CAJ | 학술논문

目的评价3种常用根管预备方法对C形根管的成形效果,为临床治疗提供参考.方法对临床拔除的具有C形根管的下颌第二恒磨牙60颗,应用改良Bramante技术,于距根尖2mm、5 mm和8mm处将牙根横断.选择手用不锈钢K锉逐步后退技术(Step-Back组)、逐步深入技术(Step-Down组)和机用旋转镍钛锉ProTaperTM系列冠向下预备技术(Crown-Down组)预备不同类型的C形根管,比较预备前后根管横截面形态的数码图像,对3种不同方法的成形效果进行评价.结果 3种方法预备离体下颌第二磨牙C形根管后均有遗漏.不锈钢K锉逐步后退技术和不锈钢K锉逐步深入技术分别在根冠部[遗漏面积百分比分别为(0.177±0.071)%、(0.068±0.074)%]和根尖部[遗漏面积百分比分别为(0.236±0.167)%、(0.295±0.171)%]遗漏较少(P＜0.05).CⅠ、CⅡ型遗漏出现在近远中多于颊舌侧,将其分为独立的2～3个根管预备可减少遗漏.不同方法预备根尖区的遗漏均显著高于根管中上部(P＜0.05).结论早期开敞根管上段,将C形根管分为2～3个独立的根管进行预备,可以增进根管预备的成形效果.
목적 평개3충상용근관예비방법대C형근관적성형효과,위림상치료제공삼고.방법 대림상발제적구유C형근관적하합제이항마아60과,응용개량Bramante기술,우거근첨2mm、5 mm화8mm처장아근횡단.선택수용불수강K촤축보후퇴기술(Step-Back조)、축보심입기술(Step-Down조)화궤용선전얼태촤ProTaperTM계렬관향하예비기술(Crown-Down조)예비불동류형적C형근관,비교예비전후근관횡절면형태적수마도상,대3충불동방법적성형효과진행평개.결과 3충방법예비리체하합제이마아C형근관후균유유루.불수강K촤축보후퇴기술화불수강K촤축보심입기술분별재근관부[유루면적백분비분별위(0.177±0.071)%、(0.068±0.074)%]화근첨부[유루면적백분비분별위(0.236±0.167)%、(0.295±0.171)%]유루교소(P＜0.05).CⅠ、CⅡ형유루출현재근원중다우협설측,장기분위독립적2～3개근관예비가감소유루.불동방법예비근첨구적유루균현저고우근관중상부(P＜0.05).결론 조기개창근관상단,장C형근관분위2～3개독립적근관진행예비,가이증진근관예비적성형효과.
Objective To investigate the shaping efficiency of three instrumentation techniques in the C-shaped canals.Methods Sixty extracted mandibular second molars with C-shaped canals were selected and cross-sectioned at 2,5,8 mm from the apex by using a muffle system as described by Bramante.The teeth containing C-shaped canals were randomly divided into three groups,respectively instrumented using stainless steel K-files in step-back and step-down techniques.and ProTaperTM series in crown-down technique.The digital images of canal cross-sections pre-and post-instrumentation were photographed to evaluate the proportion and position of uninstrumented area.Working length loss and perforation were recorded.Data were analyzed using ANOVA.Results Step-down technique gained smaller uninstrumented area in the coronal third of the canals,while step-beck technique gained the same results in the apical third(P＜0.05).Uninstrumented proportion in apical part was significantly higher than in the middle and the coronal(P＜0.05).Instrumenting type Ⅰ canal as 2 or 3 separated canals Was likely to reduce the miss.There were three perforations in manual stainless steel K-file groups.Conclusions Early opening the coronal part of C-shaped canal,shaping C-shaped canal as two or three separated canals and instrumenting the apical part with step-back technique,seemed to be the effective methods to avoid miss.