不同再治疗器械去除根充物效果的比较研究

目的：评价H锉、ProTaper Universal Retreatment和D-RaCe 3种根管再治疗器械去除根充物的效果。方法：将45颗因正畸拔除的单根管下颌前磨牙行根管充填后随机分为3组（n＝15）,分别用H锉（A组）、ProTaper Uni－versal Retreatment（B组）和D－RaCe（C组）再治疗锉配合氯仿溶剂去除根充物,记录到达工作长度的时间（T1）、预备完成所用总时间（T2）,收集根尖外推出物并称重,从颊舌向和近远中向拍摄数码X线片,用Auto－CAD软件测量根管壁上残留充填物的覆盖面积,并评价其占整个根管壁面积的百分比。结果：所有样本根管内均有充填物残留,A组管壁充填物的残留量最少,明显低于B、C组（P＜0．05）,C组管壁充填物的残留量最多,高于B组（P＜0．05）。与手用H锉相比,应用机用镍钛器械再治疗锉显著减少了再治疗所需的时间（P＜0．05）;B和C两组耗时无统计学差异（P＞0．05）。B组根尖外推出物最多,高于C组和A组（P＜0．05）。结论：使用机用镍钛再治疗器械,根管内残留物和根尖外推出物较多,但可缩短操作时间。     

3种器械去除椭圆形根管内充填物的效果研究

目的：研究两种镍钛器械和手用不锈钢器械去除椭圆形根管内充填物的效果。方法：45颗具有椭圆形根管的下颌前磨牙经逐步后退法预备、热牙胶垂直加压充填后随机分为3组,分别用ProTaper再治疗器械和ProTaper器械,Mtwo再治疗器械和Mtwo器械,手用H锉和K锉去除牙胶。测量各组中充填物的残留量及各个器械使用的时间。结果：手用器械组充填物的残留量百分比明显低于ProTaper组和Mtwo组,但操作时间高于ProTaper组和Mtwo组。结论：椭圆形根管内,使用机用镍钛器械可以减少操作时间,但是残留的根管充填物较多。     

两种根管再治疗镍钛器械去除椭圆形弯曲根管内充填物的效果评价

目的:评价2种根管再治疗镍钛器械去除椭圆形弯曲根管内充填物的效果。方法:离体的80颗根管呈椭圆形且弯曲的下颌前磨牙经Hero642预备、热牙胶垂直加压充填后随机分为4组,分别用ProTaper Universal、R-Endo、Hero642和手用H锉去除根充物,测量各组根充物的残留量百分比和操作时间。结果:4组样本均有根充物残留,ProTaper Universal、R-Endo和Hero642组根充物残留量百分比、操作时间均少于手用H锉组(P<0.01),前3组间的差异无统计学意义(P>0.05)。结论:ProTaper Universal、R-Endo机动镍钛器械对椭圆形弯曲根管内充填物的清除效果优于手用器械,且可减少操作时间,但仍不能彻底清除根充物。     

两种镍钛锉清除椭圆形弯曲单根管内充填物的效果评价

目的：评价两种镍钛器械清除椭圆形弯曲单根管内充填物的效果。方法75颗椭圆形弯曲单根管下颌前磨牙经Hero642镍钛器械根管预备后用热牙胶垂直加压充填,随机分为3组,分别以机用ProTaper Universal Retreatment( ProTaper UR)镍钛锉、机用Mtwo镍钛锉和手用不锈钢H锉去除根管内充填物,X线片法测量各组根管内颊舌向和近远中向根管充填物的残留量百分比,并记录操作时间。结果3组根管内均有根管充填物残留。ProTaper UR组和Mtwo组颊舌向(F=7.94,P<0.01)和近远中向(F=26.93,P<0.01)根管充填物残留量百分比、操作时间(F=37.6,P<0.01)均少于H锉组,但ProTaper UR组和Mtwo组间颊舌向(t=0.23,P=0.81)和近远中向(t=0.36,P=0.76)根管充填物残留量百分比和操作时间(t=41.35,P=0.08)的差异均无统计学意义。结论 ProTaper UR镍钛锉和Mtwo镍钛锉对椭圆形弯曲单根管内充填物的清除效果优于不锈钢H锉,且可缩短操作时间,但仍不能完全去除根管充填物。     

微焦点计算机断层扫描术评价根管再治疗中不同器械根管清理效果的研究

目的基于微焦点计算机断层扫描术（Micro-CT）数据建立人前磨牙三维模型,定量评价根管再治疗过程中2种根管预备系统根管清理的效果。方法选择因正畸治疗拔除的前磨牙40颗,采用ProTaper机用镍钛锉进行根管预备,冷牙胶侧方加压法充填根管。随机分为2组,以弹性K锉和ProTaper Universal再治疗系统分别进行根管二次预备。分别于根管充填及二次预备后进行Micro-CT扫描,计算根管内剩余充填物比例,分别对根管冠1/3、中1/3和下1/3的根管内剩余物进行评分,评价2种器械对根管充填物的清理效果。结果使用弹性K锉进行根管二次预备的平均根管内剩余物比例低于ProTaper Universal再治疗系统（P=0.005）;弹性K锉组根尖1/3清理效果优 ProTaper Universal 再治疗系统组（P<0.05）。结论弹性K锉和ProTaper Universal再治疗系统均不能完全清除根管内充填物。     

2种镍钛再治疗器械清理根管内充填材料效果比较

目的:比较Protaper Universal、R-Endo镍钛根管再治疗器械和手用H锉等3种器械在再治疗根管中对牙胶的清理能力。方法:选取60个单根管的离体下颌前磨牙,截去牙冠部统一工作长度,使用Hero 642镍钛器械预备至30#,侧方加压法完成牙胶尖和糊剂充填。样本随机分为3组,分别使用手用H锉,Protaper Universal和R-Endo清理根管内充填材料,记录操作过程引起的堵塞、台阶、穿孔等并发问题以及操作时间。随后从颊舌和近远中2个角度拍数码X线照片,使用图像分析软件分析根管壁的清洁度。结果:所有样本均有充填物残留,手用器械组管壁充填物的残留量明显低于机用镍钛2组(P<0.05),Pro-Taper Universal和R-Endo两者之间差异无显著性。和手用H锉比较,Protaper Universal和R-Endo均可减少再治疗的时间(P<0.05)。结论:所有器械均会残留根管充填物,机用镍钛器械残留的充填物较多,但可以明显减少操作时间。     

ProTaper镍钛系统去除根管内充填物的效果评价

比较ProTaper镍钛系统去除不同充填方法的根管内充填物的效果。A组:侧方加压法充填;B组:热牙胶垂直加压法充填。2组均采用ProTaper Universal再治疗器械(D1,D2,D3)+ProTaper Universal(F2,F3,F4)去牙胶及根管再预备,测量镍钛器械操作时间及根管内充填物的残留量。B组根管壁充填物残留量低于A组,镍钛器械所需时间高于A组。2组中牙胶残留物均主要位于根尖三分之一区域。ProTaper镍钛系统去除垂直加压法充填的牙胶管壁清洁度较高。     

上颌第一前磨牙根管及根管峡区再治疗的实验研究

目的：评估不同再治疗技术清理根管及峡区内根充物的效果。方法：30颗单牙根双根管的上颌第一前磨牙采用热牙胶连续波充填技术充填后分为3组去除根充物：A组,不锈钢器械（K锉和H锉）;B组,不锈钢器械（K锉和H锉）＋除丁克溶剂;C组,ProTaper再治疗器械＋除丁克溶剂。记录操作时间。各组用除丁克暂封5min,再使用Endo Activator冲洗,拍摄X线片,评价根管内根充物残留量。结果：A组操作时间显著高于B组和C组（P〈0．05）。B组和C组清洁效果优于A组。根管内暂封除丁克及使用Endo Activator冲洗后残留物显著少于器械操作即刻结束的残留物（P〈0．05）。结论：各种再治疗方法均不能彻底清除根管及峡区内的根充物,除丁克和Endo Activator有助于减少根充物残留。     

In vitro evaluation of retreatment efficacy with clinical microscope and ultrasonic instruments

目的 评价显微超声技术应用子根管再治疗中牙胶糊剂去除效果.方法 30颗下颌前磨牙,经ProTaper镍钛器械预备及牙胶糊剂侧方加压充填,保存2周.先用ProTaper镍钛再治疗器械去除根管内充填物,结束后拍摄数字化牙片(radiovisiography,RVG).再在根管显微镜下用根管超声锉继续去除根管内的残留物,治疗结束后再次拍摄RVG.分别计算颊舌侧及近远中侧根管壁充填物残留量的百分比,比较显微治疗前后管壁的清洁度.结果 ProTaper镍钛再治疗器械去除后管壁的残留物百分比颊舌侧为26％,配合显微超声治疗后为9％;近远中侧为21％,配合显微超声治疗后为7％;显微治疗前后颊舌侧及近远中侧管壁清洁度均有统计学意义上的改变(P＜0.05).结论 根管再治疗的牙胶去除过程中,显微超声技术有助于提高效率.     

不同方法去除根管内充填物的体外试验观察

目的通过体外试验比较根管内充填物的去除比率,评价不同方法去除根管内充填物的效果。方法选择因正畸需要拔除的40颗健康离体单根管前磨牙,根据试验要求预备充填后随机分为2组,实验组用ProTaper Universal再治疗锉+H锉去除根管内充填物,对照组仅用ProTaper Universal再治疗锉去除根管内充填物。处理前后进行CBCT扫描,数据用mimics软件分析,计算根管内充填物去除比率。结果实验组和对照组的根管内充填物去除比率分别为(95.15±2.56)%和(82.73±4.94)%,实验组根管内充填物去除比率高于对照组,差异有统计学意义(P<0.05)。结论在根管再治疗术中去除根管内充填物时,ProTaper Universal再治疗锉与H锉联合使用能取得更满意的效果。     

旋转镍钛器械与手用不锈钢器械去除根充物的效果评价

目的对比再治疗旋转镍钛器械与手用不锈钢器械去除根充物的效果。方法 54颗上切牙根管充填后分为三组(n=18),用不同方法去除根充物:A组:手用不锈钢锉+氯仿组;B组:ProTaper再治疗旋转镍钛组,不使用氯仿;C组:ProTaper+氯仿组。评价操作时间、氯仿用量及根充物残留。结果 B、C组操作时间短于A组(P<0.05),使用氯仿对总操作时间无影响(P>0.05),C组氯仿用量明显少于A组(P<0.01)。三组根充物总残留量无差异(P>0.05)。结论使用旋转镍钛器械去除根充物,可减少氯仿用量,缩短操作时间。     

3种机用镍钛器械去除根管内充填材料的比较研究

目的：研究3种机用镍钛器械去除根管内充填材料的能力。方法：80颗下颌第二前磨牙采用改良双敞技术预备根管,热牙胶垂直加压技术充填根管。水浴37℃2周后分为4组,去除根管内牙胶充填物：A组为H锉;B组为机用Protaper;C组为K3;D组为Hero642。记录操作时间。将牙根纵劈,显微镜下观察根管内整体及上、中、下3部分的残留物并评分。将结果进行统计学分析。结果：对于去除根管内充填物,B组所需时间最短,但B、C、D3组之间并无显著性差异;且3组均快于A组（P〈0.05）。观察牙根整体及各部分的残留物,A组残留物显著性高于其它3组（P〈0.05）,而B、C、D3组两两之间均无统计学差异。各组均无器械折断。结论：3种机用镍钛器械均不能完全去除根管内充填材料。但同H锉相比,镍钛器械去除效果更好且操作时间显著减少。     

Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment

The aim of this study was to evaluate the efficacy of the ProTaper Universal System rotary retreatment system and of Profile 0.06 and hand instruments (K-file) in the removal of root filling materials. Forty-two extracted single-rooted anterior teeth were selected. The root canals were enlarged with nickel-titanium (NiTi) rotary files, filled with gutta-percha and sealer, and randomly divided into 3 experimental groups. The filling materials were removed with solvent in conjunction with one of the following devices and techniques: the ProTaper Universal System for retreatment, ProFile 0.06, and hand instruments (K-file). The roots were longitudinally sectioned, and the image of the root surface was photographed. The images were captured in JPEG format; the areas of the remaining filling materials and the time required for removing the gutta-percha and sealer were calculated by using the nonparametric one-way Kruskal-Wallis test and Tukey-Kramer tests, respectively. The group that showed better results for removing filling materials was the ProTaper Universal System for retreatment files, whereas the group of ProFile rotary instruments yielded better root canal cleanliness than the hand instruments, even though there was no statistically significant difference. The ProTaper Universal System for retreatment and ProFile rotary instruments worked significantly faster than the K-file. The ProTaper Universal System for retreatment files left cleaner root canal walls than the K-file hand instruments and the ProFile Rotary instruments, although none of the devices used guaranteed complete removal of the filling materials. The rotary NiTi system proved to be faster than hand instruments in removing root filling materials.     

Hero Shaper镍钛机用器械去除根管旧充填物能力的体外研究

目的　研究Hero Shaper 镍钛机用根管预备器械去除根管旧充填物的能力。方法　选取临床拔除的48 个单根管前牙, 随机分为2组, 用改良式逐步后退法进行根管预备, 牙胶尖与碧兰糊剂侧方加压充填根管。放置30 d后用不同的方法去除根管旧充填物:A组为H型锉+氯仿组;B组为Hero Shaper+氯仿组;记录操作时间。将牙根纵劈,立体显微镜下观察根管冠1/3 ,中1/3 ,根1/3的残留物情况。结果　在根管的3部分,2种方法清理后的残留物量均无统计学差异(P>0.05)。B组操作时间明显少于A组,具有统计学差异(P<0 .01)。结论　根管再治疗中,使用Hero Shaper镍钛机用根管预备器械可以减少操作时间,获得和H锉相似的清理效果。     

Efficacy of ProTaper Universal rotary retreatment system for gutta-percha removal from root canals

Aim To evaluate the efficacy of the ProTaper Universal rotary retreatment system for gutta‐percha (GP) removal from root canals. Methodology Root canals of 60 extracted human maxillary anterior teeth were prepared and filled with laterally condensed GP and AH Plus sealer. Teeth were divided into three groups: group A – GP removal completed with the ProTaper Universal rotary retreatment system and with further canal repreparation accomplished with ProTaper Universal rotary instruments; group B – GP removal was completed using Gates Glidden drills and Hedström files with chloroform as a solvent, followed with further canal repreparation with ProTaper Universal rotary instruments; group C – the same as group B for GP removal with further canal preparation with stainless steel K‐flex files (Kerr). The operating time was recorded. Teeth were rendered transparent for the evaluation of the area of remaining GP/sealer in bucco‐lingual and mesial–distal directions. Statistical analysis was performed by using repeated measures analysis of variance and anova . Results The ProTaper Universal technique (group A) resulted in a smaller percentage of canal area covered by residual GP/sealer than in groups B and C, with a significant difference between groups A and C (P < 0.05). Mean operating time for group A was 6.73 min, which was significantly shorter (P < 0.05) than group B (10.86 min) and group C (13.52 min). Conclusions In this laboratory study all test techniques left GP/sealer remnants within the root canal. The ProTaper Universal rotary retreatment system proved to be an efficient method of removing GP and sealer from maxillary anterior teeth.     

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??Objective    To evaluate the efficacy of two nickel-titanium ??Ni-Ti?? instruments for root canal retreatment with or without System B heat carrier tips in removing filling material in root canals. Methods    Totally 80 extracted single-canal mandibular premolars were shaped using the K3 Ni-Ti rotary instruments with the Crown-Down technique. All teeth were obturated by the continuous wave of condensation technique and randomly divided into 4 groups. Removal of gutta-percha was performed with ProTaper Universal retreatment files and Mtwo-R respectively. All techniques were used with or without System B heat carrier tips respectively. Following data were recorded??time to reach the working length??T1?? and time required for the removal of gutta-percha??T2??. Then the teeth were vertically split and the cleanliness of the root canal walls was evaluated. Results    In the groups with or without System B heat carrier tips T1 and T2 were the least??P < 0.05??in Mtwo-R groups. In Mtwo-R and ProTaper Universal groups with System B heat carrier tips T1 and T2 were less than those without System B heat carrier tips??P < 0.05??. The differences of cleanliness of the root canal walls were not significant in all groups with or without System B heat carrier tips??P > 0.05??. Conclusion    System B heat carrier tips may be of some help in increasing the speed of removal of gutta-percha from root canal??but can not improve the canal cleanliness in the application of Mtwo-R and ProTaper Universal retreatment instruments. Mtwo-R groups have better work efficiency than ProTaper Universal groups.     

显微超声技术应用于根管再治疗中牙胶去除的体外评价

目的评价显微超声技术应用于根管再治疗中牙胶糊剂去除效果。方法 30颗下颌前磨牙,经Pro-Taper镍钛器械预备及牙胶糊剂侧方加压充填,保存2周。先用ProTaper镍钛再治疗器械去除根管内充填物,结束后拍摄数字化牙片(radiovisiography,RVG)。再在根管显微镜下用根管超声锉继续去除根管内的残留物,治疗结束后再次拍摄RVG。分别计算颊舌侧及近远中侧根管壁充填物残留量的百分比,比较显微治疗前后管壁的清洁度。结果 ProTaper镍钛再治疗器械去除后管壁的残留物百分比颊舌侧为26%,配合显微超声治疗后为9%;近远中侧为21%,配合显微超声治疗后为7%;显微治疗前后颊舌侧及近远中侧管壁清洁度均有统计学意义上的改变(P<0.05)。结论根管再治疗的牙胶去除过程中,显微超声技术有助于提高效率。     

Comparison of debris extruded apically and working time used by ProTaper Universal rotary and ProTaper retreatment system during gutta-percha removal

Objective

The aim of this study was to evaluate the in vitro action of ProTaper retreatment files and ProTaper Universal in the retreatment of mandibular premolars.

Material and methods

The amount of debris extruded apically was measured and the time to reach the working length and to complete the removal of gutta-percha was observed. Thirty teeth had their canals prepared using ProTaper Universal files and were obturated by the single cone technique. The teeth were then stored at 37ºC in a humid environment for 7 days. During the use of the rotary instruments for root canal filling removal, the apical portions of the teeth were attached to the open end of a resin tube to collect the apically extruded debris.

Results

ProTaper Universal files were significantly faster (p=0.0011) than the ProTaper retreatment files to perform gutta-percha removal, but no significant difference was found between the files regarding the time to reach the working length or the amount of apical extrusion.

Conclusions

ProTaper Universal rotary had better results for endodontic retreatment, and both techniques promote similar apical extrusion of debris.     

Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment

The purpose of this study was to evaluate the efficiency of FlexMaster, ProTaper, and RaCe rotary instruments compared with Hedstr?m files for removal of gutta-percha during retreatment. Sixty mandibular premolars with one single straight canal were instrumented with K-type files and filled using cold lateral compaction and sealer. The teeth were randomly divided into four groups of 15 specimens each. After repreparation with Gates Glidden burs and the test instruments the specimens were cleared. The area of remaining gutta-percha/sealer on the root canal wall was measured from two directions. The RaCe group showed significantly less residual obturation material than FlexMaster and Hedstr?m group (p < 0.05; closed test procedure). There was no difference between ProTaper and all other instruments (p > 0.05). ProTaper and RaCe instruments required significantly less time for retreatment than FlexMaster and Hedstr?m files (p < 0.05). One RaCe file, two ProTaper, and two FlexMaster instruments separated. RaCe cleaned obturated canals more effectively than hand files and FlexMaster files.