中国实用口腔科杂志

中国实用口腔科杂志 ›› 2021, Vol. 14 ›› Issue (6): 681-685.DOI: 10.19538/j.kq.2021.06.010

• 论著 • 上一篇    下一篇

不同机用镍钛器械根管预备后产生牙本质裂纹的比较研究#br#

周逸嘉，马宏涛，朱亚琴   

  1. 上海交通大学医学院附属第九人民医院口腔综合科，上海交通大学口腔医学院，国家口腔医学中心，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海  200011
  • 出版日期:2021-11-30 发布日期:2021-11-30

  • Online:2021-11-30 Published:2021-11-30

摘要： 目的    通过体外实验观察和比较不同机用镍钛器械根管预备后对牙根产生牙本质裂纹的影响，为临床器械的选择提供参考，以提高根管治疗后患牙存留率。方法    选择2018年7月至2019年9月于上海交通大学医学院附属第九人民医院口腔综合科因正畸治疗需要而拔除的单根前磨牙75颗，随机分成5组，每组15颗；4个实验组分别使用机用镍钛器械MTwo（M2组）、M3-Pro（M3组）、Reciproc（R组）、Reciproc Blue（RB组）进行根管预备，余下一组使用手用K锉（对照组）进行根管预备。在距根尖3、6、9 mm水平处切割牙根，使用光学显微镜（× 50）观察各组牙本质裂纹发生情况，并计算牙本质裂纹发生率。结果    各组牙本质裂纹发生率比较，差异有统计学意义（χ2 = 10.673，P = 0.031）。其中，对照组未发现牙本质裂纹，M2组牙本质裂纹发生率相对较高为46.7%，R组、M3组和RB组牙本质裂纹发生率依次降低，分别为33.3%、26.7%、13.3%。M2组和R组牙本质裂纹发生率与对照组比较，差异有统计学意义（均P < 0.05）；其他组间比较，差异均无统计学意义（均P > 0.05）。在距根尖3、6、9 mm水平处，牙本质裂纹发生率分别为16.0%、12.0%和1.3%，其差异有统计学意义（χ2 = 9.774，P = 0.008）；其中，在距根尖3、6 mm水平处牙本质裂纹发生率显著高于距根尖9 mm水平处，差异均有统计学意义（均P < 0.05）。结论    本实验使用的4种机用镍钛器械均可能导致牙本质裂纹的产生，且越靠近根尖牙本质裂纹发生率越高，其中Reciproc Blue根管预备后根部牙本质裂纹发生率较低。

关键词: 根管预备, 机用镍钛器械, 牙本质裂纹, Reciproc Blue, M3-Pro

Abstract: Objective    To observe and compare the effects of different Ni-Ti instruments on dentinal cracks in vitro，so as to provide reference for improving the preservation rate of teeth after root canal treatment and for the clinical selection of Ni-Ti instruments. Methods    Totally 75 single premolars extracted for orthodontic treatment from July 2018 to September 2019 in the Department of General Dentistry，the Ninth People′s Hospital，Shanghai Jiaotong University School of Medicine were selected and randomly divided into 5 groups，each with 15 teeth. Four kinds of Ni-Ti instruments-MTwo（M2 group），M3-Pro（M3 group），Reciproc（R group），and Reciproc Blue（RB group）-were used for root canal preparation （as experimental groups），the remaining group was given hand K files（control group）to perform root canal preparation. The horizontal slices of dentin were made at 3mm，6mm and 9mm away from the root apex. All slices were observed under microscope（× 50）magnification. The occurrence of dentinal cracks was observed and the the incidence rate was calculated. Results    Comparing the incidence of dentinal cracks in each group，the difference was statistically significant（χ2 = 10.673，P = 0.031）. Among them，there was no dentinal cracks in the control group. The incidence rate of dentinal cracks in the M2 group was relatively high at 46.7%. The incidence rate of dentinal cracks in the R group，M3 group and RB group decreased in turn，which was 33.3%，26.7% and 13.3%，respectively. Compared with the control group，the incidence rate of dentinal cracks in the M2 group and the R group were statistically different（all P < 0.05）. There was no statistically significant difference among other groups（all P > 0.05）). At 3，6，and 9 mm from the root tip，the incidence of dentinal cracks was 16.0%，12.0% and 1.3%，respectively，and the difference was statistically significant（χ2 = 9.774，P = 0.008）；among them，the incidence of dentinal cracks at the level of 3 and 6 mm from the root apex was significantly higher than that at the level of 9 mm from the root apex，and the differences were statistically significant（P < 0.05）. Conclusion    The four mechanical Ni-Ti instruments involved in this experiment may lead to the formation of dentinal cracks，and more dentinal cracks are generated at the level closer to the root apex. Among them，Reciproc Blue has the lowest incidence of dentinal cracks after root canal preparation. 

Key words: root canal preparation, Ni-Ti engine-driven instruments, dentinal crack, Reciproc Blue, M3-Pro