【作者】 陈梅；

【导师】 冯云枝；

【作者基本信息】 中南大学 ， 口腔临床修复学， 2008， 硕士

【摘要】 目的:通过染色法测量残根根尖与冠方染料渗入的多少,分别比较桩道预备时机及不同桩核和粘结系统对根管治疗后残根根尖和冠方封闭效果的影响,寻求能够减少微渗漏的修复时机与修复方式,为临床选择提供参考。方法:80颗单根管下颌前磨牙,采用逐步后退法预备根管后,随机选择5颗为阳性对照组,5颗为阴性对照组。另70颗随机分为即刻桩道预备组(20颗),延迟桩道预备组(40颗)和无桩道预备组(10颗)。所有标本除了阳性对照组外均采用侧向加压法充填根管。即刻预备组与延迟预备组标本用pesso扩孔钻进行桩道预备,使用两种桩核系统(玻璃纤维桩树脂核与镍铬合金铸造金属桩核)及两种粘结材料(复合树脂类粘结剂与磷酸锌水门汀粘固剂)分别修复。桩核修复后所有标本浸入中性印度墨水中37℃保持1周,采用透明技术处理,并在体视显微镜下测量根管内壁染料渗入的长度,评价残根根尖与冠方微渗漏的情况。结果:1.延迟桩道预备组根尖微渗漏值(1.15±0.65mm)显著大于即刻桩道预备组(0.50±0.45mm)(P＜0.05)。2.单纯保留5mm根充材料时,即刻桩道预备组根尖微渗漏值(0.52±0.47mm)与无桩道预备组(0.24±0.43mm)没有统计学差异(P＞0.05);延迟桩道预备组根尖微渗漏值(1.17±0.77mm)与无桩道预备组(0.24±0.43 mm)有统计学差异(P＜0.05)。3.磷酸锌粘固金属桩核组产生的冠方微渗漏值(3.94±0.45mm)明显大于复合树脂粘结金属桩核组(0.70±0.49mm)(P＜0.05)。4.玻璃纤维桩树脂核组产生的冠方微渗漏值(0.64±0.46mm)小于复合树脂粘结金属桩核组(0.70±0.49mm),但没有统计学差异(P＞0.05)。5.桩核修复(玻璃纤维桩树脂核组:0.64±0.46mm,复合树脂粘结金属桩核组:0.70±0.49mm,磷酸锌粘固金属桩核组:3.94±0.45mm)明显比暂封材料的封闭效果好(8.28±0.71mm)(P＜0.05)。结论:1.延迟桩道预备比即刻桩道预备对根尖的封闭效果影响更大2.桩核修复可以弥补桩道预备过程中去除部分充填材料带来的不利影响,有利于根管封闭3.粘结剂的应用可以明显减少微渗漏的发生,而且复合树脂粘结剂比磷酸锌水门汀粘固剂的封闭效果更好更多还原

【Abstract】 Objective: The purpose of this study was to study the effects ofimmediate and delayed post space preparation on the sealing ability offilling materials and to compare the apical and coronal microleakage ofdifferent post and core systems bonded with various luting cementsthrough measuring the dying length in root canals.Method: Eighty human mandibular premolars each with singlecanal were choosed. They were devided into five groups randomly. Fivefor positive control group, five for negative control group, twenty for immediate post space preparation group, another forty teeth used fordelayed post space preparation group and the last ten for intact group. Allteeth except the positive control group were obturated with laterallycondensed gutta-percha and AH-Plus sealer. After immediate and delayedpost space preparation was performed, all teeth were restored withdifferent post and core systems using various luting cements. Leakagealong root canals was determined by the dye method.Result:1. There is significant difference between two groups using immediate and delayed post space preparation. More leakage is found in canals with delayed post space preparation (1.15±0.65mm) than those with immediate post space preparation (0.50±0.45mm) (P<0.05).2. Canals with 5mm filling materials only cause more leakage. There is significant difference between roots with delayed post space preparation (1.17±0.77mm) and intact ones (0.24±0.43mm) (P<0.05). However, no statistical difference can be found between roots with immediate post space preparation (0.52±0.47mm) and intact ones (0.24±0.43mm) (P>0.05). 3. Compared to metal posts adhered with composite resin cement (0.70±0.49mm), those adhered with zinc phosphate luting agent (3.94±0.45mm) have more leakage (P<0.05).4. No significant difference can be found between two groups bonded with the composite resin cement (metal post: 0.70±0.49mm; glass-fiber post: 0.64±0.46mm) (P>0.05).5. Roots restored with any post and core system (glass-fiber post: 0.64 + 0.46mm; metal post and core bonded with composite resin cement: 0.70±0.49mm; metal post and core bonded with zinc phosphate luting agent: 3.94±0.45mm) have better sealing ability than those sealed by temporary materials (8.28±0.71mm) (P<0.05).Conclusion:1. Delayed post space preparation has more effect to the apical sealing ability than immediate post space preparation.2. The use of post and core systems can retrieve the disadvantages taking by post space preparation and provide better sealing ability for canals.3. Luting agent can decrease the coronal microleakage. Composite resin cement provides better sealing ability than zinc phosphate luting agent.更多还原