4种机用镍钛锉根管预备后形成牙本质微裂的研究

doi:10.7518/hxkq.2023.2023257

摘要/Abstract

摘要：

目的运用micro-CT比较T-Flex、Reciproc Blue（RB）、ProTaper Gold（PTG）和ProTaper Universal（PTU）4种机用镍钛锉在体外根管预备后牙本质微裂形成方面的差异。方法选用根管弯曲度不大于10°的新鲜离体双根管前磨牙32颗建立体外根管预备模型。根据所用镍钛系统将其随机分为T-Flex、RB、PTG、PTU组（n=8）。设置micro-CT体素大小为17.18 μm，扫描分析预备前后牙根横断面图像（n=56 940），观察牙本质微裂的存在。各组结果以存在裂纹的断层图像的数量及百分比来表示，McNemar检验用于比较预备前后牙本质裂纹的存在是否有显著差异，显著性水平设定为P<0.05。结果总体有11.04%的图像显示有牙本质微裂（n=6 288）。T-Flex、RB、PTG和PTU组在预备后观察到具有牙本质微裂截面的比例各自为9.82%、10.79%、12.27%和11.25%。所有在预备后断层图像上发现的牙本质裂纹在相应的预备前图像中均已存在。使用上述镍钛系统预备前磨牙根管未出现新的微裂纹。结论未经根管预备的离体牙中预先即存在牙本质微裂纹；T-Flex、RB、PTG和PTU 4种机用镍钛器械对前磨牙直根管进行根管预备均不会导致新的牙本质微裂纹形成。

关键词: 根管预备, 牙本质微裂, 镍钛器械, 微型计算机断层扫描

Abstract:

Objective This study aimed to compare the differences among four kinds of mechanical Ni-Ti files including T-Flex, Reciproc Blue (RB), ProTaper Gold (PTG), and ProTaper Universal (PTU) in dentinal microcrack generation after root canal preparation in vitro by using micro-computed tomography (micro-CT) analysis. Methods A total of 32 freshly extracted double-root-canal premolars with an angle not exceeding 10° were selected and established as root canal preparation models in vitro. Then, the specimens were randomly assigned to four experimental groups (n=8) according to the different Ni-Ti systems used for root canal preparation: group T-Flex, group RB, group PTG, and group PTU. The voxel size of the micro-CT was set at 17.18 μm. Pre- and post-operative cross-sectional images of roots (n=56 940) were scanned and analyzed to identify the presence of dentinal microcracks. The results of each group were expressed by the quantity and percentage of sectional images with microcracks. McNemar test was used to determine whether a significant difference existed in the existence of dentinal microcracks before and after instrumentation. The level of significance was set at P<0.05. Results Overall, 11.04% of the images presented dentinal defects (n=6 288). Dentinal microcracks were observed in 9.82%, 10.79%, 12.27%, and 11.25% of the post-instrumentation images from groups T-Flex, RB, PTG, and PTU, respectively. However, all these dentinal microcracks were already present in the corresponding pre-operative images. No new microcrack of premolars were generated after the root canal preparation utilizing the aforementioned systems. Conclusion Denti-nal microcracks already existed in advance in extracted teeth before root canal preparation. Root canal preparation using the T-Flex, RB, PTG, and PTU systems did not induce the formation of new dentinal microcracks on the straight root canals of premolars.

Key words: root canal preparation, dentinal microcracks, Ni-Ti instrument, micro-computed tomography

中图分类号:

R781.05

王梓, 薛明. 4种机用镍钛锉根管预备后形成牙本质微裂的研究[J]. 华西口腔医学杂志, 2024, 42(1): 75-81.

Wang Zi, Xue Ming. Formation of dentinal microcracks after root canal preparation with four kinds of mechanical nickel-titanium files[J]. West China Journal of Stomatology, 2024, 42(1): 75-81.

图/表 4

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扫描时间	T-Flex组		RB组		PTG组		PTU组		合计
扫描时间	有微裂	无微裂	有微裂	无微裂	有微裂	无微裂	有微裂	无微裂	有微裂	无微裂
合计	1 364	12 526	1 536	12 702	1 750	12 508	1 638	12 916	6 288	50 652
预备前	682	6 263	768	6 351	875	6 254	819	6 458	3 144	25 326
预备后	682	6 263	768	6 351	875	6 254	819	6 458	3 144	25 326

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