根管封闭剂的尺寸变化-体外模型模拟 18 个月内临床挤压场景。

Dimensional changes of endodontic sealers-An in vitro model simulating a clinical extrusion scenario during 18 months.

机构信息

Department of Odontology, Section of Dental Materials, Section of Clinical Oral Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark.

Department of Odontology, Section of Cariology and Endodontics, Section of Clinical Oral Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark.

出版信息

Clin Exp Dent Res. 2023 Apr;9(2):299-313. doi: 10.1002/cre2.704. Epub 2023 Jan 11.

DOI:10.1002/cre2.704

PMID:36628604

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10098291/

Abstract

OBJECTIVES

To examine the dimensional changes of endodontic sealers during 18 months using three-dimensional (3D) surface scanning and subtraction radiography in a novel in vitro sealer-extrusion model.

MATERIAL AND METHODS

Fifty endodontically instrumented acrylic teeth were randomly allocated to five groups (n = 10) filled with Apexit Plus, AH Plus, BioRoot RCS, TubliSeal EWT, and gutta-percha (control). Freshly mixed sealers were intentionally extruded during obturation. All teeth were immersed in a physiologic solution for up to 18 months. Blinded 3D surface scans (resolution: ~10 μm) and digital radiographs of the teeth were obtained at baseline (immediately after obturation); and then after 1 week, and at 1, 3, and 18 months. For blinded assessment of sealer dimensional change, 3D models and radiographs were superimposed using specific software. Volumetric differences, root mean square (RMS), and area change from subtraction radiography measured at each period within each sealer group were thereafter calculated. Repeated measures analyses were done with Bonferroni adjustment for multiple comparisons; standard errors, p values, and 95% confidence intervals (CI) were reported.

RESULTS

Analyses of the volumetric data confirmed significant, progressive material loss for Apexit Plus when compared to the other investigated sealers or the control group (p ≤ 0.02). Immersion period significantly influenced the volumetric dimensional changes of Apexit Plus already after 1 month (p < 0.01). For TubliSeal EW, the effect of the immersion period on the dimensional changes was noted after immersion for 3 months (p ≤ 0.02), while for BioRoot RCS this was evident only at 18 months (p < 0.01). Same trends were noted for the RMS data, whereas progressive dimensional changes using subtraction radiography only revealed significant changes for Apexit Plus (p = 0.01).

CONCLUSIONS

The largest dimensional changes were shown by Apexit Plus, followed by Tubliseal EWT and BioRoot RCS. AH Plus remained stable throughout 18 months.

摘要

目的

在新型根管封闭剂挤出体外模型中，通过三维（3D）表面扫描和减影放射摄影检查，研究 18 个月内根管封闭剂的尺寸变化。

材料和方法

将 50 颗经过根管器械处理的丙烯酸牙齿随机分配到 5 组（每组 10 颗），分别用 Apexit Plus、AH Plus、BioRoot RCS、TubliSeal EWT 和牙胶（对照组）填充。在根管充填过程中，将新鲜混合的封闭剂故意挤出。所有牙齿均在生理溶液中浸泡长达 18 个月。在基线（根管充填后立即）、1 周后、1、3 和 18 个月时，对牙齿进行盲法 3D 表面扫描（分辨率：~10μm）和数字射线照相。然后，使用特定软件对 3D 模型和射线照相进行叠加，以进行封闭剂尺寸变化的盲法评估。此后，在每个封闭剂组的每个时期内，从减影放射摄影测量计算体积差异、均方根（RMS）和面积变化。采用 Bonferroni 调整进行多重比较的重复测量分析；报告标准误差、p 值和 95%置信区间（CI）。

结果

对体积数据的分析证实，与其他研究的封闭剂或对照组相比，Apexit Plus 有明显的、进行性的材料损失（p≤0.02）。浸泡期显著影响 Apexit Plus 的体积尺寸变化，甚至在 1 个月后就已经发生（p<0.01）。对于 TubliSeal EW，浸泡 3 个月后才注意到浸泡期对尺寸变化的影响（p≤0.02），而对于 BioRoot RCS，则仅在 18 个月时才明显（p<0.01）。RMS 数据也有相同的趋势，而仅使用减影放射摄影显示 Apexit Plus 的尺寸变化有显著差异（p=0.01）。