镍钛根管预备系统预备弯曲根管的成形效果
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摘要
根管预备是根管治疗中的重要步骤，形成一个沿初始解剖形态的锥形根管是根管预备的理想结果。弯曲根管的预备容易形成根管偏移而导致治疗失败。本实验使用不同的镍钛根管预备器械，观察其在不同弯曲树脂牙和离体牙根管中的成形效果。
1．镍钛根管预备系统预备弯曲树脂根管的成形效果
目的 比较不同的镍钛器械在不同弯曲树脂根管中的成形效果。方法选用“L”形单弯(弯曲度40°)和“S”形双弯(根冠部弯曲30°，根尖部弯曲20°)的树脂根管，以不锈钢K锉作对比，选用手用和机用镍钛根管预备器械(2％锥度镍钛K锉、ProTaper、Hero642)预备根管(n=10个)。对于“S”形根管，将不同的预备器械结合，采用连续追踪的动态观察方法，扫描根管获取根管预备前后图像，使用图像分析、测量软件将预备前后图像重叠，测量根管内外侧壁树脂去除量和预备后根管宽度，比较各种器械对根管的成形效果。结果(1)手用镍钛器械预备“L”形树脂根管：手用ProTaper对根管弯曲部内侧和根尖外侧树脂去除量及根管直化角度少于不锈钢K锉(P＜0.05)，预备后根管宽度从根管口到根尖孔逐渐减小。(2)机用镍钛器械预备“L”形树脂根管：ProTaper
Root canal preparation is one of the most important steps in root canal therapy, creating a continuously tapered funnel and respecting the original shape and curvature of the canal are the ideal preparation, aberrations may occur when instruments used in curved canals, the purpose of this study was to compare the shaping ability of different nickel-titanium instruments in simulated resin curved root canals and extracted teeth.
Part 1. Shaping ability of nickel-titanium instruments in simulated resin curved root canals .
Objective To compare the shaping ability of different nickel-titanium instruments in simulated resin curved root canals.
Methods Simulated resin root canals with two different shapes were selected:one was L-shaped(curvature=40 ° ),another was S-shaped(coronal curvature =30° and apical curvature =20° ), these canals (n=10 in each group)were prepared with hand and rotary nickel-titanium instruments, respectively, canals with two shapes were prepared with hand and rotary stainless steel K files as control, a combination of different instruments were used in S- shaped canals
1．镍钛根管预备系统预备弯曲树脂根管的成形效果
目的 比较不同的镍钛器械在不同弯曲树脂根管中的成形效果。方法选用“L”形单弯(弯曲度40°)和“S”形双弯(根冠部弯曲30°，根尖部弯曲20°)的树脂根管，以不锈钢K锉作对比，选用手用和机用镍钛根管预备器械(2％锥度镍钛K锉、ProTaper、Hero642)预备根管(n=10个)。对于“S”形根管，将不同的预备器械结合，采用连续追踪的动态观察方法，扫描根管获取根管预备前后图像，使用图像分析、测量软件将预备前后图像重叠，测量根管内外侧壁树脂去除量和预备后根管宽度，比较各种器械对根管的成形效果。结果(1)手用镍钛器械预备“L”形树脂根管：手用ProTaper对根管弯曲部内侧和根尖外侧树脂去除量及根管直化角度少于不锈钢K锉(P＜0.05)，预备后根管宽度从根管口到根尖孔逐渐减小。(2)机用镍钛器械预备“L”形树脂根管：ProTaper
Root canal preparation is one of the most important steps in root canal therapy, creating a continuously tapered funnel and respecting the original shape and curvature of the canal are the ideal preparation, aberrations may occur when instruments used in curved canals, the purpose of this study was to compare the shaping ability of different nickel-titanium instruments in simulated resin curved root canals and extracted teeth.
Part 1. Shaping ability of nickel-titanium instruments in simulated resin curved root canals .
Objective To compare the shaping ability of different nickel-titanium instruments in simulated resin curved root canals.
Methods Simulated resin root canals with two different shapes were selected:one was L-shaped(curvature=40 ° ),another was S-shaped(coronal curvature =30° and apical curvature =20° ), these canals (n=10 in each group)were prepared with hand and rotary nickel-titanium instruments, respectively, canals with two shapes were prepared with hand and rotary stainless steel K files as control, a combination of different instruments were used in S- shaped canals
引文
[1] Peters OA. Current challenges and concepts in the preparation of root canal systems:a review[J]. J Endodon ,2004,30(8):559-566.
[2] Bergmans L, Cleynenbreugel JV, Beullens M, et al. Progressive versus constant tapered shaft desige using NiTi rotary instruments [J]. Int Endod J, 2003,36(4):288-295.
[3] Ponti TM, McDonald N J, Kuttler S, et al. Canal-centering ability of two rotary file systems[J]. J Endodon, 2002,28(4):283-286.
[4] Patino PV, Biedma BM, Liebana CR. The influence of a manual glide path on the separation rate of NiTi rotary instruments[J]. J Endodon ,2005,31 (2): 114-116.
[5] Martin B, Zelada G, Varela P, et al.Faetors influencing the fracture of nickel-titanium rotary instruments[J]. Int Endod J ,2003, 36(4): 262-266.
[6] 韦曦，张顺彬．镍钛机动根管预备器械对根管弯曲度的影响[J]．上海口腔医学，2001，10(4)：333-335．
[7] 彭彬，郭继华，张俊，等．三种不同器械预备弯曲根管时根管偏移的实验研究[J]．牙体牙髓牙周病学杂志，2003，13(2)：82-84．
[8] Thompson SA,Dummer PMH(1997a). Shaping ability of NT engine and McXim rotary nickel-titanium instruments in simulated root canals:pattl [J]. Int Endod J 30.262-269.
[9] Paque F, Musch U,Hulsmann M .Comparison of root canal preparation using RaCe and ProTaper rotary Ni-Ti instruments[J]. Int Endod J,2005.38(1).8-16.
[10] Thompson SA, Dummer PMH. Shaping ability of Hero 642 rotary nickel-titanium instruments in simulated root canals: part 1 [J]. Int Endod J ,2000,33:248-254.
[11] Bertrand MF, Lupi-Pegurier L, Medioni E, et al. Curved molar root canal preparation using Hero 642 rotary nickel-titanium instruments[J]. Int Endod J ,2001,34:631-636.
[12] Garala M, Kuttler S, Hardigan P, et al. A comparision of the minimum canal wall thickness remaining following preparation using two nickel-titanium rotary systems[J]. Int Endod J ,2003,36: 636-642.
[13] Peters OA, Peters CI, Schonenberger K, et al. ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by micro CT[J]. Int Endod J ,2003,36(2):86-92.
[14] Fosehi F, Nucci C, Montebugnoli L, et al. SME evaluation of canal wall dentine following use of Mtwo and ProTaper NiTi rotary instruments[J]. Int Endod J ,2004,37:832-839.
[15] 徐琼，范兵，樊明文，等．ProTaper预备弯曲根管的临床评价[J]．中华口腔医学杂志，2004，39(2)：136-138．
[16] Schneider S.A comparision of canal preparation in straight and curved root canals[J]. Oral Surg, 1971,32(2):271-275.
[17] Cunningharn CJ, Senia S. A three-dimensional study of canal curvatures in the mesial roots of mandibular molars[J]. J Endodon, 1992,18(6):294-300.
[18] Calberson FLG, Deroose CAJG, Hommez GMG, et al.Shaping ability of ProTaper nickel-titanium files in simulated resin root canals[J]. Int Endod J 2004,37 (9) :613-623.
[19] Alapati SB, Brantley WA, Svec TA, et al. Proposed role of embedded dentine chips for the clinical failure of nickel-titanium rotary instruments[J]. J Endodon ,2004,30(5):339-341.
[20] Guelzow A, Stamm O, Martus P, et al. Comparative study of six rotary nickel-titanium systems and hand instrumentation for root canal preparation[J]. Int Endod J, 2005,38:743-752.
[21] Alodeh MHA,Dummer PMH. A comparision of the ability of K-file and Hedstron files to shape simulated root canals in resin blocks[J]. Int Endod J, 1989,22:226-235.
[22] Yun H,Kim SK. A comparison n of the shaping abilities of 4 nickel-titanium rotary instruments in simulated root canals[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 95(2): 228-233.
[23] Schafer E,Vlassis M.Comparative investigation of two rotary nickel-titanium instruments:ProTaper versus RaCe.Part 1.shaping ability in simulated curved canals[J]. Int Endod J ,2004, 37 (4) : 229-238.
[24] 朱亚琴，顾迎新，杜嵘．三种器械预备磨牙弯曲根管成形能力的比较[J]．华西口腔医学杂志，2005，23(5)：393-396．
[25] 徐琼，樊明文，范兵，等．机用镍钛器械预备弯曲根管的临床应用[J]．华西口腔医学杂志，2005，23(4)：286-291．
[26] Thompson SA, Dummer PMH. Shaping ability of Hero 642 rotary nickel-titanium instruments in simulated root canals: part 2[J]. Int Endod J ,2000,33:248-254.
[27] Hulsmann M, Schade M, Schafers F. A comparative study of root canal preparation with Hero 642 and Quantec SC rotary Ni-Yi instruments[J]. Int Endod J, 2001,34:538-546.
[28] Peters OA, Peters CI, Schonenberger K, et al. ProTaper rotary root canal preparation :assessment of torque and force in relation to canal anatomy[J]. Int Endod J, 2003,36 (2) :93-99.
[29] 徐琼，樊明文，范兵．镍钛机用器械在磨牙根管治疗术中的应用研究．牙体牙髓牙周病学杂志[J]，2004，14(4)：211-214．
[30] Alapati SB, Brantey WA, Svec TA, et al. SEM observations of nickel-titanium rotary endodontic instruments that fractured during clinical use[J]. J Endodon, 2004,31 (1):40-43.
[31] 韦曦，林正梅，彭思敏．镍钛机动器械预备根管减少术后疼痛的临床研究[J]．华西口腔医学杂志，2003，21(3)：202-204．
[32] Ankrum MT, Hartwell GR,Truitt JE. k3 endo,ProTaper, and ProFile systems:breakage and distortion in severely curved roots of molars[J]. J Endodon ,2004,30(4):234-237.
[33] Berutti E, Negro AR, Lendini M, et al. Influence of manual preflaring and torque on the failure rate of ProTaper rotary instruments[J]. J Endodon ,2004,30(4):228-230.
[34] Yared G, Bou DF, Kulkami K. Influence of torque control motors and the operator's proficiency on ProTaper failures[J]. Oral Surg Oral Meal Oral Pathol Oral Radiol, Endod 2003,96(2):229-233.
[35] Cunningham CJ,Senia ES. A three-dimensional study of canal curvatures in the mesial root of mandibular molars[J]. J Endod, 1992,18(6):294-300.
[36] Goerig LAC, Michelich RJ, Schultz CHH. Instrumentation of root canal in molar using the step-down technique[J]. J Endod, 1982,8(12): 550-554.
[37] Massa GR, Nicholls JI, Harrington GW. Torsional properties of the canal master instrument[J]. J Endod ,1992,18:336-339.
[38] Weller P J, Svec TA, Power JM, et al. Remaining dentin thickness in the apical 4mm following four cleaning and shaping techniques[J]. J Endod ,2005,31 (6):464-467.
[39] Iqbal MK, Firic S, Tulcan J, et al. Comparision of apical transportation between Profile and ProTaper NiTi rotary instruments[J]. Int Endod J ,2004,37:359-364.
[40] 曾志平，韦曦，董显进，等．Pro Taper机用镍钛技术在根管预备中的应用研究[J]．口腔医学，2003，23(4)：234-236．
[41] Fife D,Gambarini G, Britto LR,et al.Cyclic fatigue of ProTaper NiTi rotary instruments after clinical use[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod ,2004,97(2):251-256.
[42] Coleman CL, Svec TA. Analysis of Ni-Ti versus stainless steel instrumentation in resin simulated canal[J]. J Endod, 1997,23: 232-235.
[43] Esposito PT, Cunningham CJ. A comparison of canal preraration with nickel-titanium and stainless steel instruments[J]. J Endod, 1995,21 (4): 173-176.
[44] Glosson CR, Hailer RH, Brent Dove S, et al. A comparison of root canal prerarations using Ni-Ti hand,Ni-Ti engine-driven,and K-Flex endodontic instruments[J]. J Endod ,1995,21:146-151.
[45] Gambill JM, Alder M, del Rio CE. Comparison of nickel-titanium and stainless steel hand file instrumentation using computed tomography[J]. J Endod, 1996,22(7):369-375.
[46] 韦曦，凌均棨．镍钛机用器械预备弯曲根管的研究进展[J]．上海口腔医学，2002，11(2)：158-160．
[47] Yosbimine Y, Ono M,Akamine A.The shping effects of three nickel-titanium rotary instruments in simulated s-shaped canals[J]. J Endodon,2005,31 (5):373-375.
[48] Blum JY, Machtou P, Ruddle C,et al.Analysis of mechanical preparation in extracted teeth using Pro Taper rotary instruments: value of the safety quotient[J]. J Endodon, 2003,29(9): 567-575.
[49] 徐琼，凌均棨，陈罕，等．新型机动镍钛器械预备根管的疗效评价[J]．上海口腔医学，2005，14(1)：2-5．
[50] Veltri M,Mollo A,Pini PP, et al.In vitro comparison of shaping abilities of ProTaper and GT rotary files[J]. J Endod , 2004,30(3): 163-166.
[51] Iqbal MK, Maggiore F, Suh B,et al. Comparision of apical transportation in four Ni-Ti rotary instrumentation techniques[J]. J Endodon ,2003,29(9):587-591.
[52] Parashos P, Gordon I, Messer HH. Factors influencing defects of rotary nickel-titanium endodontic instruments after clinical use[J].J Endodon ,2004,30(10):722-725.
1. Deplazes P, Peters O, Barbakow F. J Endod 2001,27(3): 196-202
2. Veltri M, Mollo A, Paolo Pini P, et al. J Endod 2004,30(3): 163-166
3. Bergmans L, Cleynenbreugel JV, Beullens M, et al. Int Endod J 2003, 36(4):288-295
4. Peters OA, Peters CI, Schonenberger K, et al. Int Endod J 2003, 36(2):86-92
5. Turpin YL, Chagneau F, Bartier O,et al. J Endod 2001, 27(5): 333-336
6. Yun H, Kim SK. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003,95(2):228-233
7. Sattapan B, Palamara JE, Messer HH. J Endod 2000, 26(3): 156-160
8. Blum JY, Machtou P, Ruddle C, et al. J Endodon 2003, 29(9): 567-575
9. Schafer E, Vlassis M. Int Endod J 2004,37(4):229-238
10. Peters OA, Peters CI, Schonenberger K, et al. Int Endod J 2003, 36(2): 93-99
11. Sattapan B, Nervo GJ, Palamara JEA, et al. J Endod 2000, 26(3): 161-165
12. Dietz DB , Di Fiore PM, Bahcall JK, et al. J Endod 2000, 26(2): 68-71
13. Yared G, Bou DF, Kulkarni K. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003,96(2):229-233
14. Calberson FLG, Deroose CAJG, Hommez GMG, et al. Int Endod J 2004,37(9):613-623
15. Fife D, Gambarini G, Britto LR, et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004,97(2):251-256
16. Berutti E, Chiandussi G, Gaviglio I, et al. J Endodon 2003, 29(1): 15-19
17. Berutti E, Negro AR, Lendini M, et al. J Endodon 2004, 30(4): 228-230
18. Martin B, Zelada G, Varela P, et al. Int Endod J 2003, 36(4): 262-266
[2] Bergmans L, Cleynenbreugel JV, Beullens M, et al. Progressive versus constant tapered shaft desige using NiTi rotary instruments [J]. Int Endod J, 2003,36(4):288-295.
[3] Ponti TM, McDonald N J, Kuttler S, et al. Canal-centering ability of two rotary file systems[J]. J Endodon, 2002,28(4):283-286.
[4] Patino PV, Biedma BM, Liebana CR. The influence of a manual glide path on the separation rate of NiTi rotary instruments[J]. J Endodon ,2005,31 (2): 114-116.
[5] Martin B, Zelada G, Varela P, et al.Faetors influencing the fracture of nickel-titanium rotary instruments[J]. Int Endod J ,2003, 36(4): 262-266.
[6] 韦曦，张顺彬．镍钛机动根管预备器械对根管弯曲度的影响[J]．上海口腔医学，2001，10(4)：333-335．
[7] 彭彬，郭继华，张俊，等．三种不同器械预备弯曲根管时根管偏移的实验研究[J]．牙体牙髓牙周病学杂志，2003，13(2)：82-84．
[8] Thompson SA,Dummer PMH(1997a). Shaping ability of NT engine and McXim rotary nickel-titanium instruments in simulated root canals:pattl [J]. Int Endod J 30.262-269.
[9] Paque F, Musch U,Hulsmann M .Comparison of root canal preparation using RaCe and ProTaper rotary Ni-Ti instruments[J]. Int Endod J,2005.38(1).8-16.
[10] Thompson SA, Dummer PMH. Shaping ability of Hero 642 rotary nickel-titanium instruments in simulated root canals: part 1 [J]. Int Endod J ,2000,33:248-254.
[11] Bertrand MF, Lupi-Pegurier L, Medioni E, et al. Curved molar root canal preparation using Hero 642 rotary nickel-titanium instruments[J]. Int Endod J ,2001,34:631-636.
[12] Garala M, Kuttler S, Hardigan P, et al. A comparision of the minimum canal wall thickness remaining following preparation using two nickel-titanium rotary systems[J]. Int Endod J ,2003,36: 636-642.
[13] Peters OA, Peters CI, Schonenberger K, et al. ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by micro CT[J]. Int Endod J ,2003,36(2):86-92.
[14] Fosehi F, Nucci C, Montebugnoli L, et al. SME evaluation of canal wall dentine following use of Mtwo and ProTaper NiTi rotary instruments[J]. Int Endod J ,2004,37:832-839.
[15] 徐琼，范兵，樊明文，等．ProTaper预备弯曲根管的临床评价[J]．中华口腔医学杂志，2004，39(2)：136-138．
[16] Schneider S.A comparision of canal preparation in straight and curved root canals[J]. Oral Surg, 1971,32(2):271-275.
[17] Cunningharn CJ, Senia S. A three-dimensional study of canal curvatures in the mesial roots of mandibular molars[J]. J Endodon, 1992,18(6):294-300.
[18] Calberson FLG, Deroose CAJG, Hommez GMG, et al.Shaping ability of ProTaper nickel-titanium files in simulated resin root canals[J]. Int Endod J 2004,37 (9) :613-623.
[19] Alapati SB, Brantley WA, Svec TA, et al. Proposed role of embedded dentine chips for the clinical failure of nickel-titanium rotary instruments[J]. J Endodon ,2004,30(5):339-341.
[20] Guelzow A, Stamm O, Martus P, et al. Comparative study of six rotary nickel-titanium systems and hand instrumentation for root canal preparation[J]. Int Endod J, 2005,38:743-752.
[21] Alodeh MHA,Dummer PMH. A comparision of the ability of K-file and Hedstron files to shape simulated root canals in resin blocks[J]. Int Endod J, 1989,22:226-235.
[22] Yun H,Kim SK. A comparison n of the shaping abilities of 4 nickel-titanium rotary instruments in simulated root canals[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003, 95(2): 228-233.
[23] Schafer E,Vlassis M.Comparative investigation of two rotary nickel-titanium instruments:ProTaper versus RaCe.Part 1.shaping ability in simulated curved canals[J]. Int Endod J ,2004, 37 (4) : 229-238.
[24] 朱亚琴，顾迎新，杜嵘．三种器械预备磨牙弯曲根管成形能力的比较[J]．华西口腔医学杂志，2005，23(5)：393-396．
[25] 徐琼，樊明文，范兵，等．机用镍钛器械预备弯曲根管的临床应用[J]．华西口腔医学杂志，2005，23(4)：286-291．
[26] Thompson SA, Dummer PMH. Shaping ability of Hero 642 rotary nickel-titanium instruments in simulated root canals: part 2[J]. Int Endod J ,2000,33:248-254.
[27] Hulsmann M, Schade M, Schafers F. A comparative study of root canal preparation with Hero 642 and Quantec SC rotary Ni-Yi instruments[J]. Int Endod J, 2001,34:538-546.
[28] Peters OA, Peters CI, Schonenberger K, et al. ProTaper rotary root canal preparation :assessment of torque and force in relation to canal anatomy[J]. Int Endod J, 2003,36 (2) :93-99.
[29] 徐琼，樊明文，范兵．镍钛机用器械在磨牙根管治疗术中的应用研究．牙体牙髓牙周病学杂志[J]，2004，14(4)：211-214．
[30] Alapati SB, Brantey WA, Svec TA, et al. SEM observations of nickel-titanium rotary endodontic instruments that fractured during clinical use[J]. J Endodon, 2004,31 (1):40-43.
[31] 韦曦，林正梅，彭思敏．镍钛机动器械预备根管减少术后疼痛的临床研究[J]．华西口腔医学杂志，2003，21(3)：202-204．
[32] Ankrum MT, Hartwell GR,Truitt JE. k3 endo,ProTaper, and ProFile systems:breakage and distortion in severely curved roots of molars[J]. J Endodon ,2004,30(4):234-237.
[33] Berutti E, Negro AR, Lendini M, et al. Influence of manual preflaring and torque on the failure rate of ProTaper rotary instruments[J]. J Endodon ,2004,30(4):228-230.
[34] Yared G, Bou DF, Kulkami K. Influence of torque control motors and the operator's proficiency on ProTaper failures[J]. Oral Surg Oral Meal Oral Pathol Oral Radiol, Endod 2003,96(2):229-233.
[35] Cunningham CJ,Senia ES. A three-dimensional study of canal curvatures in the mesial root of mandibular molars[J]. J Endod, 1992,18(6):294-300.
[36] Goerig LAC, Michelich RJ, Schultz CHH. Instrumentation of root canal in molar using the step-down technique[J]. J Endod, 1982,8(12): 550-554.
[37] Massa GR, Nicholls JI, Harrington GW. Torsional properties of the canal master instrument[J]. J Endod ,1992,18:336-339.
[38] Weller P J, Svec TA, Power JM, et al. Remaining dentin thickness in the apical 4mm following four cleaning and shaping techniques[J]. J Endod ,2005,31 (6):464-467.
[39] Iqbal MK, Firic S, Tulcan J, et al. Comparision of apical transportation between Profile and ProTaper NiTi rotary instruments[J]. Int Endod J ,2004,37:359-364.
[40] 曾志平，韦曦，董显进，等．Pro Taper机用镍钛技术在根管预备中的应用研究[J]．口腔医学，2003，23(4)：234-236．
[41] Fife D,Gambarini G, Britto LR,et al.Cyclic fatigue of ProTaper NiTi rotary instruments after clinical use[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod ,2004,97(2):251-256.
[42] Coleman CL, Svec TA. Analysis of Ni-Ti versus stainless steel instrumentation in resin simulated canal[J]. J Endod, 1997,23: 232-235.
[43] Esposito PT, Cunningham CJ. A comparison of canal preraration with nickel-titanium and stainless steel instruments[J]. J Endod, 1995,21 (4): 173-176.
[44] Glosson CR, Hailer RH, Brent Dove S, et al. A comparison of root canal prerarations using Ni-Ti hand,Ni-Ti engine-driven,and K-Flex endodontic instruments[J]. J Endod ,1995,21:146-151.
[45] Gambill JM, Alder M, del Rio CE. Comparison of nickel-titanium and stainless steel hand file instrumentation using computed tomography[J]. J Endod, 1996,22(7):369-375.
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