锥形束CT研究3种根管治疗方式的根管封闭效果

Sealing efficiency evaluation of three different root canal treatment methods using cone-beam computed tomography

目的应用锥形束CT定量评价目前临床上常用的3种根管治疗方式的根管封闭效果,为临床上有针对性地选择根管治疗方式提供理论依据。方法选45颗拔除的单根管前牙及前磨牙,随机分成3组,分别采用NiTi K锉预备,侧方加压充填根管治疗法(A组);机用ProTaper预备,侧方加压充填根管治疗法(B组);机用ProTaper预备,连续波热垂直加压技术充填根管治疗法(C组)。使用锥形束CT分别对根管预备后及充填后牙体进行扫描,获得根管总的封闭容量百分比(the percentage of obturated volume,POV),根管根尖1/3、中1/3及冠1/3的封闭容量百分比。比较3组的封闭效果,对数据进行WilconxonMann-Whitney U检验分析。结果 A、B组比较,无论总POV,根管根尖1/3、中1/3还是冠1/3的POV,2组之间比较均无明显统计学差异(P>0.05)。C组总POV,根管根尖1/3、中1/3及冠1/3的POV均明显高于其他2组(P<0.05)。结论对于使用相同的根管充填方式(侧方加压充填)充填根管,其最终的根管封闭效果并不受根管预备方式的影响。机用ProTaper预备,连续波热垂直加压技术充填根管治疗组的根管封闭性最佳。

Objective To quantitatively evaluate the sealing efficiency of the most common root canal treatment methods so as to provide a theoretical basis for clinical targeted selection of root canal treatment methods by cone-beam compute tomography. Methods Forty-five extracted single root anterior teeth and premolars were randomly divided into three groups, 15 in each. The first group was in- strumented with NiTi K-files and filled by lateral compaction. The second group was instrumented with ProTaper NiTi rotary files and filled by lateral compaction. The last group was instrumented with ProTaper NiTi rotary files and filled by continuous warm vertical con- densation. The root canal volume after preparation and filling of each canal was measured by cone-beam compute tomography and the percentage of obturated volume（ POV ） of an overall root canal was calculated. The POV of coronal third, mlddle third and apical third of root canals could be also obtained. Wilconxon-Mann-Whitney U analysis was performed. Results The first and the second group had no statistically significant difference in the POV of the overall, coronal third, middle third and apical third of the root canals （ P 〉 0.05 ）. The POV of the overall,coronal third,middle third and apical third of the root canals in the third group were greater than those in the other two groups （ P 〈 0.05 ）. Conclusions Using the same root canal filling method （ LC）, the sealing efficiency of root canal is not affected by the different root canal preparation methods. The group instrumented with ProTaper NiTi rotary files and filled by Warm ver- tical condensation has the best sealing efficiency.