Zuolo A S, Mello J E, Cunha R S, Zuolo M L, Bueno C E S
Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, SP, Brazil.
Int Endod J. 2013 Oct;46(10):947-53. doi: 10.1111/iej.12085. Epub 2013 Mar 18.
To compare the efficacy of reciprocating and rotary techniques with that of hand files for removing gutta-percha and sealer from root canals.
The root canals of fifty-four human extracted maxillary central incisors were cleaned and shaped using a crown-down technique to a size 40 and filled with gutta-percha and a zinc oxide-eugenol-based sealer using a lateral compaction technique. Teeth were divided into three groups according to the technique used for removing the root filling material: group I - Gates-Glidden burs and stainless steel hand files up to size 50; group II - rotary technique with NiTi Mtwo R files and additional Mtwo files to size 50, 0.04 taper; group III - reciprocating technique with the Reciproc instrument R50, size 50, 0.05 taper. Chloroform was used as a solvent in all groups. Teeth were then split longitudinally and photographed under 8× magnification. The images were transferred to a computer, and the total canal space and remaining filling material were quantified. The ratio of remaining filling material to root canal periphery was computed with the aid of Image Tool 3.0 software. The mean percentages of remaining filling material and time required to remove it were compared using the Kruskal-Wallis and Mann-Whitney tests (P < 0.05).
The mean percentage of remaining filling material was significantly higher (P < 0.05) in group II, with Mtwo rotary files (12.17%), than in group I, with the hand file technique (7.19%), and group III, with Reciproc instruments (4.57%), which were statistically similar (P > 0.05). The time required to remove filling material was significantly shorter (P < 0.05) in group III (194 s), followed by group II (365 s) and group I (725 s) (P < 0.05).
Remaining endodontic filling material was observed on the canal walls of all teeth regardless of the technique used. Hand files combined with Gates-Glidden burs (group I) and the reciprocating technique (group III) removed more filling material from the canal walls than the Mtwo R files. The reciprocating technique was the most rapid method for removing gutta-percha and sealer, followed by the rotary technique and the hand file technique.
比较往复式和旋转式技术与手动锉从根管中去除牙胶和封闭剂的效果。
对54颗拔除的人上颌中切牙的根管采用冠向下技术清理和预备至40号,并用侧向加压技术充填牙胶和氧化锌丁香酚类封闭剂。根据去除根管充填材料所采用的技术将牙齿分为三组:第一组——使用Gates-Glidden钻和50号以下的不锈钢手动锉;第二组——使用NiTi Mtwo R锉及额外的Mtwo锉至50号、锥度0.04的旋转技术;第三组——使用Reciproc器械R50、50号、锥度0.05的往复式技术。所有组均使用氯仿作为溶剂。然后将牙齿纵向劈开并在8倍放大倍数下拍照。将图像传输至计算机,对根管总空间和剩余充填材料进行定量分析。借助Image Tool 3.0软件计算剩余充填材料与根管周缘的比例。使用Kruskal-Wallis检验和Mann-Whitney检验比较剩余充填材料的平均百分比及去除所需时间(P<0.05)。
使用Mtwo旋转锉的第二组(12.17%)剩余充填材料的平均百分比显著高于使用手动锉技术的第一组(7.19%)和使用Reciproc器械的第三组(4.57%),后两组在统计学上相似(P>0.05)。第三组去除充填材料所需时间显著短于第二组(365秒)和第一组(725秒)(P<0.05)(第三组为194秒)。
无论采用何种技术,在所有牙齿的根管壁上均观察到有残留的牙髓充填材料。与Mtwo R锉相比,手动锉联合Gates-Glidden钻(第一组)和往复式技术(第三组)能从根管壁上去除更多的充填材料。往复式技术是去除牙胶和封闭剂最快的方法,其次是旋转式技术和手动锉技术。