【作者】 陈凯达； 薛明；

【Author】 Chen kaida;Xue Ming;Department of Endodontics, School of Stomatology and Affiliated Stomatology Hospital of China Medical University;

【机构】 中国医科大学口腔医学院·附属口腔医院牙体牙髓病科；

【摘要】 目的:比较四种不同的镍钛器械:ProTaper Universal Retreatment、ProTaper Next、Reciproc Blue、Mani GPR在根管再治疗过程中去除弯曲根管充填物时根尖碎屑溢出量及所需的操作时间,为临床选择根管再治疗镍钛器械提供理论依据。方法:选取40个弯曲度为30°的树脂模块,使用M3pro镍钛系统预备至25号0.06锥度,随后使用热牙胶垂直充填技术进行根管充填。冠部封闭后,放置于37℃100%湿度恒温水浴箱中保存7天。样本随机分为4组(n=10),分别使用ProTaper Universal Retreatment、ProTaper Next、Reciproc Blue、Mani GPR去除根管充填物。使用提前称重的离心管收集从根尖孔溢出的碎屑及冲洗液,放置于60℃的烘干箱内干燥7天。使用电子天平称量去除根管充填物后离心管的质量,得出差值即为碎屑质量,并记录达到工作长度(working length,WL)所用的时间(T1),和完全清除根充材料所用的时间(T2),使用SPSS 22.0对所得数据进行统计学分析。结果:1、ProTaper Universal Retreatment组根尖溢出碎屑的量(0.00276±0.00040g)明显多于其他3组(P<0.05)。ProTaper Next组(0.00194±0.00042g)、Reciproc Blue组(0.00175±0.00051g)和Mani GPR组(0.00186±0.00028g)之间根尖溢出碎屑的量差异无统计学意义(P>0.05)。2、Mani GPR组达到WL所用的时间(T1)(71.33±17.89s)短于其他3组(P<0.05)。ProTaper Universal Retreatment组(93.77±16.22s)、ProTaper Next组(89.09±19.69s)和Reciproc Blue组(99.94±20.11s)达到WL所用的时间(T1)差异无统计学意义(P>0.05)。3、ProTaper Universal Retreatment组(130.35±21.56s)和Reciproc Blue(139.55±18.09s)组完全清除根充材料所用的时间(T2)长于ProTaper Next组(111.87±21.57s)和Mani GPR组(110.00±14.82s)(P<0.05)。结论:1、在弯曲根管再治疗中,使用ProTaper Next、Reciproc Blue和Mani GPR比使用ProTaper Universal Retreatment机用镍钛器械根尖碎屑溢出量更少,有利于提高根管再治疗成功率。2、在弯曲根管再治疗中,相比于ProTaper Universal Retreatment或Reciproc Blue,使用ProTaper Next或Mani GPR清除根充材料更加省时。更多还原

【Abstract】 Objectives:This study evaluated the amount of apically extruded debris and the working time in the filling removal of curved root canals retreament with four different Ni-Ti instrumentation systems:ProTaper Universal Retreatment,ProTaper Next,Reciproc Blue and Mani GPR.Provide a theoretical guidance for how to choose suitable Ni-Ti instru-mentation system in clinical endodontic retreatment.Methods:Forty resin modules with 30°curvature canal were prepared with the M3 pro#25.06 Ni-Ti system and filled with gutta-percha.The modules were reserved in the 37℃ water bath calorstat for 7 days after closure of the crown.The modules were randomly divided into 4 groups(n=10).The canal filling was removed with ProTaper Universal Retreatment,ProTaper Next,Reciproc Blue and Mani GPR.Apically extruded debris and irrigation were collected in a preweighted Eppendorf tubes and reserved in 60°drying oven for 7 days.The weight of the debris was assessed by comparing the pre-and post-weight of the tubes using microbalance.The times required for reaching working length(WL)(T1) and complately removing the filling material were also recorded.All the experimental data were statistically analyzed by SPSS 22.0.Results:1.All systems caused apical debris extrusion.The ProTaper Universal Retreatment system(0.00276±0.00040 g) produced significantly more debris than the other three systems(P<0.05).There was no difference among ProTaper Next system(0.00194±0.00042 g),Reciproc Blue system(0.00175±0.00051 g) and Mani GPR system(0.00186±0.00028 g)(P>0.05).2.The Mani GPR system(71.33±17.89 s)required significantly less time of reaching the WL(T1)than the other three systems(P<0.05).There was no significant difference in the time of reaching the WL(T1) among ProTaper Universal Retreatment system(93.77±16.22 s),ProTaper Next system(89.09±19.69 s) and Reciproc Blue system(99.94±20.11 s)(P>0.05).3.The ProTaper Universal Retreatment system(130.35±21.56 s) and Reciproc Blue system(139.5 5±18.09 s)required significantly less time to remove the root filling materials(T2)than ProTaper Next group(111.87±21.57 s) and Mani GPR group(110.00±14.82 s)(P>0.05).Conclusions:1.In the retreatment of curved root canals,the ProTaper Next,Reciproc Blue and Mani GPR systems extruded significantly less debris than ProTaper Universal Retreatment system,which may beneficial improve the success rate of endodontic retreatment.2.In the retreatment of curved root canals,comparing with ProTaper Universal Retreatment or Reciproc Blue,use ProTaper Next or Mani GPR can remove the filling materials in less time.更多还原