2种不同根管预备技术与牙根纵折的原因分析

目的:探讨根管治疗术后牙根纵折的发生与不同根管预备技术的相关性,为临床治疗提供依据。方法:对2年间共1702颗(例)牙根管治疗术后病例进行调查,将其按根管预备技术分为镍钛旋转预备技术组(643例)和手用不锈钢预备技术组(1059例)。通过临床症状、体征和影像学结果进行评估。采用SPSS11.5软件包对数据进行统计学分析。结果:共发生牙根纵折32例(1.88%);镍钛旋转器械预备组牙根纵折率显著高于手用不锈钢器械预备组(P<0.01);镍钛旋转器械预备组根管再治疗的牙根纵折率显著高于手用不锈钢器械预备组(P<0.01),但2组的根管桩核修复病例的牙根纵折率无显著差异(P>0.05)。结论:镍钛旋转器械预备技术与术后根折并发症密切相关,如合并根管再治疗史和(或)根管内桩核修复,牙根纵折的风险更大。

Analysis of vertical root fracture with two different techniques of root canal preparation

PURPOSE: To investigate the relationship of vertical root fracture(VRF) after root canal treatment with two different technique of root canal shaping and provide clinical reference.METHODS: 1702 teeth treated with root canal treatment during recent 2 years.All teeth were divided into two groups according to different techniques of root canal shaping: 643 teeth were prepared with NiTi rotary preparation technique(NRPT) and 1059 teeth were prepared with stainless steel hand K-files preparation technique(SSPT).The clinical symptoms and signs,radiological findings were estimated.The data was analyzed by SPSS 11.5 software package.RESULTS: There were 32 teeth with vertical root fracture,the VRF rate was 1.88%.The VRF rate in NRPT group was significantly higher than in SSPT group(P<0.01).The VRF rate with retreatment history in NRPT group was significantly higher than in SSPT group(P<0.01),but The VRF rate with post and core restoration in both NRPT and SSPT groups was not significantly different(P>0.05).CONCLUSIONS: NiTi rotary preparation technique(NRPT) was closely related with vertical root fracture(VRF).And the VRF risk would be even higher if the tooth underwent root canal retreatment case or a post-core was placed in the root canal.