3种根管预备器械治疗慢性牙髓炎临床疗效评价

Clinical Study on Three Root Canal Preparation Instruments System in Treatment Chronic Pulpitis

目的对比3种根管预备器械一次性根充的治疗效果,涵盖根管预备时间、术后反应以及根管充填后远期疗效等。方法 90例慢性牙髓炎患牙随机等分为3组:P组、K3组和K组。P组:使用Protaper机用镍钛旋转锉常规法预备根管;K3组:运用K3机用镍钛旋转锉传统法实施根管预备;K组:采取手用不锈钢K锉改良逐渐后退法实施根管预备。根管预备后,即刻根充,一次性完成根管治疗,分别登记根管预备所需要的时间、手术后的反应及长期治疗效果。结果 P组根管预备时间平均为每根(276.1±82.3)s,K3组平均为每根(242.6±73.7)s,K组平均为每根(543.2±151.4)s,K组明显长于K3组及P组,差异具有统计学意义(均P<0.05)。根管治疗后1周反应严重者K组显著多于P组及K3组,差异具有统计学意义(均P<0.05),而P组与K3组反应严重程度差异无统计学意义(P>0.05)。3组根管治疗术后12个月疗效对比,差异无统计学意义(P>0.05)。结论镍钛器械一次性根管治疗法治疗慢性牙髓炎,耗时及术后反应均优于不锈钢手用器械组,值得临床推广使用。

Objective To investigate single visit root canal treatment curative effects of 3 kinds of root canal preparation instruments system including including the root canal preparation time, postoperative response and long-term efficacy after root canal filling. Methods Ninety permanent teeth with chronic pulpitis were randomly divided into three groups： P group, K3 group and K group. P group： routine preparation technique was used in root canal preparation by Protaper machine with nickel-titanium preparation system. K3 group： routine preparation technique was used in root canal preparation by K3 machine with nickel-titanium preparation system. K group： modified gradual withdrawal technique was used in root canal preparation by stainless steel K file. After canal preparation, all the teeth were underwent canal filling immediately. The root canal preparation time, the postoperative response and long-term efficacy were observed and analyzed in three groups. Results The average time of root canal preparation in K group （543.2 ±151.4 s/canal） was significantly longer than P group （276. 1 ±82.3 s/canal） and K3 group （242.6 ± 73.7 s/canal） （all P 〈 0.05 ）. After 1 weeks of root canal treatment, side effect of K group was more serious than that of P group and the K3 group （ all P 〈 0.05） , but there was no significant difference between P group and K3 group （P 〉 0.05）. 12 months later, there were no significant difference among the three groups in the curative effect after the root canal therapy （P 〉 0.05）. Conclusion Nickel-titanium instruments for treatment the chronic pulpitis could lead to less serious postoperative reaction than K file instruments, and it was worthy of wide application in clinical practice.