G P V Srikumar, Shukla Vaishali, Ghosh Megha, Barde Sakshi, Mustafa Mohammed, Almokhatieb Ahmed A
Department of Conservative Dentistry and Endodontics, Triveni Institute of Dental Sciences, Hospital and Research Centre, Bilaspur, IND.
Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, SAU.
Cureus. 2024 Oct 8;16(10):e71117. doi: 10.7759/cureus.71117. eCollection 2024 Oct.
Aim The aim of the present study was to evaluate the in vitro comparative assessment of root canal centering ratio and canal transportation associated with ProTaper Universal (PTU) (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Next (PTN) (Dentsply Maillefer, Ballaigues, Switzerland), and ProTaper Gold (PTG) (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) rotary file systems, with or without glide-path preparation, using cone beam computed tomography (CBCT) analysis. Materials and methods A total of 120 mesial roots of extracted human mandibular first molar teeth were collected and randomly divided into three groups (n = 40) depending on the type of rotary file system used for mesiobuccal root canal instrumentation: Group 1: PTU, Group 2: PTN, and Group 3: PTG rotary file systems. Each group was further divided into two Sub-groups (a and b) with 20 specimens, depending on whether glide-path preparation was performed using the ProGlider (PG) file (Dentsply Maillefer, Ballaigues, Switzerland). Before the root canal instrumentation, mesiobuccal root canals of all specimens were first scanned using the NewTom Go CBCT machine (Cefla S.C., Imola, Italy), and all root canals were then instrumented according to their groups and sub-groups. All rotary files were used according to their manufacturer's guidelines. Post-instrumentation, CBCT images of all specimens were taken with the same exposure parameters as those used in pre-instrumentation CBCT imaging. The distance between the external root surface and the internal canal wall was measured in both bucco-lingual and mesio-distal planes at 3 mm, 5 mm, and 7 mm levels of the mesiobuccal root canal of all specimens, comparing the pre-instrumentation and post-instrumentation CBCT scans for the evaluation of canal centering ratio and canal transportation using NewTom NNT software (Cefla S.C., Imola, Italy). Data were analyzed using one-way analysis of variance (ANOVA), multiple pairwise Tukey post-hoc tests, and Student's t-tests; a p-value ≤ 0.05 was considered statistically significant. Results Canal centering ratio was significant bucco-lingually and mesio-distally at 3 mm and 5 mm levels between Groups 1a, 1b, and 3a, 3b (p < 0.05). However, at 7 mm bucco-lingually, a significant difference was observed between groups 3a and 3b, and mesio-distally between Groups 2a and 2b (p < 0.05). Canal transportation was significantly bucco-lingually at 3 mm, 5 mm, and 7 mm levels between Groups 3a and 3b (p < 0.05). However, mesio-distally, no statistically significant difference (p > 0.05) was seen between the groups at all three levels of the root canal. Conclusion The use of the PG/PTN rotary file system showed the maximum canal centering ratio at all three levels of the root canal compared to the PTU and PTG rotary file systems, whether used with or without a glide-path. The PG/PTN rotary file system showed the least canal transportation at the 3 mm level, while at the 5 mm and 7 mm levels, the PG/PTU rotary file system showed the least canal transportation.
目的 本研究的目的是使用锥形束计算机断层扫描(CBCT)分析,对ProTaper Universal(PTU)(登士柏美福,瑞士巴拉格)、ProTaper Next(PTN)(登士柏美福,瑞士巴拉格)和ProTaper Gold(PTG)(美国俄克拉何马州塔尔萨登士柏塔尔萨牙科专业公司)旋转锉系统在有无引导通路预备的情况下进行根管定心率和根管偏移的体外比较评估。
材料和方法 共收集120颗拔除的人类下颌第一磨牙的近中根,根据用于近中颊根管预备的旋转锉系统类型随机分为三组(n = 40):第1组:PTU,第2组:PTN,第3组:PTG旋转锉系统。根据是否使用ProGlider(PG)锉(登士柏美福,瑞士巴拉格)进行引导通路预备,每组再分为两个亚组(a和b),各有20个标本。在根管预备前,所有标本的近中颊根管首先使用NewTom Go CBCT机(意大利伊莫拉Cefla S.C.)进行扫描,然后根据其分组和亚组进行根管预备。所有旋转锉均按照制造商的指南使用。预备后,所有标本的CBCT图像以与预备前CBCT成像相同的曝光参数拍摄。在所有标本近中颊根管的3 mm、5 mm和7 mm水平,在颊舌向和近远中平面测量牙根外表面与根管内壁之间的距离,比较预备前和预备后CBCT扫描结果,使用NewTom NNT软件(意大利伊莫拉Cefla S.C.)评估根管定心率和根管偏移。数据采用单因素方差分析(ANOVA)、多重两两Tukey事后检验和Student's t检验进行分析;p值≤0.05被认为具有统计学意义。
结果 在3 mm和5 mm水平,第1a、1b组与第3a、3b组之间在颊舌向和近远中向的根管定心率有显著差异(p < 0.05)。然而,在颊舌向7 mm水平,第3a组和第3b组之间有显著差异,在近远中向第2a组和第2b组之间有显著差异(p < 0.05)。在3 mm、5 mm和7 mm水平,第3a组和第3b组之间在颊舌向的根管偏移有显著差异(p < 0.05)。然而,在根管的所有三个水平上,各组之间在近远中向均未观察到统计学显著差异(p > 0.05)。
结论 与PTU和PTG旋转锉系统相比,无论是否使用引导通路,PG/PTN旋转锉系统在根管的所有三个水平上均显示出最大的根管定心率。PG/PTN旋转锉系统在3 mm水平显示出最小的根管偏移,而在5 mm和7 mm水平,PG/PTU旋转锉系统显示出最小的根管偏移。