根管充填封閉性的體外研究
發(fā)布時間：2018-11-12 11:02
【摘要】：目的：根管治療術(shù)(Root canal therapy, RCT)是目前治療牙髓病和根尖周病較為成熟的方法,目的是形成良好的根尖封閉性,而其療效與多種因素有關(guān),其中根管充填的糊劑和根管充填方法的選擇被認為是影響其療效的最主要因素。本研究選用機械切割功能強、具有高記憶性和超彈性的PreTaper鎳鈦器械對離體牙在體外進行統(tǒng)一的根管預備,預備方法采用根管成形能力強、術(shù)后反應輕的Crown-Down技術(shù)。在根管預備的整個過程中利用次氯酸鈉徹底沖洗根管,并且使用EDTA潤滑根管壁。根管預備完成后,選用不同根管封閉劑和充填方法充填根管,利用染色滲透的方法處理樣本牙齒,測量根尖滲透的長度,測定各組樣本牙齒根管充填后的根尖封閉性,來評價不同根管充填方法和根管充填封閉劑聯(lián)合應用的根尖封閉能力。方法：收集三個月以內(nèi)正畸拔除的單根管下頜前磨牙60顆,隨機分為A、B、C、D、E五組,每組12顆。使用機用PreTaper鎳鈦器械,采用根管預備方法中的冠根向深入法對樣本牙齒進行根管預備,選用不同種充填方法和封閉劑充填根管。A組：側(cè)向加壓充填技術(shù)及AH plus封閉劑充填根管；B組：側(cè)向加壓充填技術(shù)及Vitapex封閉劑充填根管；C組：熱牙膠垂直加壓技術(shù)與AH plus封閉劑充填根管；D組：熱牙膠垂直加壓技術(shù)與Vitapex封閉劑充填根管；E組：空根管對照組,不進行任何充填。根管充填后,所有標本置于恒溫箱內(nèi)一周,待根管充填材料完全硬固,隨后浸入印度墨水染色,硝酸脫鈣、乙醇梯度脫水、置于水楊酸甲酯溶液中透明處理制作透明標本。體視顯微鏡下測量根尖微滲漏長度,采用SPSS11.5統(tǒng)計軟件包對測量數(shù)據(jù)進行方差分析。結(jié)果：1.空根管對照組的根尖微滲漏長度明顯長于熱牙膠垂直加壓及冷側(cè)方加壓充填組(P0.05),差異具有統(tǒng)計學意義。2.熱牙膠垂直加壓充填組較冷側(cè)方加壓充填組根尖封閉性好,根尖微滲漏長度差異顯著(P0.05),差異具有統(tǒng)計學意義。3.冷側(cè)方加壓充填組, AH plus封閉劑較Vitapex糊劑的封閉性具有明顯優(yōu)越性(P0.05),差異具有統(tǒng)計學意義。4.熱牙膠垂直加壓充填組, AH plus封閉劑和Vitapex糊劑的微滲漏差異無顯著性(P0.05),無統(tǒng)計學意義。結(jié)論：1.根管充填能明顯降低微滲漏的發(fā)生,但根管充填方法及封閉劑的選擇對根管充填封閉性的影響較大。2.熱牙膠垂直加壓充填技術(shù)能形成較嚴密的根管充填體,根尖微滲漏較輕,其根尖封閉能力明顯優(yōu)于冷側(cè)向加壓充填技術(shù)。3.在冷側(cè)方加壓充填技術(shù)中,AH plus封閉劑的封閉性明顯優(yōu)于Vitapex糊劑。4.在熱牙膠垂直加壓充填技術(shù)中,AH plus封閉劑和Vitapex糊劑對封閉性的影響無明顯差異。
[Abstract]:Objective: root canal therapy (Root canal therapy, RCT) is a mature method for the treatment of pulp disease and periapical disease, with the aim of forming a good apical closure, and its curative effect is related to many factors. The selection of paste and method of root canal filling was considered to be the most important factor affecting the effect of root canal filling. In this study, PreTaper Ni-Ti instruments with strong mechanical cutting function, high memory and superelasticity were used to prepare the isolated teeth in vitro. The preparation method was Crown-Down with strong ability of root canal forming and light reaction after operation. Sodium hypochlorite was used to wash the root canal thoroughly during root canal preparation, and EDTA was used to lubricate the root canal wall. After the root canal preparation was completed, different root canal sealants and filling methods were used to fill the root canal. The sample teeth were treated by staining osmotic method, the length of the root tip osmosis was measured, and the apical closure of each group of teeth was measured. To evaluate the apical sealing ability of different root canal filling methods and root canal filling sealants. Methods: sixty mandibular premolars with single root canal were randomly divided into five groups (12 in each group). The root canal preparation of the sample teeth was carried out by the method of crown and root orientation in the root canal preparation method using the PreTaper nickel titanium instrument used in the machine, and the root canal preparation was carried out by the method of root canal preparation. Different filling methods and sealants were used for root canal filling. Group A: lateral compression filling technique and AH plus sealant for root canal filling; Group B: root canal filling with lateral compression and Vitapex sealant, group C: hot gum vertical compression technique and AH plus sealant filling root canal, group D: hot gum vertical compression technique and Vitapex sealant filling root canal, group C: hot gum vertical compression technique and AH plus sealant filling root canal, group D: hot gum vertical compression technique and Vitapex sealant filling root canal; Group E: empty root canal control group, without any filling. After root canal filling, all the specimens were placed in the incubator for one week, after which the root canal filling materials were completely hardened, then soaked in Indian ink, decalcified by nitric acid, dehydrated by ethanol gradient, then treated transparently in methyl salicylate solution to make transparent specimen. The microleakage length of root tip was measured under stereoscopic microscope, and the variance analysis of the measured data was carried out by SPSS11.5 software package. Results: 1. The length of root tip microleakage in empty root canal control group was significantly longer than that in hot gum vertical compression group and cold lateral compression group (P0.05), the difference was statistically significant. 2. Hot gum vertical compression filling group was better than cold side compression filling group, the root tip microleakage length difference was significant (P0.05), the difference was statistically significant. The sealing ability of, AH plus sealant was significantly superior to that of Vitapex paste (P0.05), and the difference was statistically significant. There was no significant difference in microleakage between, AH plus sealant and Vitapex paste in hot gum vertical compression filling group (P0.05). Conclusion 1. Root canal filling can obviously reduce the occurrence of microleakage, but the method of root canal filling and the choice of sealant have great influence on the sealing of root canal filling. 2. The hot gum vertical compression filling technique can form a tight root canal filling body, the apical microleakage is lighter, and its apical sealing ability is obviously superior to that of cold lateral compression filling technique. 3. The sealing property of, AH plus sealant is better than that of Vitapex paste in cold side filling technology. 4. There was no significant difference between, AH plus sealant and Vitapex paste on sealing property in hot gum vertical compression filling technology.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R781.05
本文編號：2326917
[Abstract]:Objective: root canal therapy (Root canal therapy, RCT) is a mature method for the treatment of pulp disease and periapical disease, with the aim of forming a good apical closure, and its curative effect is related to many factors. The selection of paste and method of root canal filling was considered to be the most important factor affecting the effect of root canal filling. In this study, PreTaper Ni-Ti instruments with strong mechanical cutting function, high memory and superelasticity were used to prepare the isolated teeth in vitro. The preparation method was Crown-Down with strong ability of root canal forming and light reaction after operation. Sodium hypochlorite was used to wash the root canal thoroughly during root canal preparation, and EDTA was used to lubricate the root canal wall. After the root canal preparation was completed, different root canal sealants and filling methods were used to fill the root canal. The sample teeth were treated by staining osmotic method, the length of the root tip osmosis was measured, and the apical closure of each group of teeth was measured. To evaluate the apical sealing ability of different root canal filling methods and root canal filling sealants. Methods: sixty mandibular premolars with single root canal were randomly divided into five groups (12 in each group). The root canal preparation of the sample teeth was carried out by the method of crown and root orientation in the root canal preparation method using the PreTaper nickel titanium instrument used in the machine, and the root canal preparation was carried out by the method of root canal preparation. Different filling methods and sealants were used for root canal filling. Group A: lateral compression filling technique and AH plus sealant for root canal filling; Group B: root canal filling with lateral compression and Vitapex sealant, group C: hot gum vertical compression technique and AH plus sealant filling root canal, group D: hot gum vertical compression technique and Vitapex sealant filling root canal, group C: hot gum vertical compression technique and AH plus sealant filling root canal, group D: hot gum vertical compression technique and Vitapex sealant filling root canal; Group E: empty root canal control group, without any filling. After root canal filling, all the specimens were placed in the incubator for one week, after which the root canal filling materials were completely hardened, then soaked in Indian ink, decalcified by nitric acid, dehydrated by ethanol gradient, then treated transparently in methyl salicylate solution to make transparent specimen. The microleakage length of root tip was measured under stereoscopic microscope, and the variance analysis of the measured data was carried out by SPSS11.5 software package. Results: 1. The length of root tip microleakage in empty root canal control group was significantly longer than that in hot gum vertical compression group and cold lateral compression group (P0.05), the difference was statistically significant. 2. Hot gum vertical compression filling group was better than cold side compression filling group, the root tip microleakage length difference was significant (P0.05), the difference was statistically significant. The sealing ability of, AH plus sealant was significantly superior to that of Vitapex paste (P0.05), and the difference was statistically significant. There was no significant difference in microleakage between, AH plus sealant and Vitapex paste in hot gum vertical compression filling group (P0.05). Conclusion 1. Root canal filling can obviously reduce the occurrence of microleakage, but the method of root canal filling and the choice of sealant have great influence on the sealing of root canal filling. 2. The hot gum vertical compression filling technique can form a tight root canal filling body, the apical microleakage is lighter, and its apical sealing ability is obviously superior to that of cold lateral compression filling technique. 3. The sealing property of, AH plus sealant is better than that of Vitapex paste in cold side filling technology. 4. There was no significant difference between, AH plus sealant and Vitapex paste on sealing property in hot gum vertical compression filling technology.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R781.05
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