根尖孔偏离根尖顶对根管预备产生根尖孔偏移影响的研究  

Study on the effect of apical foramen migrating from root apex on root canal diversification of root canal preparation

作　　者：谢妮娜 吴翠 刘宗响 

机构地区：[1]徐州医科大学附属徐州口腔医院儿童口腔科,221002 [2]徐州医科大学附属徐州口腔医院牙周粘膜科,221002

出　　处：《现代口腔医学杂志》2017年第4期218-223,共6页Journal of Modern Stomatology

基　　金：江苏省徐州市科技计划项目(KC14SH060)

摘　　要：目的研究三种机用镍钛器械对根尖孔偏离及未偏离解剖根尖顶的根管超工作长度1mm进行预备,观察并分析根尖孔发生偏移的方向、频率和程度,为根尖孔偏离解剖根尖顶与否对根管预备后根尖孔偏移的影响提供理论依据。方法选取因牙周病拔除的120颗离体单根牙,分为A、B两组各60颗牙:根尖孔偏离解剖根尖顶组为A组,根尖孔在解剖根尖顶组为B组,A、B两组再各分为3组分别是:T组(TF组)、P组(Protaper组)、K组(K3组)。根管预备前经扫描电镜拍摄术前片,记录初始根尖孔的表面形态,然后用上述三种锉对A,B组标本分别进行超工作长度(WL+1mm)根管预备,术后再次拍摄根尖孔表面形态,评价根管预备后根尖孔偏移的方向、频率和程度。结果经三种不同镍钛锉超工作长度(WL+1mm)根管预备后,无论原始根尖孔是否偏离解剖根尖顶,标本有85.83%的根尖孔发生了不同方向不同程度的根尖偏移。具体表现为:根尖孔偏移发生率A组较B组高,两组中均为K组较T组高,且差异均有统计学意义(P<0.05)。根尖孔偏移程度也存在这类似的差异,K组高于T组,且K组相对容易产生严重程度(2、3级)的根尖孔偏移,经秩和检验此差异有统计学意义(P<0.05)。结论 TF、K3、Protaper三种机用镍钛旋转器械在超工作长度根管预备时由于器械超根尖止点工作可导致根尖孔偏移发生,尤其当根尖孔偏离根尖顶时,根尖偏移的程度加重。TF锉与Protaper锉、K3锉相比较在减少根尖孔偏移发生率及程度方面更具优越性。Objective To study the incidence and degree of apical foramen diversification after root canal preparation with three kinds of nickel titanium instruments while apical foramen migrating from the anatomical apical apex or not with the root canal working length of lmm ultra and provide a theoretical basis for the effect of apical foramen migration to apical foramen diversification. Methods 120 single rooted teeth were extracted from patients with periodontal disease, which were divided into two groups （A, B） of 60 teeth： the apical foramen migrating from the anatomical apical apex group as A group, the apical foramen not migrating from the anatomical apical apex group as B group;A, B two groups were divided into three groups respeetively：T group （TF group）, P group （Protaper group）, K group （group K3）. Before and after the operation（WL＋lmm）, the changes of the surface morphology of the apical foramen were recorded under the scanning electron microscope （SEM）. The incidence,degree and direction of the apical foramen diversification were recorded. The data were analyzed by rank sum test and Logisitc regression analysis using the SPSS 16.0 statistical package. Results After root canal preparation with three kinds of nickel titanium file under working length （WL＋lmm）, there were 85.83% teeth with different directions and different degrees of apical foramen deviation. The incidence of apical foramen deviation in the A group was higher than that in the B group, the two groups were higher in the K group than in the T group, and the difference was statistically significant （P〈O.05）. There was a similar difference in the degree of apical foramen deviation, the K group was higher than the T group, and the K group is relatively easy to cause serious degree （2, 3）, the difference was statistically significant （P〈0.05） form the rank sum test. Conclusion The root canal preparation with three kinds of instruments beyond the work lengths of lmm can lead to apical foramen diversif

关 键 词：镍钛器械 根管预备 根尖孔偏离 超工作长度 根尖孔偏移 

分 类 号：R781.05[医药卫生—口腔医学]