桩冠根管预备对根尖充填物存留的影响及根尖充填术的应用

Effect of post space preparation on the persistence of apical obturation material

目的观察桩冠根管预备对根尖充填物存留的影响，探讨根尖充填术的可行性。方法选取需行桩冠修复且根充完善的143个根管进行根冠预备，根据根充材料分为Vitapex组、AH—plus组、碘氯仿组，根冠预备后通过X线牙片检查各组根尖充填物的存留情况。同时对根冠预备后根尖部充填物丢失的根管再行根尖充填术，并摄X线牙片观察其充填效果。结果Vitapex组根备后根尖部充填物存留率为84．1％（37／44），AH—plus组根备后根尖部充填物存留率为97.1％（33／34），碘氯仿组根备后根尖部充填物存留率为100.0％（65／65）。AH—plus、碘氯仿组根备后根尖部充填物存留率均明显高于Vitapex组（均P〈0.05），AH—plus、碘氯仿组间并无明显差异（P〉0.05）。根备后根尖部充填物丢失的8个根管再次行根尖充填术，X线牙片均显示根尖部根充完善，符合临床要求。结论桩冠根管预备过程中有部分根管根尖充填物会脱落，可通过取模后及时行根尖充填术予以补救。AH—plus糊剂可能是根充材料中相对较好的选择．

Objective To investigate the effect of post space preparation on the persistence of apical obturation material. Methods One hundred and forty-three roots with perfect canal filling were divided into three groups according to root canal filling materials-Vitapex group, AH-plus group and indo-chloroform group. After post space preparation all roots underwent X-ray examination for investigation on apical obturation material persistence of three different materials. Roots with apical obturation material lost due to post space preparation were refilled by apical obturation technique. X-ray examination was taken to detect apical filling. Results The persistence rates of Vitapex group, AH-plus group and indo-chloroform group were 84.1% （37/44）, 97.1% （33/34） and 100.0%（65/65）, respectively. The rate for Vitapex group was significantly lower （P 〈0.05） than that of AH-plus and indo-chloroform groups; while there were no differences between the last two groups （P 〉0.05）. After adaption of apical obturation technique the X-ray examination indicated consummate apical obturation in 8 roots which lost apical obturation material. Conclusion Apical obturation material might be lost during post space preparation, which can be retrieved by apical obturation technique after impression. Moreover,AH-plus paste might be the more suitable root canal filling material for the teeth that need post crown restoration.