Kesim Bertan, Sagsen Burak, Aslan Tugrul
Department of Endodontics, Faculty of Dentistry, Mersin University, Mersin, Turkiye.
Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkiye.
Eur J Dent. 2017 Apr-Jun;11(2):157-161. doi: 10.4103/ejd.ejd_254_16.
The aim of this study was to compare the incidence of root cracks after root canal instrumentation with thermomechanically processed nickel-titanium (Ni-Ti) files with different instrumentation kinematics.
A total of 150 extracted mandibular premolars with mature apices and straight root canals were divided into five groups and used in this study. In Group 1, 30 teeth were prepared using hand K-files and assigned to control group, Group 2 was instrumented using K3XF Rotary files (SybronEndo, Glendora, CA, USA) with continuous rotary motion. The teeth in Group 3 were instrumented by ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) rotary files which make asymmetric rotary motion, In Group 4, teeth were instrumented by RECIPROC (VDW, Munich, Germany) with reciprocation motion and in Group 5, teeth were instrumented by Twisted File (TF) Adaptive (SybronEndo, Orange, CA, USA) files that use combination of continuous rotation and reciprocation motion ( = 30/per group). All the roots were horizontally sectioned 3, 6, and 9 mm from the apex with a low speed saw under water cooling. Then, the slices were examined through a stereomicroscope to determine the presence of dentinal microcracks.
For the apical (3-mm) and coronal (9-mm) sections, the ProTaper Next and TF Adaptive produced significantly more cracks than the hand files, RECIPROC, and K3XF ( < 0.05). There was no significant difference between the experimental groups and control group at the 6-mm level ( > 0.05).
Within the limitations of this study, all thermal-treated Ni-Ti instruments and hand files caused microcracks in root canal dentin.
本研究旨在比较采用不同器械操作方式的热机械处理镍钛(Ni-Ti)锉进行根管预备后牙根裂纹的发生率。
本研究共纳入150颗根尖成熟且根管笔直的拔除下颌前磨牙,并将其分为五组。第1组,30颗牙齿采用手动K锉预备,作为对照组;第2组,使用K3XF旋转锉(美国加利福尼亚州格伦多拉市SybronEndo公司)以连续旋转方式进行预备。第3组牙齿采用ProTaper Next(瑞士巴拉格市登士柏迈耶公司)旋转锉进行预备,该锉做非对称旋转运动;第4组,采用RECIPROC(德国慕尼黑市VDW公司)往复运动锉进行预备;第5组,采用Twisted File(TF)Adaptive(美国加利福尼亚州奥兰治市SybronEndo公司)锉进行预备,该锉采用连续旋转和往复运动相结合的方式(每组n = 30)。所有牙根均在水冷条件下用低速锯从根尖3、6和9 mm处水平切片。然后,通过体视显微镜检查切片,以确定牙本质微裂纹的存在情况。
对于根尖(3 mm)和冠部(9 mm)切片,ProTaper Next和TF Adaptive产生的裂纹明显多于手动锉、RECIPROC和K3XF(P < 0.05)。在6 mm水平时,各试验组与对照组之间无显著差异(P > 0.05)。
在本研究的局限性范围内,所有经过热处理的Ni-Ti器械和手动锉均会导致根管牙本质出现微裂纹。