临床常用根管预备器械清洁能力的扫描电镜观察  

Scanning Electron Microscopic investigation on the cleaning ability of different root canal preparation instruments

作　　者：郭晓琳 彭伟[2] 鲁丽珍 吴明 刘海波 杜礼安[3] 

机构地区：[1]秦皇岛市妇幼保健院口腔科,河北秦皇岛066000 [2]河北联合大学口腔医学院,河北唐山063000 [3]唐山市职业技术学院口腔系,河北唐山063000

出　　处：《牙体牙髓牙周病学杂志》2013年第9期595-598,601,共5页Chinese Journal of Conservative Dentistry

基　　金：秦皇岛市科技支撑项目(201101A324)

摘　　要：目的：比较临床常用根管预备器械的清洁能力，为临床选择理想的根管预备器械提供依据。方法：选择60个离体单根管前磨牙（弯曲度为10-20。），随机分为6组，分别以不锈钢K锉（K组）、VDWK锉（VK组）、手用ProTaper（HP组）、机用ProTaper（P组）、Hero642（H组）、Mtwo（M组）预备根管。制备扫描电镜标本，观察并对根管壁的残屑和玷污层进行评分，比较6种预备器械对根管的清洁能力。结果：在根中1／3和根尖1／3区域，各组间碎屑评分均有统计学意义（P〈0．05），P、H、M组与K组之间碎屑评分均有统计学差异（P〈0．05）；其中P组碎屑评分最低，K组碎屑评分最高。在根管冠、中和根尖1／3区域K组与P、H、M组之间玷污层评分均有统计学差异（P〈0．05），在中1／3和根尖1／3区域，VK组与P、M组之间玷污层评分有统计学差异（P〈0．05）。结论：ProTaper、Mtwo、Hero642机用镍钛器械的清洁能力无显著区别，但明显优于不锈钢器械。所有器械均不能完全去除根管内碎屑和产生无玷污层表面，尤其是根尖1／3。AIM： To compare the cleaning ability of commonly used root canal preparation instruments, thus provide some evidence for clinical application. METHODS： 60 extracted radix bicuspid teeth were randomly di- vided into 6 groups（n = 10）. The teeth were respectively prepared with stainless steel K-files （ group K）, VDW K files （group VK） , hand use Protaper （group HP） , machine use Protaper （group P） , Hero 642 （group H） and Mtwo （ group M）. The samples were observed under scanning electron microscope and scored about the debris and smear lay er of root canals. RESULTS ： At the middle 1/3 and apical 1/3 areas, there was statistical differences among the 6 groups in terms of debris （ P 〈 0.05 ）, further pairwise comparison showed that there was statistical differences among group P, H, M and group K （P 〈 0.05 ）. The debris score of group P was the lowest and that of group K was the high est. At the coronal 1/3, middle 1/3 and apical 1/3 areas, there was statistical difference among group P, H and M in smear layer scores （P 〈 0.05）. At the middle 1/3 and apical 1/3 areas, there was statistical differences among group M ,P and VK in smear layer scores （P 〈0.05）. CONCLUSION： Machine use Protaper, Hero 642 and Mtwo Nickel titanium rotary instruments have the same cleaning efficacy and better than stainless steel root canal instrument. However, none of these instruments can completely remove the debris and smear layer, especially on the apical 1/3.

关 键 词：根管治疗 根管预备器械 清洁能力 玷污层 

分 类 号：R781.05[医药卫生—口腔医学]