三种根管充填技术根管系统充盈致密度的实验观察

目的 比较3种根管充填技术对根管系统充盈的致密度,以期为临床提供参考.方法 将57颗去除牙冠、预备好的上、下颌前磨牙按随机数字表法分为3组,每组19颗牙,其中单根管牙10颗,双根管牙9颗.分别采用常温流动牙胶技术又称GuttaFlow技术(GF组)、冷侧压技术(LC组)、热垂直加压技术(VC组)充填根管.使用Leica SP 600切片机自冠方向根尖每间隔1 mm垂直于牙长轴制备牙根横断面切片,每个切片可有冠方和根方两个截面作为研究的观测面,GF组的切片截面数为363个,LC组为361个,VC组为355个.用ZOOM-630连续变倍立体显微镜放大45倍观测切片截面上根充物中的空隙.结果 ①空隙发生率:VC组为21.4%(76/355),显著低于GF组(47.7%,173/363)和LC组(52.6%,190/361),P＜0.0167;GF组与LC组相比差异无统计学意义(P＞0.0167);②空隙面积百分比:3组有空隙切片截面的空隙面积百分比的中位数GF组为2.67,LC组为1.55,VC组为1.01,经非参数检验GF组显著高于VC组、LC组(P=0.000,P=0.008),而VC组与LC组的差异无统计学意义(P=0.076);③根管峡部的充盈完好率:VC组充盈完好率为86%(85/99),显著高于GF组(55%,43/78)和LC组(58%,49/84),P＜0.0167;GF组和LC组相比差异无统计学意义(P＞0.0167).结论 VC组根管系统充盈的致密度最高,优于LC组与GF组.

Evaluation of adaptation of root canal filled with three obturation techniques in vitro

Objective To evaluate the adaptation of root canal filled with three obturation techniques in vitro. Methods Fifty-seven cleaned and shaped premolars were divided into three groups,each group including 10 single root canal premolars and 9 double root canal premolars, and filled respectively with following techniques : GuttaFlow paste with single master cone ( GF group), cold lateral compaction technique with AH plus sealer ( LC group), warm vertical compaction technique with AH plus sealer (VC group). The roots were invested and sectioned at 1 mm interval from crown to apex using a microtome saw under water cooling. Both surfaces of the sections were digitally photographed and measured using a stereomicroscope. The number of sections with voids and the area of voids were measured and analyzed. Results The frequency of sections with voids: VC group (21.4%, 76/355 ) was significantly lower than GF group(47. 7% , 173/363 ) and LC group( 52. 6%, 190/361 ), P < 0. 0167. There was no significant difference between GF and LC group( P > 0. 0167 ). The percentage of voids area (AV%) : GF group was significantly higher than LC and VC group ( P = 0. 000, P = 0. 008 ). The median of GF group was 2. 67, LC group was 1.55, VC group was 1.01. No significant difference between VC and LC group ( P = 0. 076). The filling quality of isthmus: 86% ( 85/99 ) isthmus were well filled in VC, significantly higher than GF group(55% ,43/78) and LC group(58% ,49/84), P <0. 0167. There was no significant difference between GF and LC group(P > 0. 0167). Conclusions The adaptation of root canal filled with warm vertical compaction technique was superior to cold lateral compaction technique and GuttaFlow technique.