不同镍钛器械用于单根管一次性治疗的临床对比研究

A Comparative Study on Different Nickel Titanium Instruments for Single Root Canal Treatment

目的:评价三种镍钛器械在一次性根管治疗中的临床疗效,为寻找理想的机用根管预备器械提供科学依据。方法:对90例单根管慢性根尖周炎患牙评估,并根据所使用的器械随机分为三组:WO组(WaveOne)、PTN组(ProTaper Next)和PT组(ProTaper),在预备前后,根管内分别取样进行厌氧菌接种培养,检测根管内厌氧菌数量变化,记录三组根管预备开始至结束所需时间并对患者术后疼痛情况进行回访。结果:各组器械预备后菌落数均有明显的下降,菌落数下降差值有统计学意义(P<0.05);三组根管预备时间差异有统计学意义(P<0.05),WO组用时最短,PT组用时最长;三组术后24h疼痛率对比差异有统计学意义,三组术后7d疼痛差异无统计学意义。结论:三组镍钛器械用于感染根管的一次性治疗各有优势,应综合临床具体情况选择,机械预备并不能完全清除根管内的所有微生物,机械预备应配合化学预备提高根管治疗的成功率。

Objective To evaluate the clinical effect of three kinds of nickel titanium instruments in disposable root canal therapy, and to provide a scientific basis for finding the ideal root canal preparation instruments. Methods 90 cases of single root canal chronic periapical periodontitis were evaluated and divided into 3 groups randomly according to the instruments used： group WO （WaveOne）, group PTN （ProTaper Next） and PT group （ProTaper）. The anaerobes were inoculated in root canal before and after preparation, and the number of anaerobes in the root canal was detected, and three groups of root canal were recorded. Results The colony number of each group was significantly decreased after instrument preparation, but the difference of colony number decreased. There was no statistical significance （P〈0.05）. There was a significant difference in the time of root canal preparation between the three groups （P〈 0.05）, and the time in group WaveOne was the shortest and the time in ProTaper group was the longest ,The difference of 24h pain rate in the 3 groups was statistically significant, and there was no significant difference in the one week postoperative pain in the 3 groups. Conclusion Three groups of nickel and titanium instruments have advantages in one time treatment of root canal infection. It should be selected in a comprehensive clinical situation. Mechanical preparation can not completely remove all microbes in the root canal. Mechanical preparation should cooperate with chemical preparation to improve the success rate of root canal therapy.