冠向下法与步退法预备技术在一次性根管治疗中的疗效比较

Comparison between the effects of crown-down tecchnique and step-back technique in single-visit root canal therapy

目的比较冠向下法与步退法根管预备在一次性根管治疗中的临床疗效。方法选取患急、慢性牙髓炎或根尖周炎的患牙220个,随机分为实验组和对照组,实验组采用ProTaper机用镍钛器械及冠向下技术进行根管预备;对照组采用手用不锈钢K型锉和步退技术进行根管预备。两组均采用侧向加压法充填根管,比较治疗前后的X线片,评价根管预备和充填效果,术后1周复诊,评价疼痛反应,随访1年,评价治疗效果。结果实验组根管充填后的效果优于对照组,实验组根管治疗后短期并发症的发生率明显少于对照组,而且实验组的远期治疗成功率也显著高于对照组。结论冠向下法比步退法预备根管成型、根充效果较好,术后并发症较少,远期疗效较好。

Objective To compare the clinical effect of crown-down technique and step-back technique.Methods 220 molars involving acute or chronic pulpitis or apical periodontitis were divided randomly into 2 groups with 110 cases in each group.Root canal was prepared with machine-use ProTaper NiTi files using crown-down technique（test group） and with hand-use stainnless steel K-files using step-back technique（control group）.Root canal filling was conducted with cold lateral condensation technique.Then the quality of root canal preparation was assessed by X-ray examination,the postoperative complications such as toothache was evaluated in follow-up visit after 1 week,and the long-term clinical efficiency of the treatment was assessed in follow-up visit after 1 year.Results The effect of root canal treatment in test group was better than that in control group,and the short-term and long-term curative ratio in test group was significantly higher than that in control group.Conclusions Crown-down root canal preparation technique could achieve better root canal preparation,less postoperative complications and more successful long-term effect than step-back technique.