HERO642镍钛锉预备弯曲根管的临床应用研究(1)
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[摘要] 目的：评价HERO642镍钛锉预备磨牙弯曲根管的临床疗效。方法：将245颗具弯曲根管需行根管治疗的磨牙随机分为两组，HE组用HERO642镍钛锉及冠根向深入法预备根管，SS组用K锉及逐步后退技术预备根管。两组均采用侧向加压充填法充填根管，通过术前、术后的X线牙片评价根管预备与根管充填的效果。结果：HE组比SS组操作时间明显短、术后疼痛发生率低且程度轻、根管适充率高(P<0.01)。结论：HERO642镍钛锉在弯曲根管预备方面有明显的优越性，是值得推广的新型根管预备技术。
[关键词] 根管预备；弯曲根管；HERO642镍钛锉
[中图分类号]R781 [文献标识码] B[文章编号] 1673-7210(2009)01(c)-121-02
Clinical study of HERO642 nickel-titanium files in preparation of curved molar root canals
QIN Yong, ZHANG Jing
(Department of Stomatology, Weifang Government′s Hospital, Weifang 261061, China)
[Abstract] Objective: To evaluate the effect of HERO642 nickel-Titanium files in preparation of curved root canals.Methods: 245 molar teeth with curved root canals were randomly divided into 2 groups, HE group was prepared by HERO642 nickel-Titanium files with crown-down technique. SS group was by prepared by K-files with step-back technique. All canals were obturated using lateral condensation technique. The efficiency of preparation and obturation of root canals was analyzed with radiographs before and after operation. Results: Compared with group SS, group HE had shorter operation time, lower post treatment pain, and the original curvature were maintained well(P<0.01). Conclusion: HERO642 nickel-Titanium files can be advocated as a new instrumentation technique, especially for those curved molar root canals.
[Key words] RCT; Curved root canal; HERO642 nickel-Titanium files
根管预备是根管治疗术中最关键的一个步骤，传统的不锈钢器械由于其固有的硬度和刚度，易造成根管偏移、台阶或肘部等不良形态，且预备效率低。HERO642镍钛器械具有超弹性和良好的抗扭断性，是近年来备受瞩目的根管预备器械。本研究将HERO642镍钛锉用于磨牙的弯曲根管预备，评价其预备效果和临床疗效。
1 资料与方法
1.1临床资料
以2007年9月～2008年9月来我院就诊的初诊患者为本研究的抽样对象。纳入标准：①确诊为牙髓炎和根尖周炎的恒磨牙；②无牙髓治疗史；③根尖孔发育完全且根管通畅，无根管钙化阻塞；④患者知情同意，配合治疗；⑤具有弯曲根管，并按Schneider法测量根管弯曲度[1]，并确定根管弯曲度>10°。排除标准：①牙纵折；②松动Ⅱ度以上；③患者不合作；④严重全身性或系统性疾病。按此标准选择患牙，按就诊顺序随机分为两组。试验组：120个弯曲根管，HERO642镍钛器械冠向下技术(crown-down technique)预备根管，简称HE组；对照组：125个弯曲根管，手用不锈钢K锉逐步后退技术(step-back technique)预备根管，简称SS组。经统计学分析，两组病例在性别、年龄及牙位构成上均无显著性差异(P>0.05)。
1.2 治疗方法
HE组采用HERO642镍钛器(Micro-Mega，法国)安装于350 r/min电动手机(Anthogyr，Nouvag，瑞士)，按冠根向深入法进行根管预备。主要步骤：①常规开髓、拔髓、清理髓腔，探查根管口；②10#K锉测量根管工作长度(WL)；③0.06锥度的20#锉预备至2/3 WL→0.04锥度的20#锉预备至WL-2 mm→0.02锥度的20#锉预备至WL→0 ......
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