手用ProTaper镍钛器械预备弯曲根管的临床研究

目的:观察手用ProTaper镍钛器械预备弯曲根管的临床效果。方法:117例患者分为两组,手用ProTaper镍钛(PT)组59例,采用手用ProTaper镍钛器械预备根管,不锈钢K型根管锉(SS)组58例,采用改良双敞法预备根管。记录操作时间、器械折断情况、根管偏移发生情况、术后疼痛的发生、根管充填效果。结果:根管预备时间PT组为(5.59±1.66)min,SS组为(11.88±2.36)min;断针率PT组为3.39%,SS组为0;根管偏移率PT组为3.39%,SS组为17.24%;根充术后疼痛率PT组为5.08%,SS组为20.69%。结论:用手用ProTaper预备弯曲根管成形效果好,操作时间短,能很好地维持根管的走向和弯曲度,极少发生根管偏移等并发症,与目前较常用的K锉/改良双敞法相比有着明显的优势,可作为临床上预备弯曲根管的有效方法。但要注意预防因器械疲劳造成的折断,在形态复杂的根管中须小心操作。     

3种器械预备根管后根尖偏移的比较研究

目的:采用改良M aggiore模型,比较不锈钢K锉(SS)、手用ProTaper、机用K3预备根管后的根尖偏移。方法:选取近颊根管最大弯曲度在10°以上的下颌第一磨牙51颗,随机分成3组:SS组,手用ProTaper组,机用K3组。采用改良M aggiore模型并结合特制的夹具和RVG数字成像系统,获得样本在最大弯曲度位置时预备前后的X线影像。用AutoCAD软件进行图象处理,评价在距器械尖断0.5、1、2、3、4、5 mm处各组根尖偏移量的差别。采用方差分析法分析数据。结果:手用ProtTaper组和机用K3组的根尖偏移值在统计学上无显著性差异(P>0.05)。在距根尖0.5、1、4、5 mm处SS组偏移值较大,与ProTaper和K3组在统计学上有显著性差异(P<0.05)。结论:Pro-Taper和K3预备弯曲根管时能较好地保持原有根管的形态,无明显偏移;而不锈钢K锉预备时偏移较为明显。     

两种镍钛器械联合预备弯曲根管的效果评价

目的：评价联合使用K3和TF两种不同镍钛器械预备弯曲根管的效果。方法：选择离体下颌前磨牙及磨牙各40颗,依根管弯曲度分为轻度及中重度弯曲组,每组再随机分为两组,分别采用K3联合TF、单独K3进行根管预备。记录并分析各组单根管预备时间、并发症、根管直化角度、器械中心定位能力。结果：轻度弯曲组采用K3联合TF进行根管预备仅预备时间明显短于K3组（P<0．05）;中重度弯曲组采用K3联合TF进行根管预备,预备时间、术中并发症、根管直化角度、自根尖孔1～4 mm观测点的器械中心定位能力与K3组相比均有统计学差异（ P<0．05）。结论：K3联合TF预备弯曲根管,可节省操作时间,减少并发症,更好地维持根管原有形态,尤其适用于中重度弯曲根管的预备。     

两种镍钛器械预备根管的临床研究

目的比较两种机用镍钛器械Twisted Files（TF）和Protaper预备根管的临床效果。方法患牙髓炎或根尖周炎需进行根管治疗的患牙60颗,随机分为2组,分别使用TF锉（TF组）和Protaper锉（P组）采用根向技术预备根管,2组均采用热牙胶垂直加压充填根管。比较2组根管预备的成形效果、预备时间、预备前后工作长度、预备术后疼痛评分。结果 2组均能形成较好的根管流畅度,预备前后的锥度评价比较,差异无统计学意义（χ2=1.381,P=0.240）;预备时间P组为12.24 min,TF组为8.69 min,TF组的预备时间短于P组（F=60.18,P〈0.001）;两组预备前后工作长度差值P组为（0.09±0.46）mm,TF组为（0.20±0.33）mm,差异无统计学意义（t=1.06,P=0.29）,预备后2组疼痛评分差异无统计学意义（Z=-0.72,P=0.47）。结论 TF锉和Protaper锉均有良好的根管预备能力,TF锉预备时间较短,切割效率较高。     

机用镍钛器械预备清理根管效果的定量分析

目的:比较机用镍钛根管预备器械ProFile与手动器械对弯曲根管的清理效果.方法:3组弯曲根管分别进行ProFile、手动不锈钢RT锉、NiTiflex锉预备.立体显微镜下观察根管纵截面并采用图象分析软件Scion Image 1.62定量分析根管碎屑分布比例与根尖栓塞的形成.结果:ProFile组碎屑指数小于其他两组;碎屑栓发生率各组无显著性差异,但与根管弯曲部位相关.结论:ProFile器械采用冠根向深入法对弯曲根管碎屑的清理优于手动器械,但仍应注意弯曲位于根尖1/3段者易发生根尖阻塞.     

镍钛与不锈钢器械预备根管的比较研究

目的:观察比较手用不锈钢锉和镍钛合金机用锉预备根管的临床效果。方法:选择牙髓炎需进行去髓术的病人384例,随机分成手用不锈钢锉预备根管组(不锈钢组)、镍钛合金机用锉预备根管组(镍钛组)各192例,比较观察2组器械预备根管的临床效果。结果:①镍钛组预备后根尖偏移、根尖孔敞开等不良结果比不锈钢组显著减少(P<0.001)。②镍钛组平均弯曲度为28.8°±8.5°,显著高于不锈钢组平均弯曲度21.5°±5.5°(P<0.001)。③镍钛组预备根管的时间平均为(20.5±2.5)min,显著少于不锈钢组(30.5±5.5)min(P<0.001)。结论:应用镍钛合金机用锉预备根管,成形效果好,并发症少,操作时间短,具有良好的临床应用前景。     

两种根管器械预备后牙根管的体会

目的：比较不锈钢K锉（SS）,ProTaper手用镍钛锉（PT）,预备后牙根管的临床效果。方法：选取需做根管治疗的前磨牙、磨牙110颗,随机分为两组,每组55颗牙。PT组用ProTaper手用镍钛锉冠向下预备技术预备根管。SS组用不锈钢K型锉逐步后退技术预备根管。两组均采用标准牙胶尖侧向加压技术进行根管充填。记录两组根管预备所需时间和根管充填后的效果,进行统计学分析。结果：PT组单根管预备所需时间（6.17±1.31）min,明显低于SS组（13.22±2.32）min,（P〈0.05）,PT组根管适充率（90.91%）,明显高于SS组（70.91%）,（P〈0.05）。两组比较差异有统计学意义。结论：ProTaper手用镍钛锉在后牙根管预备中有明显的优越性,省时省力,具有良好的成形能力和根管清理效果,适充率高。     

手用ProTaper镍钛器械根管清理效果的扫描电镜研究

目的评价新型镍钛根管预备器械——手用ProTaper预备后牙根管的效果。方法选择因正畸治疗而拔除的成对上颌前磨牙20对共40个,随机分为2组进行根管预备。A组为实验组,采用手用ProTaper和冠根向深入法预备根管;B组为对照组,采用镍钛手用K锉Nitiflex和平衡力技术预备根管;记录根管预备时间。纵剖根管后,扫描电镜下观察根尖段、根中段、根管口段的碎屑和玷污层。结果在根尖和根中段,A组的碎屑和玷污层均较B组少,差异具有显著性意义(P<0.05)。在根管口段,两组间无显著性差异(P>0.05)。两组间根管预备时间无统计学差异(P>0.05)。结论手用ProTaper镍钛器械配合有效的冲洗液,具有良好的根管清理效果,是值得推广的新型手用根管预备技术。     

三种器械用于磨牙弯曲根管预备的临床评价

目的：评价不锈钢K锉、机用ProTaper和机用Safe Sider预备磨牙弯曲根管的临床疗效。方法：选取因牙髓炎或根尖周炎需要进行根管治疗的磨牙180颗（413个根管）,随机分为K-file组、ProTaper组和Safe Sider组,每组60颗牙。分别用不锈钢K锉、机用ProTaper和机用Safe Sider进行根管预备。三组均采用冷牙胶侧方加压技术充填根管。记录三组病例根管预备时间和术后并发症发生情况,根据治疗前、中、后的X线片评价根管预备和充填效果。结果：机用ProTaper、机用Safe Sider分别与不锈钢K锉在根管预备时间、根管成形以及充填效果方面在统计学上有显著性差异（P﹤0.05）,机用ProTaper与机用Safe Sider在上述方面无显著性差异（P﹥0.05）。结论：机用ProTaper和机用Safe Sider预备磨牙弯曲根管时能较好地保持原有根管形态,省时省力,术后反应少。     

机用和手用ProTaper预备中度弯曲根管后的器械损伤情况评价

目的:评估机用和手用ProTaper镍钛器械预备中度弯曲根管后的损伤情况,为临床安全使用ProTaper镍钛器械提供理论指导。方法:使用机用和手用ProTaper镍钛器械各6套预备中度弯曲的下颌第一磨牙近中颊根。每预备1个根管后,在立体显微镜下观察并记录器械分离和螺纹松解情况。预备完成后,分别以扫描电镜观察全新、预备5次、15次和20次的SX和F1表面,观察其表面和切割刃的磨损情况。结果:预备中度弯曲根管时,SX、S1、F1、F3易发生器械分离,断裂位置一般位于距离锉尖3～4 mm处。机用ProTaper器械在使用15次后,可观察到明显的裂纹和损伤,手用ProTaper器械在使用20次后,可观察到明显的微裂纹和切割刃的损伤。使用相同的次数,机用ProTaper镍钛锉的损伤比手用ProTaper镍钛锉严重。结论:推荐机用ProTaper镍钛锉可以安全使用15次,手用ProTaper镍钛锉可以安全使用20次,每次使用后,应重点观察SX、F1和F3的锉尖位置,以便及早发现安全隐患,防止镍钛锉断裂。     

Canal preparation using only one Ni-Ti rotary instrument: preliminary observations

AIM: To describe a novel canal preparation technique using only one Ni-Ti rotary instrument. SUMMARY: In this novel technique, the canal is negotiated to the working length with a size 08 hand file. Then, the canal preparation is completed with an F2 ProTaper instrument used in a reciprocating movement. In larger canals, the use of additional hand files may be required to complete the apical enlargement. *A novel canal preparation technique is introduced using only one Ni-Ti rotary instrument in a reciprocating movement. *The advantages of the technique include a reduced number of instruments, lower cost, a reduced instrument fatigue and the elimination of possible prion cross-contamination associated with the single use of endodontic instruments.     

ProTaper简化预备法的根尖微渗漏实验研究

目的观察ProTaper简化预备法的根尖微渗漏,评价其根尖的封闭性能。方法 60颗离体成人患牙,分成2组。实验组30颗牙标本采用ProTaper机动系统简化预备和0.06锥度牙胶尖垂直加压充填根管,对照组30颗牙标本采用逐步后退法0.02锥度不锈钢锉预备和0.02锥度牙胶尖冷侧方加压充填根管,经透明标本染料渗透技术后,测量根尖部染料渗透的距离。结果实验组根尖染料的渗透距离均值0.60 mm,标准差0.29 mm,对照组根尖染料的渗透距离均值1.18 mm,标准差0.83 mm,2组根尖染料的渗透距离差异有统计学意义(P<0.05)。结论 ProTaper简化法预备根管配合相应锥度牙胶尖充填其根尖的封闭性能良好。     

Increased apical enlargement contributes to excessive dentin removal in curved root canals: a stepwise microcomputed tomography study

Introduction

To determine whether increased apical enlargement would result in a complete preparation of curved canals and to progressively assess shaping quality using multiple microcomputed tomography (MCT) scans.

Methods

Ninety root canals with a curvature of 25° to 50° were selected. Five MCT scans, 1 preoperative and 4 postoperative, were acquired from each canal. Canal preparation was performed up to size 50 using 3 techniques, nickel-titanium (NiTi) hand files, Mtwo (VDW, Munich, Germany), and ProTaper (Maillefer, Ballaigue, Switzerland), by experienced operators in a dental mannequin so as to simulate the clinical conditions. At a level of 1 mm short of the working length, 2 parameters were evaluated in each of the 4 postoperative acquisitions: the percentage of the prepared outline and the amount of dentin removed (the prepared area).

Results

Statistically, there was no significant difference between the 3 systems used regarding the prepared outline. The maximum prepared outline was achieved by the use of NiTi hand files (63%; confidence interval [CI], 54%–73%), whereas Mtwo and ProTaper amounted to 58% (CI, 50%–66%) and 60% (CI, 51%–70%), respectively. In contrast, the dentin area removed by ProTaper was significantly higher than that of Mtwo and NiTi hand files.

Conclusions

Increased apical enlargement of curved canals did not result in a complete apical preparation, whereas it did lead to the unnecessary removal of dentin.     

A comparison of three rotary systems and hand instrumentation technique for the elimination of Enterococcus faecalis from the root canal

The aim of this study was to compare the in vitro reduction of a bacterial population in a root canal by mechanical instrumentation using three rotary systems and hand instrumentation technique. The root canals contaminated with a suspension of Enterococcus faecalis were instrumented using ProTaper, K3, HeroShaper and K-file hand instrumentation technique. Later the root canals were sampled. After serial dilutions, samples were incubated in culture media for 24 h. Bacterial colonies were counted and the results were given as number of colony-forming units per millilitre. The results showed that all the canal instrumentation systems reduced the number of bacterial cells in the root canals. Statistically, ProTaper instruments were more effective in reducing the number of bacteria than the other rotary files or hand instruments.