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J Endod：髓室入口设计对上颌磨牙的根管探查、探测效能及抗断裂性评估的影响

2017-07-26 MedSci MedSci原创

磨牙髓腔变窄入口形态探查根管
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这篇研究的目的是为了检测髓腔变窄(CECs)对上颌磨牙的根管探查、探测效能及抗断裂性评估的影响。正常髓腔(TECs)作为对照参考与之相比较。

这篇研究的目的是为了检测髓腔变窄(CECs)对上颌磨牙的根管探查、探测效能及抗断裂性评估的影响。正常髓腔(TECs)作为对照参考与之相比较。

研究选取30颗完整拔除的上颌第一磨牙，通过micro-CT以21 μm的分辨率对所选牙齿进行扫描观察，以此确定分组：CEC或TEC组(n = 15/组)，进而寻求开髓入口。根管探查分为3阶段：（1）不放大倍数，（2）利用手术显微镜放大(OM)，（3）利用OM和超声探查。通过Reciproc instruments (VDW GmbH， Munich， Germany)进行根管预备后，样本再次进行扫描。随后检测器械未到达的根管区域、硬组织碎屑累积、根管偏移和定心率。在完成根管充填和窝洞修复后，样本进行抗断裂性测试。所得数据通过Fisher exact， Shapiro-Wilk和t检验进行统计学分析(α = 0.05)。

结果显示，在阶段1和2，TEC组能够定位出更多的根管位置(P < .05)，而2组在阶段3未见明显差异(P > .05)。CEC (25.8% ± 9.7%)和TEC (27.4% ± 8.5%)组之间器械未到达的根管区域比率没有显著性差异。根管预备后，2组间硬组织碎屑累积率也未见明显不同(CEC： 0.9% ± 0.6%和TEC： 1.3% ± 1.4%)。CEC组的腭根距离根尖止点7 mm处的根管偏移要明显增高(P < .05)。根管预备后的中心更加集中在TEC组腭根距离根尖止点5和7 mm处(P < .05)和CEC组远颊根距离根尖止点5 mm处(P < .05)。另外，CEC (996.30 ± 490.78 N)和TEC (937.55 ± 347.25 N)组之间的抗断裂性未见明显差异(P > .05)。

结论：此项研究结果未显示与CECs相关联的任何优势。上颌磨牙的髓室入口形态在不使用OM配合超声探查的情况下会影响根管探查效果。另外，髓室入口形态不会增加牙齿的抗断裂性。

原始出处：

Rover G， Belladonna FG， et al. Influence of Access Cavity Design on Root Canal Detection， Instrumentation Efficacy， and Fracture Resistance Assessed in Maxillary Molars. J Endod. 2017 Jul 21. pii： S0099-2399(17)30582-4. doi： 10.1016/j.joen.2017.05.006.

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    2017-07-28 zhaozhouchifen

    #根管#

    0

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    2017-07-28 12498474m35暂无昵称

    #磨牙#

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    2017-07-28 hanhaisha2015

    #上颌#

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    2017-07-26 1ddf0692m34(暂无匿称)

    学习了，涨知识

    0