H K Sowmya, T S Subhash, Goel Beena Rani, T N Nandini, Bhandi Shilpa H
Lecturer, Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital , Mysore, Karnataka, India .
Professor and HOD, Department of Dentistry MMC & RI, K. R. Hospital , Mysore, Karnataka, India .
J Clin Diagn Res. 2014 Feb;8(2):206-10. doi: 10.7860/JCDR/2014/7353.4061. Epub 2014 Feb 3.
Decreased apical extrusion of debris and apical one third debris have strong implications for decreased incidence of postoperative inflammation and pain. Thus, the aim of this study was to assess quantitatively the apical extrusion of debris and intracanal debris in the apical third during root canal instrumentation using hand and three different types of rotary instruments.
Sixty freshly extracted single rooted human teeth were randomly divided into four groups. Canal preparation was done using step-back with hand instrumentation, crown-down technique with respect to ProTaper and K3, and hybrid technique with LightSpeed LSX. Irrigation was done with NaOCl, EDTA, and normal saline and for final irrigation, EndoVac system was used. The apically extruded debris was collected on the pre-weighed Millipore plastic filter disk and weighed using microbalance. The teeth were submitted to the histological processing. Sections from the apical third were analyzed by a trinocular research microscope that was coupled to a computer where the images were captured and analyzed using image proplus V4.1.0.0 software. The mean weight of extruded debris for each group and intracanal debris in the root canal was statistically analyzed by a Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test.
The result showed that, hand instrumentation using K files showed the highest amount of debris extrusion apically when compared to ProTaper, K3 and LightSpeed LSX. The result also showed that there was no statistically significant difference between the groups in relation to presence of intracanal debris in the apical one third.
Based on the results, all instrumentation techniques produced debris extrusion. The engine driven Ni-Ti systems extruded significantly less apical debris than hand instrumentation. There was no statistically significant difference between the groups in relation to presence of intracanal debris in the apical one third.
根尖碎屑挤出量减少以及根尖三分之一处的碎屑对降低术后炎症和疼痛的发生率具有重要意义。因此，本研究的目的是定量评估在根管预备过程中，使用手动器械和三种不同类型的旋转器械时，根尖碎屑的挤出情况以及根尖三分之一处的根管内碎屑情况。
将60颗新鲜拔除的单根人牙随机分为四组。采用逐步后退法进行手动器械根管预备，使用ProTaper和K3进行冠向深入技术预备，使用LightSpeed LSX进行混合技术预备。使用次氯酸钠、乙二胺四乙酸和生理盐水进行冲洗，最后冲洗时使用EndoVac系统。将根尖挤出的碎屑收集在预先称重的密理博塑料滤盘上，并用微量天平称重。对牙齿进行组织学处理。使用与计算机相连的三目研究显微镜对根尖三分之一处的切片进行分析，通过图像分析软件Image ProPlus V4.1.0.0采集并分析图像。采用Kruskal-Wallis单向方差分析和Mann-Whitney U检验对每组根尖挤出碎屑的平均重量以及根管内碎屑进行统计学分析。
结果显示，与ProTaper、K3和LightSpeed LSX相比，使用K锉进行手动器械预备时根尖挤出的碎屑量最多。结果还显示，在根尖三分之一处根管内碎屑的存在情况方面，各组之间无统计学显著差异。
基于结果，所有器械预备技术都会产生碎屑挤出。电动镍钛系统挤出的根尖碎屑明显少于手动器械。在根尖三分之一处根管内碎屑的存在情况方面，各组之间无统计学显著差异。
