桩道预备后剩余根管充填物的根尖封闭作用评价
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摘要
目的:比较不同根管充填方法及桩道预备后不同长度的充填材料对根尖的封闭作用,寻找根管充填方法和剩余充填材料的最佳搭配选择,为临床应用提供理论依据。方法:132颗单根管牙随机分为6个实验组(每组各20颗)和2个对照组(每组各6颗)。根管预备后A、B、C 3组行冷牙胶侧方加压充填,桩道预备后分别剩余4、6、8 mm根管充填物;D、E、F 3组行连续波热牙胶充填,桩道预备后分别剩余4、6、8 mm根管充填物;G组(阴性对照组)随机选择不同充填方法及不同长度剩余根管充填物;H组不进行根管充填。利用葡萄糖定量检测微渗漏模型,检测各组从冠方向根方渗漏的葡萄糖浓度(体积)。采用SPSS 19.0软件包对数据进行统计学分析。结果:A和D、B和E、C和F比较,冷牙胶侧方加压充填组微渗漏显著大于热牙胶充填组。A和B、A和C、D和E、D和F相比,差异均具有显著性;B和C、E和F相比,无显著差异,说明根尖剩余4 mm和6 mm组间具有显著差异,而剩余6 mm和8 mm组间无显著差异。结论:连续波热牙胶充填技术的根尖封闭性能显著优于冷牙胶侧方加压法。桩道预备后剩余6 mm微渗漏较少,是较合适的剩余充填材料长度。
PURPOSE: To evaluate the sealing ability of three different lengths of root canal fillings after post space and two different obturation techniques by using a glucose leakage test, and provide theoretical basis for clinical selection of best collocation of root canal filling methods and residual root canal filling materials. METHODS: One hundred and thirty-two extracted single-root teeth were randomly divided into 6 experimental groups( n =20 each), positive(n =6)and negative controls(n =6). After root canal preparation, different treatments were performed in different groups. Group A:lateral compaction and 4 mm length of root canal fillings after post space. Group B: lateral compaction and 6 mm length of root canal fillings after post space. Group C: lateral compaction and 8 mm length of root canal fillings after post space.Group D: warm gutta vertical compaction and 4 mm length of root canal fillings after post space. Group E: warm gutta vertical compaction and 6 mm length of root canal fillings after post space. Group F: warm gutta vertical compaction and 8mm length of root canal fillings after post space. Group G: random root canal filling. Group H: no root canal filling. A glucose leakage model was used for quantitative evaluation of the coronal to apical microleakage. SPSS 19.0 software package was used for statistical analysis. RESULTS: Lateral compaction showed significantly more leakage than warm gutta vertical compaction at all observation times, regardless of the length of the root canal fillings. The shorter the length of root canal fillings after post space, the worse the effect of the apical sealing for the same filling method. There was significant difference between 4 mm and 6 mm(P<0.05), but no significant difference between 8 mm and 6 mm(P>0.05).CONCLUSIONS: Warm vertical compaction shows a better sealing result than cold lateral compaction of gutta-percha.The shorter the length of root canal fillings after post space, the worse the effect of the apical sealing. 6 mm may be the proper residual root filling material length after post space preparation.
PURPOSE: To evaluate the sealing ability of three different lengths of root canal fillings after post space and two different obturation techniques by using a glucose leakage test, and provide theoretical basis for clinical selection of best collocation of root canal filling methods and residual root canal filling materials. METHODS: One hundred and thirty-two extracted single-root teeth were randomly divided into 6 experimental groups( n =20 each), positive(n =6)and negative controls(n =6). After root canal preparation, different treatments were performed in different groups. Group A:lateral compaction and 4 mm length of root canal fillings after post space. Group B: lateral compaction and 6 mm length of root canal fillings after post space. Group C: lateral compaction and 8 mm length of root canal fillings after post space.Group D: warm gutta vertical compaction and 4 mm length of root canal fillings after post space. Group E: warm gutta vertical compaction and 6 mm length of root canal fillings after post space. Group F: warm gutta vertical compaction and 8mm length of root canal fillings after post space. Group G: random root canal filling. Group H: no root canal filling. A glucose leakage model was used for quantitative evaluation of the coronal to apical microleakage. SPSS 19.0 software package was used for statistical analysis. RESULTS: Lateral compaction showed significantly more leakage than warm gutta vertical compaction at all observation times, regardless of the length of the root canal fillings. The shorter the length of root canal fillings after post space, the worse the effect of the apical sealing for the same filling method. There was significant difference between 4 mm and 6 mm(P<0.05), but no significant difference between 8 mm and 6 mm(P>0.05).CONCLUSIONS: Warm vertical compaction shows a better sealing result than cold lateral compaction of gutta-percha.The shorter the length of root canal fillings after post space, the worse the effect of the apical sealing. 6 mm may be the proper residual root filling material length after post space preparation.
引文
[1]Rippe MP,Santini MF,Bier CA,et al.Effect of root canal preparation,type of endodontic post and mechanical cycling on root fracture strength[J].J Appl Oral Sci,2014,22(3):165-173.
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[16]Ricucci D,Russo J,Rutberg M,A Prospective cohort study of endodontic treatments of 1396 root canals results after 5 years[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2011,112(6):825-842.
[17]Wu MK,Pehlivan Y,Kontakiotis EG,et al.Microleakage along apical root fillings and cemented posts[J].J Prosthet Dent,1998,79(3):264-269.
[18]Metzger Z,Abramovitz R,Abramovitz L,et al.Correlation b etween remaining length of root canal fillings after immediate post space preparation and coronal leakage[J].J Endod,2000,26(12):724-728.
[19]Rahimi S,Shahi S,Nezafati S,et al.In vitro comparison of three different lengths of remaining gutta-percha for establishment of apical seal after post-space preparation[J].J Oral Sci,2008,50(4):435-439.
[20]Brosco VH,Bernardineli N,Torres SA,et al.Bacterial leakage in obturated root canals-part 2:a comparative histologic and microbiologic analyses[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2010,109(5):788-794.
[21]Schuartz RS,Robbins JW.Post placement and restoration of endodontically treated teeth:a literature review[J].J Endod,2004,30(5):289-301.
[22]Jacobson HL,Xia T,Baumgartner JC,et al.Microbial leakage evaluation of the continuous wave of condensation[J].J Endod,2002,28(4):269-271.
[23]Ersahan S,Aydin C.Solubility and apical sealing characteristics of a new calcium silicate-based root canal sealer in comparison to calcium hydroxide-,methacrylate resin-and epoxy resinbased sealers[J].Acta Odontol Scand,2013,71(3-4):857-862.
[24]Ko?ak MM,Yaman SD.Comparison of apical and coronal sealing in canals having tapered cones prepared with a rotary Ni Ti system and stainless steel instruments[J].J Oral Sci,2009,51(1):103-107.
[25]Abramovitz L,Lev R,Fuss Z,et al.The unpredictability of seal after post space preparation:a fluid transport study[J].J Endod,2001,27(4):292-295.
[26]Lyons WW,Hartwell GR,Stewart JT,et al.Comparison of coronal bacterial leakage between immediate versus delayed post-space preparation in root canals filled with Resilon/Epiphany[J].Int Endod J,2009,42(3):203-207.
[2]Cobankara FK,Ung?r M,Belli S.The effect of two different root canal sealers and smear layer on resistance to root fracture[J].J Endod,2002,28(8):606-609.
[3]Juloski J,Radovic I,Goracci C,et al.Ferrule effect:a literature review[J].J Endod,2012,38(1):11-19.
[4]Monticelli F,Grandini S,Goracci C,et al.Clinical behavior of translucent-fiber posts:a 2-year prospective study[J].Int J Prosthodont,2003,16(6):593-596.
[5]Attam K,Talwar S.A laboratory comparison of apical leakage between immediate versus delayed post space preparation in root canals filled with Resilon[J].Int Endod J,2010,43(9):775-781.
[6]Timpawat S,Vongsavan N,Messer HH.Effect of removal of the smear layer on apical microleakage[J].J Endod,2001,27(5):35l-353.
[7]Punia SK,Nadig P,Punia V.An in vitro assessment of apical microleakage in root canals obturated with gutta-flow,resilon,thermafil and lateral condensation:A stereomicroscopic study[J].J Conserv Dent,2011,14(2):173-177.
[8]Abraham SB,Gopinath VK.Root canal anatomy of mandibular first premolars in an Emirati subpopulation:a laboratory study[J].Eur J Dent,2015,9(4):476-482.
[9]Xu Q,Fan M,Fan B,et al.A new quantitative method using glucose for analysis of endodontic leakage[J].Oral Surg Oral Med Oral pathol Oral Radiol Endod,2005,99(1):107-111.
[10]徐生,邓健,许金生,等.不同苯原酚化合物用于GOD-Trinder法测定血糖的比较研究[J].光谱学与光谱分析,2006,26(3):526-528.
[11]Antunes HS,Gominho LF,Andrade-Junior CV,et al.Sealing ability of two root-end filling materials in a bacterial nutrient leakage model[J].Int Endod J,2015.
[12]Rosales-Leal JI,Olmedo-Gaya V,Vallecillo-Capilla M,et al.Influence of cavity preparation technique(rotary vs.ultrasonic)on microleakage and marginal fit of six end-root filling materials[J].Med Oral Patol Oral Cir Bucal,2011,16(2):e185-189.
[13]Solano F,Hartwell G,Appelstein C.Comparison of apical leakage between immediate versus delayed post space preparation using AH Plus sealer[J].J Endod,2005,31(10):752-754.
[14]Balto H,Al-Nazhan S,Al-Mansour K,et al.Microbial leakage of Cavit,IRM,and Temp Bond in post-prepared root canals using two methods of gutta-percha removal:an in vitro study[J].J Contemp Dent Pract,2005,6(3):53-61.
[15]Mozini AC,Vansan LP,Sousa Neto MD,et al.Influence of the length of remaining root canal filling and post space preparation on the coronal leakage of Enterococcus faecalis[J].Braz J Microbiol,2009,40(1):174-179.
[16]Ricucci D,Russo J,Rutberg M,A Prospective cohort study of endodontic treatments of 1396 root canals results after 5 years[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2011,112(6):825-842.
[17]Wu MK,Pehlivan Y,Kontakiotis EG,et al.Microleakage along apical root fillings and cemented posts[J].J Prosthet Dent,1998,79(3):264-269.
[18]Metzger Z,Abramovitz R,Abramovitz L,et al.Correlation b etween remaining length of root canal fillings after immediate post space preparation and coronal leakage[J].J Endod,2000,26(12):724-728.
[19]Rahimi S,Shahi S,Nezafati S,et al.In vitro comparison of three different lengths of remaining gutta-percha for establishment of apical seal after post-space preparation[J].J Oral Sci,2008,50(4):435-439.
[20]Brosco VH,Bernardineli N,Torres SA,et al.Bacterial leakage in obturated root canals-part 2:a comparative histologic and microbiologic analyses[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2010,109(5):788-794.
[21]Schuartz RS,Robbins JW.Post placement and restoration of endodontically treated teeth:a literature review[J].J Endod,2004,30(5):289-301.
[22]Jacobson HL,Xia T,Baumgartner JC,et al.Microbial leakage evaluation of the continuous wave of condensation[J].J Endod,2002,28(4):269-271.
[23]Ersahan S,Aydin C.Solubility and apical sealing characteristics of a new calcium silicate-based root canal sealer in comparison to calcium hydroxide-,methacrylate resin-and epoxy resinbased sealers[J].Acta Odontol Scand,2013,71(3-4):857-862.
[24]Ko?ak MM,Yaman SD.Comparison of apical and coronal sealing in canals having tapered cones prepared with a rotary Ni Ti system and stainless steel instruments[J].J Oral Sci,2009,51(1):103-107.
[25]Abramovitz L,Lev R,Fuss Z,et al.The unpredictability of seal after post space preparation:a fluid transport study[J].J Endod,2001,27(4):292-295.
[26]Lyons WW,Hartwell GR,Stewart JT,et al.Comparison of coronal bacterial leakage between immediate versus delayed post-space preparation in root canals filled with Resilon/Epiphany[J].Int Endod J,2009,42(3):203-207.