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??Objective    To evaluate the clinical effects of two nickel-titanium ??NiTi?? instruments ??M3-Pro and Twisted File??TF???? in preparation of molar curved root canals for the aged. Methods    A total of 240 first molars and second molars with curved root canals??25°-30°??that required root canal treatment were selected and randomly divided into two groups. The root canals were prepared with M3-Pro NiTi rotary instruments in the M3-Pro group and with TF NiTi rotary instruments in the TF group. For general analysis??all the cases are chosen from the newly diagnosed cases of patients about 60 - 70 years old in clinic from Jun. 2015 to Sep. 2017. Then the root canal preparation time??incidence of the pain after root canal preparation??effects of root canal obturation??and incidence of instrument separation were compared. Results    The average root canal preparation time in the M3-Pro group was??5.22 ± 1.12??min??whereas in the TF group it was??6.47 ± 0.93??min??t = -17.816??P < 0.05??. The incidence of endodontic inter-appointment emergences in the M3-Pro group was 3.3%??whereas in the TF group it was 2.5%??χ2 = 0.147??P > 0.05??. Adequate root canal filling in the M3-Pro group was 96.72%??whereas in the TF group it was 95.84%??χ2 = 0.463??P > 0.05??. Instrument separations were not found in both groups. There were 10 instruments damaged in the M3-Pro group and 21 instruments damaged in the TF group ??χ2 = 4.482??P < 0.05??. Conclusion    M3-Pro instruments can make the preparation efficiently and reduce the incidence of endodontic inter-appointment emergences??in addition??it maintains a satisfactory anatomical shape of the root canal while significantly decreasing instrument separation. M3-Pro is suitable for the treatment of curved root canal??and has good clinical effect.     

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目的：评价声波根管器械联合ProTaper锉治疗残髓炎的临床疗效。方法选择2011年2月至2012年2月在南平市妇幼保健院牙体牙髓科门诊就诊的残髓炎患者78例（共78颗患牙）,随机分为试验组（41例）和对照组37例。试验组采用声波根管器械联合ProTaper锉进行根管预备,对照组采用单纯的ProTaper锉进行根管预备。两组患者根管预备完成后均用氢氧化钙封药1周,然后行根管充填。比较两组患者根管预备后24 h、根管充填1周后的术后反应及1年后的疗效。结果试验组患者根管预备后24 h、根管充填1周后的疼痛反应均较对照组轻;试验组1年后的疗效亦优于对照组。结论声波根管器械联合ProTaper锉治疗残髓炎,可减少预备后的疼痛反应,同时提高根管充填的质量,保证根管治疗的成功率,值得临床推广应用。     

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机用镍钦器械的发展与应用,为临床医生创造了获得最佳根管预备效果的可能性,是根管预备技术的一场革命.机用镍钛器械从螺纹设计、几何外形到锥度,与传统标准器械存在很大差别.这些改变不仅提高了根管预备的效率,也最大限度减少了根管的移位和变形,但同时临床医生也面临着机用镍钛器械折断的风险.本文对根管镍钛器械的特点以及目前常用机用镶钦器械的操作方法、操作原则等方面加以阐述.     

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目的评价ProTaper机用镍钛锉用于根管治疗术一次法的临床效果。方法选择2008年7月至2010年7月广州医学院第一附属医院口腔科就诊患者206例(206颗患牙),随机分为两组。试验组的106颗患牙用ProTaper机用镍钛锉预备根管,对照组的100颗患牙用不锈钢K型锉预备根管,两组均以常规侧方加压法进行根管充填。拍摄牙片以了解根管数目形态、确定根管工作长度及判断治疗效果,并观察根管预备及充填后1～2周的术后反应。结果试验组患牙根管充填成功率(88.7%)高于对照组患牙(64.0%),试验组患牙根管预备及充填术后急性反应发生率(1.9%)明显低于对照组(14.0%),差异均有统计学意义(P<0.05)。结论 ProTaper机用镍钛锉用于根管治疗术一次法的根管充填成功率较高,且能明显减少术后根尖不良反应的发生,近期疗效可靠。     

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目的 探讨机用PathfileTM镍钛锉联合手用ProTaper镍钛器械在磨牙狭窄根管的预备效果。方法 选择2011年8月至2012年2月广州市天河区人民医院口腔科门诊需行根管治疗的磨牙根管狭窄患者125例(患牙125颗),采用PathfileTM镍钛锉进行根管预处理,以手用Pro Taper镍钛器械完成根管预备,侧向加压技术充填根管,根据治疗前后的X线片评价根管预备和充填效果。结果 125颗患牙的419个根管中,409个形态好,7个未能完全疏通,无台阶、根尖堵塞、根管偏移及侧壁穿孔等并发症发生,有3根器械折断于根尖段。恰填403个根管,10个根管因未完全疏通、无法到达根尖孔或断针而欠填,6个根管超填。结论 采用机用PathfileTM镍钛锉疏通狭窄根管的根尖段后再以手用ProTaper镍钛器械完成根管预备,可获得良好的成形效果且较少出现并发症。     

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??Nickel-titanium instruments are the mainstream in the root canal preparation??and are widely used in the modern root canal treatment. But some researchers believe that the preparation process may cause or aggravate dentinal microcracks of the root canal wall. Dentinal microcracks will lead to bacteria colonization??microleakage and even vertical root fracture??and reduce the long-term outcome of root canal treatment. This article elaborated the hazard??etiology??prevention and controversy of the formation of dentinal microcracks in the process of root canal preparation with nickel-titanium instruments.     

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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.     

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??Objective    To analyze the impact of a retained Ni-Tiinstrument on outcome of root canal treatment. Methods    Forty teeth were collected at Nanjing Stomatology Hospital from January 2011 to March 2013. Information included tooth type??the length of separated fragments??the location of the fragments in root canal??the preoperative diagnosis and the outcome of these cases were collected. Results    Overall??weighted mean healing for the teeth with a retained instrument fragment was 80.0%.  Healing rate was 71.4% for the teeth suffering from apical inflammation before treatment and 84.6% for pulpitis. Conclusion    The outcome of endodontic treatment when a separated fragment is left within root canal is not significantly reduced.     

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??Instruments separation is one of the most troublesome complications during root canal therapy. A separated instrument may hinder the effectiveness of shaping and cleaning procedures??which may adversely affect the prognosis. Thus??the nickel-titanium instruments separation has always been a key point of clinical discussion. In this article??influencing factors and preventive strategies of the nickel-titanium instruments separation were introduced.     

Mtwo机用镍钛器械在老年人根管治疗术中的临床应用

目的:评价Mtwo镍钛机用根管预备系统在老年患者根管治疗中的临床效果.方法:应用两种不同预备方法和器械对60～93岁165名患者共180个患急、慢性牙髓炎或根尖周炎的患牙行根管治疗术,随机分为M、G组,M组使用Mtwo机用镍钛器械改良同步技术,G组使用G钻改良步退技术.根据操作时间、约诊间痛发生率和术前术后X线片评价临床效果.结果:根管预备平均时间M组与G组分别为(6.1±0.75)分和(13.0±1.06)分(P＜0.05);M组与G组约诊间痛发生率分别为5.81％和6.38％(P＞0.05);适充率分别为91.8％和88.3％(P＞0.05).结论:Mtwo镍钛根管预备系统更高效舒适,值得在老年患者临床治疗中推广.     

乳牙机用镍钛锉结合超声荡洗用于乳磨牙根管治疗中的临床效果研究

目的:评价不同锥度乳牙机用镍钛锉结合超声荡洗在乳磨牙根管治疗中的临床效果.方法:纳入51例因急、慢性乳磨牙牙髓炎治疗的患儿,共计60颗患牙,随机分为S组、M组和K组(n=20),S、M组使用不同锥度机用镍钛锉预备根管,并结合超声荡洗根管,K组使用不锈钢K锉预备根管,注射法冲洗根管,根据约诊间痛发生率、根管预备和根管治疗...     

Mtwo机用镍钛器械预备感染根管的临床对照研究

目的研究Mtwo机用镍钛器械预备感染根管的临床效果。方法选择56例患者共68个感染根管,随机分为Mtwo组（35个）与ProTaper组（33个）,Mtwo组采用单一长度技术预备根管,ProTaper组采用冠根向深入法预备根管。分别于预备前后根管内取样,接种,培养,然后检测厌氧菌量的变化;记录两组根管预备所需时间;患牙术后疼痛情况;摄片比较两组根管预备和充填质量。结果两组根管预备后厌氧菌量均明显减少,Mtwo组厌氧菌减少量大于ProTaper组;Mtwo组术后疼痛发生率较高;两组都能在较短时间内完成根管预备,都有较好的根管适充率。结论 Mtwo可以高效的清除根管内感染,有良好的根管成形能力,值得在临床推广应用。     

ProTaper机用和手用锉在乳磨牙根管治疗中的临床研究

目的：观察ProTaper机用锉和手用镍钛锉在儿童乳磨牙根管治疗中的临床效果。方法：选择4～8岁左右侧上颌第二乳磨牙同患牙髓炎或慢性根尖周炎各40名患儿,随机选择一侧为ProTaper机用锉组,对侧为对照组,观察牙髓炎患者用ProTaper机用锉拔髓、拔髓针拔髓所需时间及疼痛情况。观察慢性根尖周炎患者ProTaper机用锉、手用锉根管预备所需时间及根充效果。结果：ProTaper机用锉拔髓时间短、疼痛少、根管预备时间短,与对照组比较有显著性差异（P〈0.01）;ProTaper机用锉、手用锉根管预备后根充效果无显著性差异（P〉0.05）。结论：ProTaper机用锉配合X线牙片、根管长度测量仪用于乳磨牙的拔髓和根管预备,可缩短治疗时间、减轻疼痛、显著提高根管治疗的效率。     

Mtwo镍钛器械在钙化阻塞根管治疗中的应用

目的:对Mtwo镍钛器械处理钙化阻塞根管的疗效进行评价.方法:选取21例35个用C型先锋锉结合EDTA凝胶疏通治疗失败的钙化阻塞根管,应用10#Mtwo镍钛器械结合EDTA凝胶进行钙化疏通处理,观察根管疏通成功率和根管内并发症发生率.采用SAS 9.4软件包对数据进行统计学分析.结果:成功疏通23个钙化阻塞根管,成功率为65.71％.4个根管(11.43％)发生器械分离,3个根管(8.57％)形成根管台阶.按不同钙化部位分为3组,成功率无显著差异(P＞0.05).结论:Mtwo镍钛器械可提高钙化阻塞根管的治疗成功率.     

乳磨牙根尖炎症波及牙胚的根管治疗临床观察

目的　观察因发生根尖周炎已具有拔牙指征的乳磨牙采取根管治疗后的临床疗效。方法　对 2 2例因根尖周炎造成根方骨质吸收并波及牙胚的乳磨牙采用Vitapex糊剂进行根管治疗 ,并定期观察。结果　 2 1例病变受到控制 ,根方骨质吸收和受波及的继承牙胚都有不同程度的好转 ,仅有 1例失败。结论　根尖周炎造成根方骨质吸收并波及继承牙胚做为拔除乳牙的绝对指征值得商榷 ,应具体结合患牙的临床表现、继承牙胚的牙冠钙化程度等多方面的情况进行综合评估 ,在许多情况下 ,这些乳磨牙可以保留而无需拔除     

镍钛机用器械在磨牙根管治疗术中的应用研究

目的：探讨镍钛机用器械ProTaper在磨牙根管治疗术中的应用效果。方法：选取患牙髓炎和根尖周炎的磨牙83例，采用ProTaper预备根管，侧向加压充填法充填根管，根据治疗术前、中、后的X线片评价根管预备和充填的效果。结果：所有患牙均无根管偏移、根尖阻塞、台阶形成等并发症，操作时间短，术后疼痛的发生少且轻；有3例发生器械折断。结论：ProTaper用于磨牙根管预备快速、高效，成形效果好，极少有根管内并发症，但须注意预防器械折断。     

Easyshape和Mtwo两种镍钛预备系统对后牙弯曲根管预备效果的比较

目的 比较Easyshape和Mtwo机动镍钛预备系统对后牙弯曲根管预备的效果.方法 将临床拔除完整的第一、二磨牙随机分成两组：A组用Mtwo镍钛系统,B组用Easyshape镍钛系统,两组统一采用全长预备法进行根管预备：Mtwo器械组预备由10#锉扩大至25#,Easyshape器械组预备由15#锉扩大至30#;比较预备时间、预备前后X线片上扩大锉尖偏移的距离,用SAS9.0软件进行Wilcoxon检验方法统计分析.结果 （1） Mtwo器械组预备平均用时145s; Easyshape器械组预备平均用时156s,两组比较,差异无统计学意义（P＞0.05）.（2）离体牙预备前后X线片比较,两组根管偏移,差异无统计学意义（P＞0.05）.结论 Easyshape镍钛系统与Mtwo镍钛系统对后牙弯曲根管的预备效果无明显差异.