手用Protaper预备根管后注射式热塑牙胶充填系统充填效果的观察

目的观察Protaper手用法预备的后牙根管使用注射式热塑牙胶充填系统(Ultrafil-3D)充填的效果。方法10颗离体人上颌磨牙,开髓拔髓,截冠并截除腭根,按照Protaper的使用要求对颊根进行根管预备,均至F2(相当于主尖锉为25#K-file),测量根尖孔直径,干燥根管,涂布封闭剂(Roekoseal),Ultrafil-3D(Endoset)牙胶充填根管,记录注射针头进入的最大深度,直接观察超充情况,然后X线片评价整体的充填效果。结果①20个根管中有8个出现少量牙胶(伴封闭剂)超充,9个出现单纯的封闭剂超充;②根尖孔直径均≤0.25mm,注射针头距根尖孔的距离(L)均在8～10mm,牙胶超充组与无牙胶超充组差异无显著性(P>0.05)。③X线片显示牙胶未见欠充,与管壁未见明显空隙,可充填进入侧支根管。结论使用Protaper预备根管简便快速,根管形态好,有可能出现牙胶超充,但超出量较少,根管能获得整体良好的三维充填效果。

Effects of using Ultrafil-3D to obturate root canals prepared by hand-use Protaper

Objective To observe whether the root canal prepared by Protaper could be filled directly by Ultrafil-3D system without apical barrier. Methods The crowns and the palatal roots were removed at the cementum-enamel conjunction from 10 maxillary molars extracted from humans. The 20 buccal roots were prepared by Protaper to F2, which means the master file is equal to 25# K-file. The diameters of the foramina were measured. The root canals were dried and a thin layer of sealer was applied (Roekoseal), then were obturated by injecting Ultrafil-3D gutta-percha (Endoset). The lengths of the canula's needles entering canals were recorded. The overfilling of gutta-percha and/or sealer was observed with naked eyes. The obturations were evaluated by digital X-rays. Results ①8 root canals had gutta-percha overfilled (group GP), and 9 had only sealer overfilled (group NGP); ②the diameters of the foramina(∮)were less than or equal to 0.25 mm and the minimal distances (L) from the tip of the canula's needle to the foramen during injection were less than 8～10 mm, there was no significant difference between group GP and group NGP (P>0.05) ; ③ X-ray showed that there was no underfilling or no visible space between gutta-percha and the wall of the canal. The gutta-percha could be filled into lateral canals. Conclusion It would be easier and better to prepare the molar root canal with Protaper. Gutta-percha might be overfilled even if ∮≤0.25 mm/and L≤10～8 mm but the overfilling was just a little. The root canal could be obturated in 3-D.