不同扩根器械拆除根管充填物的比较研究  

A comparison of the removal of filling material with different instruments

作　　者：黄轶锋[1] 朱亚琴[1] 潘鸣镝[1] 李辰[2] 

机构地区：[1]上海交通大学医学院附属第九人民医院口腔内科,上海200011 [2]上海同济大学附属口腔医院口腔内科,上海200072

出　　处：《口腔材料器械杂志》2005年第4期184-186,191,共4页Chinese Journal of Dental Materials and Devices

摘　　要：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^2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。Objective To compare the abilities of different instruments used in re-treatment of filled root canals. Methods 48 canals from single-rooted maxibular anteriors were instrumented by a standardized method to an apical ISO size 40 taper. They were obturated with iodoform paste and laterally condensed gutta-percha, divided into four groups. Re-treatment was performed with the following techniques： K-files （group Ⅰ ）; H-files （group Ⅱ ）; K-files with rotary instrumentation （group Ⅲ ）; H-files with rotary instrumentation （groupⅣ）. Chloroform was used in all groups. The time required to achieve the working length was recorded. The teeth were subsequently split in vertical section, photographs were taken with a digital camera and the remnants within the root canals after the re-treatment procedure were examined. The amount of filling materials pushed out of apex was also recorded. The results were compared by means of ANOVA test and Chi square test among the four groups. Results Group Ⅳ was significantly faster than other groups （P〈0.01）to achieve the working length. All groups left gutta-percha inside the canal, and there was no significant difference among them in the coronal and middle third of canal. But in the apical third of canal, Group Ⅳ was significantly clearer than other groups （P〈0.05）. There was a perforation in group Ⅲ. Conclusion H-files remove the filling materials faster and more clearly than other instruments. Reciprocal can lighten the working intensity. But there is a risk of perforation. It＇s necessary subsequently to clean and shape the root canal.

关 键 词：根管治疗 根管充填 根管再治疗 回旋手机 根管治疗后 扩根器械 充填物 显著性差异 回旋手机 联合使用 工作长度 根管再治疗 X^2检验 

分 类 号：R781.05[医药卫生—口腔医学]