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目的评价根尖基点(根尖狭窄口)直径确定对选用大于相应直径为主牙胶尖进行根尖充填的临床效果.方法选取我科诊治的牙髓炎和根尖周炎病例120例各有1颗患牙,常规开髓揭顶备洞,确定根管工作长度,分成实验组和对照组各有60例患牙,实验组:用确定根尖基点(根尖狭窄口)直径,常规根管预备和消毒,选用比根尖基点直径大的牙胶尖为主牙胶尖和根管糊剂进行侧向加压充填.对照组:常规根管预备和消毒,选用根管工作长度的牙胶尖和根管糊剂进行侧向加压充.结果实验组3例欠充2mm,恰充57例,无疼痛出现,对照组1例欠充2mm,恰充46例,超充13例,充后当天出现疼痛5例,4例无需服药,7天后疼痛消失,1例重新治疗后并口服消炎止痛药2天.结论确定根尖基点(根尖狭窄口)直径选好主牙胶尖进行根管充填,对提高根管治疗水平有明显疗效.“,”Objective To evaluate clinical effects of determining root and opening (apical tip of the narrow root canal) diameters for selection of wider master gutta-percha points on root canal filing. Methods 120 patients from our department treated for either pulpitis or apical periodontitis were selected. The conventional procedures such as opening dental pulp cavity and determine the working length of the root canal were performed.Patients were divided into two groups (experimental and control) by 60 cases each. Experimental group: The root end opening (apical tip of the narrow root canal) diameters was measured and determined. Conventional root canal preparation and disinfection were performed. Master gutta-percha that was wider than the apical base tip diameter was selected and root canal sealer was applied by lateral pressure filing. Control group: Conventional root canal preparation and disinfection were performed. Master gutta-percha that was matched with root canal length was selected and root canal sealer was applied by lateral pressure filing. Results Experimental group: 3 cases less filed by 2 mm and 57 cases normal filed. Al were painless. Control group: 1 case less filed 2 mm, 46 cases normal filed, and 13 cases over filed. 5 cases complained pain on the same day. Among them 4 cases did not take medication and pain disappeared after 7 days. One case was re-treated and taken oral anti-inflammatory medicines to relieve pain for two days. Conclusions Determining root end opening (apical tip of the narrow root canal) diameters prior to select master gutta-percha helps to improve clinical applications of root canal treatments.