本文選題：礦物三氧化物凝聚體 + 根尖微滲漏　； 參考：《天津醫(yī)科大學(xué)》2014年碩士論文

【摘要】：根管治療術(shù)(root canal therapy,RCT)是治療牙髓病和根尖周病最常用、最有效的手段。此過程中,根管充填是根管治療進(jìn)程中的關(guān)鍵環(huán)節(jié),目標(biāo)在于對根管進(jìn)行嚴(yán)密的充填,阻攔來自牙齒冠方和根方的微滲漏,從而防止根管系統(tǒng)的再感染。根管微滲漏是衡量根管治療質(zhì)量的重要指標(biāo)。年輕恒牙根尖孔尚未發(fā)育完成,由于外傷、畸形尖折斷以及齲病等因素導(dǎo)致牙髓不可逆性的損傷時,熱牙膠充填技術(shù)難以嚴(yán)密充填根管,甚至?xí)�。年輕恒牙外傷后不經(jīng)治療,即使成年后,根尖孔也可能會呈現(xiàn)開放狀態(tài),為完善的根管充填造成一定的困難。根尖屏障術(shù)(apical barriers)是指用非手術(shù)方式將生物相容材料充填到根管的根尖部,立刻在根尖部行成人工止點。國內(nèi)外研究顯示：MTA (mineral trioxide aggregate)根尖屏障術(shù)是治療牙髓壞死、發(fā)育不完全患牙的有效方法。我們臨床應(yīng)用根尖內(nèi)屏障技術(shù)也取得了成功。 本研究通過體外實驗,應(yīng)用葡萄糖氧化酶法,檢測MTA根尖屏障技術(shù)的根尖微滲漏情況,同時結(jié)合臨床研究,全面評估MTA根尖屏障術(shù)在根管治療中的臨床效果。 目的： 1.在體外條件下,觀察比較MTA封閉根尖的熱牙膠充填方式與臨床常用的連續(xù)波熱牙膠充填方式的根尖封閉性能,為臨床選取合適的根管充填方法提供一定的實驗依據(jù)。 2.臨床比較MTA根尖屏障術(shù)和傳統(tǒng)的根尖誘導(dǎo)成形術(shù)應(yīng)用于年輕恒牙慢性根尖周炎的臨床療效。 方法： 1.體外研究30顆離體牙,隨機分成實驗組、對照組和空白對照組三組(每組10顆離體牙)。將所有樣本截冠,斷端到根尖的長度為15.0mm,用ProTaper鎳鈦系統(tǒng)按根向方式進(jìn)行根管預(yù)備,所有根管均預(yù)備到同一標(biāo)準(zhǔn)-F3,用1#G鉆擴通根尖孔,創(chuàng)建人工開放根尖孔(d=0.5mm) 實驗分組：實驗組：采用MTA根尖屏障術(shù)后熱牙膠根管充填；對照組：采用連續(xù)波熱牙膠根管充填；空白對照組：僅用牙膠尖充填根管,不使用任何根管封閉劑。 待根管充填材料干燥后,除根尖孔上2mm以外均涂兩層透明指甲油；建立葡萄糖微滲漏模型,分別于1、4、7、14、21、28天用葡萄糖定量法檢測從牙冠向牙根方向滲漏的葡萄糖量,評估根尖微滲漏情況。 2.臨床研究選取接近或超過根尖孔發(fā)育形成年齡的未閉合的、且已發(fā)展成為慢性根尖周炎的年輕恒牙(年齡上限不超過16歲)44顆。 實驗組：在根管顯微鏡下用MTA嚴(yán)密封閉根尖開放部位,硬固后行熱牙膠根管充填； 對照組：用Vitapex糊劑行根尖誘導(dǎo)成形術(shù),在根尖部有硬組織形成后行根管充填。 兩組術(shù)后均定期復(fù)查,時間期限為18個月,評估臨床療效及X線片結(jié)果。 結(jié)果： 1.體外研究空白對照組第1天均溢滿微滲漏模型中的玻璃瓶,退出實驗。實驗組和對照組相比,實驗組在各個時間點的葡萄糖滲出量均低于對照組,差別均有統(tǒng)計學(xué)意義(p0.01)。 2.臨床研究經(jīng)過18個月的觀察,實驗組中無1例出現(xiàn)臨床不適癥狀,X線片顯示,僅1例根尖病變無明顯好轉(zhuǎn),總有效率為95.45%;對照組中1例發(fā)生牙齒的根折,4例在18個月的期限內(nèi)未完全形成根尖屏障,總有效率為77.27%。實驗組治療次數(shù)少于對照組,差異有統(tǒng)計學(xué)意義(p0.01)。 結(jié)論： 1.體外研究MTA根尖屏障術(shù)后熱牙膠根管充填的微滲漏要低于連續(xù)波熱牙膠根管充填。 2.臨床研究MTA是一種較好的根尖封閉材料,它大大減少了復(fù)診治療的次數(shù)及治療周期,提高了治療成功率。
[Abstract]:Root canal therapy ( RCT ) is the most common and effective method for root canal therapy . In this process , root canal filling is a key link in root canal therapy .

Through in vitro experiments , the root tip microleakage of MTA root tip barrier technique was tested by glucose oxidase method . Combined with clinical study , the clinical effect of MTA root tip barrier technique in root canal therapy was comprehensively evaluated .

Purpose :

1 . Under the condition of in vitro , it was observed that the root tip sealing performance of MTA closed root tip was compared with that of the conventional continuous wave hot tooth filling method , which provided some experimental basis for selecting proper filling method for root canal .

2 . Clinical comparison of MTA root - tip barrier and traditional apical - induced angioplasty in the treatment of chronic periapical periodontitis in young permanent teeth .

Method :

1 . In vitro , 30 isolated teeth were randomly divided into experimental group , control group and blank control group ( 10 from each group ) . All the samples were cut , the length of root tip was 15.0mm , root canal preparation was carried out in the root canal by ProTaper nickel - titanium system , all the root canals were prepared to the same standard - F3 , and the root tip hole was expanded with 1 # G drill , and the artificial open root tip hole was created ( d = 0.5mm ) .

Experimental group : The experimental group : The root canal of MTA was filled with the root canal of MTA .
Control group : continuous wave hot tooth root canal filling was adopted ;
The blank control group : The root canal was filled with only the tip of the gum , and no root canal sealer was used .

after the root canal filling material is dried , two layers of transparent nail polish are coated except 2mm of the root tip hole ;
The glucose micro - leakage model was established , and the amount of glucose leaking from the crown to the root canal was measured with a glucose quantitative method at 1 , 4 , 7 , 14 , 21 and 28 days , respectively .

2 . The clinical study selected a young permanent tooth ( not more than 16 years old ) near or beyond the age of apical foramen development , and has developed into a young permanent tooth with chronic periapical periodontitis ( upper age limit of no more than 16 years ) .

The experimental group : The open parts of root tip were closed tightly with MTA under the root canal microscope , and the root canal was filled with hot tooth root canal .


The control group : The root tip was induced with Vitapex paste , and the root canal was filled with hard tissue at the root tip .

The two groups were periodically re - examined after operation , the time duration was 18 months , and the clinical efficacy and X - ray film results were evaluated .

Results :

1 . Compared with the control group , the amount of glucose in the experimental group was lower than that of the control group in the experimental group and the control group ( p < 0.01 ) .

2 . After 18 months of clinical study , none of the experimental groups had symptoms of clinical discomfort , X - ray films showed that only 1 case had no obvious improvement in root tip lesion , total effective rate was 95.45 % ; the total effective rate was 77.27 % in the control group , and the total effective rate was 77.27 % .

Conclusion :

1 . In vitro , the microleakage of the root canal filling of MTA was lower than that of continuous wave hot tooth root canal .

2 . The clinical research MTA is a kind of better root - tip sealing material , which greatly reduces the number of times of treatment and the treatment period , and improves the success rate of treatment .
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.05

【引證文獻(xiàn)】

相關(guān)期刊論文 前4條

1 余西江;郭靜;安春青;周艷明;;MTA與銀汞合金作為根尖倒充填材料的臨床療效分析[J];中國繼續(xù)醫(yī)學(xué)教育;2017年14期

2 林曉霞;韓亞萍;張佳音;;三氧化礦物凝聚體用于根管下段器械折斷的研究[J];中國醫(yī)藥指南;2016年31期

3 杜文娟;;熱牙膠充填技術(shù)在根管治療中的應(yīng)用分析[J];中國醫(yī)藥指南;2016年10期

4 劉玉秀;葉琴;;MTA用于穿孔修補及根尖屏障的臨床價值分析[J];中外醫(yī)療;2015年18期

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本文編號：2095180