【作者】 张鹰；

【导师】 杨富生；

【作者基本信息】 第四军医大学 ， 口腔临床医学， 2006， 硕士

【摘要】 乳牙根尖周炎是儿童口腔科常见疾病之一，对乳牙进行根管治疗，从1932年起就被认为是保护乳牙、避免乳牙早失的一种有效方法。乳牙根充糊剂除需具有恒牙根充糊剂的特性外，还需具有充填后能与乳牙牙根同步吸收、对乳牙根尖周组织和恒牙牙胚无害等性质。目前，临床上常用的乳牙根充糊剂有氧化锌丁香油(ZOE)类制剂、氢氧化钙制剂、抗生素类制剂和生物材料制剂四类。其中ZOE糊剂作为根管充填材料有很高的成功率，但Coll和Sadrian指出，有20％用ZOE糊剂根充的病例出现恒牙异位萌出的现象。而生物材料类制剂，如三氧化矿物凝聚体(MTA)，三磷酸钙(TCP)，虽然具有良好的生物相容性、生物活性和骨传导作用，能较早的引导根尖钙化组织沉积和新骨长入，促进根尖周组织愈合，但其抗菌效果差，在感染的根尖周组织难以正常发挥其生物效应。因此目前临床上应用最为广泛的乳牙根充材料是氢氧化钙类制剂和抗生素类制剂，而其中尤以Vitapex和替硝唑糊剂为代表成为临床研究与应用的热点。但由于没有一种合适的动物模型，目前对乳牙根尖周炎的研究多局限于临床流行病学调查，而且由于临床实验的条件限制，乳牙根尖周炎治疗方法的疗效评定往往局限于咬合痛、叩痛等临床症状和X线片的根尖阴影面积变化，关于其对乳恒牙替换的影响则由于所需随访时间长，失访人数多等原因未见报道。更多还原

【Abstract】 Priamary teeth’s apical periodontitis is one of the common disease at department of pediatric dentistry. Since 1932, root canal therapy has been considered as a effective treatment to protect primary tooth. Root canal filling pastes for primary tooth have to meet more needs than paste for permanent tooth, such as being absorbed with root simultaneously and doing no harm to permanent tooth germ. At present, most commonly used paste are divided into 4 groups: Zinc oxide eugenols(ZOE), calcium hydroxide(CH), antibiotics and biomaterials. Among those mentioned above, ZOE has high success rate clinically, but Coll and Sadrian pointed out that, there was a 20% incidence of succedaneous tooth’s ectopic eruption. Biomaterials, such as mineral trioxide aggregate(MTA), tricalcium phosphate(TCP), have good biocompatibility and bioactivity. It can also induce calcification and bone growth, thus accelerate the healing process at periapical region. However, because of its poor antibiotic effect, it can hardly work at infected periapical tissue. Most widely used clinically now are CH paste and antibiotic pastes, Vitapex and tinidazole paste, as the representatives of the groups mentioned above, are the focus of research更多还原