PDF(Pubmed)
Abstract：
OBJECTIVE: Sodium hypochlorite solution (NaOCl) is an effective canal irrigant but interferes with the mechanical features of dentin and the bonding capability of adhesives when restoring endodontically treated teeth. This study evaluated whether access cavity resin sealing before using canal irrigant would augment the resistance of endodontically treated anterior teeth against fracture.
METHODS: Sixty maxillary incisors underwent endodontic treatment in five groups (n = 12). Irrigation with 5.25% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) was performed in all groups except for Group 5. After root canal obturation, in Group 1, the access cavity was kept unrestored. In Group 2, immediate restoration after obturation was achieved. For Group 3, delayed restoration after 1 week was provided. In Group 4 (pre-sealed), before canal irrigation, the dentin surface of access cavities was sealed using self-adhesive composite resin (Vertise Flow) and then restored after obturation. In Group 5, which was saline irrigated, immediate restoration was performed. After storage and thermal cycling for 5000 cycles at 5°C-55°C with a dwell time of 15 s and a transfer time of 5 s, teeth were statically loaded by a universal testing machine until a fracture occurred. Data were collected as the fracture resistance (FR) and analyzed using the one-way analysis of variance and Tukey\'s tests.
RESULTS: FR significantly differed between all groups (p < 0.001). The lowest FR was recorded in the unrestored group (284 ± 86 N), which was not statistically different from the immediately restored group (p = 0.065). The pre-sealed group exhibited the highest FR value (810 ± 127 N, p ≤ 0.02 vs. other groups). The FR of the saline-irrigated and delayed restored groups was almost similar (p = 0.13).
CONCLUSIONS: NaOCl/EDTA irrigation resulted in an adverse effect on FR. Delayed restoration could reduce this adverse effect. Access cavity pre-sealing with flowable composites led to a higher FR than conventional methods and may be considered an effective step during treatment procedures.
METHODS: Sixty maxillary incisors underwent endodontic treatment in five groups (n = 12). Irrigation with 5.25% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) was performed in all groups except for Group 5. After root canal obturation, in Group 1, the access cavity was kept unrestored. In Group 2, immediate restoration after obturation was achieved. For Group 3, delayed restoration after 1 week was provided. In Group 4 (pre-sealed), before canal irrigation, the dentin surface of access cavities was sealed using self-adhesive composite resin (Vertise Flow) and then restored after obturation. In Group 5, which was saline irrigated, immediate restoration was performed. After storage and thermal cycling for 5000 cycles at 5°C-55°C with a dwell time of 15 s and a transfer time of 5 s, teeth were statically loaded by a universal testing machine until a fracture occurred. Data were collected as the fracture resistance (FR) and analyzed using the one-way analysis of variance and Tukey\'s tests.
RESULTS: FR significantly differed between all groups (p < 0.001). The lowest FR was recorded in the unrestored group (284 ± 86 N), which was not statistically different from the immediately restored group (p = 0.065). The pre-sealed group exhibited the highest FR value (810 ± 127 N, p ≤ 0.02 vs. other groups). The FR of the saline-irrigated and delayed restored groups was almost similar (p = 0.13).
CONCLUSIONS: NaOCl/EDTA irrigation resulted in an adverse effect on FR. Delayed restoration could reduce this adverse effect. Access cavity pre-sealing with flowable composites led to a higher FR than conventional methods and may be considered an effective step during treatment procedures.
摘要：
目的：次氯酸钠溶液（NaOCl）是一种有效的管道冲洗剂，但在修复经牙髓治疗的牙齿时，会干扰牙本质的机械特征和粘合剂的粘合能力。这项研究评估了在使用管道冲洗液之前进行腔内树脂密封是否会增强经牙髓治疗的前牙对骨折的抵抗力。
方法：60例上颌切牙接受牙髓治疗，分为5组（n=12）。除第5组外，所有组均进行5.25％NaOCl和17％乙二胺四乙酸（EDTA）冲洗。根管闭塞后，在第1组中，进入腔未恢复。在第2组中，闭塞后立即恢复。对于第3组,提供1周后的延迟恢复。在第4组中（预密封），在运河灌溉之前，使用自粘复合树脂（VertiseFlow）密封进入腔的牙本质表面，然后在闭塞后恢复。在第5组中，盐水灌溉，立即进行恢复。在5°C-55°C下存储和热循环5000个循环后，停留时间为15s，转移时间为5s，用万能试验机对牙齿进行静态加载，直到发生断裂。收集数据作为断裂阻力（FR），并使用单向方差分析和Tukey检验进行分析。
结果：所有组间的FR差异显著(p<0.001)。最低的FR记录在未恢复组（284±86N），与立即恢复组没有统计学差异（p=0.065）。预密封组表现出最高的FR值(810±127N,p≤0.02vs.其他团体)。生理盐水灌洗和延迟恢复组的FR几乎相似（p=0.13）。
结论：NaOCl/EDTA冲洗会对FR产生不利影响。延迟修复可以减少这种不利影响。使用可流动复合材料的入口腔预密封导致比常规方法更高的FR，并且可以认为是治疗过程中的有效步骤。
方法：60例上颌切牙接受牙髓治疗，分为5组（n=12）。除第5组外，所有组均进行5.25％NaOCl和17％乙二胺四乙酸（EDTA）冲洗。根管闭塞后，在第1组中，进入腔未恢复。在第2组中，闭塞后立即恢复。对于第3组,提供1周后的延迟恢复。在第4组中（预密封），在运河灌溉之前，使用自粘复合树脂（VertiseFlow）密封进入腔的牙本质表面，然后在闭塞后恢复。在第5组中，盐水灌溉，立即进行恢复。在5°C-55°C下存储和热循环5000个循环后，停留时间为15s，转移时间为5s，用万能试验机对牙齿进行静态加载，直到发生断裂。收集数据作为断裂阻力（FR），并使用单向方差分析和Tukey检验进行分析。
结果：所有组间的FR差异显著(p<0.001)。最低的FR记录在未恢复组（284±86N），与立即恢复组没有统计学差异（p=0.065）。预密封组表现出最高的FR值(810±127N,p≤0.02vs.其他团体)。生理盐水灌洗和延迟恢复组的FR几乎相似（p=0.13）。
结论：NaOCl/EDTA冲洗会对FR产生不利影响。延迟修复可以减少这种不利影响。使用可流动复合材料的入口腔预密封导致比常规方法更高的FR，并且可以认为是治疗过程中的有效步骤。
