平衡力法结合改良双敞技术在老年人根管治疗术中的临床应用

Clinical application of balanced force technique modified double-flare technique in elderly patients'endodontic treatment

目的:评价使用弹性K锉运用平衡力法结合改良双敞技术在老年人根管治疗术中的临床效果。方法:随机选取120例老年患者122颗患牙,分成实验组和对照组。实验组62例患者62颗患牙,采用弹性K锉(Flexofile)运用平衡力法结合改良双敞技术。对照组58例患者60颗患牙,采用不锈钢K锉运用逐步后退法结合改良双敞技术进行根管预备。两组应用侧方加压充填技术充填根管。根据治疗前、中、后X线片评价根管预备和充填效果,根据主诉及检查评价根管治疗期间急症情况。结果:两组在根管预备过程中均无器械折断,实验组无根尖阻塞、台阶形成、根尖孔敞开等情况发生,根管偏移少,能较好的维持根管弯曲度及走向,充填后的锥度和流畅度较好,术后急症反应率为4.83%。对照组有2例在根尖有台阶形成,发生根管偏移多于实验组(P<0.01),术后急症反应率有显著性差异(P<0.01)。结论:弹性K锉运用平衡力法结合改良双敞技术预备老年人根管能较好地维持根管的定向,根管偏移少,安全有效,可作为临床上预备老年人根管的有效方法。

Objective： To evaluate the effect of balanced force technique with modified double-flared technique in elderly patients＇ endodontic treatment. Methods： A total of 122 teeth in 120 elderly patients were selected and were randomly divided into two groups, with 62 teeth prepared by K-flexofile using balanced forced in test group and 60 teeth prepared by K files using step-back technique in control. All teeth were obturated with lateral condensation method. The quality of preparation and obturation were analyzed with radiographs before, during and after operation. Results： Four slight apical transportation happened in two groups, without instrument fracture and apical blockage or ledge. The test technique could keep the curvature and flow of canals. There were two cases of ledge and more transportation （P〈0.01） in the control than in the test. The acute reaction rate was 4.83%, which was significantly lower than 16.66% of the control （P〈0.01）. Conclusion： The balanced force technique in combination with modified double-flared technique could prepare root canals effectively and safely, which was an efficient method of root preparation for elderly patients.