Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals
Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals
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DOI：
10.1111/j.1365-2591.2010.01724.x
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发表时间：
2010-11-01
影响因子：
5
通讯作者：
Sousa-Neto, M. D.
中科院分区：
文献类型：
--
作者：
Fornari, V. J.;Silva-Sousa, Y. T. C.;Sousa-Neto, M. D.
目的探讨根尖大小对旋转器械预备弯曲根管1/3根管的影响。方法对44颗上颌磨牙近中颊根管进行根管预备，根尖大小分别为30、0.02、35、0.02、40、0.02、45、0.02。根管预备后，对根尖1/3进行组织学处理和检查。对标本进行40倍放大分析，并将图像提交给积分网格进行形态测量分析，以评估碎片和未预备的根管壁的百分比。根据根管表面的规律性、根管壁连续性的突变以及部分或全部去除前牙本质来评估器械在根管壁上的作用。结果用单因素方差检验和随机后Tukey检验进行统计学比较。结果使用器械30，0.02锥度(55.64±-4.62%)和35，0.02锥度(49.03±5.70%)进行根管扩大术时，根管内未预备根管牙本质的比例明显高于器械40，0.02锥度(38.08±10.44%)和45，0.02锥度(32.65±8.51%)(P<；0.05)。使用器械30，0.02锥度(34.62±9.49%)和35，0.02锥度(25.33±7.37%)进行根尖扩大时，碎屑较多(P<；0.05)。根尖残留量与未预备根管的周长有显著相关性(r=0.9130，P<；0.001)。结论根尖扩大术不能使根管壁完全形成。根尖第三清洁度可以通过器械直径来预测。
P>ObjectiveTo evaluate the influence of apical size on cleaning of the apical third of curved canals prepared with rotary instruments.MethodologyForty-four mesiobuccal canals of maxillary molars teeth were instrumented to different apical sizes (30, 0.02; 35, 0.02; 40, 0.02; 45, 0.02) using a crown-down technique. After canal preparation, the apical thirds of the roots were submitted to histological processing and examination. The specimens were analysed at 40x magnification and the images were submitted to morphometric analysis with an integration grid to evaluate the percentage of debris and uninstrumented root canal walls. The action of the instruments on the root canal walls was assessed based on the surface regularity, abrupt change on the continuity of root canal walls, and partial or total pre-dentine removal. The results were statistically compared using one-way anova with post hoc Tukey test. Pearson's correlation was performed to identify potential correlations between values.ResultsThe percentage of uninstrumented root canal dentine was higher when apical enlargement was performed with instruments 30, 0.02 taper (55.64 +/- 4.62%) and 35, 0.02 taper (49.03 +/- 5.70%) than with instruments 40, 0.02 taper (38.08 +/- 10.44%) and 45, 0.02 taper (32.65 +/- 8.51%) (P < 0.05). More debris were observed when apical enlargement was performed with instruments 30, 0.02 taper (34.62 +/- 9.49%) and 35, 0.02 taper (25.33 +/- 7.37%) (P < 0.05). There was a significant correlation between the amount of remaining debris and the perimeter of uninstrumented root canal dentine (r = 0.9130, P < 0.001).ConclusionNo apical enlargement size allowed the root canal walls to be prepared completely. Apical third cleanliness could be predicted by instrument diameter.