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年轻恒牙因发育畸形、外伤或龋损等而致牙髓、根尖周病变时,牙根可停止发育,以往用外科手术作根尖倒充填,但治疗后不能使牙根继续发育。1960年Kaiser提出用根尖诱导成形术(spexification,Ap)治疗,并在临床广泛应用。Ap经控制感染或根尖周炎症后,用诱导材料恢复牙乳头或上皮根鞘的功能,使牙根继续发育,根端闭合,重建破坏的根尖周组织。Ap可先消除感染及尖周病变,通过多次更换诱导药物,促使牙根继续发育形成后,再作根管永久充填。也可在感染消除后,将诱导材料直接充填在根尖部根管内,同时完成永久性根管充填。 诱导根尖形成的材料 氢氧化钙 氢氧化钙(calcium hydroxide,CH)是Ap应用最早、最普遍的药物,其商品制剂有Calvital、Calxyl、Pulp-dent、Calasept及Hypocal等。CH具有强碱性,可激活碱性磷酸酶活性,中和微生物的酸性产物,抑制细菌生长,溶解坏死牙髓组织并诱导骨形成;此外,CH能加速根尖周组织的自然愈合过程,并增强上皮根鞘对感染的抵抗力,从而在牙根尖处形成硬组织。CH疗效好,其制剂的组成、使用方法可影响其效果。Sheehy等总结10位学者(1970-1994)对
Young permanent teeth due to the development of deformity, trauma or caries lesions caused by dental pulp, periapical lesions, the root can stop the development of the past surgery for apical filling, but after treatment can not continue to develop roots. In 1960 Kaiser proposed appendectomy (spexification, Ap) treatment, and widely used in clinical. Ap control infection or periapical period inflammation, inducing material to restore the function of the dental papilla or the root sheath of the root, root development continued, root closure, reconstruction of damaged periapical tissue. Ap can eliminate infections and periapical lesions, by repeatedly changing the induction of drugs to promote the development of root formation continued, and then permanent filling of the root canal. Can also eliminate the infection, the inducer material is directly filled in the apical root canal, while completing permanent root canal filling. The material that induces apical formation Calcium hydroxide (CH) is the earliest and most commonly used drug for Ap. Its commercial preparations include Calvital, Calxyl, Pulp-dent, Calasept and Hypocal. CH has a strong alkaline activity, activates alkaline phosphatase activity, neutralizes the acidic products of microorganisms, inhibits bacterial growth, dissolves necrotic pulp tissue and induces bone formation. In addition, CH accelerates the natural healing process of periapical tissues Enhances the resistance of epithelial root sheaths to infection, thereby forming hard tissue at the apical apex. CH curative effect, the composition of the preparation, the use of methods can affect its effectiveness. Sheehy et al. Conclude 10 scholars (1970-1994) right