Pulp Biology and Endodontics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Int Endod J. 2010 Apr;43(4):321-7. doi: 10.1111/j.1365-2591.2010.01684.x.
To evaluate the effects of working length and root canal preparation technique on crack development in the apical root canal wall.
Seventy extracted mandibular premolars were mounted in a resin block with simulated periodontal ligaments and divided into seven groups according to preparation technique and working length: group A, step-back preparation with stainless steel files with working length set at the apical foramen and defined as root canal length (CL); group B, same as for A, except that the working length was CL-1 mm; group C, crown-down preparation with Profile instruments followed by an apical enlargement sequence with CL as working length and group D, same as for C, except that the working length was CL-1 mm. Groups E, F and G served as controls. Groups E and F were prepared only with the crown-down sequence up to CL and CL-1 mm, respectively. Group G was left unprepared. Digital images of the apical root surface (AS) were recorded before preparation, immediately after instrumentation and after removing the apical 1 mm (AS-1 mm) and 2 mm (AS-2 mm) of the root end.
Working length significantly affected crack development at AS (P < 0.05). Preparation technique significantly affected crack development at AS-1 mm (P < 0.05). At AS-2 mm, there was no significant difference between preparation technique and working length in terms of crack development on the canal wall.
Root canal preparation alone, regardless of the technique used, can potentially generate cracks on the apical root canal wall as well as the apical surface. Working 1- mm short of the apical foramen might produce fewer cracks in the apical region.
评估工作长度和根管预备技术对根尖根管壁裂纹发展的影响。
70 颗下颌前磨牙用模拟牙周韧带的树脂块固定,根据预备技术和工作长度分为 7 组:组 A,不锈钢锉后退法,工作长度设定在根尖孔,定义为根管长度(CL);组 B,与 A 相同,只是工作长度为 CL-1mm;组 C,逐步深入法用 Profile 器械预备,然后进行根尖扩大序列,以 CL 作为工作长度,组 D,与 C 相同,只是工作长度为 CL-1mm。组 E、F 和 G 作为对照组。组 E 和 F 仅用逐步深入法预备至 CL 和 CL-1mm,组 G 未预备。预备前、器械预备后和去除根尖 1mm(AS-1mm)和 2mm(AS-2mm)后,记录根尖根面(AS)的数字图像。
工作长度显著影响 AS 处的裂纹发展(P<0.05)。预备技术显著影响 AS-1mm 处的裂纹发展(P<0.05)。在 AS-2mm 处,预备技术和工作长度对根管壁上的裂纹发展没有显著差异。
根管预备本身,无论使用何种技术,都可能在根尖根管壁以及根尖表面产生裂纹。在根尖孔处短 1mm 工作可能会减少根尖区的裂纹。