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在根管预备中手动 K 锉和往复锉的根管偏移和根管中心定位能力的比较:对狭窄根管的 micro-CT 研究。

Comparison of canal transportation and centering ability of manual K-files and reciprocating files in glide path preparation: a micro-computed tomography study of constricted canals.

机构信息

Center of Dental Medicine, China-Japan Friendship Hospital, 2 Ying-Hua-Yuan East Street, Chaoyang District, Beijing, 100029, China.

Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, 22 South Zhongguancun Avenue, Haidian District, Beijing, 100081, China.

出版信息

BMC Oral Health. 2021 Feb 23;21(1):83. doi: 10.1186/s12903-021-01440-3.

Abstract

BACKGROUND

Optimum Glide Path (OGP) is a new reciprocating motion aiming to perform efficient glide path preparation in constricted canals. The aim of this study was to investigate and compare manual and OGP movement in terms of canal transportation and centering ability in glide path preparation of constricted canals.

METHODS

Thirty constricted mesial root canals of mandibular molars, with initial apical size no larger than ISO#8, were selected and negotiated with #6-#8 K-files under the microscope. Canals were randomly divided into two experimental groups: Group 1 (MAN, n = 15): Glide path was established by using #10-#15 stainless steel K-files manually; Group 2 (OGP, n = 15): #10-#15 Mechanical Glide Path super-files were used with OGP motion (OGP 90°, 300 rpm). Each instrument was used to prepare only 2 canals (as in one mesial root). Canals were scanned before and after glide path preparation with micro-computed tomography (micro-CT) to evaluate root canal transportation and centering ratio at 1, 3 and 5 mm levels from the root apex. File distortions and separations were recorded. Paired t-test was used to statistically evaluate the data (P < .05).

RESULTS

Group 2 showed a significantly lower transportation value than group 1 at 1-mm and 3-mm levels (P < .05), however the difference at 5-mm level was not significant. There was no significant difference regarding the centering ratio between the groups. Six #10 K-files were severely distorted in group 1, while no file separation or distortion was found in group 2.

CONCLUSIONS

OGP motion performed significantly less canal transportation (apical 3 mm) and file distortion during glide path establishment in constricted canals comparing to manual motion, while the centering ability between the two was similar.

CLINICAL RELEVANCE

OGP reciprocating motion provides a safer and efficient clinical approach compared to traditional manual motion in glide path establishment with small files in constricted canals.

摘要

背景

Optimum Glide Path(OGP)是一种新的往复运动,旨在在狭窄的根管中进行高效的预备。本研究旨在比较手动和 OGP 运动在狭窄根管预备中的根管偏移和中心定位能力。

方法

选择 30 个下颌磨牙近中颊根,初始根尖尺寸不大于 ISO#8,在显微镜下用 #6-#8 号 K 锉进行预弯。根管随机分为两组:第 1 组(MAN,n=15):手动使用 #10-#15 不锈钢 K 锉建立预备路径;第 2 组(OGP,n=15):使用 OGP 运动(OGP 90°,300rpm)的#10-#15 机械预弯锉。每个器械仅用于预备 2 个根管(即一个近中根)。在预备路径预备前后,使用微计算机断层扫描(micro-CT)评估根尖 1、3 和 5mm 处的根管偏移和中心定位比。记录器械的扭曲和分离。采用配对 t 检验对数据进行统计学分析(P<.05)。

结果

第 2 组在 1mm 和 3mm 处的偏移值明显低于第 1 组(P<.05),但在 5mm 处差异无统计学意义。两组的中心定位比无显著差异。第 1 组有 6 根 #10 K 锉严重变形,第 2 组未发现器械分离或变形。

结论

与手动运动相比,OGP 运动在狭窄根管预备中建立预备路径时,根管偏移(根尖 3mm)和器械变形明显减少,而两者的中心定位能力相似。

临床意义

与传统的手动运动相比,OGP 往复运动在狭窄根管中使用小锉建立预备路径时提供了更安全、更有效的临床方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7125/7903633/0176ca22bc7e/12903_2021_1440_Fig1_HTML.jpg

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