Zmener O, Pameijer C H, Banegas G
Department of Adult Dental Care, Section of Endodontics, Faculty of Odontology University of Buenos Aires, Buenos Aires, Argentina.
Int Endod J. 2005 Jun;38(6):356-63. doi: 10.1111/j.1365-2591.2005.00938.x.
To compare in vitro the cleanliness of root canal walls in oval-shaped root canals following automated or manual instrumentation.
Forty-five oval-shaped single-rooted maxillary and mandibular premolars with straight canals were divided into three groups of 15. Automated canal preparation was performed using Anatomic Endodontic Technology (AET, group 1) and the ProFile system (group 2). Manual instrumentation (group 3) was performed with K-Flexofiles. Irrigation was performed using alternately 5.25% NaOCl and 17% EDTA, followed by rinsing with saline. The roots were split longitudinally into halves and the canals examined at x200 and x400 in a scanning electron microscope. The presence of debris and smear layer was recorded at distances of 1, 5 and 10 mm from the working length using a three-step scoring scale and a 300 mum square grid. Mean scores for debris and smear layer were calculated and statistically analysed for significance (P < 0.05) between and within groups, using the Kruskal-Wallis nonparametric anova and Dunn's tests.
At 1, 5 and 10-mm levels the root canals prepared with AET had significantly less surface debris and smear layer on the canal walls compared with canals prepared with ProFile or manual instrumentation. For all three groups significantly lower mean smear layer scores (P < 0.05) were recorded at 5 and 10-mm levels compared with the 1 mm level. Significantly lower mean debris scores (P < 0.05) were also recorded at 5 and 10-mm levels for the AET group whereas no significant differences were found between the three levels for the ProFile and manual instrumentation groups.
Although better instrumentation scores were obtained in canals prepared with AET, complete cleanliness was not achieved by any of the techniques and instruments investigated.
在体外比较使用自动或手动器械预备椭圆形根管后根管壁的清洁度。
将45颗根管笔直的椭圆形单根上颌和下颌前磨牙分为三组,每组15颗。使用解剖牙髓技术(AET,第1组)和Profile系统(第2组)进行自动根管预备。使用K-Flex锉进行手动器械预备(第3组)。交替使用5.25%次氯酸钠和17%乙二胺四乙酸进行冲洗,然后用盐水冲洗。将牙根纵向劈成两半,并在扫描电子显微镜下以200倍和400倍观察根管。使用三步评分量表和300μm²的方格在距工作长度1、5和10mm处记录碎屑和玷污层的存在情况。计算碎屑和玷污层的平均得分,并使用Kruskal-Wallis非参数方差分析和Dunn检验对组间和组内的显著性(P<0.05)进行统计分析。
在1、5和10mm水平处,与使用Profile系统或手动器械预备的根管相比,使用AET预备的根管壁上的表面碎屑和玷污层明显更少。对于所有三组,在5和10mm水平处记录的平均玷污层得分(P<0.05)明显低于1mm水平。AET组在5和10mm水平处也记录到明显更低的平均碎屑得分(P<0.05),而Profile系统组和手动器械组在三个水平之间未发现明显差异。
尽管使用AET预备的根管获得了更好的器械预备评分,但所研究的任何技术和器械均未实现完全清洁。