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.     

Dynamic torque and apical forces of ProFile.04 rotary instruments during preparation of curved canals

AIM: To analyse torque and force generated whilst shaping curved canals using rotary instruments. METHODOLOGY: A specially designed computer-controlled testing platform was used to record events during the shaping of straight and curved canals in plastic blocks and in extracted human teeth using ProFile.04 instruments. Size 40 apical stops were prepared using crown-down, apical preparation and step-back procedures. Maximum torque, apically directed force and the numbers of revolutions were recorded at a resolution of 100 samples s-1. Load causing separation as required by the ISO 3630-1 test and cyclic fatigue was also recorded. Mean maximum scores were calculated and statistically tested using one- and two-way analyses of variance. RESULTS: Highest and lowest torque scores were recorded, respectively, in straight canals in plastic blocks at 25 Nmm and in natural canals at 14 Nmm. Significant differences were recorded for canal type and preparation phase (P < 0.0001). Loads causing separation varied from 3.7 to 32.3 Nmm. Apically directed forces ranged from 1 to 7.5 N. Again, there were significant differences depending on canal type and preparation phase (P < 0.0001). The number of revolutions during preparation ranged from 18 to 41. Size 15, 30 and 45 ProFile.04 instruments separated after 581, 430 and 402 revolutions, respectively, in a standard cyclic fatigue test. CONCLUSIONS: The new torque-testing platform details physical parameters during preparation of curved canals. To improve predictability, instrumentation sequences must be tested for excessively high torsional moments or forces. This study indicated that up to 10 curved canals could be safely prepared with a sequence of ProFile. 04 rotary instruments without separation due to cyclic fatigue. Efforts should continue to correlate root canal anatomy with torque and force generated during rotary root canal preparation.     

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。     

4种机用镍钛器械预备模拟弯曲根管的成形能力比较

目的:比较ProTaper Next、M3-pro、X-file和M-PRO机用镍钛器械预备弯曲根管的成形能力.方法:按照所用镍钛器械将80个单弯树脂模拟根管随机分为4组(n=20).牙科显微镜获取预备前、后根管图像.Photoshop CS6软件处理图像,测量预备后根管弯曲角度及弯曲半径的变化值、根管内外侧壁的树脂去...     

4种镍钛器械预备弯曲根管后成形能力比较

目的:比较4种镍钛器械预备弯曲根管后的成形能力.方法:收集临床上拔除的近颊根牙根弯曲度在20°～40°的上颌第一或第二恒磨牙40颗,随机分为4组,每组10颗,分别采用Protaper Universal、Protaper Next、TF、S3对近颊根进行根管预备.预备前、后采用Micro-CT扫描,使用Mimics17...     

Shaping ability of ProFile and K3 rotary Ni-Ti instruments when used in a variable tip sequence in simulated curved root canals

AIM: To compare the shaping ability of ProFile and K3 rotary Ni-Ti instruments when used in a variable tip sequence in simulated curved root canals with different curvature and radius. METHODOLOGY: ProFile or K3.06 taper instruments were used to prepare simulated canals of 20 degrees curvature and 5 mm radius (n = 10) and 30 degrees curvature and 3 mm radius canals (n = 10) in resin blocks. All canals were prepared to an apical size 40 at 0.5 mm from the canal terminus using a variable tip crown-down sequence. Pre- and postinstrumentation digital images were recorded, and an assessment of the canal shape was determined using a computer image analysis program. The material removal from the inner and outer wall of the canal was measured at 28 measuring points, beginning 0.5 mm from the end-point of the canal and the data compared using the Mann-Whitney U-test. RESULTS: In 20 degrees and 30 degrees canals both instruments significantly removed more (P < 0.05) material on the outer wall than the inner wall in the apical half of the canal. For ProFile files there was no significant difference in the amount of material removed on the outer canal wall between the 20 degrees and 30 degrees canals. However, in the K3 groups significantly more (P < 0.05) outer canal wall was removed in the apical area in 20 degrees canals. When comparing both instruments the results showed that in 20 degrees canals K3 instruments removed more outer and inner canal wall than ProFile instruments (P < 0.05) but that there was no significant difference (P > 0.05) between the instruments in 30 degrees canals. CONCLUSION: Within the limitation of this study, both rotary nickel-titanium instruments prepared a well-shaped root canal with minimal canal transportation.     

Preparation of severely curved simulated root canals using engine-driven rotary and conventional hand instruments

This in vitro study evaluated the efficacy and safety of six different nickel-titanium engine-driven instruments used with a torque-controlled engine device and nickel-titanium hand and stainless steel hand instruments in preparation of curved canals. A total of 80 curved (36°) simulated root canals were prepared. Images before and after were superimposed, and instrumentation areas were observed. Time of instrumentation, instrument failure, change in working length and weight loss were also recorded. Results show that stainless steel hand instruments cause significantly less transportation towards the inner wall of the canal than do nickel-titanium hand instruments. No instrument fracture occurred with hand instruments, but 30–60% breakage of instruments was recorded during instrumentation with the engine-driven devices. The working length was maintained by all types of instruments. Newly developed nickel-titanium rotary files were not able to prevent straightening of the severely curved canals when a torque-controlled engine-driven device was used. Received: 26 January 2000 / Accepted: 11 July     

4种机用镍钛根管通畅锉通道制备能力的对比研究

目的对临床中使用的4种机用镍钛根管通畅锉根管制备后的形态进行分析,评价4种通畅锉的通道制备能力。方法32个树脂根管(弯曲角度28~30°)随机分为4组,每组8个,分别使用M3-path0.02(A组)、M3-path双通道版(B组)、Scout RaCe0.02(C组)、RaCe ISO10(D组)制备根管通道,采集术前、术后图像,使用Photoshop和Caxa软件处理图像,测量术前、术后根管直径、弯曲角度及中心线偏移量并进行分析。结果弯曲角度变化值:A、B、C组小于D组(P<0.05)。中心线偏移量:在根尖段,C组最小;在弯曲段,B组、D组大于A组、C组;在直线段,D组最大,B组次之,A、C组最小(P<0.05)。通道制备后根管直径:在根尖段,D组最小(P<0.05);在弯曲段3~5mm位点,D组最大(P<0.05),B组与A组、C组接近(P>0.05);弯曲段6~7mm位点及根管直段,D组最大,B组次之,A、C组较小(P<0.05)结论4种器械均有较好的中心定位能力,0.02锥度通畅锉在根管全长的中心定位能力更优,大锥度通畅锉在根管中上段的预敞效果更好。     

Comparison of apical transportation between ProFile and ProTaper NiTi rotary instruments

AIM: To use a newly developed radiographic technique to compare apical transportation and loss of working length (WL) between.06 taper ProFile Series 29 and ProTaper nickel-titanium (NiTi) rotary instruments in vitro. METHODOLOGY: Mesio-buccal canals of 40 extracted mandibular molars were randomly divided into two groups. Group 1 was instrumented with ProFile and group 2 with ProTaper instruments according to the manufacturers' directions. A specially constructed radiographic jig with a Schick digital radiographic system (Schick Technologies Inc., Long Island City, NY, USA) was used to take pre- and postoperative radiographs of the samples at predetermined angulations. Using AutoCAD 2000 (Autodesk Inc., San Rafael, CA, USA), the central axes of initial and final instruments were radiographically superimposed to determine the loss of WL and degree of transportation at D(0), D(1), D(2) and D(4) from the WL. Data were analysed using repeated-measures anova. RESULTS: A statistically significant difference in apical transportation was found at the D(4) level between the two groups (P = 0.05). There was no statistical significance regarding postinstrumentation change in WL between groups. Spearman's Bivariate Correlation analysis indicated no statistically significant relationship between the radius of curvature and transportation. CONCLUSION: The results indicate that both ProTaper and ProFile instruments are comparable to each other in regards to their ability to optimally enlarge root canal with minimal transportation and loss of WL in vitro.     

镍钛器械对中重度弯曲根管成形能力的临床研究

目的:探讨机动镍钛器械Hero642结合ProTaper SX对弯曲根管的成形能力及其临床应用方法。方法:选取有中、重度弯曲根管的牙髓炎及根尖周炎患牙42颗,采用机动镍钛器械Hero642结合ProTaper SX预备根管,侧向加压充填技术充填根管,根据治疗前后的X线片评价根管预备和充填效果。结果:所有患牙均无台阶、根管偏移及侧壁穿孔等并发症发生,弯曲根管的弯曲度和走向未改变,术后疼痛发生少,有1例器械折断。结论:Hero642结合ProTaper SX的预备方法对中重度弯曲根管的成形效果好,值得临床推广应用。     

Influence of operator experience on canal preparation time when using the rotary Ni-Ti ProFile system in simulated curved canals

AIM: The aim of this study was to determine the influence of operator experience on the time needed for canal preparation when using a rotary nickel-titanium (Ni-Ti) system. METHOD: A total of 100 simulated curved canals in resin blocks were used. Four operators prepared a total of 25 canals each. The operators included practitioners with prior experience of the preparation technique, and practitioners with no experience. The working length for each instrument was precisely predetermined. All canals were instrumented with rotary Ni-Ti ProFile Variable Taper Series 29 engine-driven instruments using a high-torque handpiece (Maillefer, Ballaigues, Switzerland). The time taken to prepare each canal was recorded. Significant differences between the operators were analysed using the Student's t-test and the Kruskall-Wallis and Dunn nonparametric tests. RESULTS: Comparison of canal preparation times demonstrated a statistically significant difference between the four operators (P < 0.001). In the inexperienced group, a significant linear regression between canal number and preparation time occurred. CONCLUSION: Time required for canal preparation was inversely related to operator experience.     

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目的    对比研究3种旋转镍钛器械ProFile、ProTaper和Mtwo在弯曲根管预备中的应用。方法    选择2008年2月至2010年2月在沈阳市口腔医院牙体牙髓病科就诊的69例有弯曲根管的牙髓炎或根尖周炎患者的72颗患牙,随机分为4组,分别采用ProFile、ProTaper、Mtwo和不锈钢K锉预备根管,侧方加压法充填。评价根管预备和充填的效果。结果    3种旋转镍钛器械均能较好地维持根管的弯曲度及走向,根管的锥度及流畅度佳,无根管偏移、台阶形成等并发症;术后疼痛少且程度轻;ProTaper和Mtwo的操作时间比ProFile短。结论    机用镍钛器械ProFile、ProTaper和Mtwo预备弯曲根管成形效果好,ProTaper和Mtwo比ProFile更快速高效;临床操作须注意预防器械折断。     

两种机用镍钛根管预备器械在树脂模拟弯曲根管内的成形能力

目的 利用树脂模拟弯曲根管,研究K3和Hero642两种机用镍钛根管预备器械的成形能力.方法 使用K3和hero642分别预备两组树脂模拟弯曲根管至06锥度25#,运用扫描仪采集根管预备前后图像,Image ProPlus软件测量根管预备后的根管宽度和预备前后的弯曲度,使用SPSS13.0统计软件对预备前后树脂模拟弯曲根管宽度和弯曲度变化进行统计学分析.结果 K3组和Hero642组根管预备前后角度的变化分别为（4.11±0.18）°和（4.05±0.23）°,两者差异无统计学意义（P＞0.05）;两组器械预备后根管宽度的比较在根尖1/3、根中1/3和根管口处都无显著性差异（P＞0.05）.结论 两种机用镍钛根管预备器械均能较好地完成根管预备.     

ProTaper机用镍钛锉预备弯曲根管后的损伤评估

目的评估ProTaper机用镍钛锉在预备弯曲根管后的损伤,以指导临床安全使用。方法选择13套新的ProTaper机用镍钛锉预备下颌第一磨牙近中颊根的弯曲根管,A组6套用于预备中度弯曲根管,B组6套用于预备重度弯曲根管,另外1套作为对照组。每预备1个根管后,在立体显微镜下观察并记录镍钛锉出现磨耗、缺损和分离的情况。选取预备5、10、20个根管后,而且在立体显微镜下检测完好的S1、F1两根锉,在扫描电镜下观察其螺纹表面状况。结果A组ProTaper机用镍钛锉在使用至12个根管后逐渐出现异常;B组在使用至7个根管后逐渐出现异常。在两个实验组中,立体显微镜下未发现磨耗、缺损或分离的锉,在扫描电镜下也可见表面有微裂;随着预备根管数的增多,锉尖微裂增多,先加深后变平;切割刃的微裂逐渐加深延长,使用20次后微裂越过切割刃。结论预备重度弯曲根管较中度弯曲根管易造成ProTaper机用镍钛锉的损伤。使用ProTaper机用镍钛锉预备中度弯曲根管时不宜超过12次,预备重度弯曲根管时不宜超过7次。应用立体显微镜检查有助于发现磨耗及缺损,可以预防临床使用中镍钛锉的突然分离。     

ProTaper预备弯曲根管的临床评价

目的　评价用ProTaper预备弯曲根管的临床疗效。 方法　选取有弯曲根管的牙髓炎和根尖周炎病例的 6 8颗患牙 ,试验组用机用镍钛器械ProTaper预备根管 ,对照组用K锉、逐步后退技术预备根管 ,两组均用侧向加压充填法充填根管 ,根据治疗前、中、后的X线片评价根管预备和充填的效果。结果　试验组无根管偏移、根尖阻塞、台阶形成等并发症发生 ,能维持根管的弯曲度和走向 ,对照组 2例有台阶形成 ,根管偏移的发生明显多于试验组 (P <0 .0 1) ;试验组操作时间短 ,且少有术后疼痛的发生。结论　ProTaper预备弯曲根管快速、安全、成形效果好 ,可视为临床上预备弯曲根管的有效方法。     

机动ProTaper和Mtwo器械用于弯曲根管预备的临床评价

目的:评价机用ProTaper和Mtwo对弯曲根管的预备效果。方法:将临床需行根管治疗的171颗磨牙随机分为三组,分别采用ProTaper、Mtwo及不锈钢K锉对磨牙弯曲根管进行预备,比较器械折断、根管预备时间、术后反应及根管成型及充填情况。结果:根管预备时间:Mtwo的操作时间5.4 min比ProTaper的6.8 min和不锈钢K锉的13.6min短,ProTaper和Mtwo器械预备的根管锥度和流畅度均好,术后疼痛发生少。结论:ProTaper和Mtwo器械用于预备磨牙弯曲根管,效率高,成形能力佳。Mtwo器械应用常规预备法简单,预备时间短且有效。     

3种机用镍钛器械预备模拟弯曲根管的成形能力比较

目的:比较3种机用镍钛器械预备模拟弯曲根管的成形效果.方法:30个树脂根管随机分为3组并编号(Protaper Universal,ProTaper Next及TF Adaptive).按厂家推荐方法预备,记录预备时间.预备前、后的树脂根管使用单反相机拍照并通过计算机软件重叠,测量距根尖孔不同位置的树脂去除量,从而得出器械偏移情况和中心定位能力.采用SPSS 13.0软件包对数据进行统计学分析.结果:预备过程中未发生器械折断.ProTaper Next预备时间最短(P＜0.05).在根尖区,TF Adaptive的偏移量最小,其次是ProTaper Next (P＜0.05).在弯曲点冠方,3组偏移量无显著差异(P＞0.05).结论:ProTaper Next预备效率最高,ProTaper Next和TF Adaptive表现出良好的成形能力,3种机用镍钛器械均能较好地维持根管原始走向.     

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。     

Comparison of curved canals preparations using profile, GT and Hero 642 rotary files

This study compared preparations of curved canals, using Profile, GT file and Hero 642 rotary files. A total of 30 mesiobuccal canals of extracted first and second mandibular molars were used in this study. The teeth were embedded in resin and a pre-operative radiograph was taken. The specimens were then randomly divided into three instrument groups. Pre- and post-instrumentation radiographic images were scanned and superimposed using the VISI CAD/CAM program. At nine horizontal sections at 1 mm increments from the apex, it calculated pre- and post-instrumentation cross sectional areas (mm(2)) and enlargements to the inner aspect and outer aspects (mm). A Kruskal-Wallis test found no statistical difference among the groups in terms of total areas removed by each instrument (P > 0.05). It also found no significant difference in any group between the total of the inner and outer enlargements (P > 0.05). However the GT file removed significantly more material from the outer side of the canal than the inside at sections 3-5, and the Hero removed significantly more material from the outer side at sections 7-9 (P < 0.05). All instruments produced preparations that maintained original canal curvatures.