Alnassar Ibrahim, Alsafadi Ahmad Saleem, Kouchaji Chaza
Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Syria.
Department of Orthodontics, Faculty of Dentistry, Damascus University, Syria.
Dent Med Probl. 2019 Jan-Mar;56(1):53-57. doi: 10.17219/dmp/99655.
One of the factors that most negatively affect the endodontic instrumentation process in primary teeth is the presence of extruded debris in the periapical region. Therefore, different techniques have been evaluated to reach an answer to the question regarding which root canal preparation method produces the least amount of debris extrusion.
The main objective of this study was to assess the amount of debris extrusion as well as irrigation associated with 3 different instrumentation techniques: a rotary system (PROTAPER NEXT® - PTN), a reciprocating system (WaveOne® - WO) and hand K-files.
Forty-eight primary mandibular molars with a single distal canal were selected and randomly divided into 3 groups (n = 16). Three different techniques were used for the canal instrumentation of each group, comprising PTN, WO and hand K-files. Pre-weighed Eppendorf tubes were used for the collection of debris extrusion, then stored in an incubator at 70°C for 5 days. A one-way analysis of variance (ANOVA) test was used for data analysis, followed by Tukey's post hoc test.
Statistically significant differences were found while comparing the PTN and WO systems with the hand files. Both PTN and WO showed less debris extrusion toward the periapical tissues than the hand files. Still, no statistically significant differences were seen between the PTN and WO groups.
Generally, debris extrusion occurred in all of the 3 experimental groups. The PTN and WO systems showed the least debris extrusion as compared to the hand files during the root canal instrumentation of the primary teeth, and for these reasons along with the shorter operating time, it may be concluded that using rotary and reciprocating systems rather than manual files is highly advisable. However, a clinical assessment is suggested.
对乳牙根尖周区域进行根管预备时，最不利的因素之一是根尖周区域出现碎屑挤出。因此，人们对不同技术进行了评估，以回答哪种根管预备方法产生的碎屑挤出量最少这一问题。
本研究的主要目的是评估与三种不同预备技术相关的碎屑挤出量及冲洗情况，这三种技术分别是：旋转系统（PROTAPER NEXT® - PTN）、往复系统（WaveOne® - WO）和手动K锉。
选取48颗下颌第一乳磨牙，均为单一根管，随机分为3组（每组n = 16）。每组采用三种不同技术进行根管预备，分别为PTN、WO和手动K锉。使用预先称重的Eppendorf管收集碎屑挤出物，然后在70°C的培养箱中保存5天。采用单因素方差分析（ANOVA）进行数据分析，随后进行Tukey事后检验。
将PTN和WO系统与手动锉进行比较时，发现有统计学意义的差异。PTN和WO向根尖周组织挤出的碎屑均少于手动锉。不过，PTN组和WO组之间未观察到统计学意义上的显著差异。
一般来说，所有3个实验组均出现了碎屑挤出。在乳牙根管预备过程中，与手动锉相比，PTN和WO系统的碎屑挤出量最少，基于这些原因以及较短的操作时间，可以得出结论，使用旋转和往复系统而非手动锉是非常可取的。然而，建议进行临床评估。
