上颌第一前磨牙根管峡部的体外研究  

In Vitro Study of the Canal Isthmus in Maxillary First Premolars

作　　者：李红文[1] 耿发云[1] 耿晓瑞[1] 曾宪涛[1] 姚馨蕙[1] 韩晓东[1] 

机构地区：[1]深圳市龙岗中心医院耳鼻咽喉科医院.深圳市耳鼻咽喉研究所,广东深圳518172

出　　处：《口腔医学研究》2013年第5期427-431,共5页Journal of Oral Science Research

摘　　要：目的:比较不同冲洗剂对上颌第一前磨牙根管峡部的清洁效果,运用CT对根管峡部的充填效果进行研究。方法:140颗有根管峡部的上颌第一前磨牙,随机分为5组,采用Protaper旋转镍钛锉进行根管机械预备,冲洗液分别用A组5.25%NaOCl,B组5.25%Naocl+17%EDTA,C组生理盐水,D组3%H2O2,E组0.5%NaOCl+17%EDTA,根管预备后进行标本电镜扫描,观察根管峡部清洁效果;分别用热牙胶垂直加压及冷牙胶侧方加压充填,根管预备及充填后进行CT扫描,以观察根管峡部的形态及体积变化。结果:扫描电镜下观察B组根管峡部牙本质小管和管间结构清晰,清洁效果好;C组、D组玷污层厚,有不同程度的碎屑残留;A组有明显玷污层,少量牙本质小管暴露;E组多数牙本质小管暴露,少量玷污层。结论:5.25%NaOCl+17%EDTA根管峡部清洁效果好;热牙胶垂直加压充填率高;根管峡部充填率显著低于主根管充填率。Objective： To compare isthmus debridement efficacies among different irrigation solutions in maxillary first molars by evaluating root filling effect using computed tomography. Methods： One hundred and forty maxillary first moiars with isthmus structure were divided into five groups randomly. All canals were instrumented by Protaper rotary files before irrigated by different solutions （Group A 5.25 % Naocl, Group B 5.25 % Naocl ＋ 17 %EDTA, Group C Normal Saline, Group D 3% H2O2 , Group E 0.5% Naocl ＋ 17% EDTA）. Electronic scanning microscopy （ESM） was used to observe the isthmus debridement efficacies after these procedures. Vertical condensation filling with warm gutta-percha and lateral pressure filling with cold gutta-percha were deployed. Before instrumentation, after instrumentation, and after root filling, the morphology and volume of isthmus were investigated by CT scan. Results： Under ESM,debridement efficacy was good in Group B with clear structure showed in dentinal tubule and inter-tubular tissue of isthmus. There was a thick smear layer with residual debris to various degree in Group C and D. There was an overt contamination layer with exposure of some dentinal tubule in Group A. In Group E, most of dentinal tubules were exposed with minor contamination layer. Conclusion： The debridement efficacy in root isthmus was best in the group of 5.25% Naocl ＋17% EDTA. The filling proportion was higher in the group of vertical pressure filling with warm guttapercha. The filling ratio was lower significantly in the isthmus than in the main root canals.

关 键 词：上颌第一前磨牙 根管峡部 扫描电镜 CT扫描 

分 类 号：R781.05[医药卫生—口腔医学]