Ercan Ertuğrul, Dalli Mehmet, Duülgergil C Türksel, Yaman Ferhan
Department of Operative Dentistry, School of Dentistry, Kirikkale University, Kirikkale, Turkey.
J Formos Med Assoc. 2007 Mar;106(3):217-24. doi: 10.1016/s0929-6646(09)60243-6.
BACKGROUND/PURPOSE: Calcium hydroxide (Ca(OH)(2)) has been widely used as an intracanal medicament for endodontic retreatment, but very few studies used both Ca(OH)(2) and 1% chlorhexidine (CHX) as intracanal medicaments. The purpose of this study was to assess the in vivo effectiveness of a combination of Ca(OH)(2) and 1% CHX as intracanal medicaments in endodontic retreatment cases with periapical lesions.
Previous cases of endodontically treated teeth with periapical pathosis in 70 patients (36 men and 34 women, age range 18-60 years) were included. Of these teeth, 59 had received root canal treatment and 11 had been subjected to previous apical surgery, indicating endodontic failure. Following the routine procedures, including canal reshaping and irrigation with 2% CHX, a canal medication material containing Ca(OH)(2) powder and a 1% CHX solution was placed into the root canals. Over a 6-week period, the intracanal medication was periodically changed until the teeth became asymptomatic. Patients were recalled at 3-month intervals for radiographic and clinical examination.
Our clinical and radiographic assessment of retreatment cases showed complete healing in 41 (64%) teeth, incomplete healing in 9 (14%) teeth, and failure in 14 (22%) teeth. For complete healing teeth, the healing time varied from 6 to 36 months. The size of the periapical lesions and previous surgical treatment had no influence on the prognosis.
Our results suggest that a combination of Ca(OH)(2) and 1% CHX can be successfully used as intracanal medicament for disinfection in endodontic retreatment cases with periapical lesions.
背景/目的：氢氧化钙（Ca(OH)₂）已被广泛用作根管再治疗的根管内药物，但很少有研究同时使用Ca(OH)₂和1%洗必泰（CHX）作为根管内药物。本研究的目的是评估Ca(OH)₂和1% CHX联合作为根管内药物在根尖周病变根管再治疗病例中的体内有效性。
纳入70例患者（36例男性和34例女性，年龄范围18 - 60岁）既往接受过根管治疗且患有根尖周病变的牙齿。其中，59颗牙接受过根管治疗，11颗牙曾接受过根尖手术，提示根管治疗失败。按照常规程序，包括根管重塑和用2% CHX冲洗后，将含有Ca(OH)₂粉末和1% CHX溶液的根管用药材料放入根管内。在6周的时间里，定期更换根管内药物，直到牙齿无症状。患者每隔3个月复诊进行影像学和临床检查。
我们对再治疗病例的临床和影像学评估显示，41颗牙（64%）完全愈合，9颗牙（14%）不完全愈合，14颗牙（22%）治疗失败。对于完全愈合的牙齿，愈合时间为6至36个月。根尖周病变的大小和既往手术治疗对预后无影响。
我们的结果表明，Ca(OH)₂和1% CHX联合可成功用作根尖周病变根管再治疗病例根管内消毒药物。
