不同方法根管预备后声波冲洗的临床观察

The efficacy of ultrasonic irrigation after different canal preparations

目的对不同方法根管预备后声波冲洗进行临床评估。方法将142例患者166颗患牙,随机分成4组:手用不锈钢K锉组、手用不锈钢K锉+声波冲洗组、机用不锈钢K锉组、机用不锈钢K锉+声波冲洗组。手用不锈钢K锉采用逐步深入法预备根管,机用不锈钢K锉采用逐步后退法预备根管。比较4组根管预备后疼痛发生情况、根管充填质量、根尖偏移和侧枝根管充填情况。15个月复查疗效。结果各组根管预备后疼痛差异无统计学意义(P>0.05)。声波组与相应单纯手用和机用组间根管充填情况差异无统计学意义(P>0.05),声波组侧枝根管充填率高于单纯手用(13.2%vs.2.4%)和机用组(11.9%vs.2.3%)。术后15个月复查122牙,相应各组差异无统计学意义(P>0.05)。结论根管预备后声波冲洗对降低术后疼痛及提高临床治疗有效率无明显效果,但可提高侧枝根管充填率。

Objective To evaluate the clinical efficacy of ultrasonic irrigation after different canal preparations. Methods One hundred and sixty-six teeth collected from 142 patients were randomly divided into 4 groups. Group 1： stainless-steel K file hand instrument; Group 2： stainless-steel K file hand instrument plus ultrasonic irrigation; Group 3： stainless-steel K file M4 hand piece; Group 4： stainless-steel K file M4 hand piece plus ultrasonic irrigation. Two tech-niques of root canal preparation were used： step-down technique using hand instrumentation; and step-back technique us-ing M4 hand piece. Postoperative pain, root canal fillings, and one-year successful rates were evaluated. Results The postoperative pain was not significantly different among the 4 groups（P 〉 0.05）. The number of lateral canal obturation was higher in the group of ultrasonic irrigation than both groups of only hand instrumentation and M4 hand piece. The one-year successful rate was not significantly different among the 4 groups （P 〉 0.05）. Conclusion The ultrasonic irrigation after root canal preparation is not as efficient in reducing postoperative pain or increasing one year successful rates. But it can increase the number of lateral canal obturation.