endodontic therapy

牙髓治疗
  • 文章类型: Journal Article
    区分颞下颌关节紊乱病(TMD)疼痛和牙齿疼痛的因素是牙医感兴趣的。在接受治疗之前,参与者回答了六个问题的TMD疼痛筛查问卷。应用经过验证的TMD诊断指南(DC/TMD),口面疼痛专家和具有委员会认证的牙髓住院医师进行了牙髓和TMD检查。在我们的研究中,TMD筛选器识别所有类型的TMD的灵敏度更高(0.94(0.80-0.97),TMD疼痛不指牙齿(0.94(0.76-0.98),TMD疼痛仅指牙齿(0.94(0.64-1.00))。TMD疼痛筛查问卷可用于寻求牙髓治疗的患者的TMDS鉴定。
    The factors differentiating temporomandibular disorders (TMD) pain from tooth pain is of interest to dentists. Prior to receiving therapy, participants answered the six-question TMD Pain Screener questionnaire. Applying validated Diagnostic Guidelines for TMD (DC/TMD), an orofacial pain specialist and endodontic resident with board certification performed endodontic and TMD examinations. In our study, sensitivity was higher for TMD screener regarding identification of all types of TMDs (0.94 (0.80-0.97), TMD pain not referring to teeth (0.94 (0.76-0.98), TMD pain referring to teeth only (0.94 (0.64-1.00)). TMD Pain Screener questionnaire can be applied in identification of TMDS in patient seeking endodontic therapy.
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  • 文章类型: Journal Article
    预约间疼痛(IAP)是牙髓预约之间发生的术后疼痛的一种亚型。它可能在第一次预约后的几个小时内开始,并可能持续几天。除了机械仪表和彻底灌溉,肛门内药物在根管消毒中起着核心作用,从而降低了IAP。这项研究的目的是评估姜黄作为肛门内药物对有症状的不可逆性牙髓炎(SIP)患者的IAP的影响。100名健康的成年患者在其单根上颌或下颌牙齿之一中患有SIP,平行,单盲临床试验。经过彻底的生物力学准备,根管随机服用以下药物之一,对照(无药物),氢氧化钙,三重抗生素糊剂(TAP),还有姜黄.4h时使用视觉模拟量表记录疼痛,24h,每天,直到第七天。使用Kruskal-Wallis分析数据,Mann-WhitneyU,和Wilcoxon符号等级测试.氢氧化钙之间的疼痛评分无统计学差异,TAP或姜黄集团。可以得出结论,姜黄,氢氧化钙,和TAP在控制IAP方面同样有效。
    Inter-appointment pain (IAP) is a subtype of postoperative pain which occurs between endodontic appointments. It may begin within a few hours after the first appointment and may continue for several days. Apart from mechanical instrumentation and thorough irrigation, intracanal medicaments play a central role in the disinfection of root canals and thus decreasing IAP. The aim of this study was to evaluate the effect of Curcuma Longa as an intracanal medicament on IAP in patients with symptomatic irreversible pulpitis (SIP). One hundred healthy adult patients having SIP in one of their single-rooted maxillary or mandibular teeth participated in this randomized, parallel, single-blinded clinical trial. After thorough biomechanical preparation, the root canals were randomly medicated with one of the following medicaments, Control (no medicament), Calcium Hydroxide, triple antibiotic paste (TAP), and Curcuma Longa. The pain was recorded using Visual analog scale at 4 h, 24 h, and every day until the seventh day. Data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-rank tests. No statistical difference in pain scores was observed between Calcium Hydroxide, TAP or Curcuma Longa groups. It can be concluded that Curcuma Longa, Calcium hydroxide, and TAP are equally effective in controlling IAP.
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  • 文章类型: Case Reports
    最常见的牙源性囊肿是根性囊肿,通常由于牙髓坏死后的炎症而从牙周膜中的上皮残留物发展而来。我们报告了一例49岁的男性患者,主诉上颌前区无痛性肿胀,结果是根性囊肿.经临床检查,一个柔软的,发现了波动的非招标性肿胀。影像学检查发现根尖周病变。根据临床和放射学特征初步诊断为根性囊肿。治疗计划包括摘除,骨移植修复缺损,和抗生素牙髓治疗。在手术切除囊性病变后进行牙髓治疗。通过组织病理学分析验证了根性囊肿的诊断。本病例报告强调了多学科方法对成功治疗神经根囊肿的重要性,这也强调了需要全面的临床和影像学评估才能准确诊断。及时识别和适当的干预对于避免可能的并发症和确保成功的治疗结果至关重要。
    The most prevalent kind of odontogenic cysts is radicular cysts, which usually develop from the epithelial remnants in the periodontal ligament as a result of inflammation that follows pulp necrosis. We report a case of a 49-year-old male patient who complained of painless swelling in the maxillary anterior region, which turned out to be a radicular cyst. Upon clinical examination, a soft, nontender swelling that fluctuated was found. A periapical lesion was found upon radiographic assessment. A radicular cyst was tentatively diagnosed based on clinical and radiological features. The treatment plan included enucleation, restoration of the defect with bone graft, and endodontic therapy with antibiotics. Endodontic therapy was administered after the cystic lesion was surgically removed. The diagnosis of a radicular cyst was validated by histopathological analysis. The significance of a multidisciplinary approach for the successful management of radicular cysts is emphasized in this case report, which also underscores the need for a comprehensive clinical and radiographic evaluation for accurate diagnosis. Prompt identification and suitable intervention are essential to avert possible complications and guarantee successful treatment results.
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  • 文章类型: Journal Article
    要评估和比较三种不同的根管封闭剂(Endo-SequenceBC,BioRootRCS和氧化锌丁香酚)在单次根管治疗中的术后疼痛。
    根据纳入标准随机选择60名年龄在18-60岁之间的受试者。然后将受试者分为三组,每组20名患者。在所有患者中,进行了一次根管治疗,然后使用不同的密封剂进行闭塞。在第一组中,使用了End-Sequencesealer,在II组生物根RCS和III组中分别使用氧化锌丁香酚密封剂。
    将三组的功效与I组的功效进行比较,获得了统计学上的显着结果。
    在研究的限制范围内,可以得出结论,尽管所有的密封剂都能有效减轻术后疼痛,使用EndoSequenceBCsealers的患者评估了具有统计学意义的结果。
    UNASSIGNED: To evaluate and compare three different root canal sealers (Endo-Sequence BC, Bio Root RCS and Zinc Oxide Eugenol) on post operative pain in single visit root canal therapies.
    UNASSIGNED: 60 subjects with age ranging from 18-60 years were randomly selected depending upon the inclusion criteria. The subjects were then divided into three groups with 20 patients in each. In all the patients\' single visit root canal treatment was done followed by obturation using different sealers. In Group I Endo- Sequence sealer was used, in Group II Bio-Root RCS and in Group III Zinc Oxide Eugenol sealers were used respectively.
    UNASSIGNED: statistically significant results were obtained on comparing the efficacy of three groups with Group I proving to be much effect among the three.
    UNASSIGNED: within the limitation of the study it can be concluded that though all the sealers were effective in reducing post-operative pain, patients with Endo Sequence BC sealers evaluated statistically significant results.
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  • 文章类型: Case Reports
    临床医生应该精通解剖学,变体,牙齿异常牙齿的发育障碍会导致大小的改变,形状,number,结构,和牙齿的萌出。发育障碍会导致发芽,聚变,凹凸不平,撕裂,爪子,尖点,丹特的窝点,等。原虫,上颌磨牙颊侧的另一个尖点,这是一个罕见的临床发现,会导致斑块积聚,使口腔卫生维护困难。这导致临床附着丧失和骨丢失。这种情况可能经常无法诊断。应该诊断以防止进一步的并发症。据报道,该病例使临床医生意识到尽早诊断该病例的重要性,以便可以预防并发症并更容易管理。从法医牙科的角度来看,这种形态特征,虽然不常见,可能有助于对受害者进行大规模因果关系和身体或无生命物体上的咬痕的分类和识别。这是迄今为止报道的最罕见的原叶茎属病例之一。这不仅可能在牙髓治疗中造成重大问题,因为根管的形态学改变和由于树林形成导致无法维持无斑块区域(骨丢失)的牙周治疗,而且从法医牙科的角度来看,这也引起了极大的兴趣。
    Clinicians should be well-versed in the anatomy, variations, and teeth anomalies. Developmental disturbances of the teeth can lead to alterations in size, shape, number, structure, and eruption of the teeth. Developmental disturbances can lead to germination, fusion, concrescence, dilaceration, talons, cusps, dens in dente, etc. Protostylid, an additional cusp on the buccal aspect of the maxillary molar, which is a rare clinical finding, can lead to plaque accumulation, making oral hygiene maintenance difficult. This leads to clinical attachment loss and bone loss. This condition may often go undiagnosed. It should be diagnosed to prevent further complications. This case has been reported to make clinicians aware of the importance of diagnosing the case at the earliest possible time so that complications can be prevented and management is easier. From the perspective of forensic dentistry, this morphological feature, though uncommon, may be useful for the classification and identification of victims in mass causalities and bite marks on bodies or inanimate objects. This is one of the rarest cases of protostylids reported to date. This may not only pose a significant problem in endodontic therapy due to morphological alterations in root canals and periodontal therapy due to grove formation leading to an inability to maintain a plaque-free area (bone loss) but also be of very significant interest from the perspective of forensic dentistry.
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  • 文章类型: Journal Article
    背景:尽管在仪器系统和药物干预方面取得了重大突破,牙髓治疗后的疼痛仍然是一个严重的问题.牙髓器械系统类型在牙髓治疗后的术后疼痛中的作用一直存在争议。
    目的:为了评估不同的牙髓仪器系统,即Reciproc(GmbH,慕尼黑),OneShape®(MicroMega,法国),ProtaperGold(DentsplySirona,美国),和Hyflex®EDM(Coltène/WhaledentInc.,美国)文件系统,关于牙髓治疗后的术后疼痛方法和材料:牙髓科治疗了20至50岁的健康患者,这些患者在一个或多个上颌磨牙或下颌磨牙中出现不可修复的牙髓炎症状。五百是样品的确定大小。研究参与者分为五类,每人包括100名参与者。这些类别是:类别1:Reciproc仪器系统。类别2:OneShape®仪器系统。第3类:ProtaperGold仪表系统。第4类:HyFlex®EDM仪表系统。第5类:控制(不锈钢K文件)。牙髓治疗后,这些分数是在6小时记录的,12小时,24小时,48小时,和72小时使用VAS量表。
    结果:对照组的视觉模拟量表(VAS)评分(平均值±SD)为0.73±0.40(<0.001)。Reciproc组的VAS评分为0.43±0.05(<0.001)。OneShape®组的VAS评分为0.36±0.09(<0.001)。ProteceGold组的VAS评分为0.41±0.08(<0.001)。HyFlex®EDM组的VAS评分为0.55±0.02(<0.001)。与对照组相比,在72小时随访时,所有仪器技术的VAS评分均较低,具有有意义的统计学意义(<0.001)。然而,Reciproc术后疼痛,OneShape®,ProtaperGold,和HyFlex®EDM仪器系统之间的比较在临床上没有差异。然而,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM的VAS值更高,与Reciproc和ProtaperGold相比,OneShape和HyFlex®EDM显示术后疼痛增加。还观察到,随着随访时间从6小时增加到72小时,所有仪器系统的VAS评分均下降。随访6小时术后疼痛最大,随访72小时术后疼痛最小。然而,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM的下降幅度较小,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM术后疼痛增加。
    结论:在Reciproc的所有牙髓手术随访中,术后疼痛较少,OneShape®,ProtaperGold,和HyFlex®EDM比对照组。OneShape®和HyFlex®EDM组的VAS评分高于Reciproc和ProtaperGold组,与Reciproc和ProtaperGold相比,OneShape®和HyFlex®EDM仪器的术后疼痛增加。
    BACKGROUND: Despite substantial breakthroughs in instrumentation systems and pharmaceutical interventions, pain following endodontic therapy remains a serious concern. The effect of the type of endodontic instrumentation system in post-operative pain after endodontic therapy has been a matter of debate.
    OBJECTIVE: To evaluate different endodontic instrumentation systems, namely Reciproc (GmbH, Munich), OneShape® (MicroMega, France), Protaper Gold (Dentsply Sirona, USA), and Hyflex® EDM (Coltène/Whaledent Inc., USA) file systems, regarding post-operative pain after endodontic therapy Methods and materials: The endodontic department treated healthy patients aged 20 to 50 years who were experiencing symptoms of irreparable pulpitis in one or more maxillary molars or mandibular molars. Five hundred was the determined size of the sample. The study participants were divided into five categories, each comprising 100 participants. These categories were: Category 1: Reciproc instrumentation system. Category 2: OneShape® instrumentation system. Category 3: ProtaperGold instrumentation system. Category 4: HyFlex® EDM instrumentation system. Category 5: Control (stainless steel K-files). Following endodontic therapy, these scores were recorded at 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours using the VAS scale.
    RESULTS: The visual analog scale (VAS) score (mean±SD) in the control group was 0.73± 0.40 (<0.001). The VAS score in the Reciproc group was 0.43± 0.05 (<0.001). The VAS score in the OneShape® group was 0.36±0.09 (<0.001). The VAS score in the Protaper Gold group was 0.41 ±0.08 (<0.001). The VAS score in the HyFlex® EDM group was 0.55 ±0.02 (<0.001). The VAS score in all instrumentation techniques at 72 hours follow-up was lesser in comparison to a control group with meaningful statistical significance (<0.001). However, the post-operative pain among the Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM instrumentation systems was not different clinically when compared among themselves. However, VAS values were greater in OneShape® and HyFlex® EDM compared to Reciproc and Protaper Gold, showing increased post-operative pain in OneShape and HyFlex® EDM compared to Reciproc and Protaper Gold. It was also observed that there was a decline in the VAS score in all instrumentation systems as the follow-up period increased from 6 hours to 72 hours, with maximum post-operative pain at 6 hours of follow-up and minimum post-operative pain at 72 hours of follow-up. However, the decline was lesser in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold, with increased post-operative pain in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold.
    CONCLUSIONS: Post-operative pain at all follow-ups of endodontic procedures was less in Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM than in the control group. VAS scores were higher in the OneShape® and HyFlex® EDM groups compared to the Reciproc and Protaper Gold groups, indicating increased post-operative pain with OneShape® and HyFlex® EDM instruments in comparison to Reciproc and Protaper Gold.
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  • 文章类型: Journal Article
    本研究是在有限元分析的帮助下评估三种不同的根管锥度设计准备中的应力分布。
    下门牙具有单管,在NeoEndoFlexTitanium(NiTi)旋转文件的帮助下进行了清洁和整形,后来创建了三种设计,例如4%,6%,和8%的运河准备锥度。对所有牙齿进行锥形束计算机断层扫描(CBCT),并对应力进行有限元分析。对收集的数据进行统计分析。
    在所有三种设计中,在冠状部位发现应力最高,其次是中部,而在根尖部位发现应力最小。牙釉质中的应力值高于牙本质(MPa)。对于具有倾斜或垂直应力载荷的牙釉质和牙本质,设计3(8%锥度)和设计2(6%锥度)和1(4%锥度)发现了最高的应力值。
    与顶端和中间部分相比,所有运河准备在冠状负荷点处表现出最大的釉质应力。应力随着运河渐缩的增加而增加。
    UNASSIGNED: Present research was done to assess stress distribution in three different taper design preparation of root canal with the help of finite element analysis.
    UNASSIGNED: Lower incisors teeth having single canals that were cleaned and shaped with the help of NeoEndo Flex Titanium (NiTi) rotary file and later three designs were created such as 4%, 6%, and 8% canal preparation taper. Cone beam computed tomography (CBCT) was done for all teeth and subjected to finite element analysis for stresses. The collected data were statistically analyzed.
    UNASSIGNED: Highest stress was found in the coronal followed by the middle and least in the apical part in all three designs. The highest stress value was found in enamel than dentin (MPa). The highest stress value was found with design 3 (8% taper) followed by designs 2 (6% taper) and 1 (4% taper) for enamel and dentin with either oblique or vertical stress loading.
    UNASSIGNED: All canals preparation exhibited maximum enamel stress at the coronal load points compared to apical and middle portions. The stress increases with increase in canal tapering.
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  • 文章类型: Review
    背景:用牙源性角化囊肿重建整个牙列是一个非常具有挑战性的难题。据报道,大多数牙源性角化囊肿是良性的,导致上颌和下颌牙列严重咬合差异。牙科X光片偶尔会显示一种罕见的,局部侵袭性发展中的囊肿称为牙源性角化囊肿,通常位于后颌。当这种囊肿发生在前部区域时,由于对牙髓活力测试缺乏反应,常被误诊为其他根尖周病变。
    方法:本临床病例描述了一名诊断为牙源性角化囊肿患者的牙髓治疗。一名37岁的印度男性患者向该部门报告,左下后牙的搏动性疼痛需要进行牙髓治疗。该患者还出现了颌骨前部区域的牙源性角化囊肿,为此他接受了手术康复。此病例报告重点介绍了诊断为牙源性角化囊肿的患者的牙髓治疗的临床方案。随访期后未发现咀嚼损伤,治疗结果成功。
    结论:本病例报告详细介绍了特征性射线照相发现,和牙源性角化囊肿极为罕见的患者的牙髓治疗。管理涉及康复的多学科方法。
    BACKGROUND: Reconstruction of the entire dentition with odontogenic keratocyst is a very challenging quandary. Most cases of odontogenic keratocyst are often reported to be benign, resulting in severe occlusal discrepancies with the maxillary and mandibular dentition. Dental radiographs occasionally reveal an uncommon, locally aggressive developing cyst termed as odontogenic keratocyst, which is typically located in the posterior jaw. When this cyst occurs in the anterior region, it is often misdiagnosed with other periapical lesions due to its lack of response to pulp vitality tests.
    METHODS: This clinical case scenario demarcates the endodontic management of a patient diagnosed with odontogenic keratocyst. A 37-year-old Indian male patient reported to the department with throbbing pain in the lower left posterior tooth requiring endodontic therapy. This patient also presented with odontogenic keratocyst in the anterior region of the jaw, for which he had undergone surgical rehabilitation. This case report highlights the clinical protocol for the endodontic therapy in patient diagnosed with ododntogenic keratocyst. Masticatory impairment was not visible after the follow-up period and the treatment outcome was successful.
    CONCLUSIONS: This case report details the presentation, characteristic radiographic findings, and endodontic management of a patient with an extremely rare condition of odontogenic keratocyst. The management involves multidisciplinary approach for the rehabilitation.
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  • 文章类型: Journal Article
    牙髓治疗包括各种程序,如重要的牙髓治疗,根管治疗和再治疗,外科牙髓治疗和再生牙髓手术。消毒和组织修复对于这些疗法的成功至关重要,需要开发能够有效靶向微生物群的疗法,消除生物膜,调节炎症并促进组织修复。然而,目前没有牙髓药可以实现这些目标。抗菌肽(AMP),它们是氨基酸的序列,由于其独特的优势而受到关注,包括降低对耐药性的敏感性,广谱抗菌特性和有效调节生物体免疫反应的能力。这篇综述系统地讨论了结构,行动机制,AMP的新颖设计和局限性。此外,它强调了研究人员为克服肽缺陷所做的努力,并强调了AMP在牙髓治疗中的潜在应用。
    Endodontic therapy includes various procedures such as vital pulp therapy, root canal treatment and retreatment, surgical endodontic treatment and regenerative endodontic procedures. Disinfection and tissue repair are crucial for the success of these therapies, necessitating the development of therapeutics that can effectively target microbiota, eliminate biofilms, modulate inflammation and promote tissue repair. However, no current endodontic agents can achieve these goals. Antimicrobial peptides (AMPs), which are sequences of amino acids, have gained attention due to their unique advantages, including reduced susceptibility to drug resistance, broad-spectrum antibacterial properties and the ability to modulate the immune response of the organism effectively. This review systematically discusses the structure, mechanisms of action, novel designs and limitations of AMPs. Additionally, it highlights the efforts made by researchers to overcome peptide shortcomings and emphasizes the potential applications of AMPs in endodontic treatments.
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  • 文章类型: Journal Article
    背景:本研究的目的是评估银纳米颗粒(AgNPs)与氢氧化钙(Ca(OH)2)组合对白色念珠菌的抗真菌活性(C.albicans).
    方法:将AgNP与纯Ca(OH)2粉末在含水基质中混合。在96孔板中制备白色念珠菌的标准悬浮液(1×108个细菌细胞/mL),并在37℃下在100%湿度下在振荡器上孵育,以允许在感染的牙本质切片中形成真菌生物膜(n=98)。测定单独或与Ca(OH)2-起的AgNPs的最小抑制浓度(MIC)和最小杀菌浓度(MFC)。将样品分别置于24孔组织培养板中,并分为三个实验组(0.03、0.04和0.06)和三个对照组;阴性(盐水)和阳性氯己定凝胶和Ca(OH)2。通过XTT比色法定量测量真菌活性,并使用共聚焦激光显微镜和扫描电子显微镜进行定性测量。
    结果:与阴性对照组相比,实验组中白色念珠菌的细胞活力显着降低。(AgNP(0.04%)和Ca(OH)2)的组合对白色念珠菌是最有效的。
    结论:研究结果表明,与单独使用Ca(OH)2相比,将银纳米颗粒与Ca(OH)2结合对白色念珠菌生物膜更有效,暗示了梳理效果。
    BACKGROUND: The purpose of this study was to assess the antifungal activity of silver nanoparticles (AgNPs) in combination with calcium hydroxide (Ca(OH)2) against Candida albicans (C. albicans).
    METHODS: AgNPs was mixed with pure Ca(OH)2 powder in an aqueous base. A standard suspension (1 × 108 bacterial cells/mL) of C. albicans was prepared in a 96-well plate and incubated on shaker at 37 °C in 100% humidity to allow fungal biofilm formation in infected dentin slices (n = 98). The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of AgNPs alone or with Ca(OH)2 were determined. The samples were separately placed in 24-well tissue culture plates and divided into three experimental groups (0.03, 0.04, and 0.06) and three control groups; negative (saline) and positive chlorhexidine gel and Ca(OH)2. Quantitative measurements of fungal activity by XTT colorimetric assay and qualitative measurements using confocal laser microscopy and scanning electron microscopy were performed.
    RESULTS: The cell viability of C. albicans in the experimental groups was significantly reduced compared to the negative control group. The combination of (AgNPs (0.04%) and Ca(OH)2) was the most potent against C. albicans.
    CONCLUSIONS: The findings demonstrated that combining silver nanoparticles with Ca(OH)2 was more effective against C. albicans biofilm compared to Ca(OH)2 alone, suggesting a combing effect.
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