Reddy S A, Hicks M L
Department of Dental Medicine, Albert Einstein Medicine Center, Philadelphia, PA 19141-3098, USA.
J Endod. 1998 Mar;24(3):180-3. doi: 10.1016/S0099-2399(98)80179-9.
The purpose of this study was to investigate the quantity of apical debris produced in vitro using two hand and two rotary instrumentation techniques. Sixty minimally curved, mature human mandibular premolars with single canals were divided into 4 groups of 15 teeth each and prepared using step-back instrumentation with K-files, balanced force with Flex-R files, Lightspeed nickel-titanium instruments, or .04 taper ProFile Series 29 rotary nickel-titanium files. Debris extruded through the apical foramen during instrumentation was collected on preweighed filters. The mean weight of extruded debris for each group was statistically analyzed using a Kruskal Wallis one-way analysis of variance and a Mann-Whitney U rank sum tested. Although all instrumentation techniques produced apically extruded debris, step-back instrumentation produced significantly more debris than the other methods (p < 0.0001). There was no difference between balanced force hand instrumentation and the two rotary nickel-titanium instrumentation methods (p > 0.05). Hand or engine-driven instrumentation that uses rotation seems to reduce significantly the amount of debris extruded apically when compared with a push-pull (filing) technique. Decreased apical extrusion of debris has strong implications for a decreased incidence of postoperative inflammation and pain.
本研究的目的是调查使用两种手动和两种旋转器械技术在体外产生的根尖碎屑量。将60颗弯曲度最小、成熟的单根管人类下颌前磨牙分为4组，每组15颗牙齿，分别使用K锉逐步后退法、Flex-R锉平衡力法、Lightspeed镍钛器械或.04锥度ProFile 29系列旋转镍钛锉进行预备。器械操作过程中通过根尖孔挤出的碎屑收集在预先称重的滤纸上。使用Kruskal Wallis单向方差分析和Mann-Whitney U秩和检验对每组挤出碎屑的平均重量进行统计学分析。尽管所有器械技术都会产生根尖挤出的碎屑，但逐步后退法产生的碎屑明显多于其他方法（p < 0.0001）。平衡力手动器械操作与两种旋转镍钛器械操作方法之间没有差异（p > 0.05）。与推拉（锉）技术相比，使用旋转的手动或机用器械操作似乎能显著减少根尖挤出的碎屑量。根尖碎屑挤出量的减少对术后炎症和疼痛发生率的降低具有重要意义。
