Technical quality of a matching-taper single-cone filling technique following rotary instrumentation compared with lateral compaction after manual preparation: a retrospective study
Technical quality of a matching-taper single-cone filling technique following rotary instrumentation compared with lateral compaction after manual preparation: a retrospective study
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DOI：
10.1007/s00784-016-1931-z
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发表时间：
2017-03-01
影响因子：
3.4
通讯作者：
Jahreis, M.
中科院分区：
文献类型：
--
作者：
Krug, R.;Krastl, G.;Jahreis, M.
本研究的目的是评估镍钛旋转（NiTiR）预备和匹配锥度单锥（mSC）封闭前后根管治疗的放射学技术质量，并检测与该技术相关的程序错误。随机抽样535例患者在维尔茨堡大学保守牙科和牙周病科接受根管治疗：2002-2003年使用不锈钢器械（SSI）准备和侧压实（LC）技术治疗254颗牙齿（经典组（CG））。2012-2013年，采用NiTiR器械进行根管成形和mSC技术（先进组（AG））对281颗牙进行根管充填。质量评估是基于欧洲牙髓学协会的放射学标准。分别记录根管的根尖、中央和颈部三分之一的空隙。程序错误，如突出，根尖运输，穿孔和骨折的器械，被发现。使用卡方检验和Fisher精确检验比较CG和AG的根管填充物。采用多变量logistic回归研究自变量（患者年龄、牙齿类型和治疗类型）与因变量（密度和长度）之间的相关性。在磨牙（p = 0.017）、下颌骨（p = 0.013）和初级根管治疗（p = 0.024）中，AG比CG更容易获得足够的长度。AG和CG在总体长度（p = 0.051）和根管填充总体质量（p = 0.1）方面无显著差异。在AG组中，操作错误明显减少（p = 0.019），并且在颈部（p = 0.01）和中央（p = 0.01）三分之一的根管充填物密度也有所下降。此外，老年患者的根管出现较少的空隙（p = 0.009）。旋转根管预备，然后是匹配锥度的单锥体填充技术，提供了可靠的根管成形，较少的程序错误，并且在根尖三分之一的长度和均匀性方面更可接受的填充质量。在根管的中央和颈椎部分取得了较差的结果。匹配锥度的单锥度技术似乎可以在适当的旋转器械后有效地封闭锥度良好的根管。不规则形状的管道需要额外的横向或温暖的垂直冷凝以避免空洞。
The objectives of the study were to evaluate the radiographic technical quality of root canal treatment before and after the implementation of a nickel-titanium rotary (NiTiR) preparation followed by a matching-taper single-cone (mSC) obturation and to detect the procedural errors associated with this technique.A random sample of 535 patients received root canal treatment at the Department of Conservative Dentistry and Periodontology at the University of Wurzburg: 254 teeth were treated in 2002-2003 by using stainless steel instruments (SSI) for preparation and a lateral compaction (LC) technique (classic group (CG)). Two hundred eighty-one teeth were root filled in 2012-2013 employing NiTiR instruments for the root canal shaping and a mSC technique (advanced group (AG)). The quality assessments were based on the radiographic criteria of the European Society of Endodontology. The presence of voids was recorded separately for the apical, central and cervical thirds of the root canals. Procedural errors, such as ledges, apical transportations, perforations and fractured instruments, were detected. The root canal fillings in the CG and AG were compared using chi-squared and Fisher's exact tests. Multivariable logistic regression was performed to investigate the association between the independent variables (patient age, tooth type and type of treatment) and the dependent variables (density and length).Adequate length was achieved significantly more often in the AG compared to the CG for molars (p = 0.017), mandibular teeth (p = 0.013) and primary root canal treatments (p = 0.024). No significant difference was detected between the AG and CG regarding adequate length in general (p = 0.051) or adequate overall quality of root canal filling (p = 0.1). In the AG, a significant decrease in procedural errors was evident (p = 0.019) and decreases in the densities of the root canal fillings in the cervical (p = 0.01) and central (p = 0.01) thirds of the root canals were also observed. Moreover, root canals in elderly patients exhibited fewer voids (p = 0.009).Rotary root canal preparation followed by a matching-taper single-cone filling technique provides a reliable shaping of the root canal, with fewer procedural errors and a more acceptable filling quality in terms of length and homogeneity in the apical third. Less favourable results were achieved in the central and cervical parts of the root canals.The matching-taper single-cone technique seems to effectively obturate well-tapered root canals after adequate rotary instrumentation. Irregularly shaped canals require additional lateral or warm vertical condensation to avoid voids.