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根管治疗和牙体修复互为依存,互为疗效保证的基础,为的是共同的保存牙齿的目标。良好的牙体修复,保证冠部封闭,防止根管再感染;良好的根管治疗,有利于保证修复体功能和寿命。所以说,广义的牙体病治疗包括牙体缺损治疗和牙髓病治疗,两者不可分割。修复牙体缺损须同时考虑牙髓和根尖组织的健康,反之亦然。牙体粘接修复的临床要点:①腐质须去净;②需适当的预防性扩展;③牙体修复须考虑的力学问题;④为固位和抗力需牙体预备;⑤多个界面的问题影响粘接轻度;⑥需理解的重要概念。润湿、渗透性,预处理(底涂剂、底胶),湿粘接,聚合收缩与聚合应力,微渗漏,材料的耐磨性和可抛光性。根管治疗后牙齿的变化包括失髓后牙齿的变化,治疗过程去除牙体组织造成的牙体硬组织减少抗力减弱。选择牙体修复时首先考虑根尖周病损的状况,后考虑剩余组织的受力状况,欢迎考虑龋与牙周病的易感性。牙体修复时需记住的数据:①肩领高度不能少于1.5mm,最好大于2mm;②颈部剩余牙本质的厚度:大于1mm;③核材料进入根管口下方的距离:不少于1.5mm;④咬合面牙尖降低的厚度:2.0mm(瓷),1.0mm(复合树脂);⑤单次光固化的复合树脂的厚度:<3mm,贴近修复体表面光照;⑥桩进入根管的长度和直径:桩长度为根长的3/4,有利冠稳定和行使功能。根尖方保留5mm的根充材料,有利保证根尖区封闭效果。桩位于牙槽嵴顶下方4mm,以减少对牙本质的应力。磨牙桩,从髓室底开始,长度不宜超过7mm,以防止根管弯曲处侧穿。桩末端直径,下颌前牙安全范围是0.6-0.7mm,上颌中切牙在1.0-1.2mm之间。
Root canal treatment and dental restoration are interdependent and provide the basis for the efficacy of each other for the common goal of preserving the teeth. Good dental restoration, to ensure that the crown closed to prevent root canal re-infection; a good root canal treatment, help to ensure the restoration of function and life expectancy. Therefore, the generalized treatment of dental diseases, including dental defect treatment and treatment of endodontics, the two are inseparable. Repair of dental defects must take into account the health of pulp and apical tissue, and vice versa. The clinical points of the adhesive restoration of the tooth: ① the humus should go to the net; ② appropriate preventive expansion; ③ the mechanical problems to be considered in the restoration of the tooth; ④ the preparation of the tooth for retention and resistance; Problems affect the bonding light; ⑥ need to understand the important concepts. Wetting, Permeability, Pretreatment (Primer, Primer), Wet Bonding, Polymerization Shrinkage and Polymerization Stress, Microleakage, Abrasion and Polishability of Materials. Changes in the teeth after root canal treatment, including changes in the teeth after the loss of pulp, tooth tissue during treatment to reduce dental hard tissue resistance decreased. Select the first choice of dental restoration of periapical lesions, and consider the remaining stress conditions, please consider caries and periodontal disease susceptibility. The data to be remembered when the tooth is repaired: ① The height of the shoulder collar can not be less than 1.5mm, preferably greater than 2mm; ② The thickness of the remaining dentin in the neck is greater than 1mm; ③ The distance of the nuclear material entering the root canal mouth: 1.5mm; ④ occlusal cusp tip reduced thickness: 2.0mm (porcelain), 1.0mm (composite resin); ⑤ single light-cured composite resin thickness: <3mm, close to the restoration surface illumination; Tube length and diameter: The length of the pile is 3/4 of the root length, which is beneficial for the crown to stabilize and function. Radical root retains 5mm root filling materials, beneficial to ensure the apical zone closure effect. The pile is located 4mm below the alveolar crest to reduce stress on the dentine. Molar pile, starting from the end of the pulp chamber, the length should not exceed 7mm, to prevent the lateral bending of the root canal. The end of the pile diameter, mandibular anterior teeth safety range is 0.6-0.7mm, maxillary incisors between 1.0-1.2mm.