iRoot SP和AH Plus对牙周炎患牙根管封闭能力比较  

Comparative study of iRoot SP and AH Plus on root canal sealing ability in periodontally compromised teeth

作　　者：鹿敏 刘双 王雅楠 宋爱梅 LU Min;LIU Shuang;WANG Ya-nan;SONG Ai-mei(Department of Periodontology,School and Hospital of Stomatology,Cheeloo College of Medicine,Shandong University,Shandong Key Laboratory of Oral Tissue Regeneration,Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration,Shandong Provincial Clinical Research Center for Oral Diseases.Jinan 250012,Shandong Province;Department of Stomatology,Third People's Hospital of Shizuishan City.Shizuishan 753400,Ningxia Province,China)

机构地区：[1]山东大学齐鲁医学院口腔医学院·口腔医院牙周病科,山东省口腔组织再生重点实验室,口腔生物材料与组织再生山东省工程研究中心,山东省口腔疾病临床医学研究中心,山东济南250012 [2]石嘴山市第三人民医院口腔科,宁夏石嘴山753400

出　　处：《上海口腔医学》2024年第5期455-460,共6页Shanghai Journal of Stomatology

基　　金：山东省自然科学基金(ZR2020MH184)。

摘　　要：目的:比较i Root SP和AH Plus对牙周炎患牙根管封闭性的差异,探讨牙本质小管在牙周-牙髓交通途径中发挥的重要作用,为牙周-牙髓联合病变患牙根管治疗时机及糊剂选择提供理论依据。方法:选取因重度牙周炎拔除的单根前牙50颗,清创并刮除根面牙骨质。分为A、B 2组,每组实验牙21颗,对照牙4颗。根管预备后,分别采用iRoot SP(A组)、AH Plus(B组)加牙胶尖冷侧压根管充填。将牙根均分为冠方段组(A1、B1)、根方段根尖孔未封闭组(A2、B2)和根尖孔封闭组(A3、B3)。根据分组使用铸造蜡封闭冠、根方,侧面不封闭。将样本置于亚甲蓝染液中浸泡14 d后,牙根纵剖成两半,测量染液在各组根管内壁渗入的长度。采用Image Pro Plus软件测量染液在牙本质小管内渗透的面积百分比。利用单因素方差分析及组内LSD方法分析A、B 2组组内及组间差异。采用SPSS 26.0软件包对数据进行统计学分析。结果:A2组渗透长度显著大于A3组(P<0.05),B2组渗透长度显著大于B1和B3组(P<0.05),A组与B组组内相比无显著差异(P>0.05)。A1组牙本质小管染色面积百分比显著小于A2组(P<0.05),B1组显著小于B2与B3组(P<0.05),A组与B组组内相比无显著差异(P>0.05)。结论:采用i Root SP和AH Plus 2种根充糊剂结合牙胶尖冷侧压根管充填法,对重度牙周炎患牙进行根管治疗,对牙周炎患牙根管封闭性的影响无显著差异。牙本质小管并非牙周-牙髓互相交通的主要途径,根方1/2段的交通途径在牙周牙髓联合病变中发挥更重要作用,提示牙周附着丧失到达根方1/2以上时才可考虑根管治疗。PURPOSE:This study was aimed to compare the difference between iRoot SP and AH Plus on root canal sealing ability for teeth extracted due to severe periodontitis and explore whether the dentin tubule pathway plays an important role in the development of endodontic-periodontic lesions(EPL),in order to provide a theoretical basis for selection of proper time for root canal therapy and suitable root canal sealants in patients with EPL.METHODS:Fifty single-root anterior teeth extracted due to severe periodontitis were selected.The roots were completely debrided to remove the calculus,dental plaque and cementum.They were divided into two groups,namely group A and group B,with 25 teeth in each group which included 21 experimental teeth and 4 negative control teeth.The root canals were filled with iRoot SP(group A)and AH Plus(group B)plus gutta-percha by cold lateral condensation technique.All roots were cut across the middle section and divided into coronal segment(group A1 and B1)of which the coronal section and apical section were sealed with self-etching adhesive and fluid resin,and then covered with melted casting wax twice.The apical segment of the experimental group was further divided into two subgroups,namely,the unsealed apical foramen group(group A2 and group B2)and sealed apical foramen group(group A3 and group B3).In group A2 and group B2,only the coronal section was sealed as mentioned above.While in group A3 and B3,both the coronal sections and apical foramen were sealed.The whole surface of the specimens in negative control group were all covered with melted casting wax twice.The samples were immersed in 1%methylene blue dye solution for 14 d,then they were longitudinally cut in half.Vernier caliper was used to measure the penetration length of the dye solution along the inner wall of each root canal.The sample sections were all photographed to process for Image Pro Plus software analysis of the penetration area of the dye solution in dentin tubule.The intra-group and inter-group differences were analyze

关 键 词：牙周炎 牙周牙髓联合病变 根充糊剂 根管微渗漏 牙本质小管 

分 类 号：R781.4[医药卫生—口腔医学]