Manjunatha M, Annapurna Kini, Sudhakar V, Sunil Kumar Vc, Hiremath Vinay Kumar, Shah Ankur
Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India.
J Int Oral Health. 2013 Feb;5(1):66-78. Epub 2013 Feb 26.
The aim of any root canal treatment is to achieve a canal free of micro organisms, residual pulp remnants, debris and smear layer for the long term success of the procedure. Manual and automated instrumentation techniques along with proper irrigation regime is used to arrive at the aforementioned goal. Many authors focused on the preparation capabilities of various manual and rotary instruments but very few investigators stressed on the actual cleaning abilities of these instruments.
This study was undertaken to evaluate the cleaning efficiency of manual K flex files and rotary Pro File systems in the root canals using a scanning electron microscope.
Thirty single rooted mandibular first premolars were divided into two groups and randomized (the manual group-M and the ProFile group-P) with respect to the preparation technique. The Manual group was hand instrumented with stainless steel K- Flexofiles by means of a conventional filing technique. The Pro File group was instrumented according to the manufacturer's instructions using a rotary handpiece. All canals were shaped and cleaned under frequent irrigation with EDTA. Final irrigation was carried out with 3 mL of normal saline solution to neutralize the action of the irrigant. The roots were split, one half of each tooth was selected for further SEM technique analysis and examined under the scanning electron microscope. The canal walls were quantitatively evaluated for the amount of debris and smear layer. The apical, middle and coronal regions of the canal surface, were graded (1-5) for debris and smear layer. A statistical analysis was performed using a Mann-Whitney Rank Sum test. ProFile performed least effective cleaning. Manual K-Flexofiles led to a grooved pattern.
A statistically significant difference was observed (p<0.05) between the two instrumentation techniques concerning the amount of debris and smear layer at the apical level. The manually filed canals had less debris and smear layer than those using a rotary technique. It was concluded from this study that none of the instrumentation techniques employed, produced the canal walls which were free of surface debris and smear layer. The manual instrumentation technique was better in cleaning the canals compared to the ProFile rotary Ni-Ti instruments despite the step-back technique used for manual instrumentation. How to cite this article: Manjunatha M, Kini A, Sudhakar V, Sunil K V C, Hiremath V K, Shah A. Smear Layer Evaluation on Root Canal Preparation with Manual and Rotary Techniques using EDTA as an Irrigant: A Scanning Electron Microscopy Study. J Int Oral Health 2013; 5(1):66-78.
任何根管治疗的目的都是为了使根管内长期无菌、无残留牙髓组织、碎屑和玷污层，以确保治疗的长期成功。手动和自动器械预备技术以及适当的冲洗方案被用于实现上述目标。许多作者关注各种手动和旋转器械的预备能力，但很少有研究者强调这些器械的实际清洁能力。
本研究旨在使用扫描电子显微镜评估手动K-flex锉和旋转Pro File系统在根管内的清洁效率。
将30颗单根下颌第一前磨牙分为两组，并根据预备技术随机分组（手动组-M和Pro File组-P）。手动组采用传统锉削技术用不锈钢K-Flex锉进行手动预备。Pro File组按照制造商的说明使用旋转手机进行预备。所有根管在频繁用乙二胺四乙酸（EDTA）冲洗的情况下进行成形和清洁。最后用3毫升生理盐水进行冲洗以中和冲洗剂的作用。将牙根劈开，每颗牙齿的一半用于进一步的扫描电子显微镜技术分析，并在扫描电子显微镜下检查。对根管壁上的碎屑和玷污层数量进行定量评估。对根管表面的根尖、中部和冠部区域的碎屑和玷污层进行分级（1-5级）。使用曼-惠特尼秩和检验进行统计分析。Pro File的清洁效果最差。手动K-Flex锉导致形成沟状模式。
在根尖水平，两种器械预备技术在碎屑和玷污层数量方面存在统计学显著差异（p<0.05）。手动预备的根管比使用旋转技术预备的根管碎屑和玷污层更少。从本研究得出的结论是，所采用的任何一种器械预备技术都不能使根管壁完全没有表面碎屑和玷污层。尽管手动预备采用了逐步后退技术，但与Pro File旋转镍钛器械相比，手动器械预备技术在清洁根管方面效果更好。如何引用本文：Manjunatha M, Kini A, Sudhakar V, Sunil K V C, Hiremath V K, Shah A. 使用EDTA作为冲洗剂的手动和旋转技术根管预备的玷污层评估：一项扫描电子显微镜研究。《国际口腔健康杂志》2013年；5(1):66-78。
