Keleş Ali, Arslan Hakan, Kamalak Aliye, Akçay Merve, Sousa-Neto Manoel D, Versiani Marco Aurélio
Department of Endodontics, Faculty of Dentistry, İnönü University, Malatya, Turkey.
Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
J Endod. 2015 Feb;41(2):219-24. doi: 10.1016/j.joen.2014.09.026. Epub 2014 Nov 6.
The aim of this study was to assess the efficacy of lasers in removing filling remnants from oval-shaped canals after retreatment procedures with rotary instruments using micro-computed tomographic imaging.
The root canals of 42 mandibular canines were prepared and obturated using the warm vertical compaction technique. Retreatment was performed with rotary instruments, and the specimens were distributed in 3 groups (n = 14) according to the laser device used in a later stage of retreatment procedure: Er:YAG, Er:YAG laser-based photon-induced photoacoustic streaming, and Nd:YAG. The specimens were scanned in a micro-computed tomographic device after root canal filling and each stage of retreatment at a resolution of 13.68 μm. The percentage differences of the remaining filling material before and after laser application within and between groups were statistically compared using the paired sample t test and 1-way analysis of variance test, respectively. Significance level was set at 5%.
Overall, filling residues were located mainly in the apical third and into canal irregularities after the retreatment procedures. After using rotary instruments, the mean percentage volume of the filling remnants ranged from 13%-16%, with no statistical significant difference between groups (P > .05). Within groups, additional laser application had a significant reduction in the amount of the remaining filling materials (P < .05). A comparison between groups showed that Er:YAG laser application after the use of rotary instruments had a significantly higher removal of filling remnants (13%) than Er:YAG laser-based photon-induced photoacoustic streaming (4%) and Nd:YAG (~3%) (P < .05).
None of the retreatment procedures completely removed the filling materials. The additional use of lasers improved the removal of filling material after the retreatment procedure with rotary instruments.
本研究的目的是使用微型计算机断层扫描成像技术,评估在用旋转器械进行再治疗后,激光去除椭圆形根管内充填物残渣的效果。
42颗下颌尖牙的根管采用热垂直加压技术进行预备和充填。使用旋转器械进行再治疗,并根据再治疗后期使用的激光设备将标本分为3组(n = 14):铒钇铝石榴石激光(Er:YAG)、基于铒钇铝石榴石激光的光子诱导光声流(Er:YAG laser-based photon-induced photoacoustic streaming)和钕钇铝石榴石激光(Nd:YAG)。根管充填后及再治疗的每个阶段,将标本在微型计算机断层扫描设备中以13.68μm的分辨率进行扫描。分别使用配对样本t检验和单因素方差分析,对组内和组间激光应用前后剩余充填材料的百分比差异进行统计学比较。显著性水平设定为5%。
总体而言,再治疗后充填物残渣主要位于根尖三分之一处和根管不规则处。使用旋转器械后,充填物残渣的平均体积百分比在13% - 16%之间,组间无统计学显著差异(P > 0.05)。在组内,额外使用激光后剩余充填材料的量有显著减少(P < 0.05)。组间比较显示,使用旋转器械后应用铒钇铝石榴石激光去除充填物残渣的比例(约13%)显著高于基于铒钇铝石榴石激光的光子诱导光声流(约4%)和钕钇铝石榴石激光(约3%)(P < 0.05)。
没有一种再治疗方法能完全去除充填材料。在使用旋转器械进行再治疗后额外使用激光可提高充填材料的去除率。