氢氧化钙糊剂根管充填129例临床观察

目的探讨氢氧化钙糊剂作为根充材料治疗根尖周炎的临床疗效.方法选择急慢性根尖周炎患者118例129个牙用甲硝唑棉捻消毒根管,再用氢氧化钙糊剂加牙胶尖充填根管.结果经半年-2年连续观察,氢氧化钙糊剂治疗根尖周炎有较好的疗效.结论甲硝唑作为根管消毒剂,氢氧化钙作为根充剂治疗急、慢性根尖周炎,是一种有效、可靠的方法.     

甲硝唑碘仿糊剂根管充填的疗效观察

1998年以来 ,应用甲硝唑碘仿糊剂充填根管治疗根尖周炎 ,收到满意效果 ,现总结如下。1　资料和方法1.1　临床资料门诊患者 12 0例 12 0个牙 ,年龄 15～ 6 5岁 ,前牙 86个 ,前磨牙 2 4个 ,磨牙 10个。急性根尖周炎 18例 ,慢性根尖周炎 6 5例 ,牙髓坏死、坏疽 37例。1.2　方法常规根管预备 ,用 30mL/L过氧化氢液冲洗 ,樟脑酚棉捻封药消毒 5d后复诊。有症状者重新冲洗换药 1次 ,至根管无臭味、无症状。实验组以根管糊剂加甲硝唑和碘仿 ,再加牙胶尖行根管充填 ;对照组常规用根管糊剂加牙胶尖行根管充填。观察 2周无明显症状后 ,用光固化复合树…     

三种根管糊剂在根管治疗中的效果观察

目的观察3种根管糊剂用于根管充填的临床疗效。方法180例210颗需要根管治疗的患牙,随机分为3组,每组70颗牙,根管预备后,A组用根管糊剂和牙胶按冷侧方加压法完成充填。B组用氧化锌丁香油糊剂和碘仿以2∶1的比例调配好后加牙胶充填根管。C组用氢氧化钙糊剂和替硝唑粉以2∶1的比例调配好后加牙胶充填根管。全部病例观察术后急性反应情况和术后2年疗效。结果A组术后急性反应发生率14.29%,B组8.57%,C组2.86%,C组与A、B组差异有统计学意义(P<0.05)。A组成功率85.71%,B组91.43%,C组97.14%,A组与C组差异有统计学意义(P<0.05)。结论氢氧化钙糊剂加替哨唑粉联合牙胶根管充填可取得良好的临床效果。     

替硝唑用于根管消毒的临床疗效观察

1临床资料1.1病例选择2003—2004年在我院专家科就诊的病人中,选择同一牙列中有两个以上恒磨牙或恒前磨牙患有急慢性根尖周炎的病例43例,男21例,女22例,年龄18～65岁,共100颗患牙。治疗前一月均无服用抗生素史,排除孕妇及哺乳期妇女。采用同体异位法进行分组,实验组和对照组各50颗患牙。1.2材料替硝唑片、0.9%的氯化钠溶液、甲醛甲酚合剂(FC)、根充糊剂、牙胶尖。1.3方法常规开髓,去髓,测量牙体操作长度,用逐步后退法扩锉根管,双氧水,生理盐水反复冲洗根管,棉捻拭干。实验组:取0.5g替硝唑片磨成粉末,用注射器抽0.9%的氯化钠溶液溶解,棉捻沾…     

超声冲洗技术应用于活髓牙一次性根管治疗术的临床评价

目的 评价根管超声冲洗技术对活髓牙一次性根管治疗术疗效的影响.方法 将158例患者172颗患牙按就诊次序随机分成2组:常规冲洗组80颗患牙,常规局麻下开髓、探查根管、确定工作长度后逐步后退技术预备根管,预备中用2.5%次氯酸钠溶液反复冲洗根管,预备完后用2.5%次氯酸钠和17% EDTA溶液冲洗根管,最后用生理盐水冲洗,冷牙胶侧方加压法严密充填根管;超声冲洗组92颗患牙,治疗程序同常规冲洗组,常规根管冲洗后再进行根管超声冲洗,最后冷牙胶侧方加压法严密充填根管,观察随访术后1周内患牙的疼痛发生率、根管充填质量及侧枝根管充填情况.结果 术后1周复诊超声冲洗组和常规冲洗组根管充填1周内疼痛发生率,差异有统计学意义(P＜0.01),两组疼痛发生均与根管数目多少无关(P＞0.05),术后X线片证实各组根管充填良好,根管超声冲洗后侧枝根管充填率明显提高,差异有统计学意义(P＜0.05).结论 根管超声冲洗后一次法完成根管治疗术可减轻术后疼痛发生,提高根管充填质量.     

根管充填后疼痛的发生率及其有关临床因素

目的 探讨根管充填后疼痛的发生率及其与临床因素之间的关系。方法 对牙髓病、根尖周病患牙４５８例，采用逐步后退法进行根管预备，２０例根管仅用生理盐水冲洗，２２８例根管以３％Ｈ２Ｏ２和生理盐水交替冲洗，并封入ＦＣ棉捻消毒根管，均以氯仿牙胶糊剂加牙胶尖侧压根充，术后拍Ｘ线牙片。结果 根充后疼痛发生率为１１．５８％，疼痛的发生与超填、不彻底的根管冲洗及消毒和根管治疗中的症状有明显的关系；与患者的性别、年龄     

Cortisomol糊剂根充196例恒牙根管的临床观察

Cortisomol糊剂是一种新型的进口根充材料。我们采用了cortisomol加牙胶尖侧压充填196例牙齿,经1年的临床观察,效果满意,现报告如下。1材料和方法本组196例196个患牙,男102例,女94例,年龄16～56岁,尖周炎163例,其中伴瘘道64例,伴间隙感染23例,牙髓坏死33例。患者能按医嘱及时复诊。材料Cortisomol由法国碧兰公司生产,牙胶尖由上海齿科材料厂生产,cortisomol用丁香油调和成稀糊状。方法所有患牙治疗前摄X线片,了解根管形态和病灶范围。常规开髓预备根管。根管扩挫后用3%双氧水和氯亚明交替冲洗根管至纸捻无异味,暂封甲醛甲酚棉捻并调牙合,…     

CCQ治疗剂根管导入法治疗尖周炎486例疗效观察

我科从1985年1月至1992年1月共复查急、慢性尖周炎486病例,494牙例。其中男性246牙,女性248牙。年龄最小12岁,最大65岁。治疗方法,采用根管治疗,经开髓,髓腔及根管扩锉,3%双氧水冲洗,封入甲酚醛棉捻尖,一周后若无症状,用 CCQ 糊剂充填根管。充填前先用 CCQ 液体导入,涂布根管壁,再用消毒的根管扩大针将刚调拌好的 CCQ 糊剂,以反时针方向旋转     

2种根管治疗方法的体内、外实验比较

目的将Twisted file与Guttaflow常温流动牙胶联合应用于根管治疗,与传统K锉预备+牙胶侧方加压的根管充填方法做体内、外实验比较。方法临床实验120例下颌前磨牙根管治疗病例,对照组(K锉)和实验组(TF)各60例。对照组用0.02锥度K锉行根管预备后,用Cortisomol糊剂+0.02锥度牙胶行侧方加压充填根管。实验组用TF预备根管,Guttaflow联合大锥度牙胶尖充填根管。记录2组患者术后疼痛情况,术后3、6、12个月复查患牙状况。体外实验52颗离体下颌前磨牙,对照(K锉)组和实验(TF)组各26例,根管治疗步骤同临床实验。染料渗透法行根尖微渗漏比较。结果临床实验中实验组术后1 d疼痛情况优于对照组;远期疗效术后3个月复查2组间无统计学差异,6、12个月复查实验组优于对照组。体外实验离体牙染料渗透法显示实验组根尖密闭性优于对照组。结论 TF联合Guttaflow根管治疗法优于传统K锉预备+牙胶侧方加压法,值得临床推广应用。     

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。     

氢氧化钙-ZOE糊剂用于乳牙根管治疗术的疗效

目的：观察氢氧化钙-ZOE糊剂作为乳牙根管充填材料的疗效。方法：用3种根管充填材料对223个乳磨牙进行根管充填治疗，试验组用氢氧化钙-ZOE糊剂根管充填（A组），对照组用氢氧化钙糊剂（B组）和ZOE糊剂（C组）根管充填，观察6个月后的疗效。结果：A、B、C3组的成功率分别为90．2％、88％和71．1％。A、B两组的疗效相似（x^2检验，P〉0．05），A与C、B与C两组之间有明显差异（P〈0．05）。结论：氢氧化钙-ZOE糊剂用于乳牙根管充填的临床疗效比较理想，是一种可选择的乳牙根充材料。     

氢氧化钙糊剂用于乳牙根管充填的疗效观察

目的 :观察氢氧化钙碘仿糊剂作为乳牙根管充填材料的临床疗效。方法 :用两种根管充填材料对乳磨牙进行根管充填 ,实验组用氢氧化钙碘仿糊剂根管充填 ,对照组用氧化锌碘仿糊剂根管充填 ,观察一年后的疗效。结果 :实验组平均有效率为 84.1% ,对照组有效率为 81.4% ,实验组与对照组无显著差异(P >0 .0 5 )。结论 :氢氧化钙碘仿糊剂用于乳牙根管充填的疗效比较理想。     

Literature survey of apexification in connection with three cases

Endodontic treatment of three non-vital immature teeth is discussed. According Moorrees et al. root formation was in the stage two, six and four respectively. After access to the root canal, removing necrotic pulp and effective chemo-mechanical cleansing, Ca(OH)2 paste was used as a temporary filling material in each case. In two cases after closing the apical opening, permanent obturation was performed with half heated gutta-percha and lateral condensation to obtain a good seal. In one case permanent filling of the canal occurred with gutta-percha and AH26 as a sealer. In the first case two years, in the second case five years after obturation of the root canal with gutta-percha, periapical healing was evident in the control radiograph. In the third case using gutta-percha with AH26 as a sealer after two years new periapical lesion has developed. On the bases of literature data and our experiences in the case of non-vital immature teeth. Ca(OH)2 paste is the best temporary filling material to induce apexification process, and the half heated gutta-percha obturation is the most suitable permanent root filling material.     

Calcium hydroxide as a root canal filling material in primary teeth--a pilot study

A pilot study was carried out in five mandibular primary molars using calcium hydroxide (Ca(OH)2) Paste as root canal filling material to find out an alternative to the routinely used zinc oxide eugenol (ZnOE), which is non-resorbable and causes deflection of succedaneous teeth. The six month clinical and radiographic follow-up carried out at 2 months interval, revealed that the treated teeth with Ca(OH)2 as root canal filling material were successful, showing no pain and tenderness to percussion. A tendency for decrease in size of radiolucency was seen. Two teeth showed complete healing of the periradicular radiolucency. Depletion of Ca(OH)2 paste was seen from the root canals even prior to physiological resorption of roots in 2 out of 5 treated teeth.     

The evaluation of removal of calcium hydroxide paste from an artificial standardized groove in the apical root canal using different irrigation methodologies

AIM: To evaluate the capacity to remove a calcium hydroxide (Ca(OH)2) paste from the root canal and to evaluate the efficacy of Ca(OH)2 removal during passive ultrasonic irrigation using either sodium hypochlorite (NaOCl) or water as an irrigant. METHODOLOGY: Sixteen mandibular premolars were used. Each root was prepared to the apical foramen using GT instruments of size 30, 0.06 taper. Each root was split longitudinally. In one half of the root, a groove was cut in the canal wall 2-6 mm from the apex which was then filled with a Ca(OH)2 paste. Subsequently the roots were reassembled. In group 1 (n = 16), the teeth were ultrasonically irrigated using 50 mL 2.0% NaOCl as the irrigant. Group 2 (n = 16) was treated in the same manner as group 1, but using 50 mL water in place of the NaOCl. In group 3 (n = 16), the teeth were irrigated by syringe injection of 50 mL 2.0% NaOCl. The quantity of remaining Ca(OH)2 in the groove was scored and the data analysed with Kruskal-Wallis and Mann-Whitney tests. RESULTS: The difference in remaining Ca(OH)2 between all groups was statistically significant (P < 0.001). Group 1 had significantly lower scores than group 2 (P < 0.001) and group 3 (P = 0.002), but there was no significant difference between groups 2 and 3 (P = 0.765). CONCLUSIONS: Passive ultrasonic irrigation with 2% NaOCl was more effective in removing Ca(OH)2 paste from artificial root canal grooves than syringe delivery of 2% NaOCl or water as irrigant.     

两种根充糊剂治疗乳牙根尖周炎的疗效观察

目的观察Vitapex糊剂与氧化锌丁香油糊剂应用于乳牙根充的临床疗效。方法选择186例乳牙患急、慢性根尖周炎病例,随机分为观察组(Vitapex)和对照组(氧化锌丁香油糊剂)各93例,观察根管充填后临床疗效。结果两组根充后根尖反应程度和治疗效果差异有显著性。观察组根充反应程度(6.48%)低于对照组(10.58%),根充成功率观察组(87.04%)高于对照组(74.04%)。结论采用Vitapex糊剂作为乳牙根尖周炎治疗后的充填药物,治愈成功率优于传统的根充药物。     

Mineral trioxide aggregate as a root canal filling material in reimplanted teeth. Microscopic analysis in monkeys

This study analyzed mineral trioxide aggregate (MTA) as a root canal filling material for the immediate reimplantation of monkey teeth. Four adult capuchin monkeys Cebus apella were used, which had their maxillary and mandibular lateral incisors on both sides extracted and reimplanted after 15 min. During the extra-alveolar period, the teeth were kept in saline solution and after reimplantation retention was performed with a stainless steel wire and composite resin for 14 days. After 7 days, the reimplanted teeth were submitted to endodontic treatment with biomechanics up to file n. 30 and irrigation with a saturated solution of calcium hydroxide [Ca(OH)(2)], and then divided into two study groups: group I - root canal filled with a Ca(OH)(2) paste, and group II - root canal filled with MTA. Radiographic follow up was performed at 30, 60 and 90 days postoperatively, and after 180 days the animals were killed and specimens were processed for histomorphological analysis. The results revealed that most specimens of both groups presented organized periodontal ligament with no inflammation. The resorptions observed were surface resorptions and were repaired by cementum. Both MTA and Ca(OH)(2) were good root canal filling materials for immediately reimplanted teeth, providing good repair and also allowing biological sealing of some lateral canals. There was no significant difference between the study groups (alpha = 29.60%).     

比塔派克斯糊剂充填感染根管的疗效

目的：观察比塔派克斯糊剂充填感染根管的疗效。方法：对320例320个患牙进行根管治疗术,分为两组各160牙。实验组用比塔派克斯湖剂充填根管,对照组用氧化锌丁香油糊剂充填极管。结果：术后追踪观察2年,实验组观察158牙,成功154牙（97．47％）;对照组观察151牙,成功135牙（89．40％）。结论：用比塔派克斯糊剂充填根管疗效较好。     

复方替硝唑糊剂治疗乳磨牙根尖周炎的疗效观察

目的：观察复方替硝唑糊剂在乳磨牙有窦道型慢性根尖周炎治疗中的临床疗效。方法：用复方替硝唑糊剂或氢氧化钙甘油为根管充填材料分别对205个患牙进行根管充填并于充填后1、2年观察其疗效。结果：复方替硝唑糊剂2年根管充填成功率95．29％，氢氧化钙甘油成功率71．72％。结论：复方替硝唑糊剂是治疗乳磨牙有窦道型慢性根尖周炎较为理想的药物。     

INFLUENCE OF CALCIUM HYDROXIDE POINTS ON THE QUALITY OF INTRACANAL DRESSING FILLING

Purpose

The aim of this study was to evaluate, in vitro, the quality of calcium hydroxide [Ca(OH)₂] paste filling (Ultracal, Ultradent) associated or not with Ca(OH)₂-containing gutta-percha points (Calcium Hydroxide Plus Points™, Roeko) in curved root canals.

Material and Methods

One hundred and twenty roots of extracted human teeth, randomly divided into three curvature ranges (mild - 0 to 14°; moderate - 15° to 29°; severe - >30°) were used. After chemomechanical preparation, the roots were assigned to 4 groups (n=30), according to the technique of intracanal dressing placement: group 1 - Ca(OH)₂ paste was applied with a lentulo spiral; group 2 - Ca(OH)₂ paste was applied with a lentulo spiral and a Ca(OH)₂ point was inserted into the canal; group 3 - Ca(OH)₂ paste was applied with a Navitip™ tip (supplied with Ultracal system); group 4 - Ca(OH)₂ paste was applied with a Navitip™ tip and a Ca(OH)₂ point was inserted into the canal. The roots were cleared and the quality of apical third filling was assessed by a calibrated experienced examiner. The specimens were examined under stereomicroscopy and scored 1 to 4 (i.e., from inadequate to complete root canal filling). The results were analyzed statistically by ANOVA and Duncan''s post hoc test at 5% significance level.

Results

There were no statistically significant differences (p>0.05) among the curvature degrees in groups 1, 3 and 4. Severely curved roots in group 2 presented bordering significance (p=0.05). The groups that associated the use of Ca(OH)₂ paste and points (2 and 4) showed better apical filling than the other groups, but this difference was statistically significant (p<0.001) only for roots with severe curvature.

Conclusion

According to the results of this study, the curvature degree did not influence the quality of filling. The techniques that used Ca(OH)₂-containing gutta-percha points yielded better filling of the apical third in roots with severe curvature.