根管充填加干髓术治疗磨牙根尖周炎216例

近年来,我们采用根管充填加干髓术治疗磨牙急、慢性根尖周炎患者２１６例,效果满意。治疗方法：对磨牙的腭侧根（上颌）或远中根（下颌）常规进行根管预备,消毒后以碘仿糊剂加牙胶尖充填,于颊侧根（上颌）或近中根（下颌）根管口放置碘仿干髓糊剂,尔后常规垫底、充填。疗效：本组术后随访０．５～１年,治疗成功（临床症状消失,Ｘ线片显示尖周阴影明显缩小或消失,修复区有骨小梁形成）１９７例,失败（有自觉症状,有窦道,Ｘ线片显示根尖病灶无变化或扩大）１９例。讨论：磨牙一般２～４个牙根,其中上颌磨牙腭侧根、下颌磨牙远中根…     

显微超声技术在上颌第1恒磨牙根管探查中的应用

以60颗离体上颌第1恒磨牙为研究对象。首先采用传统方法开髓并探查近颊第2根管（MB2）口，未能发现MB2者改良髓腔形态后继续探查，最后在牙科显微镜下采用超声技术对肉眼未能发现bfB2的离体牙进行最终探查和确认。结果传统方法探查MB2发现率为31.7％，改良髓腔形态后发现率增至61.7％，使用牙科显微镜后发现率提高至83.3％。近颊两根管121的间距为（1.42±0.46）mm。认为显微超声技术有助于发现较隐匿的MB2根管口，完善根管治疗。     

66例下颌第一恒磨牙根管分布情况

笔者对66例下颌第一恒磨牙髓腔内部根管的数量进行了观察。男23例、女43例,年龄12～74岁,均为因下颌第一恒磨牙髓病而需去髓者,其根管类型、数量见附表。 讨论:本组资料显示,下颌第一恒磨牙近中双根管占81.8％,远中双根管占27.27％,3～4个根管占91％。下颌第一恒磨牙的外形扁而厚,其近、远中两根多为融合根,根管往往是2个或4个。在近中1～2个、远中1～2个根管的病例中,其近中颊根或远中舌根细而短,变异较大,继发性牙     

唇腭弓矫治器矫治替牙期单个上颌切牙严重扭转25例疗效观察

替牙期单个上颌切牙严重扭转者 ,因其扭转角度常大于4 5° ,如不及时矫正 ,其牙间隙可能越来越小 ,易形成上前牙拥挤 ,应用活动矫治器矫治效果不理想。 3年来我们应用一种固定的唇腭弓矫治器对 2 5例替牙期单个上颌切牙严重扭转者进行矫治 ,效果较好。现报告如下。临床资料 :本组男 15例 ,女 10例 ;年龄 811岁。临床表现左上中切牙近中腭向扭转 8例 ,远中腭向扭转 6例 ;右上中切牙近中颊向扭转 6例 ,远中颊向扭转 5例。扭转角度均 >4 5° ,都有足够的牙间隙 ,上颌第一恒磨牙已完全萌出。治疗方法 :①在上颌第一恒磨牙上选择合适的光带环 ,转…     

上颌第2磨牙牙根的形态学研究

目的研究上颌第2磨牙的外部形态,为临床提供理论和实验依据。方法收集213颗上颌第2磨牙离体牙,观察牙根形态和数目,利用电显游标卡尺测量牙体外形各项指标,并对根尖孔与根尖顶的位置以及至解剖性根尖的距离进行观察和测量。结果外部形态测量显示上颌第2磨牙3根发生率为50．7％,2根发生率为33．8％;上颌第2磨牙以腭侧牙最长,平均长度为18．58mm;根尖孔位于解剖性根尖顶点的为44．6％,旁侧开口占55．4％,旁侧根尖孔距根尖顶部的平均距离为1mm。结论上颌第2磨牙根尖孔大部分位于根尖旁,且根尖孔至根尖的距离并不相等,不能只凭X线片确定工作长度。     

磨牙牙冠大面积缺损修复43例报告

１９９７～１９９９年,我们采用根管螺纹钉、铸造核套共同形成核桩,修复磨牙牙冠大面积缺损患者４３例,效果满意。资料与方法：本组４３例（４８牙）,男２７例、女１６例,年龄１４～２２岁。下颌第一磨牙２９牙、第二磨牙４牙,上颌第一磨牙１５牙。修复方法：根据需要,先对牙髓病、根尖病进行根管治疗。暴露２～３个根管口,结合牙片制备根管,确定螺纹桩钉的直径及长度。然后用直接法在制备好的牙冠和髓腔内制取核套蜡形,内面制成上小下大的梯形状腔。在口内测试桩钉及核套蜡型,然后包埋铸造核套。经调试合适后隔湿、消毒、吹干,…     

两付上颌乳中切牙1例报告

7岁女孩,10个月时顺利萌出5岁时因松动而拔除,以后萌出两个上颌中切牙。上颌两个中切牙唇向倾斜,松动Ⅱ°,牙冠的近远中径大于(牙合)龈高度,牙冠体积大于正常乳牙,但小于恒 牙,牙颈部明显缩小,呈暗黄色,腭侧各有一明显的膨隆。     

YAG激光根管消毒即刻根管充填80例观察

自１９９６年以来,我们采用Ｎｄ∶ＹＡＧ脉冲激光机施行恒前牙根管预备后辐照消毒处理,然后即刻进行根管充填术８０例,疗效满意。现报告如下。临床资料：选择需进行根管充填治疗患者８０例。男５２例,女２８例;年龄１４～３２岁;其中慢性牙髓炎２５例,慢性根尖炎（有瘘型）３８例,牙外伤冠折露髓１７例。计患牙９７颗,均为上颌恒前牙,其中中切牙５７颗,侧切牙２５颗,尖牙１５颗。患牙松动度均＜Ⅱ°,叩诊（±）。Ｘ线显示根管较为粗大,根尖周骨质吸收破坏范围＜３ｍｍ,经抽髓、根管机械预备后无明显渗出物。治疗方法：使用Ｎ…     

牙髓状态影响TRR1根尖定位仪准确性的临床评价

目的 探讨TRR1根尖定位仪在不同牙髓活力状态下测量根管长度的准确性.方法 由指定的临床主治医师使用TRR1根尖定位仪对诊断为牙髓炎和尖周炎的两组患牙分别作根管长度测量,根据X线插针定位片测定K锉尖距根尖的距离(L),以0 mm≤L≤2 mm为测量准确.结果 牙髓炎组(A组)测量准确率较根尖周炎组(B组)低,但两组准确率无显著性差异.结论 TRR1根尖定位仪的准确性不受牙髓活力状态的影响.     

局部注射LPS对慢性牙周炎模型大鼠牙髓、修复性牙本质形成的影响

目的通过局部注射脂多糖(LPS)建立慢性牙周炎动物模型,并观察其对模型大鼠牙髓状态及修复性牙本质形成的影响。方法取SD雄性大鼠20只,以左侧上颌磨牙为对照侧,右侧上颌磨牙为实验侧。分别在实验侧第1、2磨牙之间颊腭侧龈沟注射2 mg/mL的LPS各0.1 mL,隔天重复注射,3次/周。模型形成后,处死大鼠;取含上颌第1、2磨牙的上颌骨,测定牙槽骨吸收值,观察牙髓状态及修复性牙本质的形成情况。结果注射LPS 3周后,大鼠右上颌第1、2磨牙牙龈轻微红肿,探诊出血,牙槽骨开始破坏吸收;第5周时牙槽骨吸收超过根长1/3,但未超过根长1/2;病理切片发现牙周袋形成,牙槽骨内可见多处破骨细胞,成牙本质细胞空泡性变,成牙本质细胞减少,排列紊乱,有炎症细胞浸润,修复性牙本质形成。结论局部注射LPS可成功建立大鼠慢性牙周炎模型;LPS能够破坏大鼠牙髓细胞,刺激修复性牙本质形成。     

The Cone Beam Computed Tomography Evaluation of Cortical Bone Plate after Piezocision-Assisted Orthodontic Upper Arch Expansion: A Case Series

Background: The purpose of the study was to evaluate cone beam computed tomography (CBCT) after piezocision-assisted orthodontic maxillary arch expansion. Methods: Forty CBCT images of 20 patients taken before and after treatment were included in the study. The following radiographic parameters were measured: buccal/palatal bone plate thickness measured in three locations, 0.5 mm, 3.5 mm, and 5 mm from the margin of alveolar process; cemento-enamel junction-crest distance (CEJ-C) measured at buccal (CEJ-B) and palatal/lingual (CEJ-P) aspects. Results: After treatment there were insignificant changes in CEJ-C and thickness of buccal/palatal plates for all the dental groups except for incisors and premolars. CEJ-B increased by 1.43 mm on premolars and CEJ-P by 1.65 mm on incisors and by 0.31 mm on premolars. On the incisors, the buccal plate width increased significantly, by 0.2 mm and 0.44 mm at 3.5-mm and 5-mm measurement points. On premolars, the buccal plate width decreased in three measuring points by 0.27 mm, 0.37 mm, and 0.25 mm. Conclusions: Piezocision-assisted orthodontic maxillary arch expansion does not cause evident negative changes of cortical plates except for the premolar region. Therefore, premolars may be at greater risk of buccal plate loss than other teeth.     

垂体腺瘤鼻内镜蝶窦入路手术的局部影像解剖学测量

目的为垂体腺瘤鼻内镜蝶窦入路手术提供影像解剖学依据。方法利用双源CT三维重建技术对100例（200侧）鼻、鼻窦及颅底正常的受试者行蝶窦、蝶鞍区有关解剖数据的测量。结果鼻小柱根部至蝶窦前壁最近点、蝶嘴最前端、蝶鞍底最近点、蝶窦口下极、颈内动脉海绵窦段、视神经管眶口前内侧缘的距离分别为（65.91±5.38）、（72.36±6.79）、（84.29±4.37）、（69.97±5.33）、（87.41±5.04）、（76.76±4.15）mm,鼻小柱根部至以上各解剖结构连线与鼻底平面的矢状角分别为25.17°±6.79°、16.19°±6.68°、26.12°±6.59°、31.17°±6.50°、23.64°±5.60°、38.15°±6.07°,鼻小柱根部至蝶窦口下极、颈内动脉海绵窦段、视神经管眶口前内侧缘的连线与颅脑正中矢状面的侧偏角分别为4.13°±1.47°、7.92°±1.41°、11.28°±1.89°。结论利用双源CT三维重建技术可以地为垂体腺瘤鼻内镜蝶窦入路手术提供影像解剖学依据。     

甲硝唑与呋喃西林根管冲洗液临床疗效观察

目的探讨甲硝唑在根管治疗中的临床疗效。方法将141颗需作根管治疗患牙随机分为2组,Ⅰ组用0．5％甲硝唑作根管冲洗液,Ⅱ组用0．02％呋喃西林作根管冲洗液,比较两组对根尖周炎的疗效,将结果进行统计学分析。结果Ⅰ组与Ⅱ组的治疗疗程有显著性差异（P〈0．01）;根管封药2次以内疼痛、红肿好转现象两组无显著性差异（P〉0．05）,但叩痛、臭味、瘘管好转有显著性差异（P〈0．01）;Ⅰ组与Ⅱ组的总有效率接近（P〉0．05）。结论甲硝唑能减少疗程,有较好的疗效。     

The analysis of root canal curvature and direction of maxillary lateral incisors by using cone-beam computed tomography: A retrospective study

The aim of this study was to investigate root canal curvature and direction of maxillary lateral incisors in Shandong, China.Cone beam computed tomography (CBCT) images of 176 maxillary lateral incisors of 88 patients were collected in Shandong Province, China. Software included with CBCT was used to measure the angle of root canal curvature of maxillary lateral incisors on the maximum bending plane. In addition, the direction of each root canal was recorded. The data were statistically analyzed by SPSS 17.0 software package.The results showed that all the samples had a single canal (Vertucci''s type I). The incidence of straight root canals, curved root canals, and S-type root canals was 39.2%, 58%, and 2.8%, respectively. The difference in the mean angle of root canal curvature failed to identify any differences between the left and right side (P > .05). The most curved root canal of maxillary lateral incisors oriented in the palato-distal direction.The maxillary lateral incisors were mainly curved root canals of which the proportion of moderate curvature was the largest. Software included with CBCT would provide some valuable information for root canal instrumentation of maxillary lateral incisors.     

超声破裂微泡介导骨髓间充质干细胞移植对心肌梗死兔心室重构和血管新生的影响

目的:观察超声破裂微泡介导的骨髓间充质干细胞(BM-MSCs)移植对兔急性心肌梗死后心室重构和血管新生的影响。方法:取日本大耳白兔52只随机均分为4组:超声组(US组):采用超声波经兔胸壁辐照;微泡组(MB组):经静脉输注微泡造影剂;超声微泡联合组(US+MB组):经静脉输注微泡造影剂后采用超声辐照破裂微泡;空白对照组:不予超声及微泡处理。各组取骨髓体外培养BM-MSCs。结扎兔左冠脉前降支建立急性心肌梗死(AMI)模型,分别于再灌注1h后对各组动物采取超声或微泡处理后(对照组不予处理),经梗死相关动脉注射BM-MSCs悬液。术后24h和4周,测量各组兔左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、室间隔厚度(IVST)和左室后壁厚度(LVPWT)。术后4周,处死动物检测各组兔左心室质量(LVM)、左心室质量指数(LVMI)、兔新生血管数目和血管内皮生长因子(VEGF)浓度。结果:术后4周,与US组、MB组和空白对照组相比,US+MB组LVEDd[(12.77±0.65)mm、(12.97±1.00)mm、(12.78±0.71)mm比(11.71±0.54)mm]、LVESd[(9.63±0.57)mm、(9.92±0.90)mm、(9.69±0.51)mm比(8.39±0.32)mm]、IVST[(2.69±0.11)mm、(2.65±0.14)mm、(2.63±0.10)mm比(2.48±0.07)mm]和LVPWT[(2.74±0.19)mm、(2.66±0.12)mm、(2.68±0.16)mm比(2.51±0.11)mm]明显减小(P<0.05或<0.01),LVM[(5931.76±120.61)mg、(6022.35±116.87)mg、(6076.28±122.73)mg比(4930.66±172.30)mg]及LVMI[(2.17±0.19)mg/g、(2.24±0.07)mg/g、(2.33±0.25)mg/g比(1.83±0.01)mg/g]明显降低(P<0.01),新生血管数目[(4.00±1.61)个、(4.20±1.23)个、(4.18±1.72)个比(8.82±2.52)个]明显增多(P<0.01),VEGF浓度[(0.33±0.17)μg/g、(0.32±0.08)μg/g、(0.29±0.05)μg/g比(0.65±0.24)μg/g]明显升高(P<0.01)。结论:超声微泡破裂介导的BM-MSCs移植可提高梗死心肌VEGF表达,促进血管新生,改善心肌梗死后心室重构,提高心脏功能。     

An In Vitro Stereomicroscopic Evaluation of Bioactivity between Neo MTA Plus,Pro Root MTA,BIODENTINE & Glass Ionomer Cement Using Dye Penetration Method

The ideal root end filling material should form a tight seal in the root canal by adhering to the cavity walls. Several materials have been used for root end filling. The present study aims to find out and compare the bioactivity of Neo MTA Plus, Pro Root MTA White, BIODENTINE & glass ionomer cement as root end filling materials using 1% methylene blue as tracer. Materials and methods: 80 extracted human permanent maxillary anterior teeth were used in the study. They were divided into four groups. Specimens were sectioned transversely in the cervical area to separate the crown from the root. The root canal was obturated with gutta percha and zinc oxide eugenol sealers. Thereafter, each sample was resected apically by removing 3 mm of the apex and filled with different materials. Samples were kept in buffering solution at 37 °C until the recommended evaluation periods. The specimens were then suspended in 1% methylene blue for 24 h, prior to the analysis. The teeth were then sectioned, and dye penetration was examined, photographed, and evaluated under a stereomicroscope. Results: Vertical dye penetration showed significant differences across different groups. The minimum dye penetration was seen in Neo MTA plus followed by BIODENTINE, Pro Root MTA and maximum in GIC. There was no significant difference in dye penetration between Neo MTA plus and BIODENTINE both at fifteen days and one-month intervals. Conclusion: The present study suggests Neo MTA plus and BIODENTINE should be the preferred material for root end filling.     

Endodontic mishaps during root canal treatment performed by undergraduate dental students: An observational study

Endodontic mishaps during root canal treatment (RCT) are considered to be one of the most commonly encountered errors, which affect the quality of treatment and may have dangerous health implications for patients.The present study was conducted to assess the frequency and types of endodontic mishaps in root canal-treated teeth performed by undergraduate dental students.A total 404 endodontically treated teeth were performed by undergraduate dental students of King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia. The radiographs of the endodontically treated teeth were studied for a period of 6 months, and the related demographic data were collected from patient files.The most commonly identified mishaps were related to obturation, where the maximum number of cases (68.1%) had under-obturated root canals. More endodontic mishaps were performed by students in level 9 education. The upper left 2nd molar teeth had a higher frequency of mishaps, and molars were found to have more access-related mishaps. Lastly, access-related and instrument-related mishaps had a low frequency of occurrence.The majority of endodontic mishaps found in the study sample were related to root canal obturation. The undergraduate students at level 9 were less proficient in conducting RCTs with many endodontic mishaps when compared to the cases performed by students at higher levels. The study suggests relevant guidance for dental students while performing RCTs, especially during obturation of the root canals.     

Push-Out Bond Strength of Resin-Modified Glass Ionomer Cement and Flowable Composite Luting Systems on Glass Fiber Post of Root Canal

Background: Posts that have been properly fitted can withstand torsion forces and so provide better retention. The push-out bonding strength of glass fiber posts to the root canal was evaluated using resin-modified glass ionomer cement (RMGIC) and flowable composite (FC). Method: Forty single-rooted maxillary central incisors were used in the study. The samples were randomly divided into two groups of 20 teeth each. The crown-down procedure was used to clean and shape the pulp area. A Tenax fiber trans Coltene whaletene post was used by both groups. The first group utilized FC (Filtek Z 350 3M ESPE) to coat the post, whereas the second group used RMGIC (Rely X 3M ESPE). The specimens were cross-sectioned after 24 h. Specimens were cross-sectioned four millimeters thick into coronal and middle parts using a sectioning machine, yielding 40 specimens per group. The strength of the bond between the luting cement and the posts was measured using push-out bond strength testing. We loaded the components at a cross speed of 0.5 mm/min on a universal testing machine until the bond failed. Results: The FC group had a 4.80 N push-out bond strength, whereas the RMGIC group had a 7.11 N push-out bond strength. Conclusion: FC’s mean push-out bond strength score is lower than RMGIC’s.     

Topographic study of extracted molars with advanced furcation involvement: furcation entrance dimension and molar type

This study investigated the topography of the furcation entrance dimension (FED) on molars with advanced furcation involvement (FI). The sample pool consisted of 169 maxillary and mandibular molars from a group of 165 individuals with severely advanced periodontal destruction. The subjects included men and women aged 24 to 84 years (mean, 47.8 +/- 7.2 years). The FEDs of the maxillary buccal, mesial, and distal surfaces as well as the mandibular buccal and lingual surfaces were measured under a stereomicroscope and clarified into grades I (FED < 0.55 mm), II (0.55-0.75 mm), and III (> 0.75 mm) using automatic grading system software designed by our research associates. The differences and relationships among molar location, furcation site, and FED grade were analyzed using the chi-square test. There was a significant difference among buccal (BFED), mesial (MFED), and distal (DFED) FEDs in both the maxillary first (chi2(4) = 58.915, p < 0.001) and second (chi2(4) = 66.839, p < 0.001) molars. The relationship between molar type and FED grade was statistically significant for both the BFED (p < 0.001) and the DFED (p < 0.001) of maxillary molars, as well as for both the BFED (p < 0.0001) and LFED (p < 0.0001). The difference in FED grade between the first and second molars was statistically significant in both maxillary (p < 0.001) and mandibular (p < 0.0001) molars. There was a significant relationship between FED grade and tooth location at molars with advanced FI.