SystemB工作温度对牙根表面温度及根管充填效果的影响

Effects of Operating Temperature of System B on Root Surface Temperature and Obturation Quality

目的:利用红外成像仪测定System B技术根管充填治疗时根管表面温度的变化,以避免牙周组织损伤,探索有良好的根管充填效果的System B工作温度,为System B的临床应用和推广提供依据。方法:选取临床拔除的双根管离体牙30颗,随机分成6组(1a、2a、3a、1b、2b、3b),每组5颗牙齿。1、2、3组充填时,System B技术温度分别设定为160℃、180℃、200℃,a组充填前不使用封闭剂,b组充填前使用封闭剂。使用System B连续波热牙胶技术进行根尖部充填,根管内向下挤压涂布根管封闭剂的0.06锥度主牙胶尖,到达距根尖5 mm处,作用2-5 s。充填过程中使用红外热成像仪进行拍照,分别记录根管表面的温度变化情况。采用染料渗透法评估每组牙的微渗漏情况,使用1%亚甲蓝染液对离体牙进行染色,透明处理后于体视显微镜下测量染料渗入牙根的长度。结果:在System B不同工作温度设定下,牙根表面温度升高值的差异有统计学意义(P<0.05);封闭剂组的使用与否对牙根表面温度升高值的差异无统计学意义(P>0.05);充填温度设定为160℃、180℃时,使用封闭剂能够减少微渗漏的产生(P<0.05);温度设定在180℃和200℃时,微渗漏的大小无明显差异(P>0.05)。当温度设定在160℃时,其微渗漏较180℃、200℃温度组有明显差异(P<0.05);当温度设定为200℃时,封闭剂的使用与否对微渗漏无明显影响(P>0.05)。结论:使用System B技术充填根管过程中,工作温度的设定会影响根管充填后的封闭,当温度设定在160℃时,对牙组织无损伤,牙根表面的温度变化随着System B工作温度的升高而增加,提示加热温度不要过高,以避免对牙周组织造成损伤。在封闭剂使用情况相同的前提下,工作温度为200℃与180℃时,根管充填效果无明显差异,封闭剂的使用与否在200℃时对充填效果无明显影响,在180℃和160℃时使用封闭剂能保证根管的充填效果。

Objective： To search an ideal operating temperature for System B technique,which can avoid the periodontal tissue injury and achieve good obturation quality. Using infrared imager to detect surface temperature change of System B technology when conducting root canal filling therapy, and to provide a basis for the clinical application and promotion of System B. Methods： 30double-rooted premolar teeth were selected for this study. The teeth were randomly divided into six test groups of 5 teeth in each group.The System B technology temperature were set at 160 ℃, 180 ℃, 200 ℃ respectively when filled in 1, 2, 3 group, group a do not use sealer before filling while group b use it. Using the System B technique to fill root apex area. Then extrude 0.06 taper gutta percha point of root canal sealer to reach 5mm place from the root tip, heat for 2-5s. Infrared thermal imager was used to take pictures, and the temperature change of root canal surface before and after in the filling process were recorded. the length of penetration under stereo microscope after transparent processing to inspect apical micro-leakage were measured by dye penetration method with 1% methylene blue dye liquor to dye. Results： Root surface temperature presented statistically significant difference at three different operating temperature settings（P0.05）. The use of sealers on root surface temperature value was not significant effective（P0.05）.When the operating temperature was set at 160℃ and 180℃, the use of sealers could reduce the generation of microleakage（P0.05）, and the apical microleakage at 200 ℃ and 180 ℃ was not significantly different. The apical microleakage showed statistically significant differences compared with the other two groups at 160 ℃（P0.05）, and when operating temperature was set at 200 ℃,the use of sealers on microleakage was not effective significantly（P0.05）. Conclusion： The working temperature setting can affect the closure of root canal filling during root canal filling process of System B technique. When the temperature was set at 160 ℃, there was no damage to the teeth tissue. The temperature change on the root surface increased with the operating temperature of System B. It suggested that the heating temperature should not be set too high so that the damage to periodontal tissue can be avoided. When the working temperature was set at200 ℃ and 180 ℃ with the same sealer, there was no significant difference, at 180 ℃ and 160 ℃, the use of sealer could reduce the generation of microleakage. Using sealer had no significant effects at 200 ℃.