Background technology
Root-canal filling is one of effective ways of treatment periapical periodontitis and dental pulp disease, and the performance of root canal filling material directly affects the effect of root-canal filling in the treatment, becomes the key of root canal success.Along with development of technology, traditional phenolic filler is abandoned gradually, and new paste class material has obtained application clinical.Relate in research and the clinical practice at present more have following several:
The existing long time of 1 zinc oxide eugenol paste zinc oxide paste application clinically, eugenol wherein has anti-microbial property, most amphimicrobes and minority anaerobe all there is in various degree inhibitory action (Torabinejad M, et al., Jendod, 1995,21 (8): 403), yet it toxicly be studies show that further zinc oxide paste does not reach the desired inertia of ideal root canal filling material and has no side effect;
2 Ca (OH)2(1992,8 (5): 183) the report calcium hydroxide can make local environment be the meta-alkalescence state to the root canal filling paste document, reduces the vigor of absorptive cell, promotes sclerous tissues to form for Trope M., Endod DentTraumatol; Calcium ion can form calcium phosphate crystal with the apatite-base qualitative response in the dentin in addition, and sealing dentinal tubule reduces the existence of antibacterial.The cytotoxicity of calcium hydroxide has absorbability less than zinc oxide eugenol paste, but its tip of a root that can only be used for young permanent teeth is induced shaping;
3 iodoform paste iodoform pastes are applicable to that pus is many, exudate is many, immature of the tip of a root is managed and the filling of newborn root canal.After iodoform and alcohol, tissue fluid, fat or antibacterial produce and contact, slowly decompose and produce free-iodine, thereby make the bacterial product oxidation, the generation bactericidal action; In addition, the root-canal filling of utilization iodoform paste may cause patient's systemic anaphylaxis.
Calcium phosphate bone cement (CPC) is a kind of novel hard tissue repairing material, by solid-liquid two phase compositions, can reconcile into pastel, and is moulding arbitrarily according to defect.Its good biocompatibility, under the environment of human body and temperature conditions, solidify voluntarily, its aquation composition finally is converted into hydroxyapatite (hydroxyapatite HAP), can guide osteogenesis, progressively be organized and absorb and generation bone regeneration effect present orthopaedics clinical practice result satisfactory (old system first-class, Chinese wound magazine, 1999,15 (3): 184-86).
Super the filling of material is the main difficult problem of root canal always, and traditional material is super can to cause swelling, pain after filling, and is the main cause that causes the root canal failure; And the super part of filling of CPC material can be organized absorption, vacuum response, and play the effect that guides the periapical osteanagenesis, changed the traditional concept of root canal.
The technical issues that need to address of the present invention are to disclose a kind of self-curable calcium phosphate root pipe filler, the mode that this root pipe filler can be taked to inject is filled, and makes things convenient for the doctor to operate, and improves therapeutic effect, alleviate even eliminate root and fill reaction, solve the root pipe and fill the treatment problem.
Technical conceive of the present invention is such: calcium phosphate bone cement and root canal wall adaptation are good, can diffuse in the tube wall dentinal tubule.Change in volume does not take place in curing voluntarily in the root pipe, increases the mechanical strength of root of the tooth, reduces the probability of root folding, can play the effect of osteanagenesis on every side of the guiding tip of a root effectively.
Synthos are mixed with appropriate developer, and introduce medicine, particularly anti-anaerobic agent, reconcile into toothpaste-like or thick paste with anhydrous innoxious solvent then with therapeutic effect, this thick paste thing is circulated in the syringe, promptly can be used for the injection for curing of root canal.
The detailed technical scheme of the present invention is as described below:
The component of Injectable self-curable calcium phosphate root pipe filler of the present invention comprises the developing agent and the stabilizing agent of compound phosphoric acid calcium salt, effective dose, and its preferred ratio is:
Compound phosphoric acid calcium salt: developing agent: medicine: stabilizing agent=10: 0～10.0: 0～3.0: 0.05～1.0, mass ratio;
Said compound phosphoric acid calcium salt is by the blended by a certain percentage mixture of several calcium phosphate, can be by (US5525148, US5545254) disclosed method preparation can be a kind of in calcium phosphate (α type or the β type) tetracalcium phosphate or both mixture; OCP, calcium hydrogen phosphate (water of crystallization is arranged or do not have water of crystallization, DCPD or DCPA), hydroxyapatite, fluor-apatite, a kind of in the calcium pyrophosphate or their mixture, wherein synthos particles of powder size should be less than 10 microns.
The particle diameter of tetracalcium phosphate is 1～20 micron in the said compound phosphoric acid calcium salt powder, and the particle diameter of DCPA is 1～10 micron.
Said developing agent is iodoform, barium sulfate etc., is good with iodoform wherein.It not only has the development effect, can also sterilize simultaneously.The particle requirement of all powder is little, must not be greater than 100 μ m.
Said medicine is the antibiotic and sterilizing medicine, as tobramycin, safe energy, metronidazole and tinidazole, wherein with tinidazole the best.
Said stabilizing agent is ethoxy or hydroxypropyl cellulose, polyvinyl alcohol, polyvinylpyrrolidone etc., wherein with polyvinylpyrrolidone the best.
Of the present invention pipe filler and solvent are in harmonious proportion and become pasty state, can adopt the mode of filling, also can adopt syringe to carry out the direct injection filling, are the best in injectable mode wherein.
Root pipe filler and solvent ratios are as follows:
Root pipe filler: solvent=10: 2.0～10.0, mass ratio;
Said solvent is glycerol, Polyethylene Glycol or dimethyl silscone wet goods, wherein with dimethicone the best.
The present invention has following advantage:
After 1 anhydrous mastic enters human body, exchange by tissue fluid with surrounding tissue, slowly hardening behind the synthos powder one chance water, but effective closure root pipe and the root pipe had certain invigoration effect, be in non-aqueous media, progressively to solidify simultaneously, firming body intensity is lower, also is easier to where necessary paste is taken out, and is beneficial to the successive treatment operation.
The main component of 2 whole pastes is a calcium phosphate composite powder.Be neutral in aqueous solution, its slack-off process is neutral slowly aquation course of reaction, does not have other stimulus object, and the ultimate constituent after the aquation is hydroxyapatite, and is similar to the inorganic constituents of human body hard tissue, good biocompatibility, nonirritant.Therefore even super filling can not produce root yet and fill reaction after inserting the root pipe, super part of filling in alveolar bone can be progressively by frontal resorption, the formation of guiding area of new bone, its effect is better than existing other types root-canal filling product, has changed the traditional concept that the root pipe is filled.
Contain part antibiotic and sterilizing medicine in 3 pipes, can local long-acting slow-releasing medicine, local concentration is better, but systemic drug concentration is very little, thereby reaches antibiotic, and root canal course of treatment is simplified in disinfective action, shortens treatment cycle.
4 oxpara particle diameters of the present invention are little, and fluidity of slurry and good stability are not stratified in the medium-term and long-term preservation of injection needle, and not phase-splitting can be used for injecting the root pipe and fills treatment.When using, can adopt by need the method for injection to carry out.But shear thinning, good fluidity, resistance are little under external force during injection, and the injection needle point only need be inserted into 1/3rd places of root pipe when injecting the root pipe.Paste still can arrive the root canal tip of a root well under injection pressure, fills sealing root pipe effectively, reaches the purpose of eliminating dead space.Even tiny canal, crooked root tube, branched root pipe also are so, make things convenient for clinical manipulation greatly, reduce and expand root and padding specification requirement, improve therapeutic effect.
The specific embodiment
Further illustrate content of the present invention below in conjunction with example, but these examples do not limit protection scope of the present invention.
Embodiment 1
Take by weighing the particle diameter that contains calcium hydrogen phosphate, tetracalcium phosphate and hydroxyapatite compound phosphoric acid calcium salt powder 10g less than 10 μ m, tinidazole 0.5g, Polyethylene Glycol-400 0.1g composition mixture reconciles into pastel with the anhydrous dimethyl silicone oil of 10g with it, joins in the syringe.This pastel is easy to injection, good stability; The root pipe is sealed in injection not stratified, the not phase-splitting in back effectively, has played sterilization, anticorrosion astringent effect.
Embodiment 2
Take by weighing the particle diameter formed by calcium hydrogen phosphate, tetracalcium phosphate and hydroxyapatite compound phosphoric acid calcium salt powder 10g less than 10 μ m, tinidazole 0.5g, glycerol 0.1g composition mixture reconciles into pastel with the anhydrous dimethyl silicone oil of 10g with it, joins in the syringe.This pastel is easy to injection, good stability; The root pipe is sealed in injection not stratified, the not phase-splitting in back effectively, has played sterilization, anticorrosion astringent effect.
Embodiment 3
Embodiment 1 described oxpara is sent in the root canal, 108 cases suffering from dental pulp disease and periapical disease have been carried out filling, have 121 teeth, 221 roots of the tooth.Women's 65 examples wherein, male's 43 examples, 41.52 years old mean age, were followed up a case by regular visits to time 12-25 month at age 9-66 year.Untoward reaction does not all take place clinically, the tooth invariant color, change in volume does not take place in the root casing pack.Also all do not have postoperative pain even surpass the part tooth that fills, roots such as local gingiva hyperemia, edema dash reaction and occur, and material has played the effect of osteanagenesis on every side of the guiding tip of a root effectively.