三种手用不锈钢根管预备器械在磨牙根管再治疗中的应用

Clinical comparison among three kinds of stainless steel hand files on molar teeth during root canal retreatment

目的评价三种手用不锈钢根管锉应用于磨牙根管再治疗的临床效果。方法收集180颗需根管再治疗的恒磨牙,随机分成3组,分别用C先锋锉、C+锉和不锈钢K锉进行根管疏通,机动镍钛器械扩大并冷牙胶侧压充填,根据术中、术后X线片评价根管疏通效果。结果在牙胶欠充根管中C先锋锉和C+锉疏通成功率均高于不锈钢K锉(P<0.05),塑化根管中C先锋锉疏通成功率高于不锈钢K锉(P<0.05);在遗漏根管和干尸根管中,三组疏通成功率比较无统计学意义(P>0.05)。结论磨牙根管再治疗病例中,欠充根管和塑化根管中C先锋锉均优于不锈钢K锉,欠充根管中C+锉也优于不锈钢K锉,值得临床推广应用。

Objective To compare root canal preparation with three kinds of stainless steel hand files on molar teeth during retreatment. Methods 180 molar teeth which needed root canal retreatment were randomly divided into three groups with 60 teeth in each group. The root canals were negotiated by C-Pilot files, C ＋ files and K-filesrespectively, and then enlarged with ProTaper rotary instruments using crown-down technique. After instrumentation, all canals were obturated with cold lateral condensation method. To estimate the effect of root canal negotiation by the X-ray of intra-operation and post -operation. Results The successful rate of re-negotiation of C-Pilot files group and C＋ files group were obviously higher than K-files groups in canals filled with gutta-percha （P〈0.05）, the successful rate of re-negotiation of C-Pilot files group was higher than K- files groups in canals subjected to resinifying therapy （P〈0.05）, while there was no significant among three groups in the missing canals and canals subjected to pulp mummification （P〉0.05）. Conclusion The ability of C-Pilot files to negotiate root canals on molar teeth during retreatment is superior to K-files in canals filled with gutta-percha or canals subjected to resinifying therapy, C＋ files is also better than K-files in canals filled with gutta-percha, they are worth clinical application.