银汞桩核用于磨牙修复的临床观察

目的 :对银汞桩核用于磨牙修复进行临床观察和分析。方法 :通过对 3 0例银汞桩核修复的磨牙进行6个月和 12个月的随访 ,观察其临床疗效。结果 :临床检查未发现修复体松动、折裂、脱落 ,X线牙片显示银汞桩与根管壁之间结合紧密。结论 :对于根管弯曲、分叉大、髓室大或C型根管的磨牙 ,银汞桩核修复效果良好。     

银汞桩核与分体式铸造桩核用于磨牙修复的疗效对比观察

目的:比较银汞桩核和分体式铸造桩核用于修复磨牙严重缺损病例的临床疗效.方法:将78例磨牙牙体严重缺损病例随机分为银汞桩核修复组40个牙和分体铸造桩核修复组41个牙,并随访观察2～3年.结果:两种桩核修复的临床疗效无显著差异(P＞0.05).结论:银汞桩核和分体式铸造桩核用于修复牙体严重缺损的磨牙都能取得较好的临床效果.     

全银汞桩核与铸造金属桩核用于磨牙修复的临床评价

目的探讨全银汞桩核与铸造金属桩核用于磨牙根管治疗后的修复效果。方法对20例采用全银汞桩核修复、20例采用铸造金属桩核修复的磨牙进行6个月到12个月的临床追踪．X线片检查桩核与牙体的适合性．观察其临床疗效。结果X线牙片检查显示．20例全银汞桩核与根管内壁、根尖方向的牙胶之间结合紧密、无暗影，根尖孔处封闭良好；20例铸造金属桩核患者中，有2例（下颌第一及第二磨牙各1例）X线牙片检查显示铸造金属桩尖端与牙胶间有约2mm间隙，根尖区见低密度影；1例患者X线牙片检查显示远中根管侧穿，根分歧区见低密度影；其余17例X线牙片检查显示铸造桩与根管内壁、根尖方向的牙胶间结合紧密、无暗影，根尖孔处封闭良好。结论全银汞桩核用于牙体缺损较严重的磨牙，较铸造金属桩核修复更安全可靠。     

玻璃纤维桩-树脂核与银汞-银粉玻璃离子桩核修复磨牙残冠的临床研究

目的比较玻璃纤维桩-树脂核与银汞-银粉玻璃离子桩用于磨牙冠缺损的修复效果。方法临床选择55例磨牙缺损患者,共75颗患牙,随机分为两组,玻璃纤维桩-树脂核组共24例29颗患牙,银汞-银粉玻璃离子桩核组31例共46颗患牙,分别进行玻璃纤维桩-树脂核和银汞-银粉玻璃离子桩核全冠修复,2年后对修复效果进行评价。结果玻璃纤维桩-树脂核组有1颗患牙出现根折,成功率96.6%;银汞-银粉玻璃离子桩核组有1颗患牙出现桩折,成功率97.8%,两组均无冠桩脱落,两组成功率差异无统计学意义(χ2=0.161,P>0.05)。结论对于重度磨牙缺损病例,选用玻璃纤维桩-树脂核和银汞-银粉玻璃离子桩核全冠修复均可。     

粘结银汞桩核在后牙修复中的应用

临床上常采用二段式桩核加全冠的形式修复经过牙髓治疗的牙齿。因材料和制作方式不同，现有多种类型的桩核系统，但各存在优缺点。近年来，不少学者对粘结银汞桩核进行了研究，它不仅能有效的防止微渗漏，还可以保留较多的牙体组织，而且能有效的避免侧穿，是一种前景广阔的修复形式。     

银汞桩核的应用研究

利用根管修复牙体缺损的桩核技术，已有两百多年历史。早在1700s年，Fauchard就将木桩置人根管辅助牙冠固位。目前临床常用的桩核是铸造金属桩、成品根管桩加复合树脂核。银汞桩核作为一种临床操作简便易行，价格低廉，无需过多制备根冠，不易造成根折的传统的修复牙体缺损的方法，开始引起临床工作者的注意并应用于临床。     

黏结银汞桩核修复磨牙残冠的临床观察

目的评价黏结银汞桩核修复磨牙残冠的临床效果. 方法对56颗磨牙残冠和43颗磨牙残冠分别采用黏结银汞桩核和成品桩-树脂核修复牙体缺损,全冠修复,并进行1～2年的随防,根据主诉及临床检查观察其疗效. 结果 56颗黏结银汞桩核修复体,3颗失败,成功率为96.4%.43颗采用成品桩-树脂核修复体,12颗失败,成功率为72.1%.两组之间成功率经χ^2检验,差异有统计学意义. 结论磨牙残冠采用黏结银汞桩核修复效果良好且优于成品桩-树脂核修复体.     

银汞桩核抗折裂强度的体外研究

目的：比较不同深度的银汞桩核修复后牙体组织的抗折裂强度和折裂模式。方法：选取40个完整拔除的下颌单根管前磨牙，常规根管治疗后，按颊舌径的大小分为4组，每组10个。Ⅰ、Ⅱ、Ⅲ组制作不同深度的银汞桩核，Ⅳ组为对照组。试件的底座固定在电子式万能测试仪上加载，记录试件折裂时测试机上的读数以及试件折裂的模式。结果：Ⅰ、Ⅱ、Ⅲ组之间无显著性差异（P〉0．05），Ⅰ、Ⅱ、Ⅲ组与Ⅳ组之间有显著性差异（P〈0．01）。结论：银汞桩核抗折裂强度与深度无关，其强度能满足人日常咀嚼食物所需的[牙合]力。     

螺纹桩树脂桩核修复下颌磨牙残根

笔者从1998年起,利用根内螺纹桩树脂桩核联合体全冠修复下颌磨牙残根。经过3年的观察,效果满意,报告如下:1资料和方法1.1一般资料29例32颗患牙,男13例,女16例;年龄28～65岁;其中下颌第一磨牙18颗,第二磨牙14颗。均为非融合根,根分叉有病变或髓室底已破坏,但牙周组织无炎症,牙根     

磨牙残冠的桩核修复

目的探讨磨牙残冠的修复方法以利于保存牙齿。方法对于磨牙可保留的残根残冠应用复合树脂粘结Para Post System成品桩，利用复合树脂制作核后冠修复。结果经过一至三年的临床观察，经过治疗的磨牙都取得良好的临床效果。结论在严格控制适应证和规范临床操作情况下，树脂粘结成品桩和复合树脂核是一种有效简便的修复方法，是磨牙保存的有效治疗手段。     

不同桩核微渗漏情况的体外研究

目的 :比较成品桩钉加复合树脂核、传统银汞桩核和粘结银汞桩核冠向微渗漏情况 ,探讨粘结银汞桩核在后牙修复中的应用前景。方法 :30颗新拔除的磨牙分为 3组 ,分别用成品桩钉加复合树脂核、传统银汞桩核和粘结银汞桩核修复后放入印度墨水中 1周 ,另选择 10颗磨牙作为阴性和阳性对照 ,评价冠方微渗漏情况。结果 :粘结银汞桩核微渗漏明显小于传统银汞桩核 (P <0 .0 1) ;传统银汞桩核与成品桩钉加复合树脂核差异无显著性 (P >0 .0 5 )。结论 :粘结银汞桩核修复可有效降低微渗漏 ,预防桩核修复后因微渗漏导致的并发症     

平行与层叠铸造分瓣桩核冠修复的临床对比观察

目的：比较平行与层叠铸造分瓣桩核冠修复牙冠大部分缺损的恒磨牙,并观察比较两种桩核冠临床修复的效果。方法：对52颗经过完善根管治疗的大面积缺损的磨牙,均采用铸造分瓣桩核冠,其中27颗采用平行分瓣桩核冠修复,25颗采用层叠分瓣桩核冠修复,随访3年。结果：平行分瓣桩核冠修复与层叠分瓣桩核冠修复方法的成功率依次是96.3%和92.0%,两组之间经χ2检验,无显著性差异。结论：采用平行分瓣桩核冠和层叠分瓣桩核冠修复牙冠大部分缺损的磨牙,均可取得良好的临床效果。     

CELAY全瓷桩核强度的研究

目的:比较Celay 全瓷桩核、铸造金属桩核及Parapost 预成桩复合树脂核修复的根管治疗牙全冠修复后的抗折裂强度。方法:60 个完整拔除的人上中切牙,根管治疗后随机分为5 组,每组12 个。A 组:牙体预备保留210 mm高的牙本质套圈,Celay 桩核;B 组:牙体预备无牙本质套圈,Celay 桩核;C 组:牙体预备保留210 mm 高的牙本质套圈,铸造金属桩核;D 组:牙体预备无牙本质套圈,铸造金属桩核;E 组:牙体预备保留210 mm高的牙本质套圈,Para2post 预成桩,复合树脂核。所有标本皆用Celay 全冠修复。标本在室温下保存于100 %湿度中30 d 后,在MTS 810 材料试验机上沿与牙长轴成45°的方向加载,测试折裂强度。结果:各组的折裂强度间有显著性差异( P < 0101) ,牙体预备保留210 mm高的牙本质套圈时,Celay 桩核与铸造金属桩核的折裂强度显著高于其他三组,其他三组之间无显著性差异,Celay 桩核修复时,有无210 mm高的牙本质套圈其折裂强度有显著性差异( P < 0105) 。结论:在牙体预备保留210 mm高的牙本质套圈时,Celay 桩核的强度可基本满足临床要求而不致发生桩核的折裂。     

Restoring a Failed Prefabricated Post and Core With a Sleeve Casting: A Clinical Report

A clinical case is described, and a technique is explained for making a custom sleeve cast post and core to salvage a fractured crown previously treated with an unretrievable prefabricated post. The restorative problem was to design and fabricate some sort of cast post and core that could be cemented to the remaining post. The amalgam and cement in the pulp chamber and coronal portion of the root canal were carefully removed so that a direct pattern could be made to form a tube which would surround the coronal part of the existing post like a sleeve. This sleeve casting was designed to provide attachment for a core to support a new restoration. This direct pattern technique results in a retained core that joins the already cemented post and provides a sound core for the retention of a new crown.     

两种根管桩在后牙牙体重度缺损修复中的应用比较

目的对比石英纤维桩和钴铬合金铸造桩的临床疗效。方法 78例患者共102颗患牙随机分为2组,每组51颗,分别用石英纤维桩全瓷冠和钴铬合金铸造桩全瓷冠修复,观察3年后的临床疗效。结果 2组各有1例患者（患牙1颗）失访,石英纤维桩组50颗患牙,49颗修复体稳固,边缘密合,咬合功能完好,1颗桩核松动。钴铬合金铸造桩组50颗患牙,43颗成功,2颗桩核松动,2颗继发根尖周炎,3颗牙根折裂。石英纤维桩组和钴铬合金铸造桩组的成功率分别为98%和86%,差异有统计学意义（χ2=4.89,P〈0.05）。结论石英纤维桩和钴铬合金铸造桩相比较少发生根折和继发根尖周炎。     

Analysis of Fracture Resistance of Endodontically Treated Teeth Restored with Different Post and Core System of Variable Diameters: An In Vitro Study

The restoration of endodontically treated teeth requires the fabrication of a post and core; to provide retention and support for the final crowns. The purpose of this study was to evaluate fracture resistance of endodontically treated teeth restored with prefabricated zirconia post (CP), milled zirconia post (MZ), pressable ceramic post (PC) and cast metal post (Ni–Cr) of 1.4 and 1.7 mm diameter. 48 freshly extracted human maxillary central incisors were used for this study. The teeth were distributed in four groups of 12 teeth each. From each group, 6 teeth were selected for 1.4 mm diameter post and rest of the 6 teeth, is selected for 1.7 mm diameter post. All teeth were restored with metal crowns. Each specimen from the group was subjected to “load to fracture” in universal testing machine at 130° angle and the maximum load at failure was recorded. Statistically significant difference was found between the failure load of the groups studied. In group I (Ni–Cr)—1.4 mm diameter post and core recorded a maximum fracture load of 534.83 ± 1.28 N and 1.7 mm diameter post and core showed 294.33 ± 1.02 N. In group II (PC)—1.4 mm diameter post and core recorded a maximum fracture load of 205.33 ± 1.61 N and 1.7 mm post and core showed 375.00 ± 1.57 N. In group III (CP)—1.4 mm diameter post and cores recorded a maximum fracture load of 313.00 ± 0.73 N and 1.7 mm post and core showed 638.67 ± 0.81 N. In group IV (MZ)—1.4 mm diameter post and cores recorded a maximum fracture load of 312.00 ± 0.86 N and 1.7 mm post and core showed 415.00 ± 0.89 N. Prefabricated zirconia post (1.7 mm) with pressable ceramic core (Cosmo post)—exhibited higher fracture resistance. Milled zirconia and prefabricated zirconia post—showed same value with 1.4 mm diameter post. Pressable ceramic post and core showed satisfactory result with 1.7 mm post, but showed lesser values with 1.4 mm diameter post.     

A Systematic Review of Dowel (Post) and Core Materials and Systems

Purpose: The aim of this systematic review was to determine which dowel (post) and core system is the most successful when used in vivo to restore endodontically treated teeth. Materials and Methods: A MEDLINE, a Cochrane, and an EMBASE search (three specified searches) were conducted to identify randomized (RCT) and nonrandomized controlled clinical trials (CCT), cohort (CS), and case control studies (CCS) until January 2008, conducted on humans, and published in English, German, and French, relating to dowel and core systems for restoring endodontically treated teeth. Also, a hand search was conducted, along with contact with the authors when needed. Results: The MEDLINE, Cochrane, and EMBASE searches identified 997, 141, and 25 published articles, respectively. Ten articles from the MEDLINE and seven articles from the Cochrane search (that were also identified in the MEDLINE search) met the inclusion and validity assessment criteria. Six out of the ten studies were RCTs, two were CCTs, and two CSs. The RCT studies suggest that carbon fiber in resin matrix dowels are significantly better than precious alloy cast dowels (number needed to treat, NNT = 8.30). Tapered gold alloy cast dowels are better than ParaPost^® gold alloy cast dowels (NNT = 13.15). ParaPost^® prefabricated dowels are slightly better than ParaPost^® cast dowels (NNT = 175.4). Glass fiber dowels are significantly better than metal screw dowels (NNT = 5.46), but worse than titanium (NNT =?21.73) (moderately). Carbon fiber dowels are worse than gold alloy cast dowels (significantly) (NNT =?5.81) and than amalgam dowels (NNT =?125) (slightly). The CCT studies suggest that metal dowels are better (NNT = 21.73) but also worse than cast dowels (NNT =?33.33) depending on the remaining amount of coronal hard tissue. Quartz fiber dowels show success rates similar to and worse than glass fiber‐reinforced dowels (NNT =?37.03). The results from the CS studies suggest that carbon fiber in resin matrix dowels are better (moderately) than carbon fiber + quartz and quartz fiber dowels. Titanium dowels with a composite build‐up are better (moderately) than gold alloy cast dowels. Conclusions: According to the studies of the highest levels of evidence, carbon fiber in resin matrix dowels are significantly better than precious alloy cast dowels (RCT). Glass fiber dowels are significantly better than metal screw dowels (RCT) and moderately better than quartz fiber dowels (CCT). Carbon fiber dowels are significantly worse than metal dowels (of precious alloy) (RCT). Prefabricated metal dowels are slightly better than cast dowels (RCT), but moderately worse when no collar of the dentin above the gingiva could be achieved (CCT).     

上颌第一磨牙分体桩核冠的三维有限元分析

目的：应用三维有限元分析不同直径和长度的分体桩核冠修复磨牙后牙根及核桩的应力分布规律,比较分体桩的直径和长度对修复磨牙的影响。方法：应用螺旋CT扫描及医学影像传输与转录技术,建立不同直径和长度的分体桩核冠的上颌第一磨牙三维有限元模型,比较不同载荷下各桩核冠修复磨牙后牙根及核桩的应力分布规律。结果：减少核桩的长度,可以降低牙根及核桩的应力峰值;牙根的应力随着核桩直径的增加而增加,而核桩的应力随其直径的增加而减少。结论：适当减少核桩的长度和直径有利于提高修复体的成功率。     

两种桩核冠修复磨牙残根的临床观察

目的:观察分瓣铸造桩核冠和成品螺纹桩树脂核冠在磨牙残根修复中的效果。方法:对69例严重缺损的磨牙,32例进行分瓣铸造桩核冠修复(A组),37例进行螺纹桩树脂核冠修复(B组),术后对其中61例残根随访2~3年。结果:54例使用良好(A组26例,B组28例),A组和B组的成功率分别为86%和90%,总成功率为88.5%。结论:两种桩核冠用于磨牙残根修复均可取得良好的临床效果。