四种方法去除根管内氢氧化钙的效率比较  

Comparison of four methods that remove calcium hydroxide from root canals

作　　者：杨楠[1,2] 王月月 单晓阳 杜钦霞[1] 李宁毅[1,2] 孙慧斌[1,2] YANG Nan;WANG Yueyue;SHAN Xiaoyang;DU Qinxia;LI Ningyi;SUN Huibin(Department of Stomatology,Affiliated Hospital of Qingdao University,Qingdao 266003,China;School of Stomatology of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院口腔科,山东青岛266003 [2]青岛大学口腔医学院,山东青岛266003

出　　处：《口腔疾病防治》2023年第7期494-500,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：青岛市医药卫生科研计划项目(2021-WJZD167)。

摘　　要：目的比较四种清除根管内氢氧化钙方法的效率,为临床根管内消毒药物的去除提供参考。方法收集65颗离体下颌单根管前磨牙,截冠、根管预备后,随机选取1颗做空白对照组,剩余64颗平均分A、B组(n=32),A组注入成品水溶性氢氧化钙,B组注入成品油溶性氢氧化钙。封药2周后,A、B组内根据不同冲洗技术随机分为4组(n=8),分别为侧方开口注射器冲洗组、声波荡洗组、超声荡洗组、Er:YAG激光荡洗组。锥形束CT扫描氢氧化钙清除前后的样本,将数据导入Mimics软件进行三维重建,将根管分为根上段、根中段和根尖段,并计算根管各段的氢氧化钙体积。清除前氢氧化钙体积为V_(1),清除后氢氧化钙体积为V_(2),清除率=(V_(1)-V_(2))/V_(1)×100%。使用三因素方差分析进行统计分析。A、B组重建后选择根尖残余氢氧化钙量较多的各1颗与空白对照行扫描电镜(SEM)观察。结果两种类型的氢氧化钙用4种冲洗方式均无法完全去除氢氧化钙。水溶性氢氧化钙清除率比油溶性氢氧化钙高(P<0.001);根管三段中,根尖段的清除率较低(P<0.05)。Er:YAG激光荡洗组在去除两种氢氧化钙的效率最高,尤其在根尖段;超声组对比声波荡洗组与注射器冲洗组,均有显著优势(P<0.05),声波荡洗组仅在油性氢氧化钙根中段组清除率高于注射器冲洗组(P<0.05)。扫描电镜观察,两种氢氧化钙均无法完全去除,但油溶性的氢氧化钙残存率大。结论四种清除方式中,两种类型的氢氧化钙均无法完全去除,油溶性较水溶性氢氧化钙难去除;Er:YAG激光荡洗较其他冲洗方式,清除效率较高。Objective To compare the efficiency of four methods that remove calcium hydroxide in root canals and to guide clinical practice.Methods Sixty-five isolated mandibular single root canal premolars were collected.After crown cutting and root canal preparation,a tooth was randomly selected as the blank control group,and the remaining64 teeth were equally divided into Groups A and B(n=32).Group A was injected with water-soluble calcium hydroxide,and Group B was injected with oil-soluble calcium hydroxide.After 2 weeks of drug sealing,Groups A and B were randomly divided into 4 groups(n=8),including the lateral opening syringe group,sonic vibration group,ultrasonic group,and Er:YAG laser group.Before and after calcium hydroxide removal,the samples were scanned by cone-beam CT,and the data were imported into Mimics for 3D reconstruction.The root canal was divided into the following segments:superior root segment,middle and apical,and the calcium hydroxide volume of each segment of the root canal was calculated.The volumes of calcium hydroxide before and after removal were V_(1)and V_(2),respectively,with a clearance rate=(V_(1)-V_(2))/V_(1)×100%.Three-factor ANOVA was used for statistical analysis.After Groups A and B were reconstructed,the apical region with residual calcium hydroxide was selected,and the blank control was observed by scanning electron microscopy(SEM).Results Two types of calcium hydroxide could not be completely removed by the four flushing methods.The clearance rate of water-soluble calcium hydroxide was higher than that of oil-soluble calcium hydroxide(P<0.001).Among the three segments of the root canal,the clearance rate of the apical segment was lower(P<0.05).The Er:YAG laser treatment group showed the highest removal efficiency of two kinds of calcium hydroxide,which was higher than that of the other groups,especially in apical of the root.Compared with the sonic wave washing group and the syringe washing group,the ultrasonic wave washing group exhibited significant advantages(P<0.05).The cleara

关 键 词：氢氧化钙 根管冲洗 Er:YAG激光荡洗 超声荡洗 声波荡洗 MIMICS软件 

分 类 号：R78[医药卫生—口腔医学]