摘要
目的比较ProTaper Retreatment、锋度O-file、M3-RT 3种机用镍钛器械与手用不锈钢器械K锉、H锉的中心定位能力以及根充物的清除率,观察预备后的根管壁形态,以期为根管再治疗3种镍钛器械的临床应用提供参考。方法40个规格相同的透明树脂单根管模块随机分为4组(n=10),分别使用手用器械K锉、H锉(A1组),ProTaper Retreatment镍钛锉(B1组),锋度O-file镍钛锉(C1组),M3-RT镍钛锉(D1组)进行根管预备;扫描仪记录各组模块预备前后的图像,使用Photoshop软件将图像重叠,Image J软件测量模拟根管内外壁树脂的去除量,比较4组器械的中心定位能力。收集因正畸拔除的下颌单根管前磨牙60颗,标准技术预备至35号后充填根管,玻璃离子封根管口,保存4周备用;随机分为4组(n=15),分别使用手用器械K锉、H锉(A2组)、ProTaper Retreatment镍钛锉(B2组)、锋度O-file镍钛锉(C2组)、M3-RT镍钛锉(D2组)清除根充物,将处理后的牙根沿近远中向劈开,10倍放大显微镜下照相,电脑软件描记根管壁和残留根充物的面积,计算每组的根充物清除率,每组随机选取两颗牙齿置于扫描电子显微镜下观察根管壁形态。结果4组根管模块在距离根尖孔9 mm以内,B1、C1、D13组的中心定位能力优于A1组(P<0.05),D1组在距离根尖孔4 mm根管转弯处的偏移小于其他3组,中心定位能力最好(P<0.05);在距离根尖孔10 mm处,4组器械的中心定位能力无差异(P>0.05)。4组器械进行根管再治疗根管预备后,根管内均有不同程度的根充物剩余,B2、C2、D2组根充物清除率无明显差异(P>0.05),但均高于A2组(P<0.05)。扫描电子显微镜结果显示,经B2、C2、D2组器械预备后的根管壁较A2组更为光滑连续,残留的细小牙胶碎屑较少。结论根管再治疗3种镍钛器械的中心定位能力优于手用器械,根管再治疗镍钛器械ProTaper Retreatment、锋度O-file、M3-RT在研究中显示出较好的性能,M3-RT中心定位能力略优。根管再治疗3种镍钛器械相比传统的手用不锈钢器械根充物清除率高,预备后的根管壁更为平滑,连续性好。
Objective Comparision of the central location ability and clearance rate of ProTaper retreatment,Feng⁃du O⁃file and M3⁃RT three kinds of nickel⁃titanium instruments and hand stainless instruments K⁃file,H⁃file.Observe the form of the root canal wall.To provide experimental basis and reference for the clinical application of nickel⁃titani⁃um instruments for root canal retreatment.Methods 40 simulated resin blocks with the same specification were ran⁃domly divided into four groups(n=10).Each group was separately prepared with hand stainless instruments K⁃file and H⁃file (group A1), ProTaper retreatment (group B1), Fengdu O⁃file (group C1), and M3⁃RT (group D1). Using scanner to ob⁃tain the pre⁃ and post⁃operative images and overlapping the images through Photoshop. Measuring the root canal innerand outer wall resin removal with Image J, compared the central location ability of the four group. A total of 60 mandibu⁃lar single canal premolars extracted due to orthodontics were collected. The teeth were randomly divided into fourgroups (n=15) after filling the root canal. Use hand stainless instruments K⁃file,H⁃file(group A2), ProTaper retreatment(group B2), Fengdu O⁃file(group C2) , M3⁃RT(group D2) to remove the filling materials. The roots were longitudinally sec⁃tioned, and the image of the root surface was photographed under the 10 × magnification microscope. The software wasused to trace the area of the root canal wall and residual root filling, and the root filling clearance rate of each group wascalculated. Two teeth were randomly selected in each group and observed under scanning electron microscope. Re⁃sults Within 9 mm from the root tip hole, the central location ability of group B1, C1, D1 was better than that of groupA1(P < 0.05). At 4 mm from the root tip hole, group D1 has the best central location ability(P < 0.05). There was no dif⁃ference of the four instruments at a distance of 10 mm from the root tip hole(P > 0.05). There were various degree offilling material remained in the root canal after the four groups of instruments for retreatment canal preparation. Therewas no significant difference between group B2, C2, D2 (P > 0.05), and both were higher than group A2(P < 0.05). Scan⁃ning electron microscope observation results shown that the root canal wall prepared by group B2, C2, D2 was moresmooth and continuous than group A2, and the residual filling material was less. Conclusion The central location abil⁃ity of three kinds of nickel⁃titanium root canal retreatment instruments were significantly better than that of hand stain⁃less instruments. ProTaper retreatment, Fengdu O⁃file and M3⁃RT three kinds of nickel⁃titanium root canal retreatmentinstruments showed good performance, the central location ability of M3⁃RT was slightly better. Nickel⁃titanium root ca⁃nal retreatment instruments are more efficient than traditional hand stainless instruments in removing root fillings andthe root canal wall after preparation is smoother and has good continuity.
作者
孔晶晶
李春年
殷亮亮
代鑫鹏
KONG Jingjing;LI Chunnian;YIN Liangliang;DAI Xinpeng(School and Hospital of Stomatol⁃ogy,Hebei Medical University&Hebei Key Laboratory of Stomatology,Shijiazhuang 050017,China)
出处
《口腔疾病防治》
2020年第8期494-498,共5页
Journal of Prevention and Treatment for Stomatological Diseases
基金
河北省医学科学研究重点课题计划(20180604)。
关键词
根管再治疗
镍钛器械
树脂模块
中心定位能力
根管预备
根充物
清除率
扫描电镜
root canal retreatment
nickel⁃titanium instrument
simulated resin blocks
central positioning ability
root canal preparation
root filling
clearance rate
scanning electron microscope
