【摘要】 目的临床评价使用4种机用镍钛器械预备后牙狭窄弯曲根管的治疗效果。方法需进行根管治疗的磨牙或前磨牙狭窄弯曲根管170个,按患者就诊顺序随机分成4组。TF组44个根管,采用TF机动预备;PathT组42个根管,采用PathFile联合TF机动预备;P组41个根管,采用ProTaper机动预备,PathP组43个根管,采用PathFile联合ProTaper机动预备。4组根管预备后均采用热牙胶连续波垂直加压充填。记录4组的根管预备时间、器械分离数量,根据X线片观察术前与术后根管弯曲度的变化量,评价根充效果。结果 TF组、PathT组、P组、PathP组的根管预备时间分别为(3.50±0.13)min、(2.80±0.09)min、(5.39±0.08)min、(4.66±0.12)min,4组根管预备时间差异具有统计学意义(F=374.081,P<0.001),PathT组根管预备时间最短(P<0.05),PathP组(t=28.65)、TF组(t=34.67)根管预备时间均短于P组(P<0.001)。4组中PathT组根管弯曲度变化量最小(0.90°±0.69°),与其余3组比较差异有统计学意义(P<0.05);4组根充效果理想,未发现欠充及牙胶尖超充,TF组与P组出现2例糊剂超充,PathT组与PathP组各出现1例糊剂超充。结论与ProTaper相比,TF锉能缩短狭窄弯曲根管的预备时间,与PathFile联合使用,则能进一步提高根管预备效率,减少根管偏移。更多还原

【Abstract】 Objective To investigate the clinical application of nickel-titanium( Ni-Ti) rotary instruments( TF,ProTaper and combined use of Pathfile and TF,and combined application of Pathfile with ProTaper) in preparation of narrow and curved root canals of posterior teeth. Methods A total of 170 narrow and curved root canals in premolar or molar teeth were prepared by TF( group TF),ProTaper( group P),combined use of Pathfile and TF( group PathT) and combined use of Pathfile and ProTaper( group PathP) rotary instruments,obturated with continuous wave compaction technique. The root canal preparation time,fracture of instruments,change of root canal curvature and obturation were recorded and analyzed. Results Operative time of group TF,group PathT,group P,group PathP was( 3. 50 ± 0. 13) min,( 2.80 ±0.09) min,( 5.39 ±0.08) min,( 4.66 ±0. 12) min,there were significant difference in four groups( F =374. 081,P < 0. 001). Operative time of group PathT( 2. 80 ± 0. 09) min was shortest than other groups( P < 0. 001).Operative time of group PathP( 4. 66 ± 0. 12) min was shorter than group P( 5. 39 ± 0. 08) min( t = 28. 65,P <0. 001). Root canal curvature variation of group PathT( 0. 90° ± 0. 69°) was minimum in four groups( F = 12. 201,P < 0. 001). There were satisfied obturation in four groups,less filling and gutta overfilled were not happened in four groups. Conclusion TF nickel-titanium file is effective for the treatment of narrow and curved root canal,combination of TF with Pathfile are more recommendable,for these instruments can improve the efficiency of root canal preparation and reduce transportation of root canal.更多还原