One-step apexification using mineral trioxide aggregate(MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex.However,ortho...One-step apexification using mineral trioxide aggregate(MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex.However,orthograde placement of MTA is a challenging procedure in terms of length control.This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex.Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA.These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues.However,intentional MTA overfilling into the periapical lesion is not to be recommended.展开更多
The present investigation assessed the effect of acid etching on marginal adaptation of white- and gray-colored mineral trioxide aggregate （MTA） to apical dentin using microcomputed tomography （micro-CT） and scann...The present investigation assessed the effect of acid etching on marginal adaptation of white- and gray-colored mineral trioxide aggregate （MTA） to apical dentin using microcomputed tomography （micro-CT） and scanning electron microscopy （SEM）. Sixty-four extracted single-rooted human maxillary teeth were used. Following root-end resection and apical preparation, the teeth were equally divided into four groups according to the following root end filling materials： （i） white-colored MTA （WMTA）, （ii） etched WMTA （EWMTA）, （iii） gray-colored MTA （GMTA） and （iv） etched GMTA （EGMTA）. After 48 h, the interface between root-end filling materials and the dentinal walls was assessed using micro-CT and SEM. Data were statistically analyzed using the KruskaI-Wallis and Dunn tests. Micro-CT analysis revealed gap volumes between the apical cavity dentin walls and EGMTA, GMTA, EWMTA and WMTA of （0.007 1±0.004） mm3, （0.053±0.002） mm3, （0.003 6±0.001） mm3 and （0.005 9±0.002） mm3 respectively. SEM analysis revealed gap sizes for EGMTA, WMTA, EWMTA and GMTA to be （492.3±13.8） μm, （594.5±17.12）μm, （543.1±15.33） μm and （910.7±26.2）μm respectively. A significant difference in gap size between root end preparations filled with GMTA and EGMTA was found （P〈O.05）. No significance difference in gap size between WMTA and EWMTA were found in either SEM or micro-CT analysis. In conclusion, pre-etching of apical dentin can provide a better seal for GMTA but not for WMTA.展开更多
BACKGROUND Invaginated teeth pose greater challenges in clinical management because of their complex configuration.With advancements in equipment and materials,such as the dental operation microscope,cone-beam compute...BACKGROUND Invaginated teeth pose greater challenges in clinical management because of their complex configuration.With advancements in equipment and materials,such as the dental operation microscope,cone-beam computed tomography and mineral trioxide aggregate,the preservation rate of type Ⅲ dens invaginatus could be greatly increased.CASE SUMMARY This case report presented a 31-year-old woman with complaints of spontaneous swelling and pain in the right maxillary lateral tooth.With the aid of cone-beam computed tomography,type Ⅲ dens invaginatus with apical periodontitis was diagnosed and confirmed.Three-visit endodontic treatment was performed.In the first visit,the invagination was carefully removed under the dental operation microscope,and chemomechanical preparation was done.In the second visit,mineral trioxide aggregate apical barrier surgery was performed in this tooth.In the third visit,the canal was finally obturated with thermoplastic gutta-percha to recover the crown morphology.A 26-mo follow-up revealed a satisfied outcome both in the radiographic and oral examinations.CONCLUSION In this case,removal of the entire abnormal structure provided great convenience for the follow-up treatment.When confronted with the same clinical case in the future,we can take a similar approach to address it.展开更多
Addition of zinc oxide(ZnO)to Mineral Trioxide Aggregate(MTA)has been shown to rectify tooth discoloration caused by Angelus MTA.This study evaluated the microhardness,compressive strength,calcium ion release and crys...Addition of zinc oxide(ZnO)to Mineral Trioxide Aggregate(MTA)has been shown to rectify tooth discoloration caused by Angelus MTA.This study evaluated the microhardness,compressive strength,calcium ion release and crystalline structures of MTA mixed with ZnO in different environmental conditions.Molds with a diameter of 4 mm and a height of 6 mm were used for compressive strength,calcium ion release and X-ray diffraction(XRD)evaluations.Molds with 6 mm diameter and 4 mm height were used for surface microhardness evaluations.Cements evaluated include Angelus MTA(Angelus,Brail),Angelus MTA+ZnO,ProRoot MTA(Dentsply Tulsa Dental,OK),and ProRoot MTA+ZnO.Each group was divided into 3 subgroups according to exposure conditions:normal saline(NS),phosphate buffered saline(PBS)or blood.After 7 days incubation,surface microhardness,compressive strength and XRD analysis was performed.Calcium ion release was evaluated after 3,24 and 168h incubation using atomic absorption spectrophotometry.Data were analyzed by One Way Anova followed by the Tukey HSD Post hoc tests and T-Test.The significance level was set at 0.05.Addition of ZnO to Angelus and ProRoot MTA significantly decreased the compressive strength of these cements regardless of the environmental conditions(P<0.001);however,it had no significant effect on their microhardness or calcium ion release.In conclusion,adding ZnO to Angelus and ProRoot MTA can adversely affect the compressive strength of Angelus and ProRoot MTA.展开更多
目的观察矿物三氧化物凝聚体(Mineral Trioxide Aggregate,MTA)和三种改良盖髓剂(nRoot、Vitapex、iRoot BP Plus)对人牙髓干细胞(hDPSCs)增殖、分化为成牙本质细胞的促进作用。方法①不同浓度四种盖髓剂对hDPSCs增殖的促进作用观察。取...目的观察矿物三氧化物凝聚体(Mineral Trioxide Aggregate,MTA)和三种改良盖髓剂(nRoot、Vitapex、iRoot BP Plus)对人牙髓干细胞(hDPSCs)增殖、分化为成牙本质细胞的促进作用。方法①不同浓度四种盖髓剂对hDPSCs增殖的促进作用观察。取第5代hDPSCs细胞分为MTA组、iRoot BP Plus组、nRoot组、Vitapex组及空白组,MTA组、iRoot BP Plus组、nRoot组、Vitapex组分别加入不同浓度(0.02、0.2、1、2 mg/mL)的MTA、iRoot BP Plus、nRoot和Vitapex培养液,空白组加入含10%FBS的DMEM/F12培养液。分别于培养24、48 h时,采用CCK-8法测算各组细胞增殖活性。②四种盖髓剂对hDPSCs分化为成牙本质细胞的促进作用观察。通过ALP活性检测筛选出四种材料对hDPSCs最适诱导浓度。取第4代hDPSCs分为五组:空白组、MTA组、iRoot BP Plus组、nRoot组和Vitapex组换为0.2 mg/mL的MTA、iRoot BP Plus、nRoot和Vitapex成骨培养基,空白组为正常成骨培养基。培养第21天时采用茜素红染色和半定量分析法观察各组细胞矿化结节形成情况,培养第7天时采用Western Blotting法检测细胞相关蛋白类核转录因子(Runt-related transcription factor 2,RUNX-2)、骨钙素(Osteocalcin,OCN)、牙本质涎磷蛋白(Dentin sialophosphoprotein,DSPP)以及牙本质基质蛋白1(Dentin matrix protein 1,DMP-1)。结果与空白组相比,培养第2天时0.02、0.2、1 mg/mL的MTA组、iRoot BP Plus在和nRoot组细胞增殖活性高(P均<0.05);与培养第1天时相比,培养第2天时2 mg/mL的MTA组和Vitapex组细胞增殖活性低(P均<0.05)。筛选0.2 mg/mL为后续受试浓度。与nRoot组和Vitapex组相比,iRoot BP Plus组和MTA组细胞钙沉积量高(P均<0.05)。与空白组相比,MTA组、iRoot BP Plus组、nRoot组和Vitapex组细胞OCN、RUNX-2、DSPP、DMP-1相对表达量均升高(P均<0.05);与nRoot组、Vitapex组相比,iRoot BP Plus组细胞OCN、RUNX-2、DSPP、DMP-1相对表达量均高(P均<0.05)。结论相比于MTA、Vitapex,nRoot和iRoot BP Plus更能促进hDPSCs的细胞增殖、诱导细胞分化为成牙本质细胞。展开更多
目的比较iRoot BP Plus与三氧化矿物聚合体(MTA)在恒牙深龋直接盖髓术中的临床疗效。方法选取82例单颗恒牙深龋露髓患者为研究对象,根据使用盖髓剂不同分为对照组和观察组,各41例。观察组采用iRoot BP Plus直接盖髓,对照组采用MTA直接...目的比较iRoot BP Plus与三氧化矿物聚合体(MTA)在恒牙深龋直接盖髓术中的临床疗效。方法选取82例单颗恒牙深龋露髓患者为研究对象,根据使用盖髓剂不同分为对照组和观察组,各41例。观察组采用iRoot BP Plus直接盖髓,对照组采用MTA直接盖髓。比较两组术后不同时间点治疗成功率,直接盖髓操作时间,钙化桥形成情况及牙冠变色发生情况。结果所有患者术后均连续随访12个月,无失访病例。观察组术后3、6、12个月治疗成功率分别为97.56%、97.56%、95.12%,对照组为95.12%、92.68%、92.68%;两组术后3、6、12个月治疗成功率比较差异均无统计学意义(P>0.05)。观察组患者直接盖髓操作时间为(2.58±0.40)min,对照组为(4.42±0.56)min;观察组患者直接盖髓操作时间短于对照组,差异有统计学意义(t=17.120,P=0.000<0.05)。术后连续随访12个月,观察组钙化桥总形成率为95.12%,对照组为90.24%,两组钙化桥总形成率比较差异无统计学意义(P>0.05);观察组牙冠变色率为0,低于对照组的56.10%,差异有统计学意义(P<0.05)。结论iRoot BP Plus与MTA应用于恒牙深龋直接盖髓术中均具有显著的临床疗效,能提高治疗成功率,但iRoot BP Plus在减少操作时间、避免牙冠变色方面更具优势,是临床上更为理想的直接盖髓剂。展开更多
目的:比较三氧矿化物凝聚体(MTA)和生物陶瓷(iRoot BP Plus)对乳牙深龋露髓后行活髓切断术的疗效影响。方法:纳入乳牙深龋露髓的患牙126颗,随机平均分为A组和B组(n=63)。A组用MTA覆盖活髓切断术牙髓组织断面,B组则使用iRoot BP Plus覆盖...目的:比较三氧矿化物凝聚体(MTA)和生物陶瓷(iRoot BP Plus)对乳牙深龋露髓后行活髓切断术的疗效影响。方法:纳入乳牙深龋露髓的患牙126颗,随机平均分为A组和B组(n=63)。A组用MTA覆盖活髓切断术牙髓组织断面,B组则使用iRoot BP Plus覆盖;比较2种材料的临床疗效,术后1、3、6、12、18月观察患牙的牙齿变色、牙髓、牙周膜及根分叉病变情况、根管内钙化情况以及根管的内外吸收情况,术后无任何不适症状视为治疗有效。结果:A组和B组成功率分别为96.8%和98.4%(P>0.05);牙齿变色率分别为100%和0%(P<0.05)。结论:用MTA和iRoot BP Plus作为乳牙活髓切断术盖髓剂,都能很好的保留乳牙根髓,但是iRoot BP Plus有更好的临床操作性并能避免乳牙出现牙体变色。展开更多
基金supported by the National Research Foundation(NRF) of Koreafunded by the Ministry of Education,Science and Technology(MEST) (No.2011-0014231,Dr.Seok-Wood Chang),Korea
文摘One-step apexification using mineral trioxide aggregate(MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex.However,orthograde placement of MTA is a challenging procedure in terms of length control.This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex.Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA.These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues.However,intentional MTA overfilling into the periapical lesion is not to be recommended.
文摘The present investigation assessed the effect of acid etching on marginal adaptation of white- and gray-colored mineral trioxide aggregate （MTA） to apical dentin using microcomputed tomography （micro-CT） and scanning electron microscopy （SEM）. Sixty-four extracted single-rooted human maxillary teeth were used. Following root-end resection and apical preparation, the teeth were equally divided into four groups according to the following root end filling materials： （i） white-colored MTA （WMTA）, （ii） etched WMTA （EWMTA）, （iii） gray-colored MTA （GMTA） and （iv） etched GMTA （EGMTA）. After 48 h, the interface between root-end filling materials and the dentinal walls was assessed using micro-CT and SEM. Data were statistically analyzed using the KruskaI-Wallis and Dunn tests. Micro-CT analysis revealed gap volumes between the apical cavity dentin walls and EGMTA, GMTA, EWMTA and WMTA of （0.007 1±0.004） mm3, （0.053±0.002） mm3, （0.003 6±0.001） mm3 and （0.005 9±0.002） mm3 respectively. SEM analysis revealed gap sizes for EGMTA, WMTA, EWMTA and GMTA to be （492.3±13.8） μm, （594.5±17.12）μm, （543.1±15.33） μm and （910.7±26.2）μm respectively. A significant difference in gap size between root end preparations filled with GMTA and EGMTA was found （P〈O.05）. No significance difference in gap size between WMTA and EWMTA were found in either SEM or micro-CT analysis. In conclusion, pre-etching of apical dentin can provide a better seal for GMTA but not for WMTA.
基金the Priority Academic Program Development of Jiangsu Higher Education Institutions,No.PAPD2018-87.
文摘BACKGROUND Invaginated teeth pose greater challenges in clinical management because of their complex configuration.With advancements in equipment and materials,such as the dental operation microscope,cone-beam computed tomography and mineral trioxide aggregate,the preservation rate of type Ⅲ dens invaginatus could be greatly increased.CASE SUMMARY This case report presented a 31-year-old woman with complaints of spontaneous swelling and pain in the right maxillary lateral tooth.With the aid of cone-beam computed tomography,type Ⅲ dens invaginatus with apical periodontitis was diagnosed and confirmed.Three-visit endodontic treatment was performed.In the first visit,the invagination was carefully removed under the dental operation microscope,and chemomechanical preparation was done.In the second visit,mineral trioxide aggregate apical barrier surgery was performed in this tooth.In the third visit,the canal was finally obturated with thermoplastic gutta-percha to recover the crown morphology.A 26-mo follow-up revealed a satisfied outcome both in the radiographic and oral examinations.CONCLUSION In this case,removal of the entire abnormal structure provided great convenience for the follow-up treatment.When confronted with the same clinical case in the future,we can take a similar approach to address it.
基金supported by a grant from Tehran University of Medical Sciences(grant no:32781).
文摘Addition of zinc oxide(ZnO)to Mineral Trioxide Aggregate(MTA)has been shown to rectify tooth discoloration caused by Angelus MTA.This study evaluated the microhardness,compressive strength,calcium ion release and crystalline structures of MTA mixed with ZnO in different environmental conditions.Molds with a diameter of 4 mm and a height of 6 mm were used for compressive strength,calcium ion release and X-ray diffraction(XRD)evaluations.Molds with 6 mm diameter and 4 mm height were used for surface microhardness evaluations.Cements evaluated include Angelus MTA(Angelus,Brail),Angelus MTA+ZnO,ProRoot MTA(Dentsply Tulsa Dental,OK),and ProRoot MTA+ZnO.Each group was divided into 3 subgroups according to exposure conditions:normal saline(NS),phosphate buffered saline(PBS)or blood.After 7 days incubation,surface microhardness,compressive strength and XRD analysis was performed.Calcium ion release was evaluated after 3,24 and 168h incubation using atomic absorption spectrophotometry.Data were analyzed by One Way Anova followed by the Tukey HSD Post hoc tests and T-Test.The significance level was set at 0.05.Addition of ZnO to Angelus and ProRoot MTA significantly decreased the compressive strength of these cements regardless of the environmental conditions(P<0.001);however,it had no significant effect on their microhardness or calcium ion release.In conclusion,adding ZnO to Angelus and ProRoot MTA can adversely affect the compressive strength of Angelus and ProRoot MTA.
文摘目的观察矿物三氧化物凝聚体(Mineral Trioxide Aggregate,MTA)和三种改良盖髓剂(nRoot、Vitapex、iRoot BP Plus)对人牙髓干细胞(hDPSCs)增殖、分化为成牙本质细胞的促进作用。方法①不同浓度四种盖髓剂对hDPSCs增殖的促进作用观察。取第5代hDPSCs细胞分为MTA组、iRoot BP Plus组、nRoot组、Vitapex组及空白组,MTA组、iRoot BP Plus组、nRoot组、Vitapex组分别加入不同浓度(0.02、0.2、1、2 mg/mL)的MTA、iRoot BP Plus、nRoot和Vitapex培养液,空白组加入含10%FBS的DMEM/F12培养液。分别于培养24、48 h时,采用CCK-8法测算各组细胞增殖活性。②四种盖髓剂对hDPSCs分化为成牙本质细胞的促进作用观察。通过ALP活性检测筛选出四种材料对hDPSCs最适诱导浓度。取第4代hDPSCs分为五组:空白组、MTA组、iRoot BP Plus组、nRoot组和Vitapex组换为0.2 mg/mL的MTA、iRoot BP Plus、nRoot和Vitapex成骨培养基,空白组为正常成骨培养基。培养第21天时采用茜素红染色和半定量分析法观察各组细胞矿化结节形成情况,培养第7天时采用Western Blotting法检测细胞相关蛋白类核转录因子(Runt-related transcription factor 2,RUNX-2)、骨钙素(Osteocalcin,OCN)、牙本质涎磷蛋白(Dentin sialophosphoprotein,DSPP)以及牙本质基质蛋白1(Dentin matrix protein 1,DMP-1)。结果与空白组相比,培养第2天时0.02、0.2、1 mg/mL的MTA组、iRoot BP Plus在和nRoot组细胞增殖活性高(P均<0.05);与培养第1天时相比,培养第2天时2 mg/mL的MTA组和Vitapex组细胞增殖活性低(P均<0.05)。筛选0.2 mg/mL为后续受试浓度。与nRoot组和Vitapex组相比,iRoot BP Plus组和MTA组细胞钙沉积量高(P均<0.05)。与空白组相比,MTA组、iRoot BP Plus组、nRoot组和Vitapex组细胞OCN、RUNX-2、DSPP、DMP-1相对表达量均升高(P均<0.05);与nRoot组、Vitapex组相比,iRoot BP Plus组细胞OCN、RUNX-2、DSPP、DMP-1相对表达量均高(P均<0.05)。结论相比于MTA、Vitapex,nRoot和iRoot BP Plus更能促进hDPSCs的细胞增殖、诱导细胞分化为成牙本质细胞。
文摘目的比较iRoot BP Plus与三氧化矿物聚合体(MTA)在恒牙深龋直接盖髓术中的临床疗效。方法选取82例单颗恒牙深龋露髓患者为研究对象,根据使用盖髓剂不同分为对照组和观察组,各41例。观察组采用iRoot BP Plus直接盖髓,对照组采用MTA直接盖髓。比较两组术后不同时间点治疗成功率,直接盖髓操作时间,钙化桥形成情况及牙冠变色发生情况。结果所有患者术后均连续随访12个月,无失访病例。观察组术后3、6、12个月治疗成功率分别为97.56%、97.56%、95.12%,对照组为95.12%、92.68%、92.68%;两组术后3、6、12个月治疗成功率比较差异均无统计学意义(P>0.05)。观察组患者直接盖髓操作时间为(2.58±0.40)min,对照组为(4.42±0.56)min;观察组患者直接盖髓操作时间短于对照组,差异有统计学意义(t=17.120,P=0.000<0.05)。术后连续随访12个月,观察组钙化桥总形成率为95.12%,对照组为90.24%,两组钙化桥总形成率比较差异无统计学意义(P>0.05);观察组牙冠变色率为0,低于对照组的56.10%,差异有统计学意义(P<0.05)。结论iRoot BP Plus与MTA应用于恒牙深龋直接盖髓术中均具有显著的临床疗效,能提高治疗成功率,但iRoot BP Plus在减少操作时间、避免牙冠变色方面更具优势,是临床上更为理想的直接盖髓剂。
文摘目的:比较三氧矿化物凝聚体(MTA)和生物陶瓷(iRoot BP Plus)对乳牙深龋露髓后行活髓切断术的疗效影响。方法:纳入乳牙深龋露髓的患牙126颗,随机平均分为A组和B组(n=63)。A组用MTA覆盖活髓切断术牙髓组织断面,B组则使用iRoot BP Plus覆盖;比较2种材料的临床疗效,术后1、3、6、12、18月观察患牙的牙齿变色、牙髓、牙周膜及根分叉病变情况、根管内钙化情况以及根管的内外吸收情况,术后无任何不适症状视为治疗有效。结果:A组和B组成功率分别为96.8%和98.4%(P>0.05);牙齿变色率分别为100%和0%(P<0.05)。结论:用MTA和iRoot BP Plus作为乳牙活髓切断术盖髓剂,都能很好的保留乳牙根髓,但是iRoot BP Plus有更好的临床操作性并能避免乳牙出现牙体变色。
