不同扩根器械拆除根管充填物的比较研究

目的比较不同器械在进行根管再治疗时拆除根管充填物的能力.方法选取48颗离体上前牙常规根管治疗后随机分为4组(每组12颗),进行根充物的拆除.记录到达工作长度牙数、到达工作长度用时、根充物推出根尖孔牙数、发生并发症牙数及器械损耗数.最后纵劈牙齿,统计根管内残余充填物量.实验结果采用ANOVA和X-检验.结果H锉联合回旋手机组到达根尖工作长度用时最短,与其它组间存在显著性差异(P＜0.01);四组根管内都有充填物残余;根管冠、中1/3的清理效果各组间无显著性差异(P＞0.05),而在根尖1/3处H锉联合回旋手机组的清理效果好,与其它组间存在显著性差异(P＜0.05);K锉联合回旋手机组有侧穿发生.结论H锉拆除根充物速度快、清理效果好;联合使用回旋手机可提高工作效率,但有一定的潜在风险,应谨慎操作.     

机用镍钛器械预备弯曲根管的临床应用

目的　研究机用镍钛器械ProFile、ProTaper和Hero 642在弯曲根管预备中的临床应用。方法　选取有弯曲 根管的牙髓炎或根尖周炎患牙80颗,分为A、B、C、D 4组,分别用ProFile、ProTaper、Hero 642和不锈钢K锉预备根管, 全部患牙均采用侧向加压法充填根管。根据X线片评价根管预备和充填的效果。结果　3种机用镍钛器械均能很 好地维持根管的弯曲度和走向,根管的锥度和流畅度佳,无根管偏移、根尖阻塞、台阶形成等并发症发生;术后疼痛 发生少且程度轻;ProTaper的操作时间比ProFile和Hero 642短;有2例镍钛器械折断。结论　机用镍钛器械ProFile、 ProTaper和Hero 642预备弯曲根管成形效果好,极少有根管内并发症发生,ProTaper比ProFile和Hero 642更快速高 效;临床操作中须注意预防器械折断。     

ProFile ProTaper镍钛根管器械与不锈钢K锉预备弯曲根管的比较研究

目的：比较ProFile镍钛机用根管器械，ProTaper镍钛手用根管器械和不锈钢K锉用于弯曲根管预备时的根管拉直和根尖偏移，为ProFile和ProTaper的临床应用提供实验依据。方法：将正畸前减数拔除的30个下颌第一前磨牙随机分为3组，分别用不锈钢K锉、ProTaper镍钛手用根管器械、ProFile镍钛机用根管器械做根管预备，分析评价其根管拉直和根尖偏移情况。结果：不锈钢K锉组的根管拉直、根尖偏移显著大于ProTaper和ProFile预备组。结论：ProFile和ProTaper镍钛根管预备器械与传统的不锈钢器械相比更适合弯曲根管的根管预备。     

机用PathfileTM联合手用ProTaper镍钛器械预备磨牙狭窄根管125例效果评价

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ProTaper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。     

机用镍钛Hero642预备磨牙弯曲根管的临床研究

目的探讨机用镍钛器械Hero642应用于磨牙弯曲根管预备的效果。方法选择根管弯曲的磨牙86颗,先采用小号K锉疏通根管,将根尖部预备至15号后,再以机用镍钛器械Hero642完成根管预备,侧向加压充填根管,根据治疗前后的x线片评价根管预备和充填效果。结果86颗磨牙共有274个根管,264个根管形态良好,无台阶、根尖堵塞、根管偏移及侧壁穿孔等并发症发生。根充恰填256个,8个根管超充,10个根管未能完全扩通,无法到达根尖孔而欠充或做塑化治疗。结论手用锉疏通弯曲根管的根尖段后再以机用镍钛器械Hero642完成根管预备,可获得良好的成形效果且较少产生并发症。     

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。     

不同根管预备方法对根尖孔溢出碎屑和液体的影响

目的 比较手用不锈钢K挫，手用镍仗挫和机用不锈钢K锉，机用镍钛锉行根管预备后，推出根尖孔的牙本质碎屑重量和冲洗液的体积。方法 将80颗单根离体牙分为4组，每组20颗，分别用手用不锈钢K锉，手用镍钛锉，机用不锈钢K锉，机用镍钛锉预备根管。预备过程中从根尖孔推出的牙本质碎屑和液体，用预先称重的离心管收集，测得推出根尖孔的液体体积和牙本质碎屑的重量。结果 机用镍钛锉组推出根尖孔的牙本质碎屑量比其他组少，但四组间无显著性差异。机用镍钛锉组推出根尖孔的液体量较少，四组间有显著性差异。结论 机用镍钛锉用于根管预备推出根尖孔的液体量及牙本质碎屑均较少。     

ProTaper与不锈钢K锉预备弯曲根管的对比研究

目的：对比ProTaper镍钛手用根管器械和不锈钢K锉进行弯曲根管预备时的根尖偏移和根充后密度。方法：将正畸减数拔除的下颌第一前磨牙20个随机分为2组,每组10个。分别用不锈钢K锉、ProTaper镍钛手用根管器械做根管预备,对比分析并评价根尖偏移和根充后密度情况。结果：两组根管偏移发生率和根充密度存在显著性差异。结论：ProTaper镍钛根管预备器械与不锈钢器械相比更适合弯曲根管的预备。     

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。     

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。     

Ex vivo study of the efficacy of H-files and rotary Ni-Ti instruments to remove gutta-percha and four types of sealer

AIM: To compare the efficacy of ProFile rotary Nickel-Titanium (Ni-Ti) instruments and Hedstroem-files (H-files) combined with Gates-Glidden (GG) drills during removal of gutta-percha root fillings used in combination with one of the four representative sealers. METHODOLOGY: Forty-eight single-rooted human teeth, with fully formed apices and straight root canals were used. The root canals were accessed and instrumented using a stepback technique with H-files. They were randomly assigned to four groups and subsequently filled with a combination of lateral and vertical condensation of gutta-percha and one of the following sealers: Roth 811, AH26, Endion and Roekoseal. The root fillings were removed 1 year later, using either H-files in combination with GG drills or the ProFile Ni-Ti system. Teeth were then grooved longitudinally and split. The amount of gutta-percha and sealer remaining on the root canal walls was traced and scored visually with the aid of a stereomicroscope. The scores were analysed and statistically compared with the Kruskal-Wallis test between the ProFile and H-file groups, as well as among the four sealer subgroups. Two samples from each group were studied under the scanning electron microscope to enhance inspection of canal walls and remaining material. RESULTS: Sealer remnants were observed with both techniques mainly in the middle and apical third of the root canal. The ProFile system and the H-files were associated with similar amounts of remaining filling material (P > 0.05). In the cervical third of the root canal all sealer remnants were removed with both techniques. In the middle and apical third AH26 was associated with a statistically significant greater quantity of remnants on the root canal walls with both removal techniques (P < 0.05). Endion, Roth 811 and Roekoseal were associated with approximately the same amount of filling material in the middle third of the root canal (P > 0.05), whereas in the apical third Endion was associated with significantly more remnants of filling material than the other two sealers with either ProFile or H-files (P < 0.05). CONCLUSIONS: None of the methods used for the removal of root fillings was totally effective, especially in the apical third of the root canal.     

Efficiency of the 0.04 taper ProFile during the re-treatment of gutta-percha-filled root canals

AIM: The objective of this study was to determine the effectiveness of 0.04 ProFile instruments during the removal of root fillings. METHODOLOGY: A total of 30 single-rooted mandibular canines were divided into three groups. The canals were accessed and then prepared with a reciprocating automated device and nickel-titanium files. Three different techniques of obturation were used: Thermafil system (group I), thermomechanical compaction (group II) and lateral condensation (group III). Sealer 26 was used in all three groups. Two weeks after obturation, the fillings were removed using 0.04 ProFile instruments following standardized sequence of size 90, 60, 45, 40, 35 and 30 at a speed of 300 rpm in a crown-down manner. The teeth were subsequently split with a chisel, photographs were taken with a colour video camera and the removal of filling material was assessed visually (by colour) by two examiners. The time required to achieve the working length was also recorded. RESULTS: ProFile instruments reached the working length in all cases. However, complete removal of gutta-percha occurred in only three specimens (two of group I, and one of group II). Thermafil plastic carriers were removed successfully in all specimens of group I. CONCLUSIONS: ProFile instruments with 0.04 taper were inadequate in completely removing the filling materials from the root canal system. However, the ideal working length was achieved rapidly.     

�������Ѹ�����������е��System BЯ��������Ӧ��ȥ�������ڳ�����Ч������

??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.     

������ת������еԤ���������ܵ��ٴ�Ч���о�

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。     

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。     

Comparative study of removal of current endodontic fillings

The aim of the present study was to assess the removability of canal fillings performed by using current methods during re-treatment with rotary instruments. Seventy-two freshly extracted human anterior teeth with single straight root canals were instrumented with Mtwo rotary files. The teeth were randomly divided into 4 obturation groups of 18 specimens each as follows: group 1, Resilon and Epiphany; group 2, GuttaFlow obturation system; group 3, EndoTwinn obturation system; group 4, gutta-percha with AH Plus sealer. The filled canals were re-treated by using Mtwo-Retreatment instruments and Mtwo instruments. The time required to remove the obturation material was recorded. After splitting the roots, the amount of residual filling material on the canal walls was imaged and measured with image analyzer software. Statistical analysis was accomplished by Kruskal-Wallis and Mann Whitney U tests for the analysis of root canal cleanliness. There was no statistically significant difference among the 4 filling techniques regarding the amount of residual material in the apical, middle, and coronal thirds and inside the whole canal area (P > .05). Regarding the mean time of re-treatment, the fillings performed by using GuttaFlow and EndoTwinn methods were removed much more quickly compared with the other 2 methods (P < .001). It was observed that the fillings performed with the above canal filling methods were removed in a similar fashion with rotary instruments during re-treatment.     

Effectiveness of the ProFile.04 Taper Series 29 files in removal of gutta-percha root fillings during curved root canal retreatment.

The purpose of this in vitro study was to evaluate the capacity of ProFile.04 Taper Series 29 files to remove gutta-percha during curved root canal retreatment. Forty-four mandibular molars whose mesial roots presented between 26 and 40 degrees of curvature, determined by Schneider's method, were selected. The root canals were enlarged to ISO size 35 and obturated with laterally condensed gutta-percha using Sealer 26. The teeth were randomly divided into three groups for gutta-percha removal: GI: size 2 Gates Glidden drills; GII: size 6 ProFile.04 Taper Series 29 files; GIII: size 7 ProFile.04 Taper Series 29 files. The penetration of the instruments was measured with millimetered x-rays and clinical observation. The ProFile.04 Taper Series 29 files removed the endodontic filling material better than the Gates Glidden files.     

Evaluation of canal filling after using two warm vertical gutta-percha compaction techniques in vivo: a preliminary study

AIM: To evaluate the quality of root canal filling when comparing two warm gutta-percha filling techniques in vivo. METHODOLOGY: Human teeth were randomly divided into two equal groups, with 30 canals each. The root canals were shaped by hand and ProFile 0.04 rotary instruments to size 20-40 at the end-point and then filled with gutta-percha cones and AH-Plus. In group A, a traditional warm vertical compaction technique was performed using the Touch'n Heat, and back-filling with the Obtura II. In group B, a modified warm vertical compaction technique was used: small amounts of gutta-percha were removed, and the remaining most apical 3 mm were compacted with a 1 mm movement; then thermomechanical back-filling was performed. The teeth were extracted, stored in dye, cleared, and the distance between the apex and apical limit of the filling, linear dye penetration, and voids were measured from the buccal, lingual, mesial and distal perspective. The homogeneity of variance and means was verified using Levene's test and t-test. ANOVA and Dunnett post hoc test were used to establish the significance and to analyse the effects through multiple comparisons. RESULTS: Compared with the specimens of group A, the specimens of group B exhibited less mean linear dye penetration (P < 0.05), smaller void length (P < or = 0.05) and maximal width (P < or = 0.05) when examined in all four views, and a more precise filling when viewed from the buccal aspect (P < 0.05). CONCLUSIONS: The modified warm vertical compaction technique with apical back-filling produced a more effective and precise three-dimensional filling.