Kosti E, Lambrianidis T, Economides N, Neofitou C
Department of Endodontology, Dental School, Aristotelion University of Thessaloniki, Thessaloniki, Greece.
Int Endod J. 2006 Jan;39(1):48-54. doi: 10.1111/j.1365-2591.2005.01046.x.
To compare the efficacy of ProFile rotary Nickel-Titanium (Ni-Ti) instruments and Hedstroem-files (H-files) combined with Gates-Glidden (GG) drills during removal of gutta-percha root fillings used in combination with one of the four representative sealers.
Forty-eight single-rooted human teeth, with fully formed apices and straight root canals were used. The root canals were accessed and instrumented using a stepback technique with H-files. They were randomly assigned to four groups and subsequently filled with a combination of lateral and vertical condensation of gutta-percha and one of the following sealers: Roth 811, AH26, Endion and Roekoseal. The root fillings were removed 1 year later, using either H-files in combination with GG drills or the ProFile Ni-Ti system. Teeth were then grooved longitudinally and split. The amount of gutta-percha and sealer remaining on the root canal walls was traced and scored visually with the aid of a stereomicroscope. The scores were analysed and statistically compared with the Kruskal-Wallis test between the ProFile and H-file groups, as well as among the four sealer subgroups. Two samples from each group were studied under the scanning electron microscope to enhance inspection of canal walls and remaining material.
Sealer remnants were observed with both techniques mainly in the middle and apical third of the root canal. The ProFile system and the H-files were associated with similar amounts of remaining filling material (P > 0.05). In the cervical third of the root canal all sealer remnants were removed with both techniques. In the middle and apical third AH26 was associated with a statistically significant greater quantity of remnants on the root canal walls with both removal techniques (P < 0.05). Endion, Roth 811 and Roekoseal were associated with approximately the same amount of filling material in the middle third of the root canal (P > 0.05), whereas in the apical third Endion was associated with significantly more remnants of filling material than the other two sealers with either ProFile or H-files (P < 0.05).
None of the methods used for the removal of root fillings was totally effective, especially in the apical third of the root canal.
比较Profile旋转镍钛器械和H锉结合Gates-Glidden钻在去除与四种代表性封闭剂之一联合使用的牙胶根管充填物时的疗效。
使用48颗单根恒牙，根尖完全形成且根管笔直。采用逐步后退技术用H锉进入并预备根管。将它们随机分为四组，随后用侧向加压和垂直加压法充填牙胶，并使用以下封闭剂之一：Roth 811、AH26、Endion和Roekoseal。1年后，使用H锉结合Gates-Glidden钻或Profile镍钛系统去除根管充填物。然后将牙齿纵向开槽并劈开。借助体视显微镜目视追踪并记录残留在根管壁上的牙胶和封闭剂的量并评分。分析评分并使用Kruskal-Wallis检验在Profile组和H锉组之间以及四个封闭剂子组之间进行统计学比较。对每组的两个样本进行扫描电子显微镜检查，以加强对根管壁和残留材料的观察。
两种技术均观察到封闭剂残留主要位于根管的中1/3和根尖1/3。Profile系统和H锉残留的充填材料量相似（P>0.05）。在根管的颈1/3，两种技术均能去除所有封闭剂残留。在根管的中1/3和根尖1/3，使用两种去除技术时，AH26在根管壁上的残留量在统计学上均显著更多（P<0.05）。Endion、Roth 811和Roekoseal在根管中1/3的充填材料量大致相同（P>0.05），而在根尖1/3，使用Profile或H锉时，Endion的充填材料残留量显著多于其他两种封闭剂（P<0.05）。
所使用的任何一种去除根管充填物的方法都不是完全有效的，尤其是在根管的根尖1/3。
