改良乳牙根管充填材料体内降解匹配性与临床效果

doi:10.3969/j.issn.1671-167X.2015.03.029

摘要/Abstract

摘要： 目的：观察改良乳牙根管充填材料（modified primary root canal filling，MPRCF）的体内降解速度与乳牙根吸收的匹配情况及临床效果。方法：临床纳入155名患儿的160颗患慢性牙髓炎的乳磨牙，随机分为3组，分别使用MPRCF、氧化锌丁香油糊剂（zinc oxideeugenol，ZOE）和氢氧化钙碘仿糊剂Vitapex行根管治疗，观察6个月和12个月时的材料降解匹配情况及临床疗效。结果：ZOE和MPRCF在6个月和12个月的临床和放射学成功率均为100.0%；Vitapex 6个月的临床和放射学成功率为100.0%和80.4%，12个月时则为94.5%和60.7%。MPRCF与Vitapex 12个月的成功率差异有统计学意义（P<0.01）。12个月时超填材料的吸收情况：ZOE组14.3%完全吸收,Vitapex组100%吸收，MPRCF组71.4%完全吸收，3组间差异有统计学意义（P<0.001）。12个月时根充材料降解速度与牙根的匹配率MPRCF（40.9%）优于ZOE（5.8%）和 Vitapex （7.2%），差异有统计学意义（P=0.001）。结论：改良乳牙根管充填制剂降解速度及与牙根生理性吸收速度的匹配度优于目前临床使用材料Vitapex和ZOE，临床和放射学成功率不低于现有材料。

关键词: 牙, 乳, 牙根吸收, 根管充填材料, 氧化锌, 氢氧化钙

Abstract: Objective：To compare clinical and radiographic success rates of a modified primary root canal filling (ingredients: zinc oxide-eugenol, iodoform and calcium hydroxide, MPRCF) vs. zinc oxide-eugenol cement (ZOE) and calcium hydroxide/iodoform paste (Vitapex) in pulpectomized primary molars at the end of 6 and 12 months, and to evaluate the degradation of materials in the root canals and in apical area. Methods: In the study, 160 primary molars from 155 children ( the average age: 5.88±1.27 years) that met the inclusion criteria were allocated to one of the three materials via block randomization. A two-visit pulpectomy was performed by an investigator. The clinical and radiographic diagnoses were blindly assessed by other two investigators. Results: At the end of 6 and 12 months, the ZOE and MPRCF success rates were 100% both in clinical and radiographic evaluation. The Vitapex group showed the clinical success of 100% at the end of 6 months and 94.5% at the end of 12 months. Radiographic evaluation for the Vitapex group showed 80.4% success at the end of 6 months and 60.7% at the end of 12 months. No statistically significant differences were noted at the end of 6 months in the three groups both in clinical and radiographic evaluation. The success rates in clinical and radiographic evaluation at the end of 12 months for ZOE and MPRCF groups were not significantly different, and better than those for Vitapex group with statistically significant difference. The completely resorb rate of excess extruded extraradicularly were 14.3%, 100% and 71.4% for ZOE, Vitapex and MPRCF at the end of 12 months. The rates of resorption of material at the same rate of the root were 5.8%, 7.2% and 40.9% for ZOE, Vitapex and MPRCF at the end of 12 months. Conclusion: MPRCF, a mixture of zinc oxide eugenol and iodoform with calcium hydroxide can be used as a root canal filling material in primary teeth, taking account of the success rate and resorbing at a similar rate with the roots of the primary teeth.

Key words: Tooth, deciduous, Root resorption, Root canal filling materials, Zinc oxide, Calcium hydroxide

中图分类号:

R788.2

陈小贤, 林碧琛, 钟洁, 葛立宏. 改良乳牙根管充填材料体内降解匹配性与临床效果[J]. 北京大学学报（医学版）, 2015, 47(3): 529-535.

CHEN Xiao-Xian, LIN Bi-Chen, ZHONG Jie, GE Li-Hong. Degradation evaluation and success of pulpectomy with a modified primary root canal filling in primary molars[J]. Journal of Peking University(Health Sciences), 2015, 47(3): 529-535.

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