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不同运动学对根管预备成形能力及硬组织碎屑堆积的影响:一项体外研究

Influence of different kinematics on shaping ability and accumulated hard tissue debris: an ex vivo study.

作者信息

Romeo Virginia Rosy, La Rosa Giusy Rita Maria, Generali Luigi, Pedullà Eugenio, Angerame Daniele

机构信息

Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.

Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

Odontology. 2025 Jul;113(3):973-983. doi: 10.1007/s10266-024-01025-w. Epub 2024 Nov 25.

Abstract

To determine the shaping ability, the amount of accumulated hard tissue debris (AHTD) and untouched area is generated by different kinematics through micro-CT. Thirty-two mesial roots of mandibular molars with Vertucci type IV were pre-scanned through micro-CT evaluation and randomized to one of the four experimental groups according to the kinematics tested: Continuous Rotation (CR), Reciprocation (REC), Optimum Torque Reverse (OTR) and Jeni motion. The root canal preparation was performed with HyFlex EDM (Coltène/Whaledent AG) up to OneFile. After each file used, irrigation was performed with 2 mL 5.25% NaOCl for 1 min. The final rinse was performed with 1 ml of 5.25% NaOCl followed by a 1 ml of 17% EDTA and, 1 ml of distilled water. Then, the samples were scanned and the images, before and after preparation, were superimposed and analyzed to determine the AHTD, untouched areas, canal transportation, centering ability, and shaping time. Data were statistically analyzed using Kruskal-Wallis test and Dunn post hoc with p < 0.05. No significant differences were detected among the tested kinematics in terms of untouched areas, AHTD, canal transportation and shaping time (p > 0.05). Significantly more untouched areas were detected in the coronal third compared to the middle (p = 0.0301) and apical ones (p = 0.0399) under continuous rotation. Moreover, a significantly higher centering ratio in the middle third compared to the apical was observed for Jeni motion (p = 0.0207). The tested kinematics showed similar untouched areas, AHTD, shaping ability and shaping time. All motions determined an appropriate mechanical preparation; yet, none of them was able to prepare all canal walls and keep the root canals completely free from hard tissue debris.

摘要

为了确定根管预备的成形能力,通过显微CT评估不同运动方式产生的累积硬组织碎屑量(AHTD)和未触及区域。对32颗具有Vertucci IV型的下颌磨牙近中根进行显微CT预扫描,并根据测试的运动方式随机分为四个实验组之一:连续旋转(CR)、往复运动(REC)、最佳扭矩反转(OTR)和Jeni运动。使用HyFlex EDM(Coltène/Whaledent AG)进行根管预备,直至使用OneFile锉。每次使用锉后,用2 mL 5.25%次氯酸钠冲洗1分钟。最后用1 mL 5.25%次氯酸钠冲洗,随后用1 mL 17%乙二胺四乙酸(EDTA)和1 mL蒸馏水冲洗。然后,对样本进行扫描,并将预备前后的图像叠加分析,以确定AHTD、未触及区域、根管偏移、定心能力和预备时间。数据采用Kruskal-Wallis检验和Dunn事后检验进行统计学分析,p < 0.05。在未触及区域、AHTD、根管偏移和预备时间方面,各测试运动方式之间未检测到显著差异(p > 0.05)。在连续旋转下,与根管中部(p = 0.0301)和根尖部(p = 0.0399)相比,冠部三分之一处检测到的未触及区域明显更多。此外,Jeni运动在根管中部三分之一处的定心率明显高于根尖部(p = 0.0207)。各测试运动方式显示出相似的未触及区域、AHTD、成形能力和预备时间。所有运动方式都能实现适当的机械预备;然而,它们都无法预备所有根管壁并使根管完全无硬组织碎屑。

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