根管预备的锥度和终末冲洗方案对椭圆形根管清理效果的影响。

Influence of apical preparation size and final irrigation protocol on the debridement of oval root canals.

机构信息

Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, SP, Brazil.

Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Patologia Oral, Campinas, SP, Brazil.

出版信息

Braz Dent J. 2021 Nov-Dec;32(6):16-27. doi: 10.1590/0103-6440202104280.

DOI:10.1590/0103-6440202104280

PMID:35019016

Abstract

This study assessed the influence of apical preparation size and final irrigation protocol on the debridement of the apical third of oval root canals of mandibular molars. Seventy-seven distal roots were divided into 7 groups (n = 11): Control: without instrumentation or irrigation; Group 30CI: ProTaper Next (up to size 30; PTN) + conventional irrigation (CI); Group 30UAI: PTN + ultrasonically activated irrigation (UAI); Group 30XPF: PTN + XP-endo Finisher (XPF); Group 40CI: PTN + ProDesign Logic (up to size 40; PDL) + CI; Group 40UAI: PTN + PDL + UAI; and Group 40XPF: PTN + PDL + XPF. The total volume of irrigating solutions used per root canal in all the experimental groups was 33 mL of 2.5% sodium hypochlorite (NaOCl) and 6 mL of 17% ethylenediaminetetraacetic acid (EDTA). After specimen processing and histological analysis under a digital microscope (100x), the percentages of untouched canal walls (UCW) and remaining debris (RD) were assessed using Image J software. A descriptive and exploratory analysis was conducted, indicating that the data failed to meet the assumptions of an analysis of variance. Therefore, generalized linear models were used to assess the effects of the different instrumentation and irrigation protocols, as well as the interaction among them, on the percentage of UCW and RD. No significant difference was found among the irrigation protocols regarding the percentage of UCW, irrespective of apical preparation size (p>0.05). However, UCW and RD were significantly lower in groups 40CI, 40UAI and 40XPF than in groups 30CI, 30UAI and 30XPF (p<0.05). The percentage of RD was significantly lower in the UAI and XPF groups than in the CI groups, irrespective of apical preparation size (p<0.05). The difference between preparation sizes 30 and 40, with respect to RD, was higher when CI was used (p<0.05). In conclusion, instrumentation up to apical preparation size 40 resulted in lower percentages of UCW and RD than up to apical preparation size 30. Use of UAI or XPF resulted in lower percentages of RD than CI.

摘要

本研究评估了根尖预备尺寸和最终冲洗方案对上颌磨牙椭圆形根管根尖三分之一区域清创效果的影响。77 个远中根分为 7 组（n=11）：对照组：不进行器械预备或冲洗；30CI 组：ProTaper Next（至 30 号；PTN）+常规冲洗（CI）；30UAI 组：PTN+超声激活冲洗（UAI）；30XPF 组：PTN+XP-endo Finisher（XPF）；40CI 组：PTN+ProDesign Logic（至 40 号；PDL）+CI；40UAI 组：PTN+PDL+UAI；40XPF 组：PTN+PDL+XPF。所有实验组每根管冲洗液的总体积为 33 毫升 2.5%次氯酸钠（NaOCl）和 6 毫升 17%乙二胺四乙酸（EDTA）。在数字显微镜（100x）下进行标本处理和组织学分析后，使用 Image J 软件评估未触及的根管壁（UCW）和残留碎片（RD）的百分比。采用描述性和探索性分析，结果表明数据不符合方差分析的假设。因此，使用广义线性模型来评估不同的器械预备和冲洗方案以及它们之间的相互作用对上颌磨牙椭圆形根管根尖三分之一区域清创效果的影响。结果显示，不论根尖预备尺寸如何，各组冲洗方案之间 UCW 的百分比均无显著差异（p>0.05）。然而，与 30CI、30UAI 和 30XPF 组相比，40CI、40UAI 和 40XPF 组的 UCW 和 RD 明显更低（p<0.05）。UAI 和 XPF 组的 RD 百分比明显低于 CI 组，不论根尖预备尺寸如何（p<0.05）。在使用 CI 时，30 号和 40 号预备尺寸之间 RD 的差异更大（p<0.05）。结论：与预备至 30 号相比，预备至 40 号时 UCW 和 RD 的百分比更低。与 CI 相比，使用 UAI 或 XPF 时 RD 的百分比更低。