本文選題：微滲漏 + 根管治療��； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：根管治療是目前牙髓病與根尖周病最有效并且最根本的治療方法，評價根管治療成功與否的關(guān)鍵因素是根管系統(tǒng)的三維充填是否嚴密，而根管充填后存在的微滲漏是導(dǎo)致根管治療失敗的重要原因。根管微滲漏包括冠滲漏和根尖滲漏，均可引起治療的失敗。長期以來，根尖滲漏一直是國內(nèi)外研究的重點，而近年來，冠滲漏亦逐漸引起廣大學(xué)者的注意，認為其是根管治療失敗的潛在原因。國內(nèi)外對一些根管治療過程中應(yīng)用的暫封材料的封閉性能有一定的研究，而對于根管治療后臨床常用的冠部填充材料的封閉性能研究相對較少。 目前臨床上根管治療后根據(jù)牙體的剩余組織量以及患者意愿，冠部封閉方式可大致分為兩種：永久充填及暫封材料暫時充填后行冠部修復(fù)治療。臨床常用的永久充填材料為樹脂類，暫封材料包括玻璃離子水門汀類及氧化鋅丁香油酚類等，這些材料的封閉性能可能影響根管治療的效果及成功率，根管治療后的冠部滲漏亦可能為根管治療后根管再感染的原因，因此本實驗通過對這些材料的封閉性能進行檢測，為根管治療后冠部封閉材料的選擇提供參考。 方法：選取100顆牙體基本完整，無充填物，無隱裂的離體前磨牙，備標準Ⅰ類或Ⅱ類洞，統(tǒng)一方法根管預(yù)備，熱牙膠連續(xù)波根充，X線檢測以保證根充密合，在牙頸部切斷牙膠尖，隨機分成A、B、C、D、E五組，分別為空白組；氧化鋅丁香油粘固粉充填，厚度2mm；氧化鋅丁香油粘固粉充填，厚度3.5mm；玻璃離子水門汀充填；磷酸鋅墊底后樹脂充填；根尖孔及牙合面所備洞緣2mm外全部涂布指甲油2層；將所有樣本浸入裝滿2%亞甲藍溶液的完全封閉容器內(nèi)，再將其置于37℃恒溫箱內(nèi)。于第1、2、3、4周后分別取出每組各5顆樣本牙齒，去除指甲油后沖洗并干燥，沿窩洞中心順牙長軸近遠中向縱向剖開。在體視顯微鏡(16倍)下觀察，并用游標卡尺（0．05mm）測量亞甲藍沿材料與洞壁界面滲入的最大長度，以此作為染料滲漏長度，進行記錄并用統(tǒng)計學(xué)軟件進行分析。 結(jié)果：A、B、C、D、E五組分別在第1、2、3、4周后的染料滲透長度及其平均值(單位mm)（表1-4），及各組在不同時間段染料滲漏達根管內(nèi)的牙數(shù)（表5）。五組均自第1周起即均可檢測到染料滲漏，其中在第1周時A組和B組的染料滲漏長度即達根管內(nèi)，而C、D、E組滲漏長度未達根管內(nèi)；第2周時C組染料滲漏長度達根管內(nèi)，第4周時D、E組各有部分樣本染料滲漏長度達根管內(nèi)，，4周內(nèi)隨時間延長，各組染料滲漏長度均增加，但均未達根尖。 結(jié)論：1、根管治療后冠部封閉物的微滲漏影響根管治療的遠期效果；2、暫時性充填材料中玻璃離子的冠部封閉效果相對更好；3、3.5mm厚度氧化鋅丁香油粘固粉冠部封閉可保證1周內(nèi)無冠滲漏達到根管內(nèi)；4、永久性充填材料可能比暫時性封閉材料具有更好的封閉性；5、根管治療后牙齒的冠部封閉物脫落4周可不引起根尖感染；6、隨時間延長，各類冠部封閉物的冠滲漏均增加。
[Abstract]:Objective: root canal therapy is the most effective and fundamental treatment for dental pulp disease and periapical disease. The key factor for evaluating the success of root canal therapy is the tight three-dimensional filling of root canal system, and microleakage after root canal filling is the major cause of root canal treatment failure. Root canal leakage includes crown leakage and root canal leakage. The apical leakage can cause the failure of the treatment. The root apex leakage has been the focus of research at home and abroad for a long time. In recent years, the crown leakage has also gradually aroused the attention of the vast number of scholars. It is considered as a potential cause of the failure of root canal therapy. There are relatively few studies on the sealing properties of crown filling materials commonly used after root canal therapy.
At present, after the clinical root canal therapy, according to the residual volume of the tooth body and the wishes of the patients, the crown closure method can be roughly divided into two kinds: permanent filling and temporary filling after temporary filling and crown repair. The commonly used permanent filling materials are resin, temporary sealing materials including glass ionomer cements and Zinc Oxide syringol. The sealing performance of these materials may affect the effect and success rate of root canal therapy. The coronal leakage after root canal therapy may also be the cause of reinfection of root canal after root canal treatment. Therefore, this experiment provides a reference for the selection of the sealing material after root canal treatment by testing the sealing performance of these materials.
Methods: 100 teeth were divided into two groups: 100 teeth, which were basically complete, without fillings and no hidden cracks. The standard type I or class II cavities were prepared, the root canal preparation, the hot tooth glue continuous root filling, X-ray examination to ensure the root filling and cutting the gum tip on the tooth neck, were randomly divided into A, B, C, D, E, the blank group, and the Zinc Oxide lilac oil paste filling powder. Filling, thickness 2mm; Zinc Oxide clove oil paste filling, thickness 3.5mm; glass ionomer cement filling; zinc phosphate bottom resin filling; all 2 layers of nail oil coated outside the hole edge 2mm of the root tip hole and coodont surface; immerse all samples in a completely sealed container full of 2% submethylene blue solution and put it in a 37 C thermostat box. After week 1,2,3,4, each group of 5 samples of the teeth were removed, and the nail oil was removed and dried, and the teeth were opened along the long axis of the CIS of the cave center. Under the stereoscopic microscope (16 times), the maximum length of methylene blue along the interface between the material and the wall was measured with the vernier caliper (0.05mm) as the leakage length of the dye. The records were recorded and analyzed with statistical software.
Results: A, B, C, D, E five groups after week 1,2,3,4 dye penetration length and the average value (unit mm) (table 1-4), and the number of teeth in each group of dyes leaking in the root canal at different time periods (Table 5). Five groups from first weeks can detect the dye leakage, of which first weeks, A and B group of dyestuff leakage length is in the canal, C, D, E. The leakage length of the group was not in the root canal; at second weeks, the dyestuff leakage in group C was within the canal of the root canal. At fourth weeks, the leakage length of some samples in the group E was within the root canal, and the length of the dyestuffs was prolonged in 4 weeks. All the dyestuffs in each group increased in length, but all of the dyestuffs were not at the end of the root.
Conclusions: 1, the microleakage of the coronal seal after root canal treatment affects the long-term effect of root canal therapy; 2, the effect of the crown closure of the glass ions in the temporary filling material is relatively better; the closure of the crown part of the 3,3.5mm thickness of Zinc Oxide clove oil visco powder can guarantee the non coronal leakage within 1 weeks to reach the root canal; 4, permanent filling material may be more than temporary. 5, the closure of the crown of the teeth after root canal treatment could not cause apical infection for 4 weeks after root canal treatment. 6, the crown leakage of all kinds of crowns increased with time.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.05

【參考文獻】

相關(guān)期刊論文 前1條

1 秦曉虹;牙面處理劑對Dyract AP復(fù)合體邊緣微滲漏的影響[J];南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版);2003年06期

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