Reciproc镍钛器械在下颌第一磨牙根管治疗的临床病例研究

发布时间：2018-03-08 11:53

本文选题：下颌第一磨牙　切入点：Reciproc单支锉　出处：《吉林大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：本文以病例报道的形式探讨单支锉Reciproc镍钛旋转器械在根管治疗下颌第一磨牙根管系统中疗效评价。方法：收集下颌第一磨牙患急，慢性牙髓炎及牙髓坏死，急性根尖周炎的临床病例10例，拍摄术前X线片，确认根管系统由MB、ML、D三个根管组成。常规制备开髓洞型，并使用小球钻去除覆盖在根管口的牙本质悬突，使髓室底完全暴露，建立器械进入根管的冠方直线通道。常规拔髓、清理髓腔。冲洗髓腔，吹干使髓室底视野清晰。术中使用DG16根管口探针探查根管口，使用10#、15#C锉疏通根管，ROOT ZX根管长度定位仪结合X线片确定根管内工作长度，17%乙二胺四乙酸（EDTA）凝胶结合单支Reciproc锉镍钛旋转器械进行根管预备，，预备时采用上下提拉式预备根管；提拉幅度不要超过3mm；提拉次数不超过3次；预备时不要产生根向压力。2%氯己定+3%过氧化氢+0.9%氯化钠交替冲洗根管，使用P5超声荡洗清理根管预备过程中产生的牙本质碎屑及沾污。干燥根管后根管内导入氢氧化钙糊剂，一周后复诊。患者复诊时无症状采用热牙胶连续波垂直加压技术充填根管。拍摄术后X线片，评价其疗效。结果：在收集的10例下颌第一磨牙临床病例全部探通。经过Reciproc锉进行根管预备后并充填，所有患牙均得到很好的治疗效果。结论： Reciproc锉作为单根锉，在牙髓炎、牙髓坏死及根尖周炎等病例中均可以安全有效的进行根管预备。下颌第一磨牙由于存在多种根管数目及复杂的根管形态，增加了在临床中进行根管治疗难度，使用Reciproc锉镍钛旋转器械结合EDTA凝胶预备根管，同时应用2%氯已啶溶液冲洗根管及严密充填根管，可以获得下颌第一磨牙良好的根管治疗效果。
[Abstract]:Objective:. A case study was conducted to evaluate the efficacy of single file Reciproc nickel titanium rotary instrument in the treatment of mandibular first molar root canal system. Methods:. Ten clinical cases of acute, chronic pulpitis, pulp necrosis and acute periapical periodontitis of the first molar of the mandible were collected. X-ray films were taken before operation to confirm that the root canal system was composed of three root canals of MBN MLD. The dentine suspensions covered in the root canal were removed with a small ball drill, and the pulp chamber floor was completely exposed. A coronal straight passage of the instrument into the root canal was established, and the pulp cavities were routinely pulled out, the pulp cavities were cleaned, and the pulp cavities were flushed. DG16 root canal probe was used to explore the root canal orifice. The working length of root canal was determined by using 10 #C file and root ZX root canal length locator combined with X ray slice to determine the working length of root canal. The preparation of root canal was performed with 17% ethylenediamine tetraacetic acid (EDTA) gel combined with single Reciproc file nickel titanium rotary instrument, and the root canal was prepared with upper and lower lifting type. No more than 3 mm in range of Czochralski; no more than 3 times of pulling; do not produce root pressure of .2% chlorhexidine 3% hydrogen peroxide 0.9% sodium chloride alternately flushing root canal during preparation, Using P5 ultrasonic wash cleaning root canal preparation process produced by dentin debris and contamination. Dry root canal back root canal introduction of calcium hydroxide paste, A week later, the patients were treated with continuous wave vertical compression of hot gum to fill the root canal. X ray film was taken after operation to evaluate the curative effect. Results:. All the 10 cases of mandibular first molar were treated with Reciproc file after root canal preparation and filling. Conclusion:. As a single file, Reciproc file can be used to prepare root canal safely and effectively in pulpitis, pulp necrosis and periapical periodontitis. It increased the difficulty of root canal therapy in clinic. The root canal was prepared with Reciproc file nickel titanium rotary instrument combined with EDTA gel. The root canal was washed with 2% chlorhexidine solution and the root canal was filled tightly. Good root canal therapy can be obtained for mandibular first molar.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.05

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