Chen Chen, Zhang Wenxin, Liang Yuhong
Department of Cardiology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China.
First Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China.
J Dent Sci. 2022 Apr;17(2):763-770. doi: 10.1016/j.jds.2021.10.009. Epub 2021 Oct 23.
BACKGROUND/PURPOSE: Canal instrumentation with rotary nickel-titanium (NiTi) instruments might weaken the dentinal wall. This study aims to investigate the apical root defects during canal instrumentation with two NiTi rotary systems by using optical coherence tomography (OCT) scans.
Twenty mandibular incisors were selected and divided into two groups instrumented using HyFlex CM (HCM) and ProTaper Universal (PTU) systems. OCT scans were taken immediately after canal instrumentation with file #25, #30 and #40. Each cross-sectional reconstructed image of 1, 2 and 3 mm from the apex was examined, root cracks were scored, and dentin thickness was measured at 12 sites. The risk sites with dentin thickness less than 0.30 mm were recorded.
In HCM group, no cracks were observed after instrumentation with file #30/.06, while in PTU group, root cracks were found in 6 teeth with a total score of 9 after using F3 (#30/.09) (P < 0.05). After file #40, 8 teeth with cracks had a score of 14 in PTU group, while one tooth was observed crack with a score of 1 in HCM group (P < 0.05). The number of risk sites in PTU group was 49 (13.16%), which was significantly more than the 28 (7.78%) in HCM group (P < 0.05) when canals were instrumented with file #30.
Within the limitations of this study, when the canals of mandibular incisors were instrumented with size #30 and #40 files, OCT scans showed less root defects in HCM group.
背景/目的:使用旋转镍钛(NiTi)器械进行根管预备可能会削弱牙本质壁。本研究旨在通过光学相干断层扫描(OCT)观察两种NiTi旋转系统进行根管预备时根尖部的牙根缺损情况。
选取20颗下颌切牙,分为两组,分别使用HyFlex CM(HCM)和ProTaper Universal(PTU)系统进行根管预备。使用25号、30号和40号锉完成根管预备后立即进行OCT扫描。检查距根尖1、2和3mm处的每层横断面重建图像,对牙根裂纹进行评分,并在12个部位测量牙本质厚度。记录牙本质厚度小于0.30mm的风险部位。
在HCM组,使用30/.06号锉预备后未观察到裂纹,而在PTU组,使用F3(30/.09)号锉预备后,6颗牙齿出现牙根裂纹,总评分为9分(P < 0.05)。使用40号锉预备后,PTU组有8颗牙齿出现裂纹,评分为14分,而HCM组有1颗牙齿出现裂纹,评分为1分(P < 0.05)。使用30号锉预备根管时,PTU组的风险部位数量为49个(13.16%),显著多于HCM组的28个(7.78%)(P < 0.05)。
在本研究的局限性范围内,当下颌切牙根管使用30号和40号锉进行预备时,OCT扫描显示HCM组的牙根缺损较少。