Sant'Anna Júnior Arnaldo, Cavenago Bruno Cavalini, Ordinola-Zapata Ronald, De-Deus Gustavo, Bramante Clovis Monteiro, Duarte Marco Antonio Hungaro
Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
J Endod. 2014 Nov;40(11):1855-9. doi: 10.1016/j.joen.2014.06.020. Epub 2014 Aug 12.
The aim of this study was to evaluate the effects of large apical preparations in the danger zones of the mesial root canals of mandibular molars instrumented with the Mtwo and Reciproc systems (VDW, Munich, Germany) until reaching apical diameters of 0.25 and 0.40 mm.
Twelve mandibular molars, the mesial roots of which presented distinct foramens and similar anatomies, were selected using micro-computed tomographic scanning. Mtwo and Reciproc instruments were used to shape the mesiobuccal or mesiolingual canals. The mesial canals were scanned before and after the use of 0.25- and 0.40-mm Mtwo and Reciproc instruments. The analyzed parameters included the root canal volume and remaining dentin thickness at 5 different levels. The obtained data were subjected to paired analysis of variance and Tukey or Friedman and Dunn tests for intragroup analysis and the Mann-Whitney U test for comparison between the mesial and distal walls.
There were no significant differences between the mesial and distal dentin thickness for the points analyzed with both instrumentation techniques (P > .05). The volumetric analysis revealed a significant difference (P < .05) among the initial volume and after the use of the 0.25- and 0.40-mm instruments for both systems. The use of the 0.40-mm instrument increased the root canal volume in comparison to the 0.25-mm instrument (P < .05).
Both systems performed similarly for the preparation of curved root canals with separate apical foramens. The increase of the root canal preparation with the 0.40-mm instrument significantly increased the root canal volume at the apical third without significantly reducing the dentin thickness in the danger zone for both instrument systems.
本研究旨在评估使用 Mtwo 和 Reciproc 系统(德国慕尼黑 VDW 公司)对下颌磨牙近中根管危险区域进行大根尖预备,直至达到根尖直径 0.25 和 0.40 毫米时的效果。
使用微计算机断层扫描选择 12 颗下颌磨牙,其近中根具有明显的根尖孔且解剖结构相似。使用 Mtwo 和 Reciproc 器械对近中颊侧或近中舌侧根管进行塑形。在使用 0.25 毫米和 0.40 毫米的 Mtwo 和 Reciproc 器械前后对近中根管进行扫描。分析参数包括根管体积以及在 5 个不同水平的剩余牙本质厚度。对获得的数据进行组内配对方差分析以及 Tukey 检验或 Friedman 和 Dunn 检验,并进行 Mann-Whitney U 检验以比较近中壁和远中壁。
两种器械技术分析的各点近中与远中牙本质厚度之间均无显著差异(P >.05)。体积分析显示,两种系统在初始体积与使用 0.25 毫米和 0.40 毫米器械后均存在显著差异(P <.05)。与 0.25 毫米器械相比,使用 0.40 毫米器械增加了根管体积(P <.05)。
对于具有独立根尖孔的弯曲根管预备,两种系统表现相似。使用 0.40 毫米器械增加根管预备显著增加了根尖三分之一处的根管体积,且两种器械系统在危险区域均未显著降低牙本质厚度。