手用ProTaper系统结合冠向下技术的临床应用研究

Clinical evaluation of Pro Taper Instruments for hand use in preparation of curved canals using crown-down technique

目的:探讨采用ProTaper系统结合冠向下技术预备弯曲根管的临床疗效。方法:选取牙髓炎和根尖周炎患者有弯曲根管的96颗患牙分成3组:手用镍钛组(NT)用手用ProTaper、冠向下技术预备根管;机用镍钛组(PT)用机用ProTaper、冠向下技术预备根管;不锈钢K锉组(SS)采用常规手用不锈钢K锉、逐步后退法预备根管。3组均用侧向加压充填法充填根管,根据治疗前、中、后的X线片及术后疼痛情况评价根管预备和充填的效果。结果:NT组和PT组均无根管偏移、根尖阻塞、台阶形成等并发症发生,能维持根管的弯曲度和走向,但PT组出现了少量断针及操作长度增加;SS组出现几例明显的台阶形成和根管偏移,且术后疼痛的发生率明显高于NT组和PT组;操作时间PT组最短,NT组次之,SS组最长。结论:手用ProTaper系统结合冠向下技术预备弯曲根管安全、省时,根管成形理想,且医师手感好,操作感强,可视为临床上预备弯曲根管的有效方法。

Objective To evaluate clinical effect of the new ProTap er NiTi instruments for hand use in preparation of curved canals using crown-dow n techique. Methods 96 teeth with curved root canals were devided into 3 groups randomly. The first group were prepared using the ProTaper NiTi instruments for hand use with crown-down techinqus( NT group). The second group were prepared u sing the the ProTaper NiTi instruments for mechanical use with crown-down techni que(PT group). The third group were prepared using the stainless steel hand K-fi les with the step-down technique(SS group). Each group were obturated with later al condenation method. The efficiency of prearation and obturation was analysize d with radiographs before, during and after operation. Results No transportation, apical blockage and ledge was found in N T and PT group. The curvature and flow of curved canals were also kept well in N T and PT group. But instrument fracture and augmentation in operation length wer e found in PT group. In SS group, canal deflection and ledge were found much mor e frequently, and the rate of post treatment pain was also much higher. The oper ation time of PT group was the shorets ,the NT group longer, and SS group the lo ngest. Conclusion The ProTaper NiTi instruments for hand use withing crown- down technique can prepare curved root canals effectively and safely. It produce s good canal shapes. And with these hand use instruments, the operators can get enough echoing information. It is an efficient method for preparation of curved canals.