两种根管长度电测仪的准确率比较

目的:评价两种根管长度电测仪的准确率。方法:选择60颗单根管下颌第一前磨牙,分别用Root ZX和ProPex根管电测仪测量根管工作长度。然后拔除牙齿,用细金刚砂车针沿牙根尖1/3纵轴方向磨出剖面,显露根尖狭窄处,在牙科手术显微镜下用游标卡尺测量根管工作长度。用电测仪测量值减去游标卡尺测量值,准确率范围限定在±1.0mm。结果:Root ZX根尖电测仪准确率为90%,ProPex根管测量仪准确率为93.3%,两者差异无统计学意义(P0.05)。两种电测仪测量的工作长度均未超出根尖孔。结论:Root ZX和ProPex根管测量仪均是较理想的测量仪,两者均能较准确的确定根管的工作长度。     

矿化三氧化复合物在年轻恒牙活髓切断术中的应用

目的:观察在年轻恒牙活髓切断术中应用矿化三氧化复合物(MTA)作为盖髓剂的临床疗效。方法:选择6.5～12.5岁患者的32颗深龋去腐露髓和意外露髓的年轻恒磨牙,平均分为MTA治疗组和光固化氢氧化钙对照组,分别用MTA和光固化氢氧化钙作直接盖髓剂进行活髓切断术治疗。18个月后进行临床评价,观察MTA和光固化氢氧化钙盖髓后牙齿的临床症状、牙髓活力、牙本质桥形成及根尖孔形成情况。结果:应用MTA直接盖髓的患牙18月后修复性牙本质桥形成,X线片提示根尖部喇叭口闭合,根尖暗影消失,牙髓保持活力,牙髓存活率为93.75%,显著高于对照组的81.25%,两组比较有统计学差异(P0.05)。结论:MTA在年轻恒牙活髓保存治疗中是一种较理想的盖髓剂。     

两种探测锉电测根管长度稳定性和准确性的比较

目的比较不锈钢根管锉和ProTaper镍钛手用根管锉电测根管长度的稳定性和准确性。方法选择临床需行根管治疗、根尖发育完全的60颗活髓后牙为研究对象。开髓、拔髓后探通根管,在同一颗牙上先用不锈钢锉初尖锉作为NeosonoTM根管长度电测仪的探测电极测量根管长度,评价其稳定性,测量稳定的根管则带针拍X光数字成像(radio visio graphy,RVG)牙片评价其准确性,然后用ProTaper手用镍钛初尖锉测量根管长度,同样的方法评价其稳定性和准确性,将结果进行统计分析。结果①不锈钢组EAL(根管长度电测仪)测量稳定的根管数为102个,占65.38%,镍钛组为142个,占34.62%,两者相比有显著性差异。②在两种探测锉测量均稳定的根管中,不锈钢组EAL测量准确的根管数为89个,占87.25%,镍钛组为95个,占93.14%,两者相比无显著性差异。结论大锥度镍钛探测电极下EAL测量稳定性高;探测电极的锥度、材质对EAL测量准确性影响很小。临床上使用大锥度镍钛锉电测根管长度更稳定可靠,且安全准确。     

Electrometric determination of the working length of root canals by means of Apex locator

AIM. To evaluate an apex locator in determining the working length of root canals and detecting micro-communications with the pulp chamber. METHODS. The apparatus was tested on 21 patients, aged 18 - 70, who received endodontic treatment of 34 teeth with 45 root canals. The apparatus was used in compliance with the instructions of the manufacturer. The precision of the instrument was determined by a radiograph of the tooth with a file inserted in it at a depth equal to the length determined with the Apex locator. The obtained results were divided into three groups: canals determined as longer; canals in which the outline of the instrument was close to the roentgenologic apex; and canals determined as shorter. CONCLUSION. The average deviation from the roentgenologic apex was 1.17 mm, which is, in fact, the area of the physiological apex opening - the ideal limits for treatment and obturation. The apparatus can be successfully used to make differential diagnosis is useful of deep caries with pulpitis chronica ulcerosa. It is ergonomic and easy to use.     

应用锥形束CT评估上颌中切牙髓腔增龄变化的研究

目的利用锥形束CT(CBCT)测量上颌中切牙髓腔的长度和直径,为临床桩核设计提供依据。方法 76名患者100颗上颌中切牙按照年龄分为5组,A组15²4岁,B组2524岁,B组25³4岁,C组3534岁,C组35⁴4岁,D组4544岁,D组45⁵4岁,E组5554岁,E组55⁶5岁。用锥形束CT进行扫描,分析上颌中切牙髓腔长度及釉牙骨质界处、根中1/2、距根尖4 mm处髓腔宽度。结果采用t检验和拉丁方进行数据比较,髓腔长度随着年龄增长没有出现显著性差异(p>0.05),釉牙骨质界处、根尖1/2、距根尖4 mm处髓腔宽度随着年龄增长有显著性差异(p<0.05),宽度逐渐变窄。结论髓腔宽度随着年龄增长逐渐变窄,髓腔长度与年龄的关系不明显。CBCT能精确测量髓腔的长度和宽度,按桩道制备的要求进行合理的分析设计。     

首次根管治疗后患牙疗效状况的影响因素分析

目的：评估首次根管治疗两年后患牙愈合率情况及影响因素。方法：便利取样法取接受初次根管治疗的132颗患牙,以手用ProTaper联合冠向下技术进行治疗。2年末随访,据临床检查和X线片评判疗效,并分析相关因素对疗效的影响。结果：88例患者（104颗患牙）完成了回访,脱落21例（28颗患牙）。随访病例中有87颗患牙治愈,17颗无效。治愈率比较：1单根牙高于多根牙,差异有统计学意义（P〈0.05）;2活髓牙高于死髓牙、根尖周无病变患牙高于有病变患牙,差异均有统计学意义（P〈0.01）。结论：牙根数目、牙髓和根尖周状况对首次根管治疗治愈率有显著影响。     

半导体激光照射预防和缓解牙髓炎急性反应

目的观察半导体激光照射预防及缓解根管治疗急性反应（endodontic interappointment EIAE）的效果。方法选取需进行根管治疗的患有牙髓炎及根尖周炎的牙病患者304例，随机分为2组，在进行根管预备及樟脑酚棉捻开放后，其中1组（155例）应用半导体激光在牙体外辐射根尖区，另1组不作处置，24h后观察记录患者主观症状和体征，比较2组根管治疗急性反应发生率。另选取根管充填后发生急性反应的牙病患者175例，随机分为2组，1组（96例）应用半导体激光在牙体外辐射根尖区；另1组（79例）给予口服甲硝唑及先锋Ⅳ，24h后观察记录患者主观症状和体征，比较2组缓解根管治疗急性反应效果。结果304例牙病患者中，应用半导体激光照射组的急性反应发生率为4．52％，未照射组为10．74％，2组差异有统计学意义（P〈0．05）；175例根管填充后发生急性反应的患者中，半导体激光照射组的EIAE缓解效果明显好于药物治疗组，2组差异有统计学意义（P〈0．05）。结论半导体激光照射可有效预防和缓解根管治疗急性反应。     

Endodontic treatment of permanent teeth in children with a new calcium-carbamide-formaldehyde paste

AIM, MATERIAL AND METHODS: Endodontic treatment of a total of 303 teeth with pulpitis and periodontitis was performed with a new calcium-carbamide-formaldehyde paste. In three children with fractured teeth with complications, the applied treatment was combined (2 teeth with apical osteotomy and 1 with cystectomy). Control examinations were carried out at months 6, 12 and 24 and clinically healthy teeth and teeth with complications were registered. RESULTS: In the pulpitis group the clinically healthy teeth were 97.55% +/- 1.08 at the 6th month; 96.85% +/- 1.26 at the 12th month and 92.92% +/- 2.41 at the 24th month. In teeth with periodontitis 91.56% +/- 3.05 were clinically healthy at the 6th month; 93.83% +/- 2.67 at the 12th month and 98.03% +/- 1.98 at the 24th month. No statistical significance of the differences between pulpites and periodontites was found (P > 0.05). Recovery of the bone structure was observed in the teeth with combined endodontic and surgical treatment at the 12th month. CONCLUSIONS: The calcium-carbamide-formaldehyde paste stimulates bone regeneration and closing of the apex without coloring the hard dental tissues.     

Vitapex诱导年轻恒牙根尖形成的临床疗效观察

目的观察Vitapex糊剂在根尖诱导形成术中的疗效。方法随机选择门诊52例根尖未发育完成的牙髓坏死年轻恒牙。根管预备,消毒后用Vitapex糊剂进行根尖诱导,观察1年。结果成功27例（51．92％）,显效21例（40．38％）,失败4例（7．69％）,总有效48例（92．31％）。结论Vitapex糊剂是一种有效的根尖诱导剂。     

Vitapex诱导年轻恒牙根尖形成的临床疗效观察

目的观察Vitapex糊剂在根尖诱导形成术中的疗效。方法随机选择门诊52例根尖未发育完成的牙髓坏死年轻恒牙。根管预备,消毒后用Vitapex糊剂进行根尖诱导,观察1年。结果成功27例(51.92%),显效21例(40.38%),失败4例(7.69%),总有效48例(92.31%)。结论 Vitapex糊剂是一种有效的根尖诱导剂。     

Root canal filling of endodontically treated teeth by dentistry students in clinical offices from 1996 to 1998--radiological results

THE PURPOSE of our study was to evaluate radiologically the degree of root canal filling of teeth treated by students. METHODS: 724 segment radiographs with an overall number of 1142 canals were examined. The level of root canal filling was measured from the radiographic apex. The objects of the study were divided into three groups: 1. canals filled to more than 2 mm from the apex; 2. canals filled up to 2 mm from the apex; 3. canals filled to the radiographic apex; 4. overfilled canals. The objects from the second and the third group were combined as a group of successfully filled canals. RESULTS: The results showed 62.90% of successfully filled canals, 27.80% of the canals were filled more than 2 mm from the radiological apex and 9.30% - with overfilling. The greatest percentage of canals filled more than 2 mm from the apex refers to the mesial and vestibular canals of the molars, and after them the most frequently obturated canals are those of single-root teeth (57.94%). CONCLUSIONS: The results obtained allow us to estimate the endodontic treatment of the students as good. The greatest difficulties are encountered in filling the vestibular and mesial canals of the molars.     

Endodontic treatment and periapical health in patients of the Institute of Dentistry in Lódź

OBJECTIVE: Retrospective assessment of periapical health in relation to sex, age and quality of root-canal treatment among adult patients of the Institute of Dentistry in Lód?. Orthopantomograms of 439 subjects were assessed considering the prevalence of endodontic treatment, technical quality of root-canal fillings and the state of periapical tissues. The assessment of orthopantomograms of 174 (39.6%) men and 265 (60.4%) women was carried out. A significant increase (p=0.016) in the mean number of endodontically treated teeth according to age (range from 1.4 in subjects under the age of 20 to 3.4 in those aged 70 years and over) and the mean number of teeth with periapical pathosis (from 0.9 to 2.4, respectively) (p=0.020) was observed. Of 10054 radiographically examined teeth 9.7% was treated endodontically, whereas, 5.5% exhibited periapical pathosis. The percentage of teeth with periapical lesions was significantly higher (p=0.015) in men (6.2%) as compared to women (5.0%). Periapical radiolucency occurred significantly more often (p=0.0001) in endodontically treated teeth (36.4% of cases) than in those with untreated root canals (2.1%). Teeth with inadequately filled root canals significantly more often revealed the presence of periapical pathosis (49.6%) in comparison to teeth with adequately filled root canals (4.2%). CONCLUSIONS: The prevalence of endodontic treatment and apical periodontitis increases with age. The prevalence of apical periodontitis depends on sex - periapical lesions were more often found in men. The quality of endodontic treatment significantly affects periapical health.     

Propex根管测量仪对急性根尖周炎患牙工作长度测量的评价

目的:评价急性根尖周炎患牙根管工作长度测量中应用Propex根管测量仪的准确性。方法:220例急性根尖周炎患者,276颗患牙512个根管,随机分为两组,对照组摄X线牙片观察并测量根管工作长度;实验组采用ProPex根管测量仪测量根管工作长度。结果:对照组和实验组工作长度准确率分别为77.5%、91.5%,两组准确率的差异有统计学意义(P0.05)。结论:ProPex可以比较准确地测量急性根尖周炎患牙的工作长度。     

前牙完全脱位再植的疗效观察

目的探讨前牙完全脱位再植的疗效情况。方法2006年1月至2009年6月对56颗完全脱位前牙实施脱位牙再植术,经过6个月至2年以上的随访观察,观察其疗效。结果离体时间越短疗效越好,脱位牙保存方式湿保存好于干保存,根尖孔未闭合者疗效好于闭合者.结论离体时间、脱位牙保存方式、根尖孔闭合情况是影响前牙完全脱位再植疗效的主要因素。     

难治性根尖周炎的治疗体会

目的：评价难治性根尖周炎的治疗效果。方法：X线根尖片加电子根管测量仪测量根管长度,预弯K型锉预备根管,5%次氯酸钠、17%乙二胺四乙酸（EDTA）交替冲洗根管,氢氧化钙纸尖与碘仿根管封药,Vitapex糊剂加牙胶尖侧压充填根管。结果：采用此方法治疗58颗患牙,2年后复查,成功率达89.7%。结论：本方法治疗难治性根尖周炎疗效值得肯定。     

甲哌卡因在不可逆性牙髓炎治疗中的应用

目的评价2%甲哌卡因在不可逆性牙髓炎治疗中的疗效。方法将396例不可逆性牙髓炎患者以2%甲哌卡因行粘膜下浸润麻醉,观察麻醉效果。结果 283例磨牙行开髓引流术或牙髓失活术,其余113例患者行一次性拔髓后行根管预备术。上下颌牙麻醉优良率分别是94.71%和83.09%,经统计学分析构成比有显著性差异(P<0.01);磨牙、前磨牙和前牙麻醉优良率分别是84.45%、98.85%和100%,经统计学分析构成比有显著性差异(P<0.01)。结论甲哌卡因操作简单,显效时间快维持时间长且副作用小,在牙髓治疗术中可取得良好的麻醉效果。     

根管治疗期急症的相关因素分析

目的探讨根管治疗期间急症发生的相关因素。方法对208例根管治疗病例进行临床观察,分析急症发生的相关因素。结果根管治疗期间急症发生率为11.1%,其中扩大针超出根尖孔、充填质量、无瘘管型尖周炎等相关因素影响下根管治疗急症发生率较高。结论根管治疗期间急症发生较为密切的因素有术者操作水平、根管病变情况等。     

3种方法测量牙齿根管工作长度准确性的比较研究

目的：探讨指感法、X光数字化成像法、电测法测量根管工作长度的准确性。方法：选取拟行根管治疗的恒前牙病例共600颗患牙,按照随机数字表法将其分为感法组207颗、X光数字化成像法组202颗和电测法组191颗,分别使用指感法、X光数字化成像法、电测法进行根管工作长度测量,并以此长度根管预备后试尖判断准确性。结果：电测法的准确率90.58%明显高于指感法的58.46%和X光数字化成像法的71.78%,差异均有统计学意义（P〈0.01）,而X光数字化成像法的准确率明显高于指感法,差异有统计学意义（P〈0.05）。结论：Raypex5测量仪是一种操作方便、准确率高的根管工作长度测量仪,X光数字化成像系统作为辅助应用于根管治疗中。     

三种根管工作长度测量法精确性的临床评价

目的：观察和探讨手感法、摄片法和电测法测定根管工作长度的精确性。方法：选择慢性根尖周炎、牙周病、残根残冠等毫无保留价值的患牙及正畸需拔的健康牙，共20颗牙30个根管，分别用手感法、摄片法和电子根测仪Root ZX测量各根管的工作长度，将拔牙后直视下测得的根管长度作为诊断标准，与各种方法所测得的值进行比较，以确定其准确率。结果：手感法的准确率为33．33％，摄片法为43．33％，电测法为80．00％，手感法与摄片法比较无统计学意义（P〉0．05），RootZX法与手感法比较有统计学意义（P〈0．01），RootZX法与摄片法比较有统计学意义（P〈0．01）。结论：电子根尖定位仪测定根管工作长度的准确率比摄片法和手感法高，临床应结合使用可提高准确率。     

四手操作对根管预备中辅助设备的使用效果与保养的意义

目的探讨四手操作在根管预备中辅助设备使用与保养的意义。方法回顾分析、总结628例在根管预备过程中电子根尖定位仪、机用镍钛器械、超声根管治疗仪和牙科显微镜辅助设备的合理使用和正确保养的临床资料。结果 628例根管预备治疗获得满意的效果,上述辅助设备功能正常、保养良好。结论四手操作在根管预备中辅助设备的合理使用和正确保养方面起到积极作用,可延长辅助设备的使用寿命、减少因设备原因造成的并发症。