
4种机用镍钛锉根管预备后形成牙本质微裂的研究
王梓, 薛明
4种机用镍钛锉根管预备后形成牙本质微裂的研究
Formation of dentinal microcracks after root canal preparation with four kinds of mechanical nickel-titanium files
目的 运用micro-CT比较T-Flex、Reciproc Blue(RB)、ProTaper Gold(PTG)和ProTaper Universal(PTU)4种机用镍钛锉在体外根管预备后牙本质微裂形成方面的差异。 方法 选用根管弯曲度不大于10°的新鲜离体双根管前磨牙32颗建立体外根管预备模型。根据所用镍钛系统将其随机分为T-Flex、RB、PTG、PTU组(n=8)。设置micro-CT体素大小为17.18 μm,扫描分析预备前后牙根横断面图像(n=56 940),观察牙本质微裂的存在。各组结果以存在裂纹的断层图像的数量及百分比来表示,McNemar检验用于比较预备前后牙本质裂纹的存在是否有显著差异,显著性水平设定为P<0.05。 结果 总体有11.04%的图像显示有牙本质微裂(n=6 288)。T-Flex、RB、PTG和PTU组在预备后观察到具有牙本质微裂截面的比例各自为9.82%、10.79%、12.27%和11.25%。所有在预备后断层图像上发现的牙本质裂纹在相应的预备前图像中均已存在。使用上述镍钛系统预备前磨牙根管未出现新的微裂纹。 结论 未经根管预备的离体牙中预先即存在牙本质微裂纹;T-Flex、RB、PTG和PTU 4种机用镍钛器械对前磨牙直根管进行根管预备均不会导致新的牙本质微裂纹形成。
Objective This study aimed to compare the differences among four kinds of mechanical Ni-Ti files including T-Flex, Reciproc Blue (RB), ProTaper Gold (PTG), and ProTaper Universal (PTU) in dentinal microcrack generation after root canal preparation in vitro by using micro-computed tomography (micro-CT) analysis. Methods A total of 32 freshly extracted double-root-canal premolars with an angle not exceeding 10° were selected and established as root canal preparation models in vitro. Then, the specimens were randomly assigned to four experimental groups (n=8) according to the different Ni-Ti systems used for root canal preparation: group T-Flex, group RB, group PTG, and group PTU. The voxel size of the micro-CT was set at 17.18 μm. Pre- and post-operative cross-sectional images of roots (n=56 940) were scanned and analyzed to identify the presence of dentinal microcracks. The results of each group were expressed by the quantity and percentage of sectional images with microcracks. McNemar test was used to determine whether a significant difference existed in the existence of dentinal microcracks before and after instrumentation. The level of significance was set at P<0.05. Results Overall, 11.04% of the images presented dentinal defects (n=6 288). Dentinal microcracks were observed in 9.82%, 10.79%, 12.27%, and 11.25% of the post-instrumentation images from groups T-Flex, RB, PTG, and PTU, respectively. However, all these dentinal microcracks were already present in the corresponding pre-operative images. No new microcrack of premolars were generated after the root canal preparation utilizing the aforementioned systems. Conclusion Denti-nal microcracks already existed in advance in extracted teeth before root canal preparation. Root canal preparation using the T-Flex, RB, PTG, and PTU systems did not induce the formation of new dentinal microcracks on the straight root canals of premolars.
根管预备 / 牙本质微裂 / 镍钛器械 / 微型计算机断层扫描
root canal preparation / dentinal microcracks / Ni-Ti instrument / micro-computed tomography
R781.05
1 | Soares CJ, Rodrigues MP, Faria-E-Silva AL, et al. How biomechanics can affect the endodontic treated teeth and their restorative procedures[J]. Braz Oral Res, 2018, 32(): 169-183. |
2 | Yoldas O, Yilmaz S, Atakan G, et al. Dentinal microcrack formation during root canal preparations by diffe-rent NiTi rotary instruments and the self-adjusting file[J]. J Endod, 2012, 38(2): 232-235. |
3 | Patel S, Bhuva B, Bose R. Present status and future directions: vertical root fractures in root filled teeth[J]. Int Endod J, 2022, 55(): 804-826. |
4 | Bürklein S, Tsotsis P, Sch?fer E. Incidence of dentinal defects after root canal preparation: reciprocating versus rotary instrumentation[J]. J Endod, 2013, 39(4): 501-504. |
5 | Alkahtany SM, Al-Madi EM. Dentinal microcrack formation after root canal instrumentation by XP-Endo Shaper and ProTaper Universal: a microcomputed tomo-graphy evaluation[J]. Int J Dent, 2020, 2020: 4030194. |
6 | Orel L, Velea-Barta OA, Sinescu C, et al. Comparative assessment of the shaping ability of Reciproc Blue, WaveOne Gold, and ProTaper Gold in simulated root canals[J]. Materials (Basel), 2022, 15(9): 3028. |
7 | Bayram HM, Bayram E, Ocak M, et al. Effect of ProTaper Gold, Self-Adjusting File, and XP-endo Shaper instruments on dentinal microcrack formation: a micro-computed tomographic study[J]. J Endod, 2017, 43(7): 1166-1169. |
8 | De-Deus G, Silva EJ, Vieira VT, et al. Blue thermomechanical treatment optimizes fatigue resistance and flexibility of the reciproc files[J]. J Endod, 2017, 43(3): 462-466. |
9 | ?apar ?D, G?k T, Uysal B, et al. Comparison of microcomputed tomography, cone beam tomography, stereomicroscopy, and scanning electron microscopy techni-ques for detection of microcracks on root dentin and effect of different apical sizes on microcrack formation[J]. Microsc Res Tech, 2019, 82(10): 1748-1755. |
10 | Miguéns-Vila R, Martín-Biedma B, De-Deus G, et al. Microcomputed tomographic evaluation of dentinal microcracks after preparation of curved root canals with ProTaper Gold, WaveOne Gold, and ProTaper Next instruments[J]. J Endod, 2021, 47(2): 309-314. |
11 | Aksoy ?, Keri? EY, Yaman SD, et al. Evaluation of XP-endo Shaper, Reciproc Blue, and ProTaper Universal NiTi systems on dentinal microcrack formation using micro-computed tomography[J]. J Endod, 2019, 45(3): 338-342. |
12 | Jamleh A, Nassar M, Alfadley A, et al.Influence of additional apical enlargement on microcrack formation in root dentine: a micro-computed tomography investigation[J]. Clin Oral Invest, 2021, 25(6): 4137-4143. |
13 | Tonelli SQ, Antunes MA, Soares de Toubes KM, et al. Dentinal microcracks induced by endodontic procedures: suggested design for experimental studies using micro- computed tomography and strain gauges[J]. J Endod, 2021, 47(7): 1157-1165. |
14 | Tolentino ES, Amoroso-Silva PA, Alcalde MP, et al. Accuracy of high-resolution small-volume cone-beam computed tomography in detecting complex anatomy of the apical isthmi: ex vivo analysis[J]. J Endod, 2018, 44(12): 1862-1866. |
15 | De-Deus G, Silva EJ, Marins J, et al. Lack of causal re-lationship between dentinal microcracks and root ca-nal preparation with reciprocation systems[J]. J Endod, 2014, 40(9): 1447-1450. |
16 | PradeepKumar AR, Shemesh H, Jothilatha S, et al. Diagnosis of vertical root fractures in restored endodontically treated teeth: a time-dependent retrospective cohort study[J]. J Endod, 2016, 42(8): 1175-1180. |
17 | Borges áH, Dami?o MS, Pereira TM, et al. Influence of cervical preflaring on the incidence of root dentin defects[J]. J Endod, 2018, 44(2): 286-291. |
18 | Kfir A, Elkes D, Pawar A, et al. Incidence of microcracks in maxillary first premolars after instrumentation with three different mechanized file systems: a comparative ex vivo study[J]. Clin Oral Investig, 2017, 21(1): 405-411. |
19 | Karata? E, Gündüz HA, K?r?c? D?, et al. Incidence of dentinal cracks after root canal preparation with ProTaper Gold, Profile Vortex, F360, Reciproc and ProTaper Universal instruments[J]. Int Endod J, 2016, 49(9): 905-910. |
20 | PradeepKumar AR, Shemesh H, Chang JW, et al. Pree-xisting dentinal microcracks in nonendodontically trea-ted teeth: an ex vivo micro-computed tomographic analysis[J]. J Endod, 2017, 43(6): 896-900. |
21 | JCLGD Martins, Oliveira BP, Duarte DA, et al. Micro-computed tomographic assessment of dentinal microcra-ck formation in straight and curved root canals in extracted teeth prepared with hand, rotary and reciprocating instruments[J]. Int Endod J, 2021, 54(8): 1362-1368. |
22 | De-Deus G, César de Azevedo Carvalhal J, Belladonna FG, et al. Dentinal microcrack development after canal preparation: a longitudinal in situ micro-computed tomo-graphy study using a cadaver model[J]. J Endod, 2017, 43(9): 1553-1558. |
23 | PradeepKumar AR, Shemesh H, Archana D,et al. Root canal preparation does not induce dentinal microcracks in vivo [J]. J Endod, 2019, 45(10): 1258-1264. |
24 | R?dig T, Kr?mer J, Müller C,et al. Incidence of microcracks after preparation of straight and curved root canals with three different NiTi instrumentation techniques assessed by micro-CT[J]. Aust Endod J, 2019, 45(3): 394-399. |
25 | üstün Y, Top?uo?lu HS, Düzgün S, et al. The effect of reciprocation versus rotational movement on the incidence of root defects during retreatment procedures[J]. Int Endod J, 2015, 48(10): 952-958. |
/
〈 |
|
〉 |