K3XF机用镍钛系统预备根管的临床疗效研究

发布时间：2018-03-17 05:38

  本文选题：根管预备　切入点：K3XF机用镍钛系统　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：本文通过病例报告的形式将K3XF机用镍钛系统与手用不锈钢K锉预备根管的疗效进行对比，观察根管治疗期间急症(IAE)发生率及疼痛程度情况，为K3XF机用镍钛系统的使用提供一定的临床依据。 方法：依就诊次序，将纳入研究的40例牙髓炎患者，随机分为实验组和对照组，每组各20例。全部病例身体健康，就诊前均未接受任何治疗，要求能够配合治疗，且经过临床口内检查和辅助检查确诊为牙髓炎，X线显示无钙化根管，同时排除急性根尖周炎、重度牙周病和牙隐裂等疾病，防止影响后期疗效的评价。两组患牙采用的根管治疗方法均为多次法。患牙拍术前X线片，局麻下去净腐质，制备开髓洞型，探寻根管口，，清除已感染的病变牙髓，3%过氧化氢和0.9%生理盐水彻底冲洗。10#或15#手用不锈钢K锉探查并建立每个根管通道，通过根管测量仪联合比对X线片确定工作长度。实验组：使用K3XF机用镍钛系统结合冠向下法预备根管。对照组：手用不锈钢K锉常规法预备根管。每更换一次器均使用3%过氧化氢和0.9%生理盐水彻底冲洗，预备结束，棉卷隔湿，纸尖吸干管腔，导入氢氧化钙消毒，牙胶条和氧化锌双层暂封一周。嘱患者如果有疼痛或肿胀情况发生，立即就诊治疗。若症状轻微，则可以考虑重新更换封药；若有严重症状出现，如疼痛加重，局部肿胀等情况发生时，则及时行CP棉球开放引流，带症状消退后，重新封药。一周后复诊，记录患牙根管预备后疼痛发生情况。在患者无不适，无明显叩痛，无大量渗出的前提下，去除原封存，3%过氧化氢和0.9%生理盐水彻底冲洗，棉卷隔湿，纸尖吸干管腔，导入氧化锌碘仿糊剂，用牙胶尖侧方加压充填严密。 结果：在IAE发生率方面，实验组IAE发生率是5%，对照组IAE发生率是35%，两组IAE发生率差异具有统计学意义（P0.05）；在疼痛程度方面，两组在疼痛程度为Ⅱ级时差异具有统计学意义（P0.05），实验组优于对照组。在疼痛程度为0级、Ⅰ级和Ⅲ级时差异无统计学意义（P0.05）。 结论：通过使用K3XF机用镍钛系统与手用不锈钢K锉预备根管，显示K3XF机用镍钛系统在IAE发生率及疼痛程度为Ⅱ级方面明显低于手用不锈钢K锉。在临床使用中，K3XF机用镍钛系统有较好的发展前景。
[Abstract]:Objective: to compare the curative effect of K3XF machine nickel titanium system with hand stainless steel K file in root canal preparation by case report, and to observe the incidence of acute disease and the degree of pain during root canal therapy. To provide certain clinical basis for the use of K 3 XF machine nickel titanium system. Methods: 40 patients with pulpitis were randomly divided into experimental group and control group with 20 cases in each group. In addition, the diagnosis of pulpitis by clinical intraoral examination and auxiliary examination showed that there were no calcified root canals on X-ray, and acute periapical periodontitis, severe periodontal disease and tooth cleft were excluded. Two groups of teeth were treated with multiple methods of root canal treatment. X-ray films were taken before operation, local anaesthesia was used to purify rot, pulp opening cavity was prepared, and root canal orifice was explored. Remove 3% hydrogen peroxide and 0.9% normal saline from infected pulp and thoroughly flush .10# or 15# hand stainless steel K file to explore and establish each root canal, The working length was determined by the combination of root canal measuring instrument and X ray film. Experimental group: root canal was prepared by using K3XF machine with nickel-titanium system combined with crown down method. Control group: hand stainless steel K file routine method for root canal preparation. All of them were washed thoroughly with 3% hydrogen peroxide and 0.9% normal saline. At the end of preparation, the cotton is wetted, the paper tip absorbs the tube cavity, the calcium hydroxide is introduced into the cavity, the dental gum strip and zinc oxide are temporarily sealed for a week. If there is pain or swelling, the patient is advised to see a doctor immediately for treatment. If the symptoms are mild, If there are serious symptoms, such as aggravated pain, local swelling, and so on, the CP cotton ball should be opened and drained in time. After the symptoms have subsided, the medicine can be re-sealed. A week later, the doctor will return to the hospital. To record the occurrence of pain after root canal preparation. On the premise of no discomfort, no obvious percussion pain, no exudation, 3% hydrogen peroxide and 0.9% normal saline were removed from the original seal, the cotton was wetted, and the paper tip was sucked. Introduce zinc oxide iodoform paste and fill tightly with gum tip side pressure. Results: in the incidence of IAE, the incidence of IAE in the experimental group was 5 and the incidence of IAE in the control group was 35. The difference between the two groups in the incidence of IAE was statistically significant (P 0.05). The difference between the two groups was statistically significant when the pain degree was grade 鈪

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