三种根管预备器械对根管再治疗的临床效果比较  

Comparison of clinic dffects of three instruments in root canal retreatment

作　　者：张爱惠 

机构地区：[1]开封市卫生学校附属医院,河南开封475000

出　　处：《医药论坛杂志》2016年第1期70-72,75,共4页Journal of Medical Forum

摘　　要：目的本文从根管充填质量及根管再治疗后急性反应发生率两方面,对比三种根管预备器械对根管再治疗的疗效。方法选取自2011年至2015年来开封市卫生学校附属医院牙体牙髓病科进行根管再治疗的上颌第一磨牙患牙180颗,按三种不同的根管预备方法将其随机分为三组。A组:采用Mtwo机用镍钛器械标准法预备根管;B组:采用Protaper手用镍钛锉逐步深入法预备根管;C组:采用不锈钢K锉逐步后退法预备根管,三组均釆用氢氧化钙糊剂消毒根管,冷牙胶尖侧压充填法永久充填根管,之后,拍摄术后X线片,观察根管充填效果,并在术后1周进行回访,了解患者急症反应发生情况。结果三组根管充填成功率和急症反应发生率分别是:A组95.1%,10%;B组94.8%,7%;C组81.7%,30%。(A组+B组)根管充填效果优于C组(χ2=8.25,P<0.05);而采用A组和B组进行根管预备后的根管充填效果无明显差异(χ2=0.088,P>0.05)。A组、B组急症反应发生率均显著小于C组,近期疗效优于C组,(P<0.05)。而采用A组和B组进行根管预备后的根管,其发生急性反应的几率无明显差异(P>0.05)。结论进行根管再治疗时,采用Mtwo机用镍钛器械标准法预备根管和Protaper手用镍钛锉逐步深入法预备根管可提高根管预备效果,完善根管充填质量,且术后急症反应发生率相对较低,为这两种方法的临床使用提供一些借鉴。Objective To compare the clinic effects of three instruments in root canal retreatment. It is described from two aspects： root canal filling and the rate of acute pain post operation. Methods Totally 180 maxillary first molars those were need root canal retreatment were selected in our endodontics department from 2011 to 2015, and divided randomised into three groups. A group： routine preparation technique was used in root canal preparation with rotary Ni -Ti instruments Mtwo ; B group ： Crown - down technique was used in root canal preparation with hand - used Ni - Ti Pro- Taper instrument; C group ： modified step - back technique was used in root canal preparation with K - file. All of the teeth were sterilizedby Ca（OH） 2, cold gutta-percha lateral condensation and take X- ray. The efficiency of quality of root canal filling and patients＇eaetion post operation were analyzed after one week root canal retreatment. Results The correct fill -in and the rate of acute pain post operation of three data sets were ：A group 95.1% ,10% ;B group 94.8%, 7% ;C group81.7% ,30%. The correct fill -in of A and B were better than C （P 〈 0.05） ; The rate of acute pain post operation of A and B were lower than C （ P 〈 0.05 ）. Conclusion Root canal retreatment is more effective with rotary Ni - Ti instruments Mtwo and hand - usedNi - Ti ProTaper instruments, Which is worth of clinical popularization and application.

关 键 词：根管再治疗 根管预备 Mtwo机用镍钛锉 PROTAPER手用镍钛锉 

分 类 号：R197.39[医药卫生—卫生事业管理]