Pabel Anne-Kathrin, Hülsmann Michael
Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Odontology. 2017 Oct;105(4):453-459. doi: 10.1007/s10266-017-0293-6. Epub 2017 Mar 15.
To compare four different techniques for removal of calcium hydroxide from straight root canals. The present study used the design suggested by Lee et al. (Int Endod J 37:607-612, 32) and van der Sluis et al. (Int Endod J 40:52-57, 17). One-hundred and ten extracted human teeth with straight root canals were prepared to ISO-size 50 and split longitudinally. Two lateral grooves were prepared, filled with calcium hydroxide and the root halves reassembled in a muffle. Calcium hydroxide was removed using one of five techniques: (1) passive ultrasonic irrigation, (2) hydrodynamic irrigation using RinsEndo, (3) sonic irrigation using the EndoActivator, (4) motor-driven plastic brush (CanalBrush™), and (5) manual irrigation with a syringe as the control group. Distilled water was used as irrigant. Cleanliness of the grooves was scored under a microscope with 40× magnification. For intraindividual reproducibility and interrater agreement, Cohens Kappa was calculated. Results of scoring were analyzed using a non-parametric test. Post hoc pairwise comparisons were used for irrigation techniques (α = 0.05). Passive ultrasonic irrigation performed significantly better than all other groups in the apical groove. Significant differences were found between RinsEndo and CanalBrush (P = 0.01855) and CanalBrush and syringe irrigation (P = 0.00021). In the coronal groove, passive ultrasonic irrigation performed significantly superior and hand irrigation performed significantly worse than all other groups. A statistically significant interaction was shown between irrigation technique and localization of the groove (P = 0.01358). The coronal grooves showed more remaining calcium hydroxide than the apical grooves. Complete removal of calcium hydroxide from the root canal could not be achieved with any of the techniques investigated. The highest degree of cleanliness resulted from the use of passive ultrasonic irrigation.
比较四种从直根管中去除氢氧化钙的不同技术。本研究采用了Lee等人（《国际牙髓病学杂志》37:607 - 612, 32）和van der Sluis等人（《国际牙髓病学杂志》40:52 - 57, 17）建议的设计。选取110颗具有直根管的拔除人类牙齿，预备至ISO 50号规格并纵向劈开。制备两条侧方凹槽，填充氢氧化钙，然后将半根牙齿重新组装在马弗炉中。使用以下五种技术之一去除氢氧化钙：（1）被动超声冲洗；（2）使用RinsEndo进行流体动力冲洗；（3）使用EndoActivator进行声波冲洗；（4）电动塑料刷（CanalBrush™）；（5）用注射器手动冲洗作为对照组。使用蒸馏水作为冲洗液。在40倍放大倍数的显微镜下对凹槽的清洁度进行评分。为了评估个体内的可重复性和评分者间的一致性，计算了科恩卡方值。使用非参数检验分析评分结果。采用事后两两比较分析冲洗技术（α = 0.05）。被动超声冲洗在根尖凹槽中的表现明显优于所有其他组。RinsEndo与CanalBrush之间（P = 0.01855）以及CanalBrush与注射器冲洗之间（P = 0.00021）存在显著差异。在冠方凹槽中，被动超声冲洗的表现明显优于其他所有组，而手动冲洗的表现明显差于其他所有组。冲洗技术与凹槽位置之间存在统计学上的显著交互作用（P = 0.01358）。冠方凹槽中残留的氢氧化钙比根尖凹槽更多。所研究的任何技术都无法完全从根管中去除氢氧化钙。使用被动超声冲洗获得的清洁度最高。
