管外表面温度的升高无论是减少还是增加都未超过1℃,均无统计学意义(P＞0.05).结论:Obtura Ⅱ热牙胶系统在160、180℃的工作温度下进行根管充填时,不会对牙周组织造成热损伤,但200℃的温度设定需谨慎选择;使用封闭剂对抑制根管表面温度的升高无明显影响.     

根管封闭剂对System B和Obtura Ⅱ根管充填系统的疗效影响

目的探讨System B联合ObturaⅡ根管充填系统中应用根管封闭剂对临床疗效的影响。方法 60颗上颌恒中切牙随机分成二组,每组各30颗牙。第一组用A H Plus联合System B、ObturaⅡ充填,第二组直接用System B和ObturaⅡ充填。术后即刻及术后1年行X线片对比研究。结果两组根管充填质量,术后1年复查没有显著性差异（P〉0.05）。根管超填情况第一组多于第二组,二者有显著性差异（P〈0.01）。术后1年复查治疗成功率无明显性差异。结论是否使用根管封闭剂对根管治疗的成功率无明显影响。     

Perspectives on root canal obturation with thermoplasticized injectable gutta-percha

Summary. Perspectives on the clinical usage of a thermoplastic injection delivery system for guttapercha are presented. Areas which have been identified as problems in the clinical use of the technique and management of the system are highlighted. succinct guidelines for effective usage are presented along with cases typifying clinical achievement.     

热塑牙胶充填根管临床观察

目的：观察连续波热塑牙胶注射法充填根管的临床效果.方法：选择360例根管治疗患者,共380颗牙,其中240颗牙用热塑牙胶注射充填仪做连续波热塑牙胶充填根管,140颗牙用常规冷牙胶侧方加压充填根管,通过X线片比较两组病例的充填质量并比较两组病例间每根管根充需用时间.结果：X线片显示连续波热塑牙胶充填组欠填率1.67％,超填率2.91％,恰填率95.41％,冷牙胶侧压充填组欠填率8.57％,超填率2.85％,恰填率88.57％,比较两组间欠填率与恰填率有统计学差异（P＜0.05）,连续波热塑牙胶充填组平均每根管根充时间8 min.冷牙胶侧压组充填平均每根管根充时间12 min.连续波热塑牙胶充填组缩短根充时间30％.结论：连续波热塑牙胶充填术比冷牙胶侧方加压充填术根管充填质量更高且节约根充时间,提高了工作效率.     

FP core carrier technique: thermoplasticized gutta-percha root canal obturation technique using polypropylene core

Core carrier techniques are unique among the various root canal filling techniques for delivering and compacting gutta-percha in the prepared root canal system. Thermafil (TF), considered the major core carrier device, is provided as an obturator consisting of a master core coated with thermoplasticized gutta-percha. We have devised a thermoplasticized gutta-percha filling technique using a polypropylene core, FlexPoint? NEO (FP), which was developed as a canal filling material that can be sterilized in an autoclave. Therefore, FP can be coated onto thermoplasticized gutta-percha and inserted into the prepared canal as a core carrier. The FP core carrier technique offers many advantages over the TF system: the core can be tested in the root canal and verified radiographically; the core can be adjusted to fit and surplus material easily removed; furthermore the core can be easily removed for retreatment. The clinical procedure of the FP core carrier technique is simple, and similar that with the TF system. Thermoplasticized gutta-percha in a syringe is heated in an oven and extruded onto the FP core carrier after a trial insertion. The FP core carrier is inserted into the root canal to the working length. Excess FP is then removed with a red-hot plastic instrument at the orifice of the root canal. The FP core carrier technique incorporates the clinical advantages of the existing TF system while minimizing the disadvantages. Hence the FP core carrier technique is very useful in clinical practice. This paper describes the FP core carrier technique as a new core based method.     

A comparison of thermoplasticized injectable gutta-percha obturation techniques

This study compared the quality of obturation of high- and low-temperature thermoplasticized injectable gutta-percha techniques and standard lateral condensation. A new model system was developed to more closely simulate the clinical environment. All obturations were performed in this same model which allowed direct comparisons between the different techniques. The resultant mass of gutta-percha was visually examined and graded for each obturation. Statistical analysis of the results indicated that both thermoplasticized injectable techniques were significantly better than lateral condensation. There was no significant difference between either of the thermoplastic obturation techniques.     

Three-dimensional obturation of the root canal using injection-molded, thermoplasticized dental gutta-percha.

The technique of injection-molding was applied to thermoplasticized dental gutta percha in vitro. Teeth were biochemically instrumented before obturation of the root canal space. Thermoplasticized gutta percha was injected, with and without the use of a sealer, using a pressure syringe. The quality of the seal was assessed by dye penetration studies. The findings showed that the injection-molding technique leads to a seal comparable to that of conventional approaches. The technique holds promise for in vivo use.     

In vitro infrared thermographic assessment of root surface temperatures generated by high-temperature thermoplasticized injectable gutta-percha obturation technique

The aim of this in vitro study was to measure the temperature rises on the outer surface of roots produced by high-temperature thermoplasticized injectable gutta-percha technique. Thirty extracted human teeth with a single canal (15 maxillary central incisors and 15 mandibular central incisors) were used in this study. After root canal cleaning and shaping, the teeth were obturated with the injected gutta-percha heated to 160 degrees C (Obtura II). Temperature changes on the whole mesial outer surface of the roots was measured using an infrared thermal imaging camera. It showed that the use of gutta-percha heated to 160 degrees C to fill the maxillary central incisors and mandibular central incisors resulted in the rises of the root surface temperature by 8.5 degrees C and 22.1 degrees C, respectively. In conclusion, the injection of the gutta-percha heated to 160 degrees C into the root canal of maxillary central incisors produces temperature on the outer root surfaces below the theoretical critical level and, therefore, should not cause damage to supporting periradicular tissues. The injection of gutta-percha into the root canal space of the mandibular central incisors in vitro, resulted in an elevation of the root surface temperature by more than 10 degrees C.     

Sealing ability of thermoplasticized gutta-percha in root canal obturation using a sectional vs. a single-phase technique

Abstract Properly prepared straight root canals of freshly extracted maxillary canines and central incisors were used to evaluate the sealing ability of the sectional thermoplasticized gutta-percha obturation technique, with or without sealer and the single-phase thermoplasticized gutta-percha filling technique. The teeth were divided into 3 groups (A, B, C) of 20 teeth and were obturated using the 3 thermoplasticized gutta-percha techniques. Group A: single phase with sealer; group B: sectional technique without sealer; and group C: sectional technique with sealer. The obturated teeth were immersed in India ink for 3 days followed by clearing procedures. The teeth were then examined under a stereo microscope and the linear leakage was recorded. Statistical unpaired Student's t-tests showed significantly less dye penetration in teeth obturated using the sectional technique with sealer (group C) than in teeth obturated with the single-phase technique with sealer (group A) or the sectional technique without sealer (group B).     

Sealing ability of thermoplasticized gutta-percha in root canal obturation using a sectional vs. a single-phase technique

Properly prepared straight root canals of freshly extracted maxillary canines and central incisors were used to evaluate the sealing ability of the sectional thermoplasticized gutta-percha obturation technique, with or without sealer and the single-phase thermoplasticized gutta-percha filling technique. The teeth were divided into 3 groups (A, B, C) of 20 teeth and were obturated using the 3 thermoplasticized gutta-percha techniques. Group A: single phase with sealer; group B: sectional technique without sealer; and group C: sectional technique with sealer. The obturated teeth were immersed in India ink for 3 days followed by clearing procedures. The teeth were then examined under a stereo microscope and the linear leakage was recorded. Statistical unpaired Student's t-tests showed significantly less dye penetration in teeth obturated using the sectional technique with sealer (group C) than in teeth obturated with the single-phase technique with sealer (group A) or the sectional technique without sealer (group B).     

The sealing ability of an epoxy resin root canal sealer used with five gutta-percha obturation techniques

The purpose of the present study was to evaluate the apical sealing ability of an epoxy resin root canal sealer (AH-26) when used with different gutta-percha obturation techniques (i.e. cold lateral condensation, warm vertical condensation, hybrid condensation) and with Thermafil and Soft-Core obturators. Straight single-rooted teeth with mature apices were prepared according to the crown-down/step-back technique and divided in five groups of 45 teeth and one group of 12 control teeth. After root canal filling 15 teeth of each group were kept for 1 day, another 15 teeth for 1 week, and another 15 teeth for 4 months at 37 degrees C in vacutainers in 80% relative humidity. The 237 teeth were immersed in india ink for 90 hours, each root was split and sectioned longitudinally, and the maximum extent of leakage was measured using a stereomicroscope at x6 magnification. It became clear that leakage occurred whatever technique was combined with AH26 and that leakage increased with time. The amount of apical leakage and the number of leaking teeth in the Soft-Core obturator groups was significantly higher than all other 4 gutta-percha obturation techniques combined with AH26. In this respect, the hybrid gutta-percha condensation technique turned out to be superior to the four other condensation techniques.