牙胶尖对机用镍钛器械预备弯曲根管的适应性的评价

发布时间：2019-01-23 12:23

【摘要】：在实际临床操作中我们发现，大部分根管都存在着不同程度的弯曲。随着根管弯曲程度的加大，根管预备困难增加，出现器械分离、侧壁穿孔、台阶、原有根管形态改变的可能性增加，同时根管充填的困难也相应增加。而根尖1/3的封闭是根管治疗取得成功的关键。根管微渗漏的大小反映根管充填材料对根管的封闭能力。在根尖部根管的偏移率增大，可能会增加根管充填后的根尖孔微渗漏。因此，弯曲根管的预备和充填一直是临床上操作的难点之一。由于弯曲根管预备后形成的三维结构较直根管更复杂，使得根管充填材料对弯曲根管的根管壁不能完全贴合，本研究旨在找到最佳的预备号数和锥度，使得牙胶尖对弯曲根管的根管壁适应性最佳，为临床治疗提供指导意义。 目的：评价牙胶尖对机用镍钛器械预备弯曲根管的适应性，探讨牙胶尖与弯曲根管根管壁的适应性的最佳效果。 方法：将塑料弯曲根管模型随机分为8组，其中4组为MTwo组、4组为Sendoline组，分别预备至0.06/20#、0.06/25#、0.04/35#、0.04/40#和0.04/20#、0.04/25#、0.04/30#、0.06/30#。单尖法充填根管，静置一周，将模型的根尖孔以上1、2、3、4和5mm处垂直于模型长轴方向用慢速切割机横切，，并用显微镜照相，绘图软件测量各截面牙胶尖的充填率及糊剂的最大宽度。 结果：距根尖孔1mm处，牙胶尖的充填率最小，越接近根管口，充填率越大，距根尖孔5mm处，各组根尖部充填率均为最大值。随号数的增大，充填率减小，糊剂的宽度增大，当根管预备的号数≤30#时，差异无统计学意义（P0.05）；≥30#时，与0.04/30#组比较，0.04/35#组和0.04/40#组根尖部充填率减小（P0.05）；与0.04/35#组比较，0.04/40#组根尖部充填率减小，在1mm和4mm处差异有统计学意义（P0.05），在2mm、3mm和5mm处差异无统计学意义（P0.05）。与0.04/30#组比较，0.04/35#组根尖部糊剂的宽度增大，在1mm、2mm和3mm处差异无统计学意义（P0.05），在4mm和5mm处差异有统计学意义（P0.05），0.04/40#组根尖部糊剂的宽度增大，在1mm、2mm、4mm和5mm处差异有统计学意义（P0.05），在3mm处差异无统计学意义（P0,05）；与0.04/35#组比较，0.04/40#组根尖部部糊剂的宽度增大，在1mm处差异有统计学意义（P0.05），在2mm、3mm、4mm和5mm处差异无统计学意义（P0.05）。0.04锥度组比0.06锥度组相同号数充填率大、根尖部糊剂的宽度小，但差异无统计学意义（P0.05）。 结论：根管预备终末号数≤30#时，牙胶尖对根管壁的适应性最佳，充填效果最好。
[Abstract]:In clinical practice, we found that most root canals have varying degrees of curvature. With the increase of root canal bending degree, the difficulty of root canal preparation increased, the possibility of instrument separation, lateral wall perforation, step, and root canal shape change increased, and the difficulty of root canal filling increased accordingly. A third of the apical closure is key to the success of root canal therapy. The microleakage of root canal reflects the sealing ability of root canal filling material. The increase of root canal deviation may increase the microleakage of root canal after root canal filling. Therefore, the preparation and filling of curved root canal is always one of the difficulties in clinical operation. Because the three-dimensional structure formed by curved root canal preparation is more complex than that of straight root canal, the root canal filling material can not completely fit the root canal wall of curved root canal. The purpose of this study is to find out the best preparation number and taper. The canaliculus tip has the best adaptability to the curved root canal wall, which provides guidance for clinical treatment. Objective: to evaluate the adaptability of gum tips to the preparation of curved root canals with machine-used nickel-titanium instruments, and to explore the best effect of the adaptation of gum tips and curved root canal walls. Methods: the plastic curved root canal model was randomly divided into 8 groups: MTwo group (n = 4) and Sendoline group (n = 4). 0.04/25#,0.04/30#,0.06/30#. The root canal was filled with a single tip method, and the root canal was statically set for one week. Perpendicular to the long axis of the model, the above apical foramen of the model was cut perpendicular to the long axis of the model with a slow cutting machine, and a microscope was used to photograph the root canal. The filling rate and the maximum width of paste were measured by drawing software. Results: the filling rate of gum tip was the smallest from apical foramen to 1mm. The closer the root canal orifice, the greater the filling rate was, and the maximum filling rate was from 5mm to apical foramen. With the increase of the number, the filling rate decreased, the width of paste increased, when the number of root canal preparation 鈮

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