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预备模拟根管内桩道后剩余牙本质厚度和预成桩与根管预备形态的适合性。

Remaining dentinal thickness after simulated post space preparation and the fit of prefabricated posts to root canal preparation shapes.

出版信息

J Am Dent Assoc. 2021 Dec;152(12):1020-1032.e12. doi: 10.1016/j.adaj.2021.06.014. Epub 2021 Oct 14.

Abstract

BACKGROUND

Post space preparation can increase the risk of experiencing perforation and root fracture. The authors assessed remaining dentin thickness after post space preparation and the fit of different prefabricated posts to root canal preparation systems in a theoretical model.

METHODS

Ten datasets per type of tooth from cone-beam computed tomography were analyzed to determine the minimum root diameter from 5 through 13 mm from the apical foramen. The preparation shapes of 10 root canal preparation systems were calculated and compared with the root dimensions to determine the remaining dentin thickness. Eight post brands were compared with root dimensions to determine the areas where there was less than 1 mm dentin thickness.

RESULTS

The average root canal preparation shape produced canal diameters of 0.57 mm at 5 mm from the canal terminus and 0.94 mm at 13 mm from the canal terminus. The mean post size tip diameter was 1.03 mm, which is larger than the dimensions of the average canal preparation. Post preparation would result in less than 1 mm of dentin thickness remaining in premolars, smaller roots of molars, and mandibular incisors. The area with less than 1 mm of dentin thickness was around the post tip.

CONCLUSIONS

Endosequence Fiber Post (Brasseler USA), RelyX Fiber Post 3D (3M), and Rebilda (VOCO) were the better fitting posts with the root canal preparation shapes.

PRACTICAL IMPLICATIONS

Many posts would result in less than 1 mm dentin thickness. Clinicians should use posts that fit their root canal preparations to minimize dentin removal.

摘要

背景

后牙根管预备会增加穿孔和根折的风险。作者通过理论模型评估了后牙根管预备后剩余牙本质厚度以及不同预成桩与根管预备系统的适配性。

方法

对来源于锥形束 CT 的每颗牙 10 个数据集进行分析,以确定从根尖孔起 5-13mm 处的最小根管直径。计算了 10 种根管预备系统的预备形状,并与根管尺寸进行比较,以确定剩余牙本质厚度。将 8 种桩品牌与根管尺寸进行比较,以确定牙本质厚度小于 1mm 的区域。

结果

平均根管预备形状在距根管末端 5mm 处产生 0.57mm 的根管直径,在距根管末端 13mm 处产生 0.94mm 的根管直径。平均桩尖端直径为 1.03mm,大于平均根管预备的尺寸。在后牙牙本质预备中,前磨牙、磨牙较小的根以及下颌切牙的剩余牙本质厚度将小于 1mm。牙本质厚度小于 1mm 的区域在桩尖端周围。

结论

Endosequence Fiber Post(Brasseler USA)、RelyX Fiber Post 3D(3M)和 Rebilda(VOCO)是与根管预备形状适配性更好的桩。

临床意义

许多桩会导致剩余牙本质厚度小于 1mm。临床医生应选择与根管预备相适配的桩,以最大程度减少牙本质的去除。

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