Al-Rubaie Ahmed I M, Al-Shamma Abdulla M W
Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq.
Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Al-Muthanna, Al-Muthanna, Iraq.
Clin Oral Investig. 2025 May 14;29(6):297. doi: 10.1007/s00784-025-06371-9.
This study aims to measure and compare the effects of immediate pre-endodontic dentin sealing (IPDS) and late dentin hybridization (LDh), combined with two different irrigation protocols (NaOCl/EDTA or normal saline), on cuspal deflection (CD) and fracture strength (FS) of endodontically treated teeth.
Sixty maxillary first premolars were divided into four experimental groups (A1: LDh + NS, A2: LDh + NaOCl/EDTA, B1: IPDS + NS, B2: IPDS + NaOCl/EDTA) and two control groups (C: sound teeth, D: unrestored teeth). Teeth underwent standardized MOD cavity preparation, endodontic treatment, and restoration, except for group D was left without restoration. CD was measured after cavity preparation, 15 min post-restoration, and after thermocycling. FS was assessed using a universal testing machine.
No significant CD differences were found after cavity preparation. However, 15 min post-restoration, LDh groups (A1, A2) exhibited significantly higher CD than IPDS groups (B1, B2), with A2 group CD being higher than A1 group. After thermocycling, IPDS groups demonstrated greater cuspal relaxation compared to LDh groups. FS was highest in sound teeth (1533.2N) and lowest in unrestored teeth (571.5N). IPDS groups had significantly higher FS than LDh groups, with no significant difference between B1 and B2 groups.
The study concluded that IPDS reduces CD and enhances FS compared to LDh, suggesting it as an effective step before endodontic treatment. NaOCl/EDTA irrigation influenced CD and FS in LDh groups but had no significant impact in IPDS groups.
Dentin sealing before root canal treatment and prior to exposure to chemical substances (such as irrigation with NaOCl) enhances the structural integrity of endodontically treated teeth. This protective measure protects the freshly cut dentin from the detrimental effects of these substances, thereby improving the bonding strength and overall clinical outcomes.
本研究旨在测量并比较即刻根管治疗前牙本质封闭（IPDS）和延迟牙本质杂交（LDh），联合两种不同冲洗方案（次氯酸钠/乙二胺四乙酸或生理盐水），对根管治疗后牙齿的牙尖偏移（CD）和抗折强度（FS）的影响。
60颗上颌第一前磨牙被分为四个试验组（A1：LDh + 生理盐水，A2：LDh + 次氯酸钠/乙二胺四乙酸，B1：IPDS + 生理盐水，B2：IPDS + 次氯酸钠/乙二胺四乙酸）和两个对照组（C：健康牙齿，D：未修复牙齿）。除D组不进行修复外，所有牙齿均进行标准化的近中- 远中- 合面（MOD）洞形预备、根管治疗和修复。在洞形预备后、修复后15分钟以及热循环后测量CD。使用万能试验机评估FS。
洞形预备后未发现显著的CD差异。然而，修复后15分钟，LDh组（A1、A2）的CD显著高于IPDS组（B1、B2），且A2组的CD高于A1组。热循环后，与LDh组相比，IPDS组表现出更大的牙尖松弛。FS在健康牙齿中最高（1533.2N），在未修复牙齿中最低（571.5N）。IPDS组的FS显著高于LDh组，B1组和B2组之间无显著差异。
该研究得出结论，与LDh相比，IPDS可减少CD并提高FS，表明其作为根管治疗前的有效步骤。次氯酸钠/乙二胺四乙酸冲洗对LDh组的CD和FS有影响，但对IPDS组无显著影响。
根管治疗前以及在接触化学物质（如用次氯酸钠冲洗）之前进行牙本质封闭，可增强根管治疗后牙齿的结构完整性。这种保护措施可保护新切割的牙本质免受这些物质的有害影响，从而提高粘结强度和整体临床效果。
