Root Canal Therapy

根管治疗
  • 文章类型: Journal Article
    目的:探讨种植体辅助牙有意再植(IR)治疗前牙周无希望牙(PHT)的临床效果。
    方法:作者招募了22例III/IV期牙周炎患者,这些患者患有上颌前牙漂移,总共有25颗牙齿。提取PHT用于体外根管治疗(RCT)。使根部表面平滑并修剪形状,牙槽窝被划伤了.牙种植系统用于根据方向制备牙槽,牙齿植入的深度和形状。将PHT重新植入制备的肺泡窝中。对手术前后的牙周指标进行统计学分析。
    结果:完成整个疗程的22名患者,总共25个PHT,成功保留率为88%。平均牙周探诊深度(PPD)在6个月和1年时分别下降2.880±0.556mm和3.390±0.634mm,分别,而临床附着丧失(CAL)在同一时间点分别下降2.600±0.622mm和2.959±0.731mm,分别,显着改善(P<0.05)。
    结论:牙种植系统辅助IR可有效保护III/IV期牙周炎患者的“漂移”自然PHT。
    OBJECTIVE: To investigate the clinical effect of implant-assisted dental intentional replantation (IR) for the treatment of \"drifted\" anterior periodontally hopeless teeth (PHT).
    METHODS: The present authors recruited 22 patients with stage III/IV periodontitis who suffered drifting of the maxillary anterior teeth, with a total of 25 teeth. The PHT were extracted for in vitro root canal treatment (RCT). The root surface was smoothed and the shape was trimmed, and the alveolar socket was scratched. The dental implant system was used to prepare the alveolar socket according to the direction, depth and shape of the tooth implantation. The PHT were reimplanted into the prepared alveolar socket. The periodontal indicators were analysed statistically before and after surgery.
    RESULTS: Twenty-two patients who completed the full course of treatment, with a total of 25 PHT, had a successful retention rate of 88%. Mean periodontal probing depth (PPD) decreased by 2.880 ± 0.556 mm and 3.390 ± 0.634 mm at 6 months and 1 year, respectively, and clinical attachment loss (CAL) decreased by 2.600 ± 0.622 mm and 2.959 ± 0.731 mm at the same time points, respectively, showing significant improvement (P < 0.05).
    CONCLUSIONS: Dental implant system-assisted IR can effectively preserve \"drifted\" natural PHT in patients with stage III/IV periodontitis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    本研究旨在评估放射治疗和不同牙髓治疗方案对牙髓腔牙本质粘结强度的影响。将80颗下颌磨牙随机分为两组(n=40):未辐照和辐照(60Gy)。纸浆室被剖开,每组被细分(n=8),根据牙髓治疗方案:不治疗(对照);单次访问;两次访问;立即牙本质密封(IDS)单次访问;和IDS两次访问。每次牙髓治疗都是通过用2.5%NaOCl灌溉来模拟的,17%EDTA和蒸馏水。IDS是通过在纸浆室的侧壁上积极施加两层通用粘合剂来进行的。之后,用复合树脂修复纸浆室,并获得四根棒进行微拉伸试验。此外,评估牙髓室屋顶的牙本质的表面粗糙度,化学成分,和每个治疗方案后的地形。双向方差分析,Tukey的posthoc,Mann-Whitney,Kruskal-Wallis和Dunn的事后表现(α=5%)。处理方案影响粘结强度(p<0.05),而照射没有(p>0.05)。对照组呈现最高值(p<0.05)。与其他组相比,单次访视组表现更好(p<0.05),它们之间没有差异(p>0.05)。使用IDS改变了表面粗糙度(p<0.05),牙本质的化学成分(p<0.05)和形貌。总之,治疗方案影响牙本质粘连,而辐照没有。
    This study aimed to evaluate the influence of radiotherapy and different endodontic treatment protocols on the bond strength to pulp chamber dentin. Eighty mandibular molars were randomly divided into two groups (n = 40): non-irradiated and irradiated (60 Gy). The pulp chambers were sectioned, and each group was subdivided (n = 8), according to the endodontic treatment protocol: no treatment (Control); Single-visit; Two-visits; Immediate dentin sealing (IDS) + single-visit; and IDS + two-visits. Each endodontic treatment visit was simulated through irrigation with 2.5% NaOCl, 17% EDTA and distilled water. IDS was performed by actively applying two coats of a universal adhesive to the lateral walls of the pulp chamber. After, the pulp chambers were restored with resin composite and four sticks were obtained for microtensile test. In addition, the dentin of the pulp chamber roof was assessed for surface roughness, chemical composition, and topography after each treatment protocol. Two-way ANOVA, Tukey\'s post hoc, Mann-Whitney, Kruskal-Wallis and Dunn\'s post hoc were performed (α = 5%). The treatment protocol affected bond strength (p < 0.05), while the irradiation did not (p > 0.05). The control group presented the highest values (p < 0.05). The single-visit group demonstrated better performance compared to the other groups (p < 0.05), which did not differ from each other (p > 0.05) The use of IDS changed the surface roughness (p < 0.05), chemical composition (p < 0.05) and topography of the dentin. In conclusion, the treatment protocol influenced dentin adhesion, while irradiation did not.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    此案例介绍了可用于内部隧道牙根吸收管理的临床技术和材料,一种很少有文献发表的罕见疾病。一名25岁的妇女在偶然发现射线照相射线可透性后,由其普通牙医转介到专科中心,提示牙根吸收与牙齿有关21。暂时诊断为宫颈外部吸收,以及随后的锥形束计算机断层扫描(CBCT),给出了内部隧道根吸收的明确诊断。使用基于硅酸钙的密封剂的连续波压实完成非手术牙髓治疗。不需要进一步干预。组织学总结,病因学,患病率,诊断,提供了内部隧道牙根吸收的管理和预后。CBCT用于诊断和管理内部隧道吸收缺陷以及使用硅酸钙基密封剂的连续波压实的好处,与冷闭塞技术相比,正在讨论。
    This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    非炎性囊肿与细菌相关的根尖周脓肿相比,根尖切除术后逆行充盈的必要性存在争议。这项研究旨在研究在根尖切除术中是否存在逆行充盈对炎症性和非炎症性囊肿的长期预后影响。
    这项回顾性研究包括2013年至2022年在颌骨囊肿摘除术期间接受牙尖切除术的患者,并接受了至少6个月的随访锥形束计算机断层扫描。在随访期间根据囊肿类型评估牙齿的预后,是否存在逆行填充,下颌骨或上颌骨,和位置。
    本研究共纳入147颗牙齿。所有手术牙齿都接受了牙髓专家的术前根管治疗。对119个炎性囊肿和28个非炎性囊肿进行了根尖切除术。对22颗具有炎性囊肿的牙齿和3颗具有非炎性囊肿的牙齿进行逆行填充。所有牙齿在3.5年的随访中幸存下来(范围,1.0-9.1年)。然而,1颗具有炎性囊肿的牙齿在手术后1年出现并发症,需要重新进行牙髓治疗。
    在囊肿摘除过程中,通过根尖切除术治疗而没有逆行充填的牙齿的预后是有利的,不管囊肿类型。
    UNASSIGNED: The necessity of retrograde filling after apicoectomy is controversial in cases of non-inflammatory cysts as opposed to bacteria-related periapical abscesses. This study aims to investigate whether the presence or absence of retrograde filling during apicoectomy has differential long-term prognostic implications between inflammatory and non-inflammatory cysts.
    UNASSIGNED: This retrospective study included patients who underwent tooth apicoectomy during jaw cyst enucleation between 2013 and 2022, and who underwent follow-up cone-beam computed tomography for at least 6 months. The prognosis of the tooth was evaluated during the follow-up period according to the cyst type, the presence or absence of retrograde filling, mandible or maxilla, and location.
    UNASSIGNED: A total of 147 teeth was included in this study. All the operated teeth underwent preoperative root canal treatment by an endodontic specialist. Apicoectomy was performed for 119 inflammatory cysts and 28 non-inflammatory cysts. Retrograde filling was performed on 22 teeth with inflammatory cysts and 3 teeth with non-inflammatory cysts. All teeth survived the 3.5-year follow-up (range, 1.0-9.1 years). However, 1 tooth with an inflammatory cyst developed complications 1 year after surgery that required re-endodontic treatment.
    UNASSIGNED: The prognosis of a tooth treated by apicoectomy without retrograde filling during cyst enucleation is favorable, regardless of the cyst type.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    背景:牙周和牙髓联合病变的成功取决于消除这两种疾病过程。在合并内围手术期病变的情况下,牙髓治疗导致参与的牙髓成分愈合,而牙齿的预后最终取决于牙周结构的愈合。
    方法:本病例报告评估自体纤维蛋白胶和植骨的疗效,也就是说,粘骨在治疗与子宫内膜病变相关的骨缺损中的应用。内周病变首先进行牙髓治疗,其次是牙周治疗。结论:患者随访9个月,在骨填充和口袋深度减少方面获得了令人满意的结果。
    在治疗围手术期病变时,粘骨可增强再生。
    BACKGROUND: The success of a combined periodontal and endodontic lesion depends on the elimination of both these disease processes. In the case of a combined endo-perio lesion, endodontic therapy results in healing of the endodontic component of involvement, while the prognosis of teeth would finally depend on the healing of the periodontal structure.
    METHODS: This case report evaluates the efficacy of autologous fibrin glue and bone graft, that is, sticky bone in the management of bone defects associated with endo-perio lesion. The endo-perio lesion is first treated endodontically, followed by periodontal therapy. Conclusion: The patient was kept on follow-up for 9 months, and satisfactory results in terms of bone fill and reduction in pocket depth were obtained.
    UNASSIGNED: The sticky bone enhances regeneration in treatment of endo-perio lesions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    这项前瞻性研究旨在评估牙齿疼痛,焦虑,以及接受根管治疗的孕妇的灾难性水平。该研究包括60名出现牙痛和根管治疗适应症的孕妇和非孕妇。使用经过验证的问卷调查了牙科焦虑和灾难。进行了牙髓干预,和测量术前和术后牙痛的数字量表。结果采用STATA软件12.0进行分析。未经调整的分析评估了怀孕和疼痛之间的关联,焦虑,和灾难性的水平。使用“正向逐步”进入程序的多元线性回归模型用于评估变量对疼痛评分的独立影响。显著性水平设定为0.05。最初,大多数患者经历了剧烈的牙齿疼痛。牙齿疼痛的程度,牙科焦虑,孕妇和非孕妇之间的灾难没有差异。Logistic回归分析显示,术后疼痛与不可逆牙髓炎诊断(OR=4.78;95CI1.55-13.55)和高灾难性水平(OR=1.96;95CI1.01-3.84)相关。孕妇和非孕妇的术前和术后疼痛率以及焦虑和恐惧相似。术后疼痛与不可逆牙髓炎诊断和高灾难化水平有关。孕妇和非孕妇在术前和术后牙痛以及恐惧和焦虑水平方面的相似性支持在必要时在妊娠期进行根管治疗的指征。
    This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using \'forward stepwise\' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    最近的证据表明,越来越多的儿科患者需要侵入性治疗,如根管治疗(RCT)在他们的恒牙,尽管几乎没有关于风险因素的信息,例如在其原牙列中进行牙髓切除术或牙髓切除术的侵入性治疗。因此,这项研究的主要目的是确定在其乳牙中接受过任何类型的侵入性治疗的儿科患者的数量,评估它们与任何后续侵入性治疗(根管治疗,提取)在他们的恒牙中,并评估这些趋势。这项回顾性研究利用了2013-2022年期间临床儿科患者库(0-17岁)的汇总数据。这项分析显示,在2013年(n=417,n=156)和2022年(n=250,n=12)之间,需要进行牙列切除和牙列切除的儿科患者有所下降。恒牙根管治疗(RCT)从n=54增加到n=330,增加了六倍。此外,少数(7.8%)RCT患者既往有牙髓切除术或牙髓切除术史,这表明在原发性牙列中进行的侵入性治疗与随后在恒牙中进行侵入性治疗的需要没有直接联系,尽管需要更多的研究来确定这些观察结果的解释。
    Recent evidence suggests that an ever-growing number of pediatric patients require invasive treatments such as root canal therapy (RCT) in their permanent dentition, albeit with little information about risk factors such as prior invasive treatments of pulpotomy or pulpectomy in their primary dentition. Therefore, the primary objectives of this study were to determine the number of pediatric patients who have had any type of invasive treatment in their primary teeth, to assess their association with any subsequent invasive treatment (root canal therapy, extractions) in their permanent dentition, and to assess these trends over time. This retrospective study utilized summary data from a clinical pediatric patient pool (ages 0-17) over the period of 2013-2022. This analysis revealed that pediatric patients requiring pulpotomies and pulpectomies in primary dentition declined between 2013 (n = 417, n = 156) and 2022 (n = 250, n = 12), while root canal therapy (RCT) in permanent dentition increased six-fold from n = 54 to n = 330. In addition, few (7.8%) patients with RCT had a previous history of pulpotomy or pulpectomy, which suggests that invasive treatments performed in primary dentition have no direct association with the subsequent need for invasive treatments in permanent dentition, although more research is needed to determine the explanations for these observations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported.
    OBJECTIVE: The aim of this study was to evalúate the quality of endodontic treatment and the frequency of missed canals associated with teeth with apicalperiodontitis (AP) through CBCTin a Colombian sub-population.
    METHODS: This was a cross-sectional study assessing 318 cone beam computed tomography (CBCT) scans of endodontically treated teeth from Colombian individuals. The scans were taken using J Morita X550 (J Morita Corporation, Osaka, Japan), with voxel size 0.125 to 0.20 mm. All endodontically treated teeth were assessed for quality of treatment, presence of missed canals and AP. Allsamples were analyzed bytwo endodontics specialists and an radiology specialist. Chi-square or Fisher \'s test and odds ratio were calculated to identify the association and risk relationship between the presence of AP and the study variables.
    RESULTS: Missed canals were found in 18.61% (86/462), and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/288) of the teeth with adequate endodontic treatment, in contrast to 72.57% (209/288) of the teeth with inadequate treatment (P<0.01). The frequency of missed canals was highest in maxillary molars, with 55.23% (58/105), with 96.55% presenting AP. The second mesiobuccal canal wasthe most frequently missed canal, 88.52%o(54/61), with AP in 90.74% (49/54) of the cases.
    UNASSIGNED: There was a high frequency of teeth with missed canals and PA. More than half of the teeth with missed canals were maxillary molars, with MB2 being the most common canal, commonly presenting apical periodontitis.
    Uma alta prevalência de periodontite apical pós-tratamento associada a variáveis como qualidade do tratamento endodôntico e fracasso do tratamento é relatada na literatura. O objetivo deste estudo foi avaliar a qualidade do tratamento endodôntico e a frequência e fracasso do tratamento associados a dentes com periodontite apical (PA) por meio de tomografia computadorizada de feixe cônico (TCFC) em uma subpopulação colombiana.
    UNASSIGNED: Este foi um estudo transversal que avaliou 318 tomografias computadorizadas de dentes tratados endodonticamente de indivíduos colombianos. Os exames foram realizados utilizando o tomógrafo J Morita X550, com tamanho de voxel de 0,125 a 0,20 mm. Todos os dentes tratados endodonticamente foram avaliados quanto à qualidade do tratamento, presença de canais não localizados e AP. Todas as amostras foram avaliadas por dois especialistas em endodontia e um especialista em radiologia. Foram calculados o teste qui-quadrado ou de Fisher e a razão de chances para identificar associação e relação de risco entre a presença de PA e as variáveis do estudo.
    RESULTS: Foram encontrados canais não localizados em 18,61% (86/462) e 95,3% estavam associados à PA. A frequência de AP foi de 62,34% (288/462) para todos os dentes avaliados. AP foi encontrada em 27,43% (79/288) dos dentes com tratamento endodôntico adequado, em contraste com 72,57% (209/288) dos dentes com tratamento inadequado (P<0,01). A frequência de canais não localizados foi maior nos molares superiores, com 55,23% (58/105), sendo que 96,55% apresentavam PA. O canal mésio-palatino (MB2) apresentou maior frequência de canal não localizado (88,52% - 54/61), com PA em 90,74% (49/54) dos casos.
    UNASSIGNED: Houve alta frequência de dentes com canais não localizados e com PA. Mais da metade dos dentes com canais não localizados eram molares superiores, sendo o MB2 é o canal com a maior frequência, comumente apresentando periodontite apical.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目标:这项研究评估了氯己定(CHX)和异丙醇(IA)对纤维桩与牙本质的即时和后期推出粘结强度(PBS)的影响。材料和方法:在这项体外研究中,对54颗单管前磨牙进行了牙髓治疗,并随机分配到3组(N=18),用蒸馏水(对照组)处理牙本质,2%CHX,和70%的IA后空间准备。纤维桩用TheraCem自粘水泥粘合,并将每组细分为两个亚组(N=9),用于键合后立即进行PBS测量,并且在5000个热循环(5-55°C)之后。然后将根部切开,并测量了他们的PBS。在立体显微镜下以X40放大倍数评估失效模式。数据采用重复测量方差分析和Tukey检验(α=0.05)。结果:24小时后IA组PBS最高(21.12MPa),热循环后最低的PBS属于对照组(7.48MPa)。对照组即刻和后热循环PBS显著低于CHX组(P<0.05)。对照组和CHX组的PBS均低于IA组(P<0.001)。不管是哪种类型的洗涤剂,热循环后观察到PBS的显着减少(P<0.003)。在所有组中,PBS从宫颈向顶端区域显着降低(P<0.001)。结论:根据研究结果,自粘水泥前IA的应用有效地改善了即刻和后期PBS,并且明显比CHX更有效。
    Objectives: This study assessed the effect of chlorhexidine (CHX) and isopropyl alcohol (IA) on immediate and late pushout bond strength (PBS) of fiber posts to dentin. Materials and Methods: In this in vitro study, 54 single-canal premolars were endodontically treated, and randomly assigned to 3 groups (N=18) for root dentin conditioning with distilled water (control), 2% CHX, and 70% IA after post space preparation. Fiber posts were cemented with TheraCem self-adhesive cement, and each group was subdivided into two subgroups (N=9) for PBS measurement immediately after bonding, and after 5000 thermal cycles (5-55°C). The roots were then sectioned, and their PBS was measured. The mode of failure was evaluated under a stereomicroscope at ×40 magnification. Data were analyzed by repeated measures ANOVA and Tukey\'s test (alpha=0.05). Results: The highest PBS was noted in the IA group (21.12 MPa) after 24 hours and the lowest PBS belonged to the control group after thermocycling (7.48 MPa). The immediate and post-thermocycling PBS were significantly lower in the control group than the CHX group (P<0.05). The PBS in both the control and CHX groups was lower than that in the IA group (P<0.001). Regardless of the type of detergent, a significant reduction in PBS was observed after thermocycling (P<0.003). The PBS significantly decreased from the cervical towards the apical region in all groups (P<0.001). Conclusion: According to the results, application of IA before the self-adhesive cement effectively improved the immediate and late PBS, and was significantly more effective than CHX.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    本文说明了在其他健康患者中,磨牙和前磨牙的牙髓非手术(再)治疗方法不同,并伴有C形和根管等异常。除了用NaOCl积极灌溉外,照明放大是处理这些情况的最有用的项目。
    This paper illustrated successful endodontic non-surgical (re)treatments of molars and premolar with different taurodontic classifications and accompanied anomalies like C-shape and extra root canals in otherwise healthy patients. Magnification with illumination besides active irrigation with NaOCl were the most helpful items in managing these cases.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号