微焦点计算机断层扫描术评价根管再治疗中不同器械根管清理效果的研究
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[摘要] 目的 基于微焦点计算机断层扫描术（Micro-CT）数据建立人前磨牙三维模型，定量评价根管再治疗过程中2种根管预备系统根管清理的效果。方法 选择因正畸治疗拔除的前磨牙40颗，采用ProTaper机用镍钛锉进行根管预备，冷牙胶侧方加压法充填根管。随机分为2组，以弹性K锉和ProTaper Universal再治疗系统分别进行根管二次预备。分别于根管充填及二次预备后进行Micro-CT扫描，计算根管内剩余充填物比例，分别对根管冠1/3、中1/3和下1/3的根管内剩余物进行评分，评价2种器械对根管充填物的清理效果。结果 使用弹性K锉进行根管二次预备的平均根管内剩余物比例低于ProTaper Universal再治疗系统（P=0.005）；弹性K锉组根尖1/3清理效果优于ProTaper Universal
再治疗系统组（P
[关键词] 微焦点计算机断层扫描术； 三维重建； 根管再治疗
[中图分类号] R 781.05 [文献标志码] A [doi] 10.3969/j.issn.1000-1182.2012.03.018
Evaluation of the efficiency of different instrumentation for root canal retreatment using Micro-computed to-mography Guo Jing1，2, Yin Kaifeng2，3, Yang Haibing1，2, Han Xuan1，2, Wang Yan1，2. （1. Dept. of Endodontics, School
of Stomatology, Shandong University, Jinan 250012, China; 2. Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan 250012, China; 3. Dept. of Orthodontics, School of Stomatology, Shandong University, Jinan 250012, China）
[Abstract] Objective To establish the three-dimensional model of human permanent premolars based on Micro-computed tomography（Micro-CT） data, and evaluate the efficiency quantitatively of two different instrumentations for
root canal retreatment. Methods Forty extracted permanent premolars for the reason of orthodontic treatment were collected, prepared by using ProTaper Ni-Ti files and filled by cold gutta pertscha lateral condensation technique. The subjects were scanned by Micro-CT. Forty teeth were randomly divided into two groups and retreated by K-Flexo files and ProTaper Universal retreatment system respectively. Then all subjects were scanned again, and the mean percentage of remaining filling materials and the scores of remaining filling materials presented in upper, middle and apical 1/3 of the canal were calculated. Results Mean percentage of the remaining filling materials by K-Flexo files was lower than that by ProTaper Universal retreatment system（P=0.005）. The scores demonstrated that K-Flexo files had greater
efficiency than ProTaper Universal retreatment system when retreating the apical 1/3 of canal（P
This study shows that both techniques could not remove filling materials completely.
[Key words] Micro-computed tomography； three-dimensional reconstruction； root canal retreatment
目前，根管治疗是治疗牙髓病和根尖周病的有效方法。然而，由于器械本身的限制、根管解剖结构的复杂性及技术性因素等，常导致根管预备与消毒不彻底、根管充填不完善，从而使细菌及其代谢产物继续残留于充填物周围及牙本质小管内而导致根管治疗失败[1-3]。因此，根管再治疗要求彻底清除根管内的充填物、残留的微生物及代谢产物以确保根管再治疗的成功。目前，去除原根充物的器械有多种，常用器械有弹性K锉（K-Flexo file）和机用镍钛锉[4-6]。