单根锉WaveOne镍钛器械高效治疗弯曲根管的实验研究

Clinical research of treatment of curved root canal with Wave-One nickel-titanium instruments

摘要:

目的研究单根锉WaveOne镍钛器械治疗弯曲根管的疗效，并与不锈钢K 锉、ProTaper 镍钛器械进行比较。方法选取根管弯曲度在20～40°的单根管离体前磨牙60颗，随机分为A、B、C 3组，每组20颗离体牙，3组分别采用WaveOne/Crown-down法、K 锉逐步后退法及ProTaper/Crown-down法行根管预备，并采用口腔颌面锥形束计算机体层摄影分别于根管预备前后对离体牙行横向扫描。预备完成后，对3 组中的60 颗离体牙行冷牙胶侧方加压充填。测量3 组中每颗离体牙的根管预备时间、根管充填时间；分析每颗离体牙根管预 备前后，根管距根尖孔2、4 和6 mm 处的根管偏移量和轴中心率，并对以上结果进行统计学分析。结果A 组根管预备时间低于B、C 组；在根管充填时间上，A 组与C 组比较差异无统计学意义（p >0.05），但A 组短于B组（p <0.05）。在距根尖孔2、4和6 mm处，A组与B组间的根管偏移量及轴中心率比较，差异有统计学意义（p <0.05）；A 组与C 组比较，差异无统计学意义（p >0.05）。结论与不锈钢K 锉及ProTaper 相比，WaveOne 治疗弯曲根管具有效率高、根管成形效果好的优点，可广泛应用于临床弯曲根管的治疗。

关键词:WaveOne 镍钛旋转器械;锥形束CT;根管偏移量;轴中心率

Abstract:

Ojective To evaluate the effect of WaveOne nickel-titanium instruments on the treatment of curved root canal and compare WaveOne with stainless steel K-file and ProTaper nickel-titanium instruments. Methods With curvature ranging from 20-40o, 60 isolated premolars with single root canal were chosen and randomly divided into A, B and C three groups with 20 teeth in each. The teeth in the groups A, B and C were shaped by Crown-down technique with WaveOne nickel-titanium rotary instruments, modified step-back technique with stainless steel K -file and Crown -down technique with ProTaper nickel -titanium rotary instruments respectively. All the teeth underwent cone-beam computed tomography (cone-beam CT, CBCT)imaging before and after instrumentation. All the 60 teeth in three groups were treated with cold gutta-percha lateral condensation after root canal preparation. Then the time taking for root canal preparation and root canal filling was recorded. The apical transportation and centering ability at 2, 4 and 6 mm from the apical foramen were analyzed. All these results were statistically analyzed. Results The time taking for root canal preparation in the group A was obviously shorter than that in the groups B and C. The time taking for root canal filling was not significantly different between the group A and the group C (p > 0.05), but was significantly shorter in the group A than in the group B (p < 0.05). There were statistical differences between the group A and the group B in terms of apical transportation and centering ability at 2, 4 and 6 mm from the apical foramen (p < 0.05); however, the differences between the group A and the group C were not significant (p > 0.05). Conclusions WaveOne has advantages of high efficiency, favorbale effect of root canal shaping as compared to stainless steel K-file and ProTaper. So, it can be widely applied to the treatment of curved root canal in clinical practice.

Key words:WaveOne nickel-titanium rotary instruments; cone-beam computed tomograph; root canal transportation; centering ability