根管治疗中根尖疏通对术后疼痛影响的研究

目的：探讨根管治疗中根尖疏通对术后疼痛的影响.方法：选择需行根管治疗的患者90例,随机分为3组：A组,根管预备前和结束时使用10#K锉进行根尖疏通并超出工作长度1 mm,B组,每次更换器械均使用10#根管疏通器械到达工作长度,C组,每次更换器械均使用根管疏通器械并超出工作长度1 mm.记录各组患者术前及术后疼痛发生情况,并记录各时间段疼痛的视觉模拟评分法（visual analogue scale,VAS）的分值,比较各组患者术后疼痛的发生率以及VAS分值的统计学差异.结果：A组83.33％的患者术后无疼痛或轻微疼痛,B组为86.67％,C组为90％.各组的疼痛发生率无统计学意义.C组VAS分值略低于A组及B组,但差异无统计学意义.结论：根管治疗中根尖疏通对患者术后疼痛发生率和程度没有影响.     

氢氧化钙预防根管治疗术后疼痛的临床观察

目的评价氢氧化钙作为根管内药物预防根管治疗术后疼痛的效果。方法选择90颗牙髓坏死的前磨牙,将其随机分为A、B、C组,每组30颗牙。A组患牙1次完成根管治疗;B组患牙2次完成根管治疗,但约诊期间根管内不封任何药物;C组患牙2次完成根管治疗,但约诊期间根管内封Ca(OH)2糊剂。采用改良10点视觉模拟量表对患者根管治疗后疼痛的严重程度进行评价,比较3组患者根管治疗后的疼痛水平。结果A组与B组、B组与C组患者根管治疗术后疼痛的差异有统计学意义(P<0.05),A组与C组患者根管治疗术后疼痛的差异无统计学意义(P>0.05)。结论氢氧化钙作为根管内封药可有效预防根管充填后疼痛的发生。     

Single-visit revascularization treatment of an immature permanent tooth with apical periodontitis: A case report

We herein describe successful revascularization treatment of an immature mandibular left second premolar with apical periodontitis in a 10-year-old patient. The tooth was treated using coronal root irrigation with 5% sodium hypochlorite (NaOCl) and 3% hydrogen peroxide without instrumentation and then packed using calcium hydroxide paste into the coronal canal in a single visit. X-ray photographic examination showed the start of apical closure 5 months after the revascularization procedure. Thickening of the canal wall and complete apical closure was confirmed 15 months after the initial treatment. The successful outcome of this case report suggests that this conservative revascularization treatment approach can preserve the vitality of dental pulp stem cells and create new hard tissues for pulp repair, resulting in completion of root maturation.     

Effects of root canal irrigations on intracanal medication with calcium hydroxide effects in root external resorption models

Objective

The objective of the present in vitro study was to evaluate the influence of endodontic irrigation systems on the removal of smear layer and ion diffusion of calcium hydroxide through dentinal tubules in root external resorption models.

Assessment of root dentin pH changes in primary and permanent molars with different types of calcium hydroxide intracanal medication

Purpose

To evaluate root dentin pH changes using different calcium hydroxide medications in primary and permanent molar root canals.

CBCT在牙根尖周炎源性上颌窦黏膜炎根管治疗疗效评价中的应用

目的　通过CBCT检查患根尖周炎的上颌后牙,探讨牙根尖周源性上颌窦黏膜炎的特点及根管治疗后黏膜及骨质的改变。方法: 对25例患上颌后牙根尖周炎患者上颌窦进行CBCT扫描重建,确诊为黏膜炎后,根管治疗3个月后CBCT扫描明确黏膜炎消退程度,6个月后扫描通过根尖周指数评估根尖骨质愈合情况。结果: 剔除2例上颌窦炎,14例上颌窦表现为黏膜炎（61％),根管治疗3个月后,黏膜炎完全消退5例（35.7％）;部分消退6例（42.9％）;3例无明显改变（21.4％）。6个月后,3颗牙齿愈合（21.4％）,4颗牙齿好转（28.6％）,7颗牙齿未愈合（50％）。结论:上颌后牙根尖周炎易引发上颌窦黏膜炎,根管治疗是该疾病有效的治疗方法,CBCT影像能精确反映根管治疗前后上颌窦黏膜炎消退及骨质愈合情况,具有重要的临床参考价值。     

The use of 0.2% chlorhexidine in the absence of a structured mechanical regimen of oral hygiene following the non-surgical treatment of periodontitis

Abstract. The aim of the present study was to evaluate a 0.2% chlorhexidine mouthrinse following the non-surgical treatment of advanced human periodontitis in the absence of a structured mechanical oral hygiene regimen. 10 patients and a total of 1483 sites were used. Recordings for plaque, bleeding, pocket depth and attachment levels were made at baseline and at 3, 6, 9, and 12 months. Debridement was performed under local anaesthesia. No instruction or reinforcement in mechanical ocal hygiene procedures was given at any time. However, at each visit the patients were instructed in the 2× daily use of 0.2% chlorhexidine mouthwash. The plaque indices, scored as % of sites with removable deposits, showed negligible improvement from baseline scores of 80%-100% for all categories of initial probing depth. Mean bleeding score was reduced to 10–20% irrespective of initial probing pocket depth, site location or tooth surface location. Sites ≥7 mm at baseline demonstrated a reduction in mean probing pocket depth of 3.9 mm and a gain in mean probing attachment level of 2.5 mm. Moderately deep sites (4–6.5 mm) demonstrated a reduction in mean probing pocket depth of 2 mm and a gain in mean probing attachment level of 0.8 mm. Shallow sites (≤3.5 mm) demonstrated a reduction in mean probing pocket depth of 0.5 mm and a loss in mean probing attachment level of 0.2 mm. Site-specific attachment level analysis demonstrated that over 80% of losing sites were shallow with low bleeding frequency, indicating that the loss of attachment may have occurred for reasons other than inflammatory periodontal disease. The results indicate that chlorhexidine can be used as an adjunct to inadequate mechanical oral hygiene over an observation period of 1 year.     

A laboratory study of the effect of calcium hydroxide mixed with iodine or electrophoretically activated copper on bacterial viability in dentinal tubules

AIM: The aim of this laboratory study was to evaluate the ability of calcium hydroxide (CH), CH/iodine-potassium iodide (IKI) and electrophoretically activated copper to kill bacteria in dentinal tubules. METHODOLOGY: In an in vitro model of dentinal tubule infection, 42 cylindrical root specimens, prepared from freshly extracted bovine teeth were used. After removal of the smear layer, intracanal dentinal tubules were infected with Enterococcus faecalis for 3 weeks. CH alone or preparations of CH with copper or IKI were placed in the root canal for 1 week. In specimens containing copper/CH, an electrophoretic current(5 mA/5 min) was applied using two electrodes follow-ing placement of the medicament in the canal. Powder dentine samples obtained from the canal wall using ISO sizes: 025, 027, 029, 031 and 033 burs were examined for the presence of viable bacteria by inoculating agar plates and counting colony forming units (cfu). RESULTS: A significant difference was found between the experimental groups and the positive control group. CH and CH/IKI significantly (P < 0.001)reduced bacterial viability in dentinal tubules to a depth of 200 microm. Specimens with CH/IKI had significantly fewer viable bacteria than CH alone in tubules between the depths of 200-500 microm. Treatment with CH/copper and electrophoresis was most effective: specimens showed no viable bacteria in dentinal tubules to a depth of 500 microm from the root-canal space. CONCLUSIONS: IKI or electrophoretically activated copper additives can significantly improve the antibacterial properties of CH in dentinal tubules.     

Effectiveness of the proton pump inhibitor omeprazole associated with calcium hydroxide as intracanal medication: an in vivo study

Introduction

The objective of this study was to evaluate the efficacy of the association of a proton pump inhibitor (omeprazole) with Ca(OH)₂ as intracanal medication in a rat model of periapical lesions.

Methods

Periapical lesions were induced on the first right mandibular molar tooth of 36 male Wistar rats (6 per group). After 28 days, the distal canal of each tooth was prepared, filled with the respective dressing (negative control group, PEG 400; positive control group, Ca(OH)₂ + PEG400; test group, Ca(OH)₂ + omeprazole + PEG 400), and sealed with amalgam for 15 or 28 days. Microbiological samples were taken in 3 periods: S1, after 28 days of lesion induction; S2, after the biomechanical preparation; and S3, after the medication (15 and 28 days).

Results

The radiographic and histologic analysis revealed that either Ca(OH)₂ or Ca(OH)₂ plus omeprazole dressings produced a reduction of periapical lesions at 28 days, when compared with the negative control group. The reduction of periapical lesions and inflammatory cell infiltration was visibly improved by associating omeprazole with Ca(OH)₂, with an increase of reparative bone areas. The microbiological assessment showed a significant decrease of colony-forming units count from S1 to S2 or S3 collecting times, but no differences were observed between the S2 and the S3 time-periods or among the experimental groups within the S3 period. Further bacterial characterization showed a possible selective activity of the medications.

Conclusions

Our data showed that association of omeprazole with Ca(OH)₂ favored a superior repair of rat periapical lesions and seemed to display different selective activity over endodontic microbiota, in comparison with the conventional Ca(OH)₂ dressing.