hero642狭窄根管(阅读).doc

机用镍钛器械预备磨牙狭窄弯曲根管的效果 ( 　　　　　　　 滁州市中西医结合医院口腔科 赵炬 [摘要] 目的 探讨机用镍钛器械在磨牙狭窄管的预备过程中的临床应用方法和效果。方法 选取根管狭窄的牙髓炎及根尖周炎患牙118颗，采用小号K锉疏通根管，将根尖部预备至15号，以机动镍钛器械Hero 642完成根管预备，侧向加压充填技术充填根管，根据治疗前后的X线片评价根管预备和充填效果。结果 397个根管中391个形态好，6个未能完全疏通，无台阶、根尖堵塞、根管偏移及侧壁穿孔等并发症发生，有2根手用器械折断于根尖段。适充患牙111颗，4颗欠充，3颗超充。结论 采用手用锉疏通狭窄根管的根尖段后再机用镍钛器械完成根管预备，可获得良好的成形效果且较少产生并发症。 [关键词] 镍钛器械；根管预备；根管成形能力 Clinical appliance of Nickel- titanium rotary instruments in management of fine root canals [Abstract] Aim To discuss the clinical appliance and method of Nickel-titanium (NiTi) rotary instruments in management of fine root canals. Methods 118 teeth with fine root canals were chosen. The apical portion of the root canals were negotiated by small size hand files and enlarged to 15 size. The NiTi rotary instruments Hero 642 were then used for root canal preparation with crown-down technique. All root canals were obturated with lateral condensation method. The efficiency of preparation and obturation was analyzed by radiographs before and after treatment. Results Good shape was achieved in 391 root canals. The original curvature and flow of root canals were kept well. No transportation, apical blockage, ledge or perforation was found. There was two separated hand file in two very fine canals. The obturation results showed that flush filling was found in 111 teeth, under-filling in 4 teeth, and over-filling in 3 teeth. Conclusion With NiTi rotary instrumentation technique after negotiation of small size hand files, fine root canals can be prepared effectively and quickly. [Key words] Nickel-titanium instruments; Root canal preparation; Root Canal shaping ability 狭窄根管是临床根管治疗的难点，在预备过程中易产生台阶、根尖堵塞、根管偏移、侧壁穿孔以及器械折断等多种并发症，使根管形态被破坏或堵塞，难以被彻底清理和充填，严重影响根管治疗的疗效。镍钛根管器械具有超弹性和良好的抗扭断性，预备根管极少产生并发症，尤其是机用镍钛器械，成形效果好，操作时间短，可明显提高根管预备的效率、减少并发症的发生率[1，2]，正越来越多地用于临床。然而，机用器械因操作中手感较差，在狭窄或弯曲的根管内易发生器械折断，一定程度上限制了其广泛应用。本研究选择具有狭窄根管的磨牙，将手用锉与机用镍钛器械Hero 642结合用于根管预备，评价机用镍钛器械对狭窄根管的成形效果，并探讨其使用方法。 1 材料和方法 1.1主要器械和材料 机用镍钛根管器械Hero642（Micro-mega，法国）；Endo