未器械预备但清洁过的人前磨牙根管管壁牙本质结构：扫描电子显微镜研究。

Root Canal Wall Dentin Structure in Uninstrumented but Cleaned Human Premolars: A Scanning Electron Microscopic Study.

机构信息

Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

J Endod. 2018 May;44(5):842-848. doi: 10.1016/j.joen.2018.01.014. Epub 2018 Mar 15.

DOI:10.1016/j.joen.2018.01.014

PMID:29550004

Abstract

INTRODUCTION

Conventional endodontic treatment includes instrumentation of the canals in most cases to size #25/.06 or larger, which changes the original canal wall anatomy. In recent years, energy-driven equipment, such as photon-induced photoacoustic streaming (Fotona LLC, Dallas, TX) and a multisonic GentleWave system (Sonendo Inc, Laguna Hills, CA), have been introduced to facilitate cleaning of minimally instrumented canals or even uninstrumented canals. The purpose of this study was to examine root canal wall anatomy in premolar teeth cleaned by a noninstrumentation method after #10 K-file patency examination.

METHODS

Twenty-four freshly extracted human premolars were accessed, and patency was established by a #10 K-file. Seventeen teeth were treated by the GentleWave system using 3% sodium hypochlorite, and 7 untreated teeth served as negative controls. The dentin surface in the coronal, middle, and apical thirds of the root canal was examined by scanning electron microscopy after tooth splitting. The canal wall structures were assessed using a predefined scale of 4 parameters: calcospherites, surface irregularities, dentinal tubule openings, and tissue debris.

RESULTS

A clean surface of mineralized dentin was exposed with no organic tissue remnants or debris left in the root canal system, including the isthmus areas between the 2 canals. The uninstrumented root canals showed an irregular dentin structure in many areas, including previously unreported fingerlike projections. The isthmus areas had no or only a few dentinal tubule openings. The dentin structures were well preserved in the test group, whereas in the untreated control teeth tissue debris covered most of the dentin surface.

CONCLUSIONS

Root canal wall dentin in premolars cleaned with a noninstrumentation method showed a wide structural variety, especially in the middle and apical region. No organic tissue remnants or dentin debris were detected.

摘要

介绍

传统的根管治疗包括在大多数情况下将根管扩大到 #25/.06 或更大，这会改变原始的根管壁解剖结构。近年来，已经引入了能量驱动的设备，如光诱导光声流（Fotona LLC，达拉斯，TX）和多频声GentleWave 系统（Sonendo Inc，拉古纳山，CA），以促进最小化器械预备或甚至未器械预备的根管清洁。本研究的目的是检查经过 #10 K 锉通畅性检查后，采用非器械方法清洁的前磨牙的根管壁解剖结构。

方法

共纳入 24 颗新鲜拔除的人前磨牙，通过 #10 K 锉建立通畅性。17 颗牙齿用 GentleWave 系统处理，使用 3%次氯酸钠，7 颗未处理的牙齿作为阴性对照。牙劈裂后，通过扫描电子显微镜检查根管冠、中、根尖三分之一的牙本质表面。使用 4 个参数的预设标准评估根管壁结构：钙球、表面不规则、牙本质小管开口和组织碎片。

结果

根管系统中，包括 2 个根管之间的峡部区域，均未发现有机组织残留物或碎片，仅露出矿化牙本质的清洁表面。未器械预备的根管在许多区域显示出不规则的牙本质结构，包括以前未报道过的指状突起。峡部区域没有或只有少数牙本质小管开口。实验组的牙本质结构保存良好，而未处理的对照组牙齿的牙本质表面大部分被组织碎片覆盖。