Division of Endodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina 29425-5070, USA.
J Endod. 2012 Oct;38(10):1380-2. doi: 10.1016/j.joen.2012.06.021. Epub 2012 Aug 18.
A common adverse effect when using thermoplasticized obturators is overextension. A canal preparation allowing for predictable obturation length would be of clinical value. This study compared straight canals instrumented to a size 40 file by evaluating the extension of 2 thermoplastic obturation systems, a 0.04 standardized taper preparation (STP) and a varied taper preparation (VTP), by evaluating the extension of 2 thermoplastic obturation systems, RealSeal 1 (RS-1) and Thermafil Plus (TP).
Eighty extracted mature human premolars with single straight canals were randomly divided into 4 experimental groups (n = 20). Groups 1 and 2 were instrumented to size 40/04 at working length with STP. Groups 3 and 4 were instrumented to size 40/02 at working length with VTP. Groups 1 and 3 were obturated with RS-1, and groups 2 and 4 were obturated with TP. All groups were obturated per manufacturer's instructions. Extension of material was evaluated and assessed ordinally. Statistically significant differences were determined by logistic regression with significance level set at P < .05.
Significant differences in extrusion existed between groups 2 and 4 when controlling for type of material (P = .026) and all groups for extrusion of TP compared with RS-1 when controlling for type of preparation (P < .001).
The results indicate that when filling with RS-1 obturators, the canal can be instrumented to an STP or VTP with a low likelihood of excessive extrusion. If the clinician prefers to use TP obturators, this study validates a VTP to decrease the occurrence of overextension.
使用热塑牙胶充填时,常见的不良反应是过度超填。如果根管预备能够预测牙胶长度,将具有重要的临床价值。本研究通过比较两种热塑牙胶充填系统(0.04 标准锥度预备(STP)和变锥度预备(VTP))的延伸度,评估直根管预备至 40 号锉的效果,比较两种热塑牙胶充填系统(RealSeal 1[RS-1]和 Thermafil Plus[TP])的延伸度,来评估 2 种热塑牙胶充填系统的延伸度。
80 颗具有单一直根管的成熟人离体前磨牙被随机分为 4 个实验组(n = 20)。第 1 组和第 2 组用 STP 预备至工作长度 40/04。第 3 组和第 4 组用 VTP 预备至工作长度 40/02。第 1 组和第 3 组用 RS-1 充填,第 2 组和第 4 组用 TP 充填。所有组均按照制造商的说明进行充填。评估材料的延伸度并进行有序评估。通过逻辑回归确定有统计学意义的差异,显著水平设为 P <.05。
在控制材料类型的情况下,第 2 组和第 4 组的挤出量存在显著差异(P =.026),在控制预备类型的情况下,所有组的 TP 挤出量均明显高于 RS-1(P <.001)。
结果表明,使用 RS-1 牙胶充填时,用 STP 或 VTP 预备根管,牙胶发生过度超填的可能性较小。如果临床医生更愿意使用 TP 牙胶,本研究验证了 VTP 可减少超填的发生。