Endodontic Residency Program, Veterans Affairs Hospital, Long Beach, California, USA.
J Endod. 2010 Nov;36(11):1892-6. doi: 10.1016/j.joen.2010.08.027.
This study was designed to calculate probabilities for tissue injury and to measure effectiveness of various coolant strategies in countering heat buildup produced by dry ultrasonic vibration during post removal.
A simulated biological model was used to evaluate the cooling efficacy of a common refrigerant spray, water spray, and air spray in the recovery of post temperatures deep within the root canal space. The data set consisted of cervical and apical measures of temperature increase at 1-second intervals from baseline during continuous ultrasonic instrumentation until a 10 °C increase in temperature at the cervical site was registered, wherein instrumentation ceased, and the teeth were allowed to cool under ambient conditions or with the assistance of 4 coolant methods.
Data were analyzed with analysis of variance by using the independent variables of time of ultrasonic application (10, 15, 20 seconds) and cooling method. In addition to the customary means, standard deviations, and analysis of variance tests, analyses were conducted to determine probabilities that procedures would reach or exceed the 10 °C threshold. Both instrumentation time and cooling agent effects were significant at P <.0001.
Under the conditions of this study, it was shown that injurious heat transfer occurs in less than 1 minute during dry ultrasonic instrumentation of metallic posts. Cycles of short instrumentation times with active coolants were effective in reducing the probability of tissue damage when teeth were instrumented dry. With as little as 20 seconds of continuous dry ultrasonic instrumentation, the consequences of thermal buildup to an individual tooth might contribute to an injurious clinical outcome.
本研究旨在计算组织损伤的概率,并测量各种冷却策略在对抗热积聚的有效性,这种热积聚是由去除桩后干燥超声振动产生的。
使用模拟生物模型来评估常用制冷剂喷雾、水喷雾和空气喷雾在恢复根管深部桩温度方面的冷却效果。数据集包括在连续超声仪器使用期间每隔 1 秒测量的颈和根尖部位的温度升高,从基线开始,直到在颈部位的温度升高 10°C 时记录下来,此时仪器停止使用,牙齿在环境条件下或使用 4 种冷却方法进行冷却。
使用超声应用时间(10、15、20 秒)和冷却方法的独立变量进行方差分析。除了常规均值、标准差和方差分析测试外,还进行了分析以确定程序达到或超过 10°C 阈值的概率。仪器使用时间和冷却剂效果都具有统计学意义(P<.0001)。
在本研究的条件下,证明在金属桩的干燥超声仪器使用过程中,不到 1 分钟就会发生有害的热传递。在干燥仪器使用时,使用短时间的周期性活跃冷却剂可以有效降低组织损伤的概率。只要进行 20 秒的连续干燥超声仪器使用,热积聚对单个牙齿的后果可能会导致有害的临床结果。