Musale Prasad K, Jain Krutika R, Kothare Sneha S
Department of Pedodontics and Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India.
J Indian Soc Pedod Prev Dent. 2019 Jan-Mar;37(1):80-86. doi: 10.4103/JISPPD.JISPPD_210_18.
Pediatric endodontics has witnessed many advances in recent years, thus facilitating a faster and efficient treatment option in root canal therapy in children. This in vitro evaluation aims to determine the amount of dentin removal in primary mandibular first and second molars instrumented with hand and rotary files using cone-beam computed tomography (CBCT).
Sixty primary mandibular molars were divided into two groups: Group I was prepared by manual instrumentation using K-type files and Group II was prepared with rotary instrumentation using 0.04 Hero Shaper Classics. Both these groups were further divided into two subgroups, namely (a) primary mandibular first molar and (b) primary mandibular second molar. All the root canals were prepared up to size 30 using the stepback technique. They were mounted on silicone-based impression material and subjected to CBCT scans for the evaluation of dentin removal before and after instrumentation. Dentin removal was calculated by superimposing images using the InVivo 5.1 Anatomage software. Data were statistically analyzed using independent samples t- test.
An average amount of dentin removed was found to be significantly higher in manual instrumentation compared to rotary instrumentation in both primary mandibular first and second molars (P < 0.001).
Rotary technique serves as an efficient alternative to the traditional manual instrumentation by overcoming its shortcomings in terms of conservation of the remaining dentin thickness and the time required for its preparation.
近年来儿童牙髓病学取得了许多进展，从而为儿童根管治疗提供了更快、更有效的治疗选择。本体外评估旨在使用锥形束计算机断层扫描（CBCT）确定用手动和旋转锉处理的下颌第一和第二乳磨牙的牙本质去除量。
60颗下颌乳磨牙分为两组：第一组采用K型锉手动预备，第二组采用0.04 Hero Shaper Classics旋转器械预备。这两组又进一步分为两个亚组，即（a）下颌第一乳磨牙和（b）下颌第二乳磨牙。所有根管均采用逐步后退技术预备至30号。将它们安装在硅基印模材料上，并进行CBCT扫描，以评估预备前后的牙本质去除情况。使用InVivo 5.1 Anatomage软件通过叠加图像计算牙本质去除量。数据采用独立样本t检验进行统计学分析。
在下颌第一和第二乳磨牙中，手动预备的平均牙本质去除量均显著高于旋转预备（P < 0.001）。
旋转技术克服了传统手动预备在保留剩余牙本质厚度及其预备所需时间方面的缺点，是一种有效的替代方法。
