64颗并发牙髓病或根尖周病隐裂牙的临床和治疗分析

目的 观察牙隐裂的临床表现，对隐裂牙的治疗方法进行评价。方法 对６４颗并发牙髓病或根尖周病隐裂牙在根管治疗前有无带环，其牙折率进行研究。结果 在６４颗隐裂牙中，有２８颗发生于上颌第一磨牙。先上带环，再根根管治疗，患牙保存率明显高于对照组。结论 隐裂牙在做根管治疗之前应上带环，根管治疗后行全冠修复。     

牙降裂治疗的临床疗效分析

目的：了解牙隐裂的临床表现及疗效。方法：根据牙隐裂的不同程度和不同临床表现，采用调He,充填，根管治疗后全冠修复进行治疗。结果：85例共97颗隐治疗成功率达87．6％，结论：牙隐裂早发现，早治疗才能取得好的疗效。     

老年患者隐裂牙的诊断与治疗

目的:探讨老年患者隐裂牙的诊断与治疗的特点.方法:对经临床确诊的63例老年患者的67颗隐裂牙进行综合治疗,包括①无症状且牙髓活力正常者单纯调(牙合)治疗(4个牙):②有深裂纹、牙髓活力正常伴有过敏症状者行调(牙合)加充填治疗(5个牙);③伴牙髓炎或根尖炎者先行钢丝环扎、调胎,再行根管治疗,观察2周,无临床症状后及时全冠修复(58个牙).半年后随访观察.结果:60个牙治疗有效,7个牙失败,综合治疗的有效率为90%,其中58个牙治疗后经全冠修复有效率为97%,明显高于未行全冠修复的充填组(40%)以及调(牙合)组(50%),且差异有显著性(p＜0.01).结论:综合治疗是老年患者隐裂牙较为理想的治疗方法,且隐裂牙在综合治疗后全冠修复疗效更好.     

64颗并发牙髓病或根尖周病隐裂牙的临床和治疗分析

目的观察牙隐裂的临床表现，对隐裂牙的治疗方法进行评价。方法对64颗并发牙髓病或根尖同病隐裂牙在根管治疗前有无带环，其牙折率进行研究。结果在64颗隐裂牙中，有28颗发生于上颌第一磨牙。先上带外，再做根管治疗，患牙保存率明显高于对照组。结论隐裂牙在做根管治疗之前应上带环，根管治疗后行全冠修复。     

隐裂牙综合治疗63例的临床疗效分析

目的 探讨隐裂牙综合治疗的临床效果。方法 63例65颗隐裂牙根据临床表现及检查结果,分别进行树脂充填、根管治疗及全冠修复的综合治疗。结果 经综合治疗的隐裂牙随访1～2年,总有效率为90.77%。结论 对隐裂牙进行综合治疗,特别是行全冠修复有利于保存患牙。     

70例隐裂牙临床疗效观察

目的:观察牙隐裂的临床特点,探讨其治疗方法.方法:对70例并发牙髓病或根尖周病的隐裂牙进行治疗,包括对患牙调(牙合),消除(牙合)创伤.为防止患牙折裂,对其进行铜丝环扎或粘带环,进行完善的根管治疗,并进行全冠修复.结果:在70个隐裂牙中成功62个牙,占88.57%;有效6个牙,占8.57%;无效2个牙,占2.86%.结论:对隐裂牙采取及时的恰当的综合治疗,能取得较好的临床效果.     

老年人隐裂牙一次法充填治疗的疗效分析

目的　观察老年人牙隐裂的临床表现 ,对老年人隐裂牙的治疗效果进行分析。方法　对 112颗隐裂牙在治疗前用不锈钢丝环形结扎并调牙合 ,碘仿氧化锌糊剂一次性根管充填治疗 ,全冠修复 ,观察治疗成功率。结果　经 3个月和 6个月随访 ,根据X线片复查 ,患牙保存率达 94 %。结论　一次法充填治疗老年人隐裂牙是可行的。     

隐裂性牙髓炎一次性根管治疗的临床观察

目的 观察隐裂性牙髓炎一次性完成根管治疗术的临床疗效。方法 对53例58颗隐裂性牙髓炎患牙进行一次性根管治疗后全冠修复,追踪随访2年,通过临床及X线片检查评价其疗效。结果 51颗牙成功,占87.93%。4颗患牙根管治疗后未及时全冠修复导致牙体折裂,2颗原有的根分叉病变扩大,1颗新出现根分叉病变。结论 隐裂性牙髓炎患牙一次性完成根管治疗后及时全冠修复,可提高患牙保存的成功率。     

老年人牙隐裂治疗临床疗效分析

目的:探讨老年人牙隐裂治疗的临床疗效及其影响因素。方法:对44颗隐裂患牙根据其临床表现不同,分别采用活髓全冠修复(5颗)、根管治疗前即刻暂时冠修复 根管治疗后全冠修复(6颗)、大量调 根管治疗后全冠修复(25颗)、桩核冠修复(6颗)及冠延长术 桩核冠修复(2颗)等不同的治疗方法,治疗后追踪半年-5年。结果:修复后的成功率84.1%,临床疗效受多种因素的影响,其中隐裂纹的深度、隐裂纹涉及的边缘嵴数、牙周袋的深度均影响治疗的成功率。结论:针对不同程度的牙隐裂,采取不同的临床治疗方法是治疗成功的关键。     

老年人隐裂牙根管治疗一次法的疗效分析

1999—2004年在我科就诊的120例患者，112个牙。其中男58例，女62例，年龄59—81岁，平均65．8岁。上颌牙79个，下颌牙33个。随访时间1-3年。     

隐裂牙综合治疗的临床评价

目的：目的：评价隐裂牙综合治疗的临床效果。方法：对107例隐裂牙综合治疗，1年以上随访观察。结果：99例成功，8例失败，其中7例于治疗后1年内失败，1例在治疗后3年失败，总成功率为92．5％。结论：综合治疗可以保留牙体组织并恢复咬合力，是目前隐裂牙治疗较理想的方法。     

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目的观察牙隐裂综合治疗的临床疗效。方法对2001年5月至2004年1月来沈阳市口腔医院就诊的107例牙隐裂患者的122颗患牙,采取调、带环黏固后根管治疗加全冠修复的方法修复,随访2年,复查治疗效果。结果122颗患牙中,成功91颗(74.59%),好转28颗(22.95%),失败3颗(2.46%),有效率达97.54%。结论对隐裂牙进行综合治疗,特别是采取调、带环黏固后根管治疗加全冠修复的方法疗效确切,值得推广应用。     

Degradation of trans-polyisoprene after root filling with thermoplasticized techniques

Aim To evaluate ex vivo degradation of gutta‐percha following six thermoplastic obturation techniques. Methodology Ninety human‐extracted mandibular premolars were selected and divided randomly into nine groups for filling. Group 1: thermomechanical compaction for 3 s with Konne gutta‐percha points (Konne Ind. e Com. de Mat. Odontol., Belo Horizonte, MG, Brazil); Group 2: thermomechanical compaction for 3 s with Dentsply TP gutta‐percha points (Dentsply Indústria e Comércio Ltda, Petrópolis, R.J. Brazil); Group 3: thermomechanical compaction for 10 s with Konne; Group 4: thermomechanical compaction for 10 s with Dentsply TP; Group 5: warm vertical condensation using System B (EIE/Analytic, Richmond, WA, USA) with Konne; Group 6: warm vertical condensation using System B with Dentsply TP; Group 7: vertical condensation with Konne; Group 8: vertical condensation with Dentsply TP; Group 9: Microseal cone (Analytic Endodontics, Glendora, CA, USA). A further four groups were assessed without using teeth, Group 10: Microseal microflow (Analytic Endodontics); Group 11: Obtura (Obtura Corporation, Penton, MO, USA); Group 12: Obtura flow (Obtura Corporation); Group 13: Thermafil (Dentsply Maillefer, Tulsa, OK, USA). The filling material was removed from the root canal and trans‐1,4‐polyisoprene isolated by solubilization of the root filling remnants in chloroform followed by filtration and centrifugation. By gel permeation chromatography and infrared spectroscopy, the occurrence and degree of degradation were assessed. The results were analysed statistically using the Kruskal–Wallis test. With differential scanning calorimetry, the thermal behaviour of the gutta‐percha was determined. Results A significant decrease in polymer molar mass and the production of carboxyl and hydroxyl groups in the polymer were observed with thermomechanical compaction used for 10 s and vertical condensation filling techniques (P = 0.0001 and P = 0.0005, respectively). Other techniques caused no polymer degradation. Conclusion Polyisoprene degrades with high temperature. Thermomechanical compaction for 10 s and vertical condensation were associated with the greatest degradative process.     

高龄老年人根管治疗的临床特点

目的：总结高龄老年人根管治疗的临床特点。方法：对患有各种系统性疾病的、年龄在70岁以上的老年人243例共292颗需进行根管治疗的牙齿的诊断治疗进行临床研究。结果：高龄老年人的牙齿进行根管治疗是可行的，是治疗根尖周炎的有效方法，老年人的根管治疗有其自身的特点。结论：在老年人牙齿的根管治疗过程中，要兼顾老年人的全身性疾病。     

ProTaper手用镍钛锉用于老年人根管治疗术一次法的临床评价

目的:评价ProTaper手用镍钛锉应用于老年人根管治疗术一次法的疗效。方法:将109例患者124颗患牙(包括牙髓炎、慢性根尖周炎)随机分为2组,每组62颗牙。实验组用ProTaper手用镍钛锉预备根管,对照组用不锈钢K型锉预备根管,2组均一次完成根管充填,记录根管治疗术后3d疼痛反应情况及术后1年临床效果。结果:实验组根管治疗术后3d疼痛反应少于对照组(P<0.05);2组间1年后疗效差异无显著性(P>0.05)。结论:ProTaper手用镍钛锉用于老年人根管治疗术一次法能明显减少术后根尖反应,效果可靠。     

Microorganisms from canals of root-filled teeth with periapical lesions

AIM: The objective of the present study was to identify the microbial flora within root canals of teeth with failed root-canal treatment and to determine the association of the various species with clinical features. METHODOLOGY: Sixty root-filled teeth with persisting periapical lesions were selected for this study. During nonsurgical endodontic re-treatment, the root-filling material was removed and the canals were sampled. Microbial sampling, isolation and species determination were performed using advanced microbiological techniques for anaerobic species. The association of microbiological findings with clinical features was investigated. RESULTS: Microorganisms were recovered from 51 teeth. In most cases, one or two strains per canal were found. Of the microbial species isolated, 57.4% were facultative anaerobic species and 83.3% Gram-positive microorganisms. Enterococcus faecalis was the most frequently recovered bacterial species. Obligate anaerobes accounted for 42.6% of the species and the most frequently isolated genera was Peptostreptococcus. which was associated with clinical symptoms (P < 0.01). Significant associations were also observed between: (a) pain or history of pain and polymicrobial infections or anaerobes (P < 0.05): (b) tenderness to percussion and Prevotella intermedia/P. nigrescens (P < 0.05); (c) sinus and Streptococcus spp. (P < 0.001) or Actinomyces spp. (P < 0.01); (d) coronally unsealed teeth and Streptococcus spp. or Candida spp. (both with P < 0.01). CONCLUSION: The microbial flora in canals after failure of root-canal treatment were limited to a small number of predominantly Gram-positive microbial species. Facultative anaerobes, especially E. faecalis, were the most commonly isolated microorganisms, however, polymicrobial infections and obligate anaerobes were frequently found in canals of symptomatic root-filled teeth.     

Comparative in-vitro evaluation of three chelator pastes

AIM: To compare the effect of three paste chelating agents on the root dentine of extracted teeth: Calcinase-Slide (lege artis, Dettenhausen, Germany), Glyde-File (DeTrey/Dentsply, Konstanz, Germany), RC-Prep (Premier, Norristown, USA). METHODOLOGY: Ten slices of root dentine were covered with one of the chelating agents for 30 s, 1 min and 2 min and irrigated with 5 mL H2O2 and NaOCl. This was repeated five times. Pre- and postoperative Vickers hardness of root dentine was measured. Twenty slices of root dentine were covered with 0.1 mL of the chelating agents for 3, 6 and 9 min. Differences between pre- and postoperative weight were recorded. Ten root canals of extracted teeth were enlarged five ISO-sizes with 0.1 mL chelator paste for each file. The teeth were split longitudinally and cleanliness of the root-canal walls was evaluated under the SEM using a four-score evaluation index. Results were statistically analysed using the Wilcoxon-Mann-Whitney test, the Friedman test and the Kruskal-Wallis test with P<0.05 for all tests. RESULTS: No significant differences between the chelating agents were found in terms of changes in dentine hardness. Loss of hardness increased significantly with increasing time of contact of the chelating pastes with dentine. There were significant differences between the three chelating agents and the control for loss of weight. After 3 min there was no significant difference between the chelating agents, after 6 and 9 min Calcinase-Slide showed significantly more weight loss than RC-Prep; after 6 min Glyde-File showed significantly more weight loss than RC-Prep. In the coronal and middle parts of the root canals, the cleaning ability of Calcinase-Slide was significantly better than of RC-Prep and Glyde-File; in the apical third no differences could be found. CONCLUSIONS: Under the circumstances of this in vitro study, the three chelator pastes evaluated had no or only slight differences in terms of weight loss, changes of Vickers hardness in root dentine and cleanliness of root-canal walls. The use of a chelating agent may be useful to enhance cleanliness of the coronal and middle part of the root canal.     

老年人根管治疗临床疗效评价

目的：观察老年患者根管治疗的效果。方法：对178颗老年患牙进行常规根管治疗，2年后进行复查，并以同期治疗的200颗同类青年患牙作对照，采用文献根管治疗疗效标准评定X线片并结合临床检奁，对根管治疗疗效进行评价。结果：老年组与青年组根管治疗疗效在不同病种、不同牙位、不同性别差异均无显著性（P〉0．05），老年患者根管治疗有效率86．5％。结论：对老年患牙也可行常规根管治疗，且有效率高，应作为老年牙髓病患牙的首选治疗方法。     

老年人残根的临床保留效果分析

目的：对老年人残根临床保留效果进行分析,评估可保留进行固定修复的残根的牙周手术效果。方法：对402例586颗残根临床可保留性进行分析,对于121颗位于龈下的残根,根据残根根面位置分成3组进行不同牙周手术治疗。术后4周常规修复,随访1年。结果：586颗老年人残根中,148（25.26%）颗被用于覆盖义齿,314（53.58%）颗被用于固定义齿修复。对于牙槽嵴顶距残根断面〉3mm的残根,牙龈切除术效果较好;对于〈3mm的残根,牙冠延长术效果较好（P〈0.01）。结论：老年人多数残根是可以保留用于活动或固定修复。老年人的残根在选择适合的牙周手术治疗后,再进行固定修复是可行的。     

老年人根管治疗疗效的相关因素

目的:研究老年人根管治疗疗效及其影响因素.方法:对56例65岁以上老年人,根管治疗后2年以上的126颗牙齿进行检查,按治疗后年限分3组:2～3年组,4～5年组,6年以上组.应用根尖周指数(Periodicalindex)评定X线片和综合临床检查,对其治疗进行评价.结果:老年人根管治疗成功率为72.2%;三组间根管治疗成功率差异无显著性.恰填根管治疗的成功率(82.2%)比欠填和超填的成功率(47.2%)要高;恰填病例中,冠方修复体质量好的患牙比质量差的患牙根尖周炎发病率低(25.7%和58.4%);去除欠填和超填病例后,桩冠修复患牙的根管治疗成功率为58.8%,而未做桩冠修复的患牙成功率为87.5%.结论:根充质量、冠方修复体质量、桩冠修复是影响老年人根管治疗疗效的主要因素.