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四种机械镍钛锉预备根管后牙本质微裂纹的形成。

Formation of dentinal microcracks after root canal preparation with four kinds of mechanical nickel-titanium files.

机构信息

Dept. of Conservative Dentistry and Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China.

出版信息

Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Feb 1;42(1):75-81. doi: 10.7518/hxkq.2023.2023257.

Abstract

OBJECTIVES

This study aimed to compare the differences among four kinds of mechanical Ni-Ti files including T-Flex, Reciproc Blue (RB), ProTaper Gold (PTG), and ProTaper Universal (PTU) in dentinal microcrack generation after root canal preparation by using micro-computed tomography (micro-CT) analysis.

METHODS

A total of 32 freshly extracted double-root-canal premolars with an angle not exceeding 10° were selected and established as root canal preparation models . Then, the specimens were randomly assigned to four experimental groups (=8) according to the different Ni-Ti systems used for root canal preparation: group T-Flex, group RB, group PTG, and group PTU. The voxel size of the micro-CT was set at 17.18 μm. Pre- and post-operative cross-sectional images of roots (=56 940) were scanned and analyzed to identify the presence of dentinal microcracks. The results of each group were expressed by the quantity and percentage of sectional images with microcracks. McNemar test was used to determine whether a significant difference existed in the existence of dentinal microcracks before and after instrumentation. The level of significance was set at <0.05.

RESULTS

Overall, 11.04% of the images presented dentinal defects (=6 288). Dentinal microcracks were observed in 9.82%, 10.79%, 12.27%, and 11.25% of the post-instrumentation images from groups T-Flex, RB, PTG, and PTU, respectively. However, all these dentinal microcracks were already present in the corresponding pre-operative images. No new microcrack of premolars were generated after the root canal preparation utilizing the aforementioned systems.

CONCLUSIONS

Denti-nal microcracks already existed in advance in extracted teeth before root canal preparation. Root canal preparation using the T-Flex, RB, PTG, and PTU systems did not induce the formation of new dentinal microcracks on the straight root canals of premolars.

摘要

目的

本研究旨在通过微计算机断层扫描(micro-CT)分析比较 T-Flex、Reciproc Blue(RB)、ProTaper Gold(PTG)和 ProTaper Universal(PTU)四种镍钛锉在根管预备后牙本质微裂纹产生方面的差异。

方法

共选择 32 颗角度不超过 10°的新鲜双根管前磨牙,建立根管预备模型。然后,根据不同的镍钛系统进行根管预备,将标本随机分为四组(每组 8 个):T-Flex 组、RB 组、PTG 组和 PTU 组。微 CT 的体素大小设置为 17.18 μm。扫描并分析根的术前和术后横截面图像(=56 940),以确定牙本质微裂纹的存在。每组的结果用有微裂纹的横截面图像的数量和百分比表示。采用 McNemar 检验确定器械预备前后牙本质微裂纹的存在是否存在显著差异。显著性水平设置为<0.05。

结果

总体而言,11.04%的图像显示牙本质缺陷(=6 288)。T-Flex、RB、PTG 和 PTU 组术后图像中分别有 9.82%、10.79%、12.27%和 11.25%出现牙本质微裂纹,但所有这些牙本质微裂纹在相应的术前图像中均已存在。在利用上述系统进行根管预备后,前磨牙没有产生新的微裂纹。

结论

在根管预备前,提取牙齿中已经存在牙本质微裂纹。T-Flex、RB、PTG 和 PTU 系统的根管预备不会在前磨牙直根管上形成新的牙本质微裂纹。

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