中国实用口腔科杂志

中国实用口腔科杂志 ›› 2024, Vol. 17 ›› Issue (2): 186-191.DOI: DOI：10.19538/j.kq.2024.02.010

• 论著 • 上一篇    下一篇

不同根管冲洗方法对Vitapex清除及根尖封闭的效果研究

唐芝羲1，2，钟    苑1，2，钟    琳1，2，鲁铭炜1，2，田    欢2，戴丽霞1，2   

  1. 1. 湖南中医药大学，湖南  长沙  410208；2. 长沙市口腔医院特诊中心，湖南  长沙  410004
  • 出版日期:2024-03-30 发布日期:2024-03-30
  • 基金资助:
    湖南省自然科学基金项目（2023JJ60400）；长沙市自然科学基金项目（kq2202041）

  • Online:2024-03-30 Published:2024-03-30

摘要： 目的    比较3种根管冲洗方法对根管内Vitapex清除及根尖封闭的效果，为临床选择合适的根管冲洗方法提供依据。方法    收集2023年3—5月于长沙市口腔医院口腔颌面外科门诊因正畸治疗拔除的下颌单根前磨牙80颗，随机分为4组，每组20颗。对照组不予Vitapex糊剂封药及根管冲洗处理，其他3组实验组行Vitapex糊剂封药并根据根管冲洗方法分别记为传统注射器冲洗（CNI）组、被动超声荡洗（PUI）组和Er∶YAG激光组。每组随机选取10颗离体牙纵剖后于扫描电子显微镜（SEM）下观察并行Vitapex残留评分；另10颗离体牙根管充填后行亚甲基蓝染料渗透实验，纵剖离体牙于口腔显微镜下观察并测量染料最长渗透长度。结果    SEM观察示实验组根管表面均可见不同程度的Vitapex糊剂残留和少量玷污层残留，且相较于根颈1/3和根中1/3，根尖1/3的Vitapex残留评分较高，差异均有统计学意义（均P < 0.05）。各组相同部位Vitapex残留评分及最长渗透长度总的比较，差异均有统计学意义（均P < 0.05）。其中，Er∶YAG组、PUI组和CNI组相同部位Vitapex残留评分均高于对照组；在根颈1/3和根中1/3处，PUI组和Er∶YAG组Vitapex残留评分均低于CNI组；在根尖1/3处，Er∶YAG组Vitapex残留评分低于PUI组和CNI组，以上差异均有统计学意义（均P < 0.05）。Er∶YAG组染料最大渗透长度［（0.58 ± 0.05）mm］短于CNI组［（1.07 ± 0.13）mm］和PUI组［（0.94 ± 0.17）mm］，差异均有统计学意义（均P < 0.001）；其与对照组［（0.45 ± 0.04）mm］比较，差异无统计学意义（P = 0.105）。结论    相比于CNI和PUI应用于根管冲洗，Er∶YAG激光活化冲洗可更有效去除根尖1/3的Vitapex糊剂，且具有更佳的根尖封闭效果。

关键词: Vitapex糊剂, 根管冲洗, Er∶YAG激光, 根尖封闭

Abstract: Objective    To compare the effects of 3 root canal irrigation methods on the removal of Vitapex in the root canal and apical sealing，providing a basis for selecting appropriate root canal irrigation methods in clinical practice. Methods    Collect 80 mandibular single premolars to be extracted for orthodontic treatment at the Oral and Maxillofacial Surgery Outpatient Department of Changsha Stomatological Hospital from March to May 2023，and randomly divide them into 4 groups，with 20 teeth in each group. The control group was not treated with Vitapex paste and root canal irrigation，while the other three experimental groups were treated with Vitapex paste and recorded as the conventional needle irrigation（CNI）group，passive ultrasound irrigation（PUI）group，and Er∶YAG laser group according to the root canal irrigation method. Ten detached teeth were randomly selected from each group and were observed under a scanning electron microscope（SEM）for parallel Vitapex residual score after longitudinal dissection. After root canal filling，another 10 extracted teeth underwent methylene blue dye penetration experiments，and the longest dye penetration length was observed and measured under an oral microscope after longitudinal dissection of the extracted teeth. Results    SEM observation showed that different degrees of residue of Vitapex paste and a small amount of smear layer were visible on the surface of the root canal in the experimental group. Compared with the cervical 1/3 and middle 1/3，the residue score of Vitapex in the apical 1/3 was higher，and the differences were statistically significant（all P < 0.05）. The comparison of Vitapex residue score and total longest penetration length in the same site among different groups showed statistically significant differences（all P < 0.05）. Among them，the Er∶YAG group，PUI group，and CNI group had higher residual scores of Vitapex in the same area compared to the control group. At cervical 1/3 and middle 1/3，the residual scores of Vitapex in the PUI group and Er∶YAG group were lower than those in the CNI group；at apical 1/3，the residual score of Vitapex in the Er∶YAG group was lower than that in the PUI and CNI groups；the above differences were statistically significant（all P < 0.05）. The maximum penetration length of dye in the Er∶YAG group ［（0.58 ± 0.05）mm］ was shorter than that in the CNI group ［（1.07 ± 0.13）mm］ and the PUI group ［（0.94 ± 0.17）mm］，and the differences were statistically significant（all P < 0.001）. Comparing the Er∶YAG group with the control group ［（0.45 ± 0.04）mm］，there was no statistically significant difference（P = 0.105）. Conclusion    Compared to CNI and PUI for root canal cleaning，Er∶YAG laser can more effectively remove the Vitapex paste at apical 1/3 and has a better apical sealing effect.

Key words: Vitapex paste, root canal irrigation, Er∶YAG laser, apical sealing