两种根管充填糊剂一次性根管治疗术后疼痛和疗效观察

目的：比较两种根管充填糊荆治疗的一次性根管治疗术后疼痛和临床疗效。方法：103颗需根管治疗的患牙随机分为2组，分别采用Cortisomol糊剂和碘仿氧化锌丁香油水门汀、以及牙胶尖，冷侧压法一次性充填根管。观察术后1周内疼痛的VAS评分和1年后的临床疗效。结果：Cortisomol组2天的VAS评分显著低于碘仿氧化锌丁香油组（P〈0．01），7天时差异无显著性（P〉0．05）。术后一年复查，Cortisomol组疗效好于氧化锌组，两组之间差异无显著性（P〉0．05）。结论：Cortisomol糊剂充填根管，可以有效减少一次性根管充填术后急性期疼痛的发生。     

老年人慢性根尖周炎根管治疗一次术及多次术术后疼痛的临床研究

目的：比较老年人慢性根尖周炎根管治疗一次术及多次术术后疼痛的发生率和程度。方法：将老年人慢性根尖周炎患牙共70例随机分为两组：根管治疗一次术组（实验组,40例）和根管治疗多次术组（对照组,30例）,分别进行根管治疗一次术和多次术,于术后0h、6h、12h、24h、48h和7d由患者自评VAS疼痛分值,并于术后24h、7d临床评定患者疼痛率。结果：两组间术后各观察时间点患者自评VAS疼痛分值差异无统计学意义（P〉0．05）;两组间术后24h和术后7d临床评定轻、中、重度疼痛率差异无统计学意义（P〉0．05）。结论：老年人根尖周炎根管治疗一次术和多次术后患者自评疼痛程度及临床评定的疼痛发生率相近,提示在严格选择适应症并谨慎操作下,老年人根管治疗一次术具有临床可行性。     

机用镍钛根管器械用于根管治疗术一次法的近远期疗效

目的：观察机动镍钛根管器械用于根管治疗治疗术一次法治疗根尖周炎的近远期效果，并探讨其临床适应症。方法：300例病人随机分成两组，实验组150例297个牙，进行根管治疗术一次法，以ProTaper机用镍钛器械预备根管；常规组150例304个牙，采用常规法完成根管治疗术。术后3d复诊，评估术后疼痛情况；术后1年、2年复查并评估治疗效果。结果：根管充填术后疼痛率实验组为4．38％，常规组为4．28％；术后2年根管治疗术成功率实验组为95．18％，常规组为94．58％。两组近远期疗效均无显著性差异（P〉0．05）。结论：机动镍钛根管器械用于根管治疗术一次法术后反应少，有较为可靠的远期疗效，适应于非急性期的各类根尖周病。     

感染根管一次性根管治疗的疗效观察

目的评价感染根管一次性根管治疗的临床效果和可靠性。方法选择临床诊断为牙髓坏死、慢性根尖周炎、急性根尖周炎的单根管患牙138颗为研究对象。76颗患牙在一次治疗内完成根管预备和根管充填,设为一次组;62颗患牙经2次治疗后完成根管充填（第1次治疗后氢氧化钙封药1周）,设为二次组。观察2组在根管治疗术前、术后的疼痛状况,评价术后6月、1年和2年的治愈率,比较2组的临床疗效。结果根管治疗后,一次组和二次组术后疼痛率的差异无统计学意义。术后6月、1年和2年,一次组的治愈率为68.4%、92.1%、98.7%,二次组分别为64.5%、91.9%、96.8%,2组治愈率的差异也无统计学意义（P>0.05）。结论与2次治疗后完成根管充填相比,一次性根管治疗的术后疼痛和2年治愈率差异不大,且疼痛期较短,具有一定的临床可行性。     

降低咬合对急性牙髓炎一次性根管治疗术后疼痛影响的研究

目的探讨降低咬合对急性牙髓炎一次性根管治疗术后疼痛的影响。方法选择2012年1—8月汕头市金平区中医医院口腔科门诊收治的下颌磨牙急性牙髓炎患者44例（共44颗患牙）,按就诊顺序随机分为试验组和对照组,每组22例（22颗患牙）。试验组患牙在行一次性根管治疗术后作降低咬合处理,使其在正中、侧方咬合位均无咬合接触;对照组患牙在行一次性根管治疗术后不作降低咬合处理。记录两组患者术后疼痛发生情况,并在术后7d内每天1次记录疼痛的视觉模拟评分（visual analogue scale／score,VAS）分值。比较两组患者术后疼痛发生率及疼痛VAS分值的差异。结果试验组患者术后疼痛发生率为36_36％,对照组为40．91％,两组患者的术后疼痛发生率差异无统计学意义（P〉0．05）。两组患者术后7d内的疼痛VAS分值比较,实验组均比对照组略低,但差异并无统计学意义（P〉0．05）。两组患者中发生术后疼痛者7d内的疼痛VAS分值比较,试验组均比对照组低,且差异均有统计学意义（P〈0．05）。结论单纯降低咬合对急性牙髓炎一次性根管治疗术后疼痛发生率无明显影响,但对于会发生术后疼痛的患者,可以减轻其疼痛的程度。     

老年人死髓牙一次性根管治疗的临床疗效评价

目的：观察老年人感染根管应用机用镍钛器械ProTaper,联合超声冲洗一次性根管治疗的术后反应和短期治愈情况,评价一次性根管治疗的临床可行性。方法：选择2010年1月至2013年6月在我院就诊,临床诊断为牙髓坏死、慢性根尖炎的老年人感染根管病例120例患牙,年龄6l-83（71.3＆#177;5.8）岁。应用机用镍钛器械ProTaper联合超声冲洗完成根管预备后按就诊顺序随机分为一次组和二次组,一次组60例一次法完成根管充填;二次组60例分二次法根管治疗术,疗程间氢氧化钙根管封药,对两组患牙进行临床效果比较分析。临床观察的主要指标有术后1周患者的自评疼痛同时参考医师的临床检查进行综合评定的疼痛率、术后6个月与术后2年X线片和临床评定治愈率。结果：两组患者术后1周临床评定疼痛率一次组为40.0%,两次组为33.3%,两组间差异无统计学意义（P＞0.05）。治疗术后6个月及2年回访复诊综合疗效评估情况为：术后6个月一次组治愈成功率为73.31%,两次组为71.4%;术后2年的临床治愈成功率分别为：78.3%、73.8%,两组间差异无统计学意义（P＞0.05）。结论：应用机用镍钛器械ProTaper联合超声冲洗,一次法治疗老年人感染根管,能够有效地减少术后疼痛,疼痛程度较轻,并可减少患者复诊次数,缩短疗程,具有良好的临床效果和可行性。     

ProTaper机用镍钛锉预备根管的临床评价

目的观察ProTaper机用镍钛锉的根管预备效果。方法将行根管治疗的76颗患牙共146个根管随机分为P组（38颗牙，74个根管）和S组（38颗牙，72个根管），P组用ProTaper机用镍钛锉冠根向逐步深入法预备根管，S组用手用不锈钢锉逐步后退法预备根管，观察两组在根管预备时间、锉折断、备根后患牙的疼痛发生率和根充效果的差异。结果P组根管预备时间平均为4min20s，明显少于S组的9min31s；两组的器械折断率无显著性差异（P〉0．05）；P组备根后疼痛发生率为5．3％，明显低于S组的23．7％（P〈0．05）；P组根充恰填率明显高于S组（P〈0．01），欠填率明显低于S组（P〈0．01）。结论只要掌握冠根向备根技术的要点，ProTeper机用锉比传统手用不锈钢锉更省时省力，可以有效地降低术后疼痛发生率，提高根充效果。     

热侧压牙胶根管充填术的临床疗效

目的 观察热侧压牙胶根管充填术的临床疗效。方法 随机选择200例单根管患牙,实验组用热侧压牙胶充填术,对照组用传统冷侧压牙胶充填术,比较两组的根管充填效果及术后疼痛发生率。结果 两组的恰填率无显著性差异（P〉0．05）,热侧压牙胶充填术组的欠填率低于对照组（P〈0．05）。结论 热侧压牙胶根管充填术改善了牙胶的根管适应性,提高了临床根管充填效果。     

根管预备后开放引流对根管治疗期间急症发生的影响

目的探讨减少根管治疗期间急症的方法。方法选择460颗慢性根尖周炎患牙，随机分为2组。试验组在根管预备后预防性开放引流3—4d，复诊时超声治疗仪荡洗根管后行根管充填。对照组进行封药后常规根管治疗。观察2组在根管预备和根管充填后发生根管治疗期间急症的情况。结果根管预备后，试验组有33例出现疼痛等不良反应，发生率为14．47％；对照组有54例出现不良反应，发生率为23．28％；2组间差异有统计学意义（P〈0．05）。试验组有195颗患牙如期完成根管充填，其中20例发生急症，发生率为10．23％，对照组有183颗如期完成充填，21例发生急症，发生率为11．48％，两组间差异无统计学意义（P〉0．05）。结论根管预备后开放引流可减少根管预备后急症的发生。     

根管预备后超声冲洗的临床研究

目的 对不同方法根管预备后超声冲洗进行临床评估。方法 将121例患者144颗患牙，随机分成四组：手用不锈钢K锉组；手用不绣钢K锉＋超声冲洗组；机用不锈钢K锉组；机用不绣钢K锉＋超声冲洗组。手用不绣钢K锉采用逐步深入法预备根管，机用不绣钢K锉采用逐步后退法预备根管。比较四组根管预备后疼痛发生情况率、根管充填质量、根尖偏移和倜枝根管充填情况，以及根管充填一年疗效观察。结果各组根管预备后疼痛无显著性差异（P〉0．05）。超声组侧枝根管充填率高于单纯手用和机用组。术后一年复查98颗，相应各组无显著性盖异（P〉0．05）。结论 根管预备后超声冲洗，对降低术后疼痛及提高临床治疗有效率无明显效果；但可以提高侧枝根管充填率。     

Periradicular repair after two-visit endodontic treatment using two different intracanal medications compared to single-visit endodontic treatment

The number of appointments necessary to treat infected root canals is one of the most controversial issues in endodontics. This study evaluated, in dogs, the response of the periradicular tissues to the endodontic treatment of infected root canals performed in a single visit or in two visits, using different interappointment dressings. Periradicular lesions were induced by inoculating Enterococcus faecalis in the root canals. After confirming that a periradicular lesion developed, the root canals were treated within one or two visits, using either ozonized oil or calcium hydroxide in camphorated paramonochlorophenol (CMCP) as an intracanal medication. After 6 months, the animals were sacrificed and the specimens were processed for histological and histobacteriological analysis. The root canals treated in a single visit showed a success rate of 46%. When a calcium hydroxide/CMCP-based interappointment intracanal medication was used, 74% of the cases were categorized as success. In cases where ozonized oil was used as the intracanal medication, a success rate of 77% was observed. These results of the present study demonstrated that the two-visit treatment offered a higher success rate compared to one-visit therapy. In addition, ozonized oil may potentially be used as an intracanal medication.     

Clinical and radiographic evaluation of one- and two-visit endodontic treatment of asymptomatic necrotic teeth with apical periodontitis: a randomized clinical trial

The present investigation recorded the 2-year clinical and radiographic outcome of one- and two visit endodontic treatment and studied the significance of the bacteriologic sampling results on the outcome. A randomization procedure allocated 53 teeth to one-visit treatment and 48 teeth to two-visit treatment. At the end of the study period, 32 teeth (65%) in the one-visit group and 30 teeth (75%) in the two-visit group were classified as healed. The statistical analysis of the healing results did not show any significant difference between the groups (p = 0.75). Forty-nine (80%) of the 61 teeth that were obturated after a negative micobiologic sample were classified as healed. Teeth sealed after positive samples healed in 44%. The present study gave evidence that similar healing results might be obtained through one- and two-visit antimicrobial treatment.     

Influence of calcium hydroxide intracanal dressings on the prognosis of teeth with endodontically induced periapical lesions

AIM: This prospective clinical study explored the influence of calcium hydroxide as an interappointment dressing on the healing of periapical lesions associated with pulpless teeth that had not been endodontically treated previously. This was achieved by comparing the prognosis after a two-visit root canal treatment with that following a one-visit treatment. METHODOLOGY: Seventy-three patients were recruited having one tooth with an endodontically induced lesion. Of these patients, 67 could be re-examined. Calcium hydroxide was placed in the instrumented root canals of 31 teeth for at least one week and the treatment finished at the second visit. Thirty-six teeth were root canal treated at one visit. The criteria for success were the absence of signs and symptoms indicating an acute phase of periapical periodontitis and radiographically a periodontal ligament space of normal width. Methods for event time analysis were used to evaluate and compare the prognosis of both treatment approaches. RESULTS: The probability that complete periapical healing will take place increased continuously with the length of the observation period. In both treatment groups the likelihood that the root canal treatment yields a success within an observation time of five years exceeded 90%. A statistically significant difference between the two treatment groups could not be detected. CONCLUSIONS: From a microbiological perspective, one-visit root canal treatment created favourable environmental conditions for periapical repair similar to the two-visit therapy when calcium hydroxide was used as antimicrobial dressing. One-visit root canal treatment is an acceptable alternative to two-visit treatment for pulpless teeth associated with an endodontically induced lesion.     

Outcome of one-visit and two-visit endodontic treatment of necrotic teeth with apical periodontitis: a randomized controlled trial with one-year evaluation

The choice of one-visit versus two-visit root canal therapy for necrotic teeth with apical periodontitis is a source of current debate. The primary objective of this randomized controlled clinical trial was to compare radiographic evidence of periapical healing after root canal therapy completed in one visit or two visits with an interim calcium hydroxide/chlorhexidine paste dressing. Ninety-seven patients met the inclusion criteria and consented to participate in this study. Patients were randomly assigned to either the one-visit or two-visit group, and root canal therapy was performed with a standardized protocol. Patients in the two-visit group received an intracanal dressing of calcium hydroxide/chlorhexidine paste. Sixty-three patients, 33 in the one-visit group and 30 in the two-visit group, were evaluated at 12 months. The primary outcome measure was change in apical bone density by using the periapical index (PAI). Secondary outcome measures were proportion of teeth healed or improved in each group. Both groups exhibited equally favorable periapical healing at 12 months, with no statistically significant differences between groups.     

锥形束CT与根尖片对实验性根尖周炎根管治疗结果的评估

目的：???观察一次法根管治疗的短期临床疗效,并比较锥形束CT（CBCT）与根尖片在根管治疗结果评估中的差异。方法??选择4只比格犬的24颗上颌前磨牙（56个根管）为研究对象,所有牙齿形成实验性根尖周炎后,随机分为2组,一组采用一次法根管治疗,另一组采用两次法根管治疗,术后6个月应用CBCT和根尖片评估根管治疗疗效。结果 CBCT显示：一次法根管治疗成功率为28.57%,二次法根管治疗成功率为53.57%,两组间的成功率差异无统计学意义（P=0.057）。根尖片显示：一次法根管治疗成功率为67.86%,二次法成功率为78.57%,两组间差别无统计学意义（P=0.365）。CBCT显示的根管治疗总成功率为41.07%,根尖片显示的总成功率为73.21%, CBCT与根尖片在根管治疗后疗效评估中的差异有统计学意义（P=0.001）。结论??在针对实验性根尖周炎的治疗中,一次法根管治疗的近期治愈率与两次法根管治疗的近期治愈率相比较,其差异无统计学意义;然而,CBCT与根尖片的检查结果,在根管治疗后的疗效评估上,存在着一定差异。由此可见,CBCT这种三维检查手段相较于根尖片的二维影像来说,在根管治疗后对疾病的诊断评估中的准确性以及灵敏度更高。     

Outcome of Root Canal Treatment in Dogs Determined by Periapical Radiography and Cone-Beam Computed Tomography Scans

The purpose of this study was to compare the favorable outcome of root canal treatment determined by periapical radiographs (PRs) and cone beam computed tomography (CBCT) scans. Ninety-six roots of dogs' teeth were used to form four groups (n= 24). In group 1, root canal treatments were performed in healthy teeth. Root canals in groups 2 through 4 were infected until apical periodontitis (AP) was radiographically confirmed. Roots with AP were treated by one-visit therapy in group 2, by two-visit therapy in group 3, and left untreated in group 4. The radiolucent area in the PRs and the volume of CBCT-scanned periapical lesions were measured before and 6 months after the treatment. In groups 1, 2, and 3, a favorable outcome (lesions absent or reduced) was shown in 57 (79%) roots using PRs but only in 25 (35%) roots using CBCT scans (p = 0.0001). Unfavorable outcomes occurred more frequently after one-visit therapy than two-visit therapy when determined by CBCT scans (p = 0.023).     

一次根管治疗术与两次根管治疗术术后短期临床疗效的比较

目的比较一次根管治疗术与两次根管治疗术术后短期临床疗效,并分析不同因素对疗效的影响。方法将96例需行根管治疗的患者随机分成2组,分别进行一次根管治疗术（一次治疗组）和两次根管治疗术（两次治疗组）,并在术后的1、3d和1周进行随访,记录其疼痛情况,术后3个月行影像学检查,评估分析其短期疗效。结果一次治疗组和两次治疗组在术后短期疼痛和影像学检查方面的差异均无统计学意义;患者的性别及患牙术前根尖周指数（PAI）对根管治疗的术后疗效有一定影响,而患者年龄、患牙解剖牙位、患牙牙髓情况（未出现根尖周病损）的差异对根管治疗术术后疗效影响意义不大。结论一次性根管治疗在术后短期的疼痛发生率较低,在临床可根据实际情况推广应用;患者性别及术前PAI会影响根管治疗的术后疗效。     

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??Abstract??Objective To discuss the effect of occlusal reduction on the postoperative pain level after one-visit endodontic treatment for acute pulpitis. Methods Totally 44 cases of acute pulpitis of mandibular molar were selected and divided into the experiment and control groups. The experiment group included 22 cases receiving total occlusal reduction in both centric and lateral occlusion after the root canal therapy. The control group included 22 cases without reduced occlusion. The rate of pain response and VAS ??Visual Analogue Scale/Score???? which was evaluated 7 days?? 1 time per day??were recorded after operation. A comparison of the pain response and VAS results was done between the two groups. Results There was no statistically significance between the groups regarding the rate of pain response after operation ??the experiment group 36.36%?? the control group 40.91%?? P > 0. 05??. The VAS of the experiment group was slightly lower than the control group?? the difference having statistical significance ??P < 0.05??. Conclusion Occlusal reduction has no effect on the rate of pain response?? whereas it might diminish the pain degree following acute pulpitis in one-visit root canal therapy.