中国实用口腔科杂志

中国实用口腔科杂志

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四种机用镍钛系统根管预备后牙本质微裂比较研究

王全禹1，3[Author]) AND 1[Journal]) AND year[Order])" target="_blank">3，毕婉婷2，3[Author]) AND 1[Journal]) AND year[Order])" target="_blank">3，薛明3[Author]) AND 1[Journal]) AND year[Order])" target="_blank">3   

  1. 1. 鞍钢集团总医院口腔科，辽宁  鞍山  114002；2. 中国医科大学附属第一医院鞍山医院口腔科，辽宁  鞍山  114012；3. 中国医科大学口腔医学院·附属口腔医院，辽宁  沈阳  110002
  • 出版日期:2018-01-15 发布日期:2018-02-01

  • Online:2018-01-15 Published:2018-02-01

摘要：

目的    通过比较4种机用镍钛系统体外预备根管后产生牙本质微裂的差异，为临床医生选择根管预备器械和方法提供参考。方法    选取2016年1—10月在中国医科大学附属口腔医院、鞍钢集团总医院口腔科及中国医科大学附属第一医院鞍山医院口腔科门诊拔除的新鲜完整下颌切牙为研究对象，按统一标准选择125颗样本制作研究模型，采用随机号码表法将样本平均分为5组，4个预备组分别应用机用ProTaper Next（N组）、WaveOne Gold（W组）、M3-Pro（M组）、ProTaper Universal（P组）进行根管预备，余下一组作为对照（C组）不进行根管预备。在距根尖3、6、9 mm处水平切割牙根，显微镜下观察记录各截面出现牙本质微裂情况，应用SPSS软件进行卡方检验。结果    未预备的C组没有发现牙本质微裂，P组产生微裂的牙数与N组、W组和M组分别对比均有显著增多，差异有统计学意义（P < 0.05）。所有预备组在距根尖3 mm处产生微裂的牙总数对比距根尖6 mm处和9 mm处有显著增多，差异有统计学意义（P < 0.05）。结论    应用机用镍钛器械进行根管预备可能造成牙本质微裂，在距根尖3 mm处产生的微裂要显著多于距根尖6 mm和9 mm处；相较ProTaper Universal，使用ProTaper Next、WaveOne Gold和M3-Pro可显著降低微裂的发生率。

关键词: 镍钛器械, 根管预备, 牙本质微裂, 牙根纵裂

Abstract:

Objective    To compare the differences in the dentinal microcracks after the root canal preparation（RCP）by four kinds of Ni-Ti rotary instruments in vitro，so as to provide references for clinicians in the selection of instruments and methods during RCP. Methods    A total of 125 complet incisors extracted from Jan. to Oct. of 2016 were selected as the research subjects，and they were divided into 5 groups on average according to the random table methed. Four kinds of Ni-Ti rotary instrument（Group N：ProTaper Next，Group W：WaveOne Gold，Group M：M3-Pro，Group P：ProTaper Universal）were respectively used for RCP，the remaining group being as the control group （Group C）. The roots were cut horizontally at 3 mm，6 mm and 9 mm from the apices，and existence of dentinal microcracks were observed and recorded under the microscope. Results    No dentinal microcracks were found in the control group without RCP. The number of teeth with microcracks in Group P was obviously higher than that in Group N，Group W and Group M. The total number of teeth with microcracks from the apical 3 mm was obviously higher than that from the apical 6 mm and 9 mm in all the preparation groups. Conclusion    Dentinal microcracks may be caused during RCP using Ni-Ti instruments；the dentinal microcracks produced at 3 mm from the apical tip were significantly more than those at 6 mm and 9 mm；compared to ProTaper Universal，ProTaper Next，WaveOne Gold and M3-Pro can significantly reduce the incidence of dentinal microcracks.

Key words: Ni-Ti instrument, root canal preparation, dentinal microcrack, vertical root fracture