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1、不同方法预备根管对根管治疗后牙齿冠渗漏影响[摘要]目的采用3种不同方法预备根管,评价其对根管治疗后牙齿冠渗漏的影响。方法48颗单根管离体牙随机分为4组,使用不同的根管预备方法去除根管壁的玷污层。A组为对照组,采用生理盐水和过氧化氢溶液冲洗根管;B组采用乙二胺四乙酸(EDTA)凝胶和5.25%次氯酸钠溶液冲洗;C组采用Odontoson-M型超声波治疗仪荡洗;D组采用脉冲Nd:YAG激光照射。每组取2颗牙,于扫描电子显微镜(SEM)下观察冠部玷污层的去除情况;其余10颗牙采用ObturaII高温注射式热牙胶垂直加压法充填根管,氧化锌丁香油黏固剂封闭根管口,
2、浸于质量浓度20g-L-1亚甲基蓝溶液中染色7d,脱水脱钙制作透明牙标本,体视显微镜下测量染料渗入的深度。结果SEM观察:A组整个根管内壁被覆玷污层及大量碎屑,牙本质小管被堵塞;B组与C组根管内壁清洁,玷污层消失,牙本质小管开放;D组根管内壁牙本质小管封闭或半封闭,玷污层熔融消失。A、B、C、D组染料渗入深度分别为(2.15±0.38)、(1・75±0.28)、(2.04±0・40)、(1.73±0.36)mmoA组的渗入深度明显高于B、D组,其差异有统计学意义(P<0.05)o结论使用不同的方法预备根管去除玷污层,可以减少根管治疗后牙齿的冠渗漏。[关键
3、词]玷污层;超声波;冠渗漏;Nd:YAG激光;根管治疗[中图分类号]R781.05[文献标志码]A[doi]10.3969/j.issn.1000-1182.2012.05.017Effectofdifferenttechniquesinrootcanalpreparationoncoronalmicroleaka.geofendodonticallytreatedteethLiuYan,MaWeidong,GaoWeihong・(Dept.ofSpecialDiagnosis,DalianStomatologicalHospital,Dalian116
4、021,China)[Abstract]ObjectiveTocomparetheeffectofthreetechniquesinrootcanalpreparationoncoronalmicrolea-kageofendodonticallytreatedteeth・MethodsForty-eighthumansingle-rootedteethweredividedinto4groupsrandomlyandsubjectedtodifferenttechniquesonremovalofsmearlayer.GroupA,thecontrol
5、group,irrigationwithhydrogenperoxide(H202)andnormalsaline(NS);groupB,smearclearedwith5.25%sodiumhypochlorite(NaClO)andethylenediaminetetraacetis(EDTA)gel;groupC,irrigationwithOdontoson—Multrasonics;groupD,smearlayerremovedwithNd:YAGlaserirradiation.Twospecimensofeverygroupwerespl
6、itlongitudinallyintoequalsegmentsandcanalwallsatcoronalportionwereexaminedunderscanningelectronmicroscope(SEM)・ThententeethofeverygroupwerefilledwithwarmverticalcondensationbyObturaIIthermoplasticizedgutta-perchinjectiontechniqueandsealedwithzincoxideeugenol(ZOE).Theteethwereimme
7、rsedin20g•L-lmethylenebluefor7days,thenweredemineralized,dehydratedandcleared.Lineardyepenetrationwasdeterminedunderasteremicroscope・Thedatawerestatisticallyanalyzed・ResuItsIngroupA,thereweresmearlayeranddebrisremainedanddentinaltubuleswerecovered・IngroupBandgroupC,thesmearlayero
8、frootcanalswereremovedanddentinaltubules