往复运动器械与连续旋转器械造成牙本质微裂的系统评价及应用研究

发布时间：2018-04-14 23:14

本文选题：WaveOne + Reciproc　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:本研究第一部分通过采用系统评价及Meta-分析的研究方法,探讨两种往复运动器械Wave One和Reciproc与连续旋转器械Pro Taper完成根管预备后造成牙本质微裂的差异,从而为根管器械进一步改进和临床医师的工作提供参考意见。本研究第二部分根管预备前首先建立直线通道并预敞根管口,之后比较两种往复运动器械Wave One和Reciproc与传统的连续旋转器械Pro Taper根管预备后造成牙本质微裂的差异情况。方法:本研究第一部分首先制定了中英文检索策略以及详尽的纳入与排除标准,之后通过计算机检索Pub Med、OVID、Springer Link、Cochrane Library、Science Direct、中国知网、万方数字化全文数据库、中文科技期刊数据库、中国生物医学数据库自建库至2016年10月期间公开发表的相关随机对照试验(RCTs)的文献,仔细筛选文献、客观评价研究质量,最终将符合纳入标准的研究导入Rev Man5.3软件中,由两名研究员独立提取数据并进行统计分析。本研究第二部分收集新鲜拔除的60颗下颌前磨牙,按随机数字法将样本随机分为A、B、C、D 4个组(n=15):A组为空白对照组,不进行根管预备;B组Pro Taper组,根管序列预备至F2;C组Wave One组,使用Primary(#25/.08)预备根管;D组Reciproc组,使用R25(#25/.08)预备根管。实验组根管预备前均使用Pathfile建立顺畅的直线通道并使用开口锉Sx预敞根管口。根管预备完成后距根尖3mm、6mm、9mm处做标记,使用硬组织切片机垂直牙体长轴在标记处水平截断,体视显微镜下放大25倍观察和记录各组样本不同横断面的裂纹类型及数目。结果:第一部分通过计算机检索中英文数据库,经严格筛选,总共有14篇文献纳入研究,试验组(往复运动器械组)共350支,其中Wave One185支,Reciproc165支;对照组(Pro Taper组)225支。Meta-分析结果显示:(1)两种往复运动器械总体与Pro Taper相比根管预备后所造成的牙本质微裂纹数目差异无统计学意义[RR=1.00,95%CI(0.75,1.32),P=0.99];(2)往复运动器械Wave One根管预备后造成牙本质微裂纹数与Pro Taper差异无统计学意义[RR=0.74,95%CI(0.51,1.07),P=0.11];(3)往复运动器械Reciproc较Pro Taper根管预备后产生的牙本质微裂纹数目多,差异有统计学意义[RR=1.47,95%CI(1.10,1.97),P=0.01];(4)往复运动器械中Wave One根管预备完成后造成牙本质微裂纹数目比Reciproc少,差异有统计学意义[RR=0.74,95%CI(0.57,0.96),P=0.02];(5)两种往复运动器械总体较Pro Taper根管预备后造成有微裂纹的牙根数少,差异有统计学意义[RR=0.34,95%CI(0.23,0.50),P0.00001]。第二部分结果显示对照组未发现任何类型的牙本质微裂纹产生,往复运动器械Wave One和Reciproc与连续旋转器械Pro Taper根管预备后造成牙本质微裂方面差异无统计学意义(P0.05)。往复运动器械Wave One和Reciproc根管预备所需时间明显短于Pro Tape,差异有统计学意义(P0.05),Reciproc根管预备所用时间最短,但与Wave One相比差异无统计学意义(P0.05)。结论:1、往复运动器械Wave One与连续旋转器械Pro Taper相比不增加牙本质微裂发生风险,两种往复运动器械中,Wave One较Reciproc根管预备后在造成牙本质微裂方面安全性更高。由于研究对象、测量方法的差异导致各亚组所纳入文献数目较少,希望今后通过更大样本量的高质量的随机对照试验来进一步验证本次系统评价的结果。2、往复运动器械Wave One和Reciproc根管预备时间短,较连续旋转器械Pro Taper相比临床操作更加简便,且不增加牙本质微裂发生风险。
[Abstract]:Objective: the first part of this study by adopting the research method of system evaluation and Meta- analysis, discusses two kinds of reciprocating motion device Wave One and Reciproc Pro Taper with continuous rotary instruments to complete root canal dentin differences caused by micro crack, so as to provide reference for further improvement and clinical work for root canal instruments on the second. Part of the root canal preparation before the first set up the linear channel and pre open orifice after the comparison of two kinds of Wave devices and Reciproc One reciprocating motion with the traditional continuous rotary instruments Pro Taper root canal dentin micro crack caused by difference. Methods: the first part of this study was first made in English retrieval strategy and detailed inclusion and the exclusion criteria, followed by Med OVID, the computer retrieval Pub, Springer Link, Cochrane Library, Science Direct, China CNKI, Wanfang digital full-text database, Chinese scientific journal database, relevant randomized controlled trials China biomedical databases from published up to October 2016 (RCTs) literature, carefully screening literature, objective evaluation of the quality of the final, will meet the inclusion criteria of the research into Rev Man5.3 software, conducted by two researchers independently extracted data and statistical analysis of the second part of this study. Collect 60 freshly extracted mandibular premolars, the samples were randomly divided into A, B, C randomly, D group 4 (n=15): A group was the control group, no root canal preparation; B group Pro group Taper, root canal preparation sequence to F2; C group Wave group One the use of Primary (#25/.08), root canal preparation; D group, Reciproc group, R25 (#25/.08) in root canal preparation. The experimental group root canal preparation were established using the Pathfile linear channel smooth and use open file Sx pre open mouth. Root canal root canal after the completion of the apical 3mm 6mm, mark 9mm, the use of hard tissue slicing machine perpendicular to the tooth axis at the mark level truncation, stereo microscope magnified 25 times to observe and record the specimens in different sections of the crack type and number. Results: the first part English database retrieval by computer, the strict screening, a total of 14 papers are included in the study and the test group (reciprocating equipment group) with a total of 350, including Wave One185, Reciproc165; the control group (Pro Taper group) 225.Meta- analysis results showed that: (1) no significant number of [RR=1.00,95%CI micro cracks caused by two kinds of dental instruments in general and Pro Taper reciprocating motion phase root canal. The difference (0.75,1.32), P=0.99] (2); the reciprocating motion device Wave One root canal dentin caused by micro crack number and Pro Taper had no significant difference between [RR=0.74,95%CI (0.51,1.07), P=0.11] (3); the reciprocating motion device Rec The number of micro cracks in dentin iproc than Pro Taper after root canal preparation produced, there was a significant difference between the [RR=1.47,95%CI (1.10,1.97, P=0.01]); (4) caused by the number of micro cracks in dentin is less than Reciproc Wave One root canal preparation equipment in reciprocating motion, the difference was statistically significant (0.57,0.96), P=0.02] [RR=0.74,95%CI; (5) two kinds of instruments are generally Pro Taper reciprocating motion after root canal preparation caused by micro crack root number was less, the difference was statistically significant (0.23,0.50, [RR=0.34,95%CI) P0.00001]. second shows some results were not found in any type of dentin micro cracks, the reciprocating motion device Wave and Reciproc with One continuous rotary instruments Pro Taper root canal dentin caused by micro crack was no statistically significant differences (P0.05). Wave One and Reciproc instruments reciprocating motion of root canal preparation required time was significantly shorter than Pro Tape, difference There was statistical significance (P0.05), Reciproc root canal preparation with the shortest time, but Wave and One had no significant difference (P0.05). Conclusion: 1. Wave One and continuous reciprocating motion device Pro Taper rotary instruments do not increase the risk of dentin micro crack, two kinds of reciprocating devices, Wave One compared with Reciproc after root canal preparation in dentin caused by micro crack safety higher. As the research object, different measurement methods lead to various subgroups in literature are limited in number, hope that through high quality RCTs with larger samples to further verify the evaluation results of.2 reciprocating motion device Wave One and Reciproc in root canal preparation time is short, compared with the continuous rotary instruments Pro Taper compared the clinical operation more convenient, and does not increase the risk of dentin micro crack.

【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R781.05

【参考文献】