Department of Oral and Maxillo-Facial Sciences, La Sapienza University, Rome, Italy.
Division of Endodontics, University at Buffalo, Buffalo, NY, USA.
Int Endod J. 2019 May;52(5):737-745. doi: 10.1111/iej.13042. Epub 2018 Dec 4.
To compare two different clinical techniques when using endodontic rotary instruments by monitoring the torque in vivo.
Ten single-rooted maxillary anterior teeth were prepared by an endodontist using size 25, .06 taper TF rotary instruments (KerrEndo, Orange, CA, USA). All instruments were rotated at 500 rpm with maximum torque set at 2.5 N cm using an endodontic motor (Kavo, Biberach, Germany), which automatically recorded the torque values every 1/10 of a second. Instruments were used with two modi operandi: (i) Inward action: short-length intermittent progression with slight apical pressure aiming to reach the working length (also known as pecking motion), followed by (ii) Outward action: lateral brushing action selectively directed to address the canal circumference whilst removing instruments in the coronal direction. The mean, maximum and accumulated torque values were recorded and analysed statistically (t-test and Wilcoxon test) with a significance level set at 5%. None of the recorded values exceeded the selected torque limit.
A significant difference between inward and outward actions was found regarding the evaluated parameters (P < 0.05). The outward action (brushing) was significantly safer (requiring less torque) compared to the inward action (pecking).
Torque measurements during in vivo instrumentation provided useful information regarding the techniques evaluated. Although the torque limit was not reached by any of the two actions, the technique impacted significantly on the torque applied to the instrument.
通过监测体内扭矩,比较两种不同的根管器械预备时使用根管旋转器械的临床技术。
由一位牙髓病专家使用 25 号、.06 锥度 TF 旋转器械(美国 KerrEndo,Orange,CA)预备 10 颗上颌单根前牙。所有器械均在 500 rpm 下旋转,最大扭矩设定为 2.5 N cm,使用根管马达(德国 Kavo,Biberach),马达自动每 1/10 秒记录一次扭矩值。器械使用两种操作模式:(i)向心运动:短长度间歇性推进,轻微根尖向压力,旨在达到工作长度(也称为啄击运动),随后(ii)离心运动:侧向刷洗动作,选择性地针对根管圆周,同时向冠方方向移除器械。记录平均、最大和累积扭矩值,并进行统计学分析(t 检验和 Wilcoxon 检验),显著性水平设定为 5%。记录的值均未超过所选扭矩限制。
两种操作模式在评估参数上有显著差异(P<0.05)。离心运动(刷洗)比向心运动(啄击)更安全(需要的扭矩更小)。
体内器械预备过程中的扭矩测量为评估的技术提供了有用的信息。虽然两种动作都没有达到设定的扭矩限制,但该技术显著影响了器械所受的扭矩。