【作者】 许利利； 王瑞； 黄定明；

【Author】 Xu lili Wang Rui Huang Dingming(West China school of stomatology,Sichuan University)

【机构】 四川大学华西口腔医学院；

【摘要】 目的:比较3种不同的器械对去除根管系统内原充填物的效率的体外研究,为临床上采用不同器械进行根管再治疗提供理论依据。方法:选取30颗单根管直根管的下颌前磨牙,使用逐步后退法预备根管至40号,主尖25号,采用冷侧方加压法用AH-plus糊剂和牙胶严密充填根管。拍摄X线片确定充填质量,置于100%湿度,37℃的环境中一年。将30颗离体牙随机分为3组(n=10),分别使用H锉、K3和TF进行根管再预备,对再预备后的离体牙进行显微CT(micro-CT)扫描,分析根管内残余原充填物体积并进行三维重建。距根尖5mm和7mm处分别截断牙根,以5mm处为观察对象使用扫描电子显微镜(SEM)进行扫描,观察原充填物进入牙本质小管内的量,记录进入牙本质小管内最深的深度。结果:(1)Micro-CT扫描分析得根管内原充填物残留量占根管总体积的百分比:H锉组根管内残余原充填物体积占根管总体积的百分比明显小于TF组和K3组(P<0.01),TF组和K3组比较差异无统计学意义。(2)电镜下观察原充填物进入牙本质小管的最深深度:H锉组小于K3组(P<0.05),而与TF组比较差异无统计学意义,TF组小于K3组(P=0.017)。(3)电镜下观察原充填物进入牙本质小管的分布面积占总断面面积的百分比计分:H锉组小于K3组(P<0.05),而与TF组间比较无统计学差异,TF组小于K3组(P=0.022)。结论:手用H锉具有较理想的根管内原充填物清除效率,手用H锉和TF挤压进入牙本质小管内的原充填物较少,能保牙本质小管系统清洁。更多还原

【Abstract】 Aim:To assess the effectiveness of removing gutta-percha from root canals when using K3 instrument,H files or Twist files(TF).Methodology:Thirty human mandibular premolar teeth,each with single straight root canal,were selected.The teeth were prepared with K-files to size 40 by step-back technique and filled using cold lateral condensation with gutta-percha and AH-Plus sealers.After 1 year,thirty teeth were divided into three groups(n=10) and the gutta-percha removed using H file, K3 instrument or Twist files(TF).Micro-CT scans(72um) were taken to evaluate the residual filling material.Teeth were sectioned and prepared for observation using scanning electron microscopy.The depth of filling material into dentinal tubules was measured and the percentage of the old filling material in dentinal tubules was observed.Results: (1)Evaluate the percentage of the old filling material using Micro-CT:H file resulted in a smaller percentage than twist file and K3,there are no difference between twist file and K3.(2) Depth of filling material into dentinal tubules under the SEM:H file and twist file instrumentation resulted in a lesser depth than K3(P<0.05),but there is no differences between H file and twist file.(3) Evaluate the percentage of the old filling material in dentinal tubules under the SEM:H file and twist file instrumentation resulted in a lesser percentage than K3(P<0.05),there are no differences in other groups.Conclusions:H file left less residual filling material within root canal.H file and twist file instrumentation resulted in less old filling material in dentinal tubules.更多还原