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4种冲洗方法对弯曲根管玷污层影响的体外研究

马艳华,殷恺   

  1. 天津医科大学一中心临床学院
  • 收稿日期:2013-11-29 修回日期:2014-01-25 出版日期:2014-05-15 发布日期:2014-05-15
  • 通讯作者: 殷恺

In vitro Study of Four Endodontic Irrigation Protocols on Smear Layer Removal in Curved Canals

  • Received:2013-11-29 Revised:2014-01-25 Published:2014-05-15 Online:2014-05-15

摘要:    【摘要】目的 研究有效去除弯曲根管玷污层的冲洗方案。方法 选取40颗近中根管弯曲的下颌第一磨牙,截冠。手用ProTaper根管锉预备近颊根管至F3后,依最终冲洗方法不同随机分为4组,A组:注射器冲洗;B组:#30K锉提拉冲洗;C组:被动超声冲洗(passive ultrasonic irrigation,PUI);D组:#30K锉提拉冲洗+PUI,超声锉位于弯曲起始处冠方0.5 mm内。沿根管近远中向劈开,并在弯曲起始处、弯曲起始处以下2 mm处刻痕,将根管分为三部分,由冠方及根方分别为Ⅰ、Ⅱ、Ⅲ。扫描电镜下观察各部分根管壁玷污层。结果 在各处根管壁,D组均为少量、散在的或者薄的玷污层,分值最低。在Ⅰ、Ⅱ处,D组与C组玷污层评分差异无统计学意义,但均低于A、B组(P<0.05);在Ⅲ处,D组低于A、B、C组,B、C组低于A组(均P<0.05)。 结论 超声锉位于弯曲起始处冠方时,采用与根尖预备大小相同的K锉提拉和PUI能有效去除弯曲根管的玷污层。

关键词: 根管制备, 弯曲根管, 玷污层, 根尖预备, 被动超声冲洗

Abstract:    [Abstract] Objective To research effective endodontic irrigation protocols on smear layer removal from curved canals.Methods Forty mandibular first molars with curved mesial root canal were selected,decoronated. Mesiobuccal root canal was instrumented to F3 using handed Protaper system,and randomly divided into four groups according to final irrigation protocols. They are group A:syringe irrigation;group B:#30K File agitation;group C:passive ultrasonic irrigation (PUI);group D:combination of #30K File agitation and PUI. Ultrasonic file was located within 0.5mm coronally from start of the curvature. All root canal were mesio-distally split,snicked at start of the curvature and 2mm apically from start of the curvature ,and divided into three sections.They are Ⅰ,Ⅱ,Ⅲfrom coronally to apically. Smear layer of each section of root canal was examined under scanning electron microscope(SEM). Result Group D presented small amounts of scattered or thin smear layers and obtaind the lowest score at each section of root canal wall. At sectionⅠandⅡ,there was not significant difference for smear layer score between Group D and Group C ,and they were both lower than Group A,B(P<0.05); At section Ⅲ, Group D showed lower score than Group A,B,C, while Group B,C were lower than Group A (P<0.05). Conclusion When ultrasonic file was located coronally from start of the curvature, to apply K File which was the same size as dimension of apical portion preparation to agitate and PUI can remove smear layer from curved canals efficiently.

Key words:  root canal preparation, curved canals, smear layer, apical portion preparation, passive ultrasonic irrigation