A micro-computed tomographic evaluation of apical root canal preparation using three instrumentation techniques
A micro-computed tomographic evaluation of apical root canal preparation using three instrumentation techniques
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DOI：
10.1111/j.1365-2591.2009.01626.x
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发表时间：
2009-12-01
影响因子：
5
通讯作者：
Parashos, P.
中科院分区：
文献类型：
--
作者：
Moore, J.;Fitz-Walter, P.;Parashos, P.
P>目的研究采用三种技术预备后根管根尖三分之一处的形态变化。方法在使用仪器之前和之后使用微型计算机断层扫描对四十颗磨牙进行扫描：第 1 组 - 使用平衡力技术的不锈钢 K 锉刀；第 1 组 - 使用平衡力技术的不锈钢 K 锉刀；第2组-不锈钢K锉（平衡力），然后用同等尺寸0.04锥度FlexMaster仪器精修根尖预备；第 3 组 - 混合 ProTaper/FlexMaster（ProFile 适用于尺寸 45 和 60）序列。由于图像中存在伪影或不可避免的堵塞，8 条运河被排除，剩下 110 条运河可以分析。根据牙本质去除量、根管圆度、运输以及所制备的根尖管尺寸与最终使用的器械的相关性来评估根尖根管预备体。结果三组的根尖预备体尺寸中位数分别为：30、30和40。尽管尺寸较大且操作者经验较少，但使用混合旋转镍钛器械技术预备的根管的体积变化（去除牙本质的量）仍然很小，并且更有效。生产出与最终仪器尺寸 (P < 0.001) 紧密匹配的圆形制剂 (P < 0.001)。使用旋转式镍钛器械进行根管交通有减少的趋势。结论不锈钢手预备体对根尖牙本质不保守。如果正确使用，即使是经验不足的操作员，旋转镍钛器械也能够精确地将根管“加工”至更大的根尖尺寸，同时将医源性损伤的风险降至最低。
P>AimTo investigate the morphological changes in the apical third of the root canal after preparation with three techniques.MethodologyForty molar teeth were scanned using micro-computed tomography before and after instrumentation with: Group 1 - stainless steel K-files using the balanced force technique; Group 2 - stainless steel K-files (balanced force) and then refining the apical preparation with the equivalent size 0.04 taper FlexMaster instrument; Group 3 - a hybrid ProTaper/FlexMaster (ProFile for sizes 45 and 60) sequence. Eight canals were excluded because of artefacts in the images or unnegotiable blockages leaving 110 canals that could be analysed. Apical root canal preparation was evaluated with respect to the amount of dentine removed, canal roundness, transportation and how the dimensions of the prepared apical root canal correlated with those of the final instrument used.ResultsThe median apical preparation sizes for the three groups respectively were: 30, 30 and 40. Despite the larger size and less experienced operator, the volumetric change (the amount of dentine removed) in canals prepared with a hybrid rotary nickel-titanium instrumentation technique remained small and, a more rounded preparation (P < 0.001) that closely matched the final instrument dimensions (P < 0.001) was produced. There was a trend for less canal transportation using rotary nickel-titanium instruments.ConclusionsStainless steel hand preparation was not conservative of apical dentine. When used correctly, even by less experienced operators, rotary nickel-titanium instruments were able to precisely 'machine' a canal to larger apical sizes with minimal risk of iatrogenic damage.