根管充填封闭性的体外研究
发布时间：2018-11-12 11:02
【摘要】：目的：根管治疗术(Root canal therapy, RCT)是目前治疗牙髓病和根尖周病较为成熟的方法,目的是形成良好的根尖封闭性,而其疗效与多种因素有关,其中根管充填的糊剂和根管充填方法的选择被认为是影响其疗效的最主要因素。本研究选用机械切割功能强、具有高记忆性和超弹性的PreTaper镍钛器械对离体牙在体外进行统一的根管预备,预备方法采用根管成形能力强、术后反应轻的Crown-Down技术。在根管预备的整个过程中利用次氯酸钠彻底冲洗根管,并且使用EDTA润滑根管壁。根管预备完成后,选用不同根管封闭剂和充填方法充填根管,利用染色渗透的方法处理样本牙齿,测量根尖渗透的长度,测定各组样本牙齿根管充填后的根尖封闭性,来评价不同根管充填方法和根管充填封闭剂联合应用的根尖封闭能力。方法：收集三个月以内正畸拔除的单根管下颌前磨牙60颗,随机分为A、B、C、D、E五组,每组12颗。使用机用PreTaper镍钛器械,采用根管预备方法中的冠根向深入法对样本牙齿进行根管预备,选用不同种充填方法和封闭剂充填根管。A组：侧向加压充填技术及AH plus封闭剂充填根管；B组：侧向加压充填技术及Vitapex封闭剂充填根管；C组：热牙胶垂直加压技术与AH plus封闭剂充填根管；D组：热牙胶垂直加压技术与Vitapex封闭剂充填根管；E组：空根管对照组,不进行任何充填。根管充填后,所有标本置于恒温箱内一周,待根管充填材料完全硬固,随后浸入印度墨水染色,硝酸脱钙、乙醇梯度脱水、置于水杨酸甲酯溶液中透明处理制作透明标本。体视显微镜下测量根尖微渗漏长度,采用SPSS11.5统计软件包对测量数据进行方差分析。结果：1.空根管对照组的根尖微渗漏长度明显长于热牙胶垂直加压及冷侧方加压充填组(P0.05),差异具有统计学意义。2.热牙胶垂直加压充填组较冷侧方加压充填组根尖封闭性好,根尖微渗漏长度差异显著(P0.05),差异具有统计学意义。3.冷侧方加压充填组, AH plus封闭剂较Vitapex糊剂的封闭性具有明显优越性(P0.05),差异具有统计学意义。4.热牙胶垂直加压充填组, AH plus封闭剂和Vitapex糊剂的微渗漏差异无显著性(P0.05),无统计学意义。结论：1.根管充填能明显降低微渗漏的发生,但根管充填方法及封闭剂的选择对根管充填封闭性的影响较大。2.热牙胶垂直加压充填技术能形成较严密的根管充填体,根尖微渗漏较轻,其根尖封闭能力明显优于冷侧向加压充填技术。3.在冷侧方加压充填技术中,AH plus封闭剂的封闭性明显优于Vitapex糊剂。4.在热牙胶垂直加压充填技术中,AH plus封闭剂和Vitapex糊剂对封闭性的影响无明显差异。
[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.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R781.05
本文编号：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.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R781.05
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