机用镍钛器械ProTaper预备老年人后牙弯曲根管的临床评价

Clinical evaluation of Ni-Ti rotary instruments in preparation curved root canals for the aged

目的:评价用机用镍钛器械ProTaper预备老年人后牙弯曲根管的临床疗效。方法:选取患有牙髓炎或根尖周炎的具有弯曲根管的老年人后牙82例,随机分为实验组(41例)和对照组(41例),实验组采用机用镍钛器械ProTaper以冠根向深入法进行根管预备,对照组采用手用不锈钢K锉以标准的逐步后退法进行根管预备,根据治疗前、中、后的X线片评价根管预备和充填的效果。结果:与对照组相比,实验组ProTaper能很好地维持根管的弯曲度和走向,根管的锥度和流畅度极佳,且操作时间短,少有术后疼痛的发生,但实验组有2例器械折断。每根管预备时间实验组为5.5±1.2min,对照组为9.5±1.1min;根管预备后疼痛发生率实验组为12.2%,对照组为43.9%;根充适充率实验组为87.8%,对照组为68.3%;断针率实验组为4.9%,对照组为0。结论:机用镍钛器械ProTaper预备老年人后牙弯曲根管快速,高效,成形效果好,根充适充率高,术后疼痛少,但须注意预防器械折断。

Objective：To evaluate the clinical effect of a set of nickel-titanium rotary instruments,named ProTaper,in preparing curved root canals of the aged.Methods：Eighty-two posterior teeth of aged people with curved root canals were randomly divided into two groups.The 41 teeth in experiment group were managed by ProTaper nickel-titanium rotary instruments using crown-down technique;while the 41 teeth in control group by stainless steel K files.All teeth were obturated with lateral condensation method.The effects of preparation and obturation with radiographs before,during and after operation were analyzed.Results：Compared with the control group,the nickel-titanium rotary instruments kept the curvature and flow of curved canals very well,and the continuously tapered root canal shape was achieved in all cases.The time of operation was short and endodontic flare-up seldom occurred.However,the test group had two fractured files.Conclusion：The ProTaper nickel-titanium rotary instruments can prepare curved root canals effectively and quickly.Meanwhile,the problem of instrument separation due to many reasons such as variations in canal anatomy and fatigue of instruments should be prevented.