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用旋转器械预备的上颌第一磨牙近中颊根第二根管的牙本质厚度

Dentine Thickness of Second Mesibuccal Canals in First Maxillary Molars Prepared with Rotary Instruments.

作者信息

Forghani Maryam, Hamedi Ali, Khorasani Monireh, Moushekhian Siavash, Kheirabadi Nasir

机构信息

Dental Research Center, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran.

Endodontist, Private Practice, Mashhad, Iran.

出版信息

Iran Endod J. 2022 Summer;17(3):126-131. doi: 10.22037/iej.v17i3.35487.

Abstract

INTRODUCTION

The purpose of this study was to evaluate the thickness of the remaining dentine wall in the danger zone of the second mesiobuccal (MB2) canals using cone-beam computed tomography (CBCT) in maxillary first molars following preparation by means of HERO 642 rotary instruments with different tapers.

METHODS AND MATERIALS

The study samples included twenty-five mesiobuccal roots of maxillary first molars. A two-step method was employed to prepare the MB2 canals applying HERO 642 instruments: using a 0.02 taper (step 1), and a 0.04 taper (step 2). The roots were scanned before preparation, and after each step. The thickness of the dentine wall was recorded at the CEJ level, as well as 2 mm and 4 mm below the CEJ. The repeated-measures ANOVA in conjunction with the Cochran tests were used to compare the changes in the thickness of the root canal wall.

RESULTS

There was no area with dentine thickness of <0.5 mm before preparation. A significant reduction in dentine thickness occurred following the preparation with both 0.02 and 0.04 files at all three levels compared with the pre-instrumentation values (< 0.05). However, areas with dentine thickness of < 0.5 mm after preparation using 0.04 files were significantly more than those resulting from the application of 0.02 files both at the CEJ and 2 mm-below-CEJ points, but the differences were not significant at the 4mm-below-CEJ level.

CONCLUSION

Within the limitations of the present in vitro study, the use of larger taper instruments in MB2 root canals of maxillary first molars increased the quantity of samples with dentine thickness less than 0.5 millimeter at the coronal level of the root canal. It was concluded that instruments with large tapers, should be used with caution in troughing or preparing such root canals to reduce the risk of strip perforation.

摘要

引言

本研究的目的是使用锥形束计算机断层扫描(CBCT)评估在上颌第一磨牙中,采用不同锥度的HERO 642旋转器械预备后,第二近中颊根(MB2)根管危险区剩余牙本质壁的厚度。

方法和材料

研究样本包括25个上颌第一磨牙的近中颊根。采用两步法使用HERO 642器械预备MB2根管:第一步使用0.02锥度的器械,第二步使用0.04锥度的器械。在预备前以及每一步骤后对牙根进行扫描。在牙骨质界水平以及牙骨质界下方2mm和4mm处记录牙本质壁的厚度。采用重复测量方差分析结合 Cochr an检验来比较根管壁厚度的变化。

结果

预备前没有牙本质厚度<0.5mm的区域。与预备前的值相比,使用0.02和0.04锉预备后,在所有三个水平上牙本质厚度均显著降低(<0.05)。然而,在牙骨质界和牙骨质界下方2mm处,使用0.04锉预备后牙本质厚度<0.5mm的区域显著多于使用0.02锉的情况,但在牙骨质界下方4mm处差异不显著。

结论

在本体外研究的局限性内,在上颌第一磨牙的MB2根管中使用较大锥度的器械会增加根管冠部牙本质厚度小于0.5毫米的样本数量。得出的结论是,在修整或预备此类根管时应谨慎使用大锥度器械,以降低根管壁侧穿的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99ef/9869008/18934c9d107f/IEJ-17-126-g001.jpg

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