Charara Karine, Friedman Shimon, Sherman Adria, Kishen Anil, Malkhassian Gevik, Khakpour Mehrzad, Basrani Bettina
Department of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Département de Restauration, Section Endodontie, Faculté de Médecine Dentaire, Université de Montréal, Montréal, Québec, Canada.
Department of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
J Endod. 2016 Jan;42(1):135-9. doi: 10.1016/j.joen.2015.04.009. Epub 2015 Nov 4.
This study assessed apical extrusion during treatment with GentleWave (GW; Sonendo Inc, Laguna Hills, CA), a conventional open-ended 30-G needle (CN), or Endovac (EV; SybronEndo, Orange, CA) in root canals enlarged to different dimensions with and without apical constriction.
Sixteen mandibular molars were mounted in an in vitro apparatus. Roots were immersed in a pressure-regulated chamber containing distilled water with pressure kept at 5.88 ± 0.15 mm Hg to simulate periapical back pressure. Mesiobuccal (curved ≤30°) and distal (straight) canals were instrumented to the working length (WL) as follows: minimal instrumentation (MI, #15/.04), traditional instrumentation (#35/.06), or overinstrumentation (OI, #35/.06, to the WL + 1 mm). Canals were tested 5 times each with distilled water using GW, CN (at WL-3 mm), or EV and the mass (g) of extruded water recorded. Extrusion frequency and mean extruded mass were compared for each canal, irrigation group, and canal instrumentation mode (Wilcoxon t test, P < .05).
No extrusion occurred with GW and EV, whereas the frequency of extrusion with CN was 33%. Mean extruded water mass using CN ranged in mesial canals from 0.000 ± 0.000 g (OI) to 0.047 ± 0.098 g (MI) and in distal canals from 0.123 ± 0.191 g (MI) to 0.505 ± 0.490 g (OI). With traditional instrumentation and OI instrumentation, extruded mass in distal canals was significantly higher than in mesial canals (P < .002) and distal canals with MI (P < .020).
Within this study's limitations, root canal treatment with GW and irrigation with EV was not associated with extrusion. Extruded irrigation mass using the open-ended 30-G needle depended on the canal type and enlargement. These results have to be interpreted with caution, and further investigations are warranted to evaluate the possibility of extrusion using GW in different tooth types and clinical situations.
本研究评估了在使用GentleWave（GW；Sonendo公司，加利福尼亚州拉古纳希尔斯）、传统的30G开放式针头（CN）或Endovac（EV；SybronEndo公司，加利福尼亚州奥兰治）进行根管治疗时，在有和没有根尖狭窄的情况下，根管扩大到不同尺寸时的根尖挤出情况。
将16颗下颌磨牙安装在体外装置中。将牙根浸入一个压力调节室中，该室装有蒸馏水，压力保持在5.88±0.15毫米汞柱，以模拟根尖周反压。近中颊侧（弯曲度≤30°）和远中（直的）根管按以下方式预备到工作长度（WL）：最小预备（MI，#15/.04）、传统预备（#35/.06）或过度预备（OI，#35/.06，到WL + 1毫米）。使用GW、CN（在WL - 3毫米处）或EV，用蒸馏水对根管各测试5次，并记录挤出的水的质量（克）。比较每个根管、冲洗组和根管预备方式的挤出频率和平均挤出质量（Wilcoxon t检验，P <.05）。
GW和EV未发生挤出，而CN的挤出频率为33%。使用CN时，近中根管的平均挤出水量范围为0.000±0.000克（OI）至0.047±0.098克（MI），远中根管为0.123±0.191克（MI）至0.505±0.490克（OI）。在传统预备和OI预备时，远中根管的挤出质量显著高于近中根管（P <.002）以及采用MI的远中根管（P <.020）。
在本研究的局限性范围内，使用GW进行根管治疗和用EV冲洗与挤出无关。使用30G开放式针头时的挤出冲洗量取决于根管类型和扩大程度。这些结果必须谨慎解释，有必要进行进一步研究以评估在不同牙型和临床情况下使用GW时挤出的可能性。
