Prabhakar Attiguppe, Kiran N K
Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India.
J Contemp Dent Pract. 2009 Jul 1;10(4):26-34.
The aim of this study was to evaluate the carious dentin removal efficacy of new rotary polyamide burs capable of selectively removing infected dentin without removing sound dentin.
This study included 40 subjects with bilateral occlusal carious lesions on mandibular first permanent molars. The lesions were randomly assigned to receive one restoration after carious dentin removal with a polymer bur and the second after removal of carious dentin with a carbon steel round bur. Both procedures were completed by a single operator in one appointment. The efficacy of caries removal, time taken for caries removal, and patients' perception of the treatment were evaluated. The restorations were evaluated immediately and after six months using intraoral periapical radiographs (IOPA).
The results revealed statistically significant differences between the polymer burs and carbon steel burs with respect to caries removal efficacy (p<0.001) and the time taken for caries removal (p<0.001). No statistically significant results were obtained regarding patients' perception of the treatment and longevity of the restorations.
Carbon steel round burs remove caries lesions more efficiently than polymer burs but they tend to contribute to the over-preparation of the cavity. Polyamide burs were found to be self-limiting and lose their cutting efficiency on reaching affected dentin and do not cut sound dentin. The time required for caries removal using the polymer bur was significantly longer than when using a carbon steel round bur.
One of the goals of conservative dentistry is to develop a method for removing caries-infected dentin while preserving caries-unaffected dentin. The use of polymer burs appears to offer a straightforward and efficient means for achieving this goal and conserving healthy tooth structure.
本研究旨在评估新型旋转聚酰胺车针在选择性去除感染牙本质而不损伤健康牙本质方面对龋坏牙本质的去除效果。
本研究纳入40名下颌第一恒磨牙双侧咬合面龋损的受试者。将龋损随机分为两组,一组在使用聚合物车针去除龋坏牙本质后进行修复,另一组在使用碳钢圆车针去除龋坏牙本质后进行修复。两种操作均由同一名操作者在一次就诊时完成。评估龋坏去除效果、龋坏去除时间以及患者对治疗的感受。使用口腔内根尖片(IOPA)在修复后即刻及六个月后对修复体进行评估。
结果显示,在龋坏去除效果(p<0.001)和龋坏去除时间(p<0.001)方面,聚合物车针和碳钢车针之间存在统计学显著差异。在患者对治疗的感受和修复体寿命方面未获得统计学显著结果。
碳钢圆车针去除龋损比聚合物车针更有效,但它们往往会导致窝洞过度预备。发现聚酰胺车针具有自限性,在到达感染牙本质时会失去切割效率,并且不会切割健康牙本质。使用聚合物车针去除龋坏所需的时间明显长于使用碳钢圆车针时。
保守牙科的目标之一是开发一种在保留未受龋坏影响的牙本质的同时去除感染龋坏牙本质的方法。使用聚合物车针似乎为实现这一目标和保留健康牙体结构提供了一种直接有效的手段。