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[牙胶尖作为根管充填材料的充填效率研究。手用扩孔钻和锉联合使用时的结果差异]

[Study on obturating efficiency of Gutta-percha point as a root canal filler. Difference in results among combinational usages of hand reamers and files].

作者信息

Sato M, Amano Y

出版信息

Meikai Daigaku Shigaku Zasshi. 1989;18(3):390-410.

PMID:2489679
Abstract

The last treatment step followings extirpation of pulp from an infected root canal is root canal filling. Before root canal filling is done, however, the canal must be enlarged enough and the infected dentin and debris removed thoroughly from the canal. Furthermore, re-infection from the apical foramen at the apex of the root canal should be prevented. In this study, we examined the root apex sealing ability of gutta-percha points applied by the lateral condensation method and the vertical condensation method, as well as the difference in root canal sealing ability of gutta-percha points when either a hand reamer or file or their combination was used for root canal enlargement. Extracted human upper incisors were used for root canal enlargement. The condition of the root canal wall after enlargement was observed by scanning electron microscope. The fitness between the wall and gutta-percha was determined by observation of replicas filled with gutta-percha. Furthermore, to assess the degree of apex sealing after root canal filling, we immersed the extracted teeth in Indian ink for 1 day, 3 days, 1 week, 2 weeks, or 4 weeks (Indian ink permeation test). The results obtained were as follows: 1. Reamer and K-file could smooth the root canal wall more than H-file by the scratch-up method. And also the instruments used by the rotation method formed a sure apical seat, which resulted in film apex filling. 2. By the observation of gutta-percha point-filled replicas we noted a border line between the apical seat and apical foramen when the lateral condensation method was used, whereas the line was not observed with the vertical condensation method. 3. Between the 2 filling methods there was no difference in the ink permeation by Indian ink permeation test, but high sealing ability was observed in the root canal in which a sure apical seat had been formed.

摘要

根管治疗中,在感染根管的牙髓摘除术后的最后一个治疗步骤是根管充填。然而,在进行根管充填之前,根管必须充分扩大,并且必须彻底清除根管内感染的牙本质和碎屑。此外,应防止根管根尖孔再次感染。在本研究中,我们检查了采用侧方加压法和垂直加压法应用牙胶尖时的根尖封闭能力,以及在根管扩大时使用手动扩孔钻或锉或两者结合时牙胶尖的根管封闭能力差异。采用拔除的人上颌切牙进行根管扩大。通过扫描电子显微镜观察根管扩大后根管壁的情况。通过观察充满牙胶的复制品来确定根管壁与牙胶之间的贴合度。此外,为了评估根管充填后的根尖封闭程度,我们将拔除的牙齿浸泡在印度墨水中1天、3天、1周、2周或4周(印度墨水渗透试验)。得到的结果如下:1. 用刮除法,扩孔钻和K锉比H锉能更有效地使根管壁光滑。而且,采用旋转法使用的器械能形成确定的根尖止点,从而实现薄膜状根尖充填。2. 通过观察充满牙胶尖的复制品,我们注意到采用侧方加压法时根尖止点与根尖孔之间有一条边界线,而采用垂直加压法时未观察到该线。3. 在两种充填方法之间,印度墨水渗透试验中的墨水渗透情况没有差异,但在形成确定根尖止点的根管中观察到了较高的封闭能力。

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