根管逆充填與修復性材料之改良應用

Enhancement of an endodontic repair and retrograde filling material

李佩穎(Pei -Ying Lee)

指導教授 ： 謝松志

共同指導教授 ： 李勝揚

臺北醫學大學/口腔醫學院/牙醫學系碩博士班/碩士(2008年)

摘要

以傳統非手術性的根管治療方式，可以達到高達80%~90%的成功率。但面對傳統治療方式失敗的病例或是無法以傳統非手術性根管治療的牙齒，手術性根管治療是一種常見的治療選擇。整體的根尖手術應包含根尖切除術和根尖逆充填。三氧礦化物(mineral trioxide aggregate, MTA)雖然符合了多項根尖逆充填或穿孔修補材料之理想性質，但在臨床應用上調拌時操作性不佳以及長達3~4小時之固化時間，容易受到手術區域的組織液、血液浸潤流失，影響預期之治療效果。本研究透過可加速水泥水合反應速率之含鈣化合物(calcium compound)的添加，達到MTA 硬化時間縮短目的，並藉由非結晶型含鈣化合物之析出，改善原有以蒸餾水調拌MTA之操作性。分別以10%氯化鈣水溶液及30%乳酸葡萄糖酸鈣溶液取代蒸餾水作為MTA的調拌液體，75%白水泥(white Portland cement)結合5 % gypsum與20%bismuth oxide (Bi2O3)的混成球磨粉末為調拌粉體，進行先期試驗，再將最佳配比應用於市售商品white MTA，以維克針及XRD探討水合反應時之硬化時間(setting time)的改變及水合後之結晶變化。結果顯示以10%氯化鈣溶液及30 %乳酸葡萄糖酸鈣溶液作為MTA的調拌液體時，white MTA之完全硬化時間分別為45以及20分鐘。此外，上述兩種調拌溶液，30%乳酸葡萄糖酸鈣在操作性質上有明顯改變。推測因為乳酸葡萄糖酸鈣析出後由於是非結晶型態，相對於氯化鈣之結晶型態，更能造成水粉體之黏稠度改變進而改變操作便利性。
關鍵字：三氧礦化物、鈣化合物、硬化時間。

關鍵字

三氧礦化物 ； 鈣化合物 ； 硬化時間

並列摘要

The success rate of non-surgical endodontic treatment may reach up to 80~90%, while surgical endodontic treatment is a frequent alternative for the failure or limited cases of traditional root canal therapy. A thorough apical surgery includes apicoectomy and root tip retrograde filling. Mineral trioxide aggregate (MTA) fulfills most of the ideal properties of retrograde filling and perforation repair, but its handling properties and the long setting time make itself susceptible to be washout by the surrounding blood or tissue fluid, leading to the limitation of the expected prognosis. The purpose of this study was to decrease the setting time of mineral trioxide aggregate by the addition of accelerants of Portland cement hydration, calcium compound. Meanwhile, attempt to improve the handling characteristics through the composition of amorphous calcium compound. 10% calcium chloride and 30% calcium lactate gluconate solution were used as the mixing fluid of the cement powder respectively. In the pilot study, white Portland cement was used to find out the ultimate concentration of the mixing fluid. Setting time was measured by Vicat needle while x-ray diffraction analysis was used to characterize the crystal phase of the cement. The total setting time of white Portland cement with 10% calcium chloride and 30% CLG was reduced to 45 and 20 minutes, respectively. In addition, the handling properties were significantly enhanced in the CLG group. The improvement of the MTA handling propertie might be attributed to the viscous characteristics of CLG during the precipation at the late stage of hydration.

Keyword: mineral trioxide aggregate, calcium compound, setting time

並列關鍵字

mineral trioxide aggregate ； calcium compound ； setting time

參考文獻

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