手用镍钛protaper及机用镍钛kerr k3器械预备根管成形效果分析.doc

手用镍钛protaper及机用镍钛kerr k3器械预备根管成形效果分析 　【摘要】 　　目的　评价使用两种镍钛器械预备磨牙根管的临床疗效。方法选取需要进行根管治疗的150颗患有牙髓炎及根尖炎的磨牙，分别用手用镍钛器械protaper，机用器械kerr k3预备根管，两组均使用侧压充填法充填根管。记录根管预备时间，器械折断数量。根据治疗前、中、后的X线片观察根管的变化，评价根管预备和充填的效果。结果protaper和kerr k3预备根管时间短，根管锥度、流畅度好。Prtaper器械有9例器械分离，kerr k3未发生器械折断（P＜0.05）。结论手用镍钛器械protaper和机用kerr k3预备磨牙根管成锥形，根充效果好。Protaper易折断，Kerr k3不易折断。 【关键词】 根管疗法；牙科器械；镍；钛 　　AbstractObjectiveTo evaluate the clinical effects of two kinds of nickel-titanium instruments in root canal preparation.Methods150 molars with pulpitis or apicitis were divided into 2 groups, their root canal preparations were performed with nickel-titanium protaper hand and nickel-titanium Kerr k3 instrument respectively; the molars in both groups were all obturated with lateral condensation method; the time of root canal preparation and the numbers of instrument fracture were recorded; the X-ray films before, during and after treatment were compared in evaluating the effect of preparation and obturation. ResultsBoth protaper and kerr k3 took short time for root canal preparation and kept good and smooth taper; there were 9 instrument fractures of protaper but non of kerr k3. ConclusionsBoth protaper and kerr k3 are of good effect of preparation and obturation while protaper is more likely to have fractures. 　　KEYWORDSroot canal therapydental instrument nickeltitanium 　　镍钛根管锉不管是手用的还是机用的都具有超弹性和柔韧性，克服了不锈钢器械硬度大的缺点。镍钛手用器械和机用器械效率高，成形效果好，在目前的临床工作中广泛应用，不同镍钛器械由于锉针设计的不同，切割效率、成形性能有差异［1］。我们使用手用镍钛器械protaper和机用kerr k3预备磨牙根管，比较二者根管预备及充填的效果，并对两种根管锉的折断情况、预备时间、患者术后疼痛等临床指标进行评价。 　　1资料与方法 　　1.1一般资料选择2007年8月至2008年7月在我科就诊的患者为研究的对象，年龄23~69岁，平均42.2岁。选择标准：（1）均为恒磨牙；（2）患牙诊断为各型牙髓炎和根尖周炎；（3）根管通畅，无根管钙化阻塞；（4）无牙髓治疗史；（5）根管弯曲度小于15°；（6）知情同意，愿意治疗。按照此标准选择120例患者，150颗患牙，随机分为P组和H组，每组75颗患牙。P组：患者60例，平均年龄41.2岁，使用protapre手用器械，冠向下预备法预备根管，预备44颗上磨牙，31颗下磨牙；H组：患者60例，平均42.6岁。使用机用kerr k3器械，冠向下预备法预备根管，预备28颗上磨牙、47颗下磨牙。 　　1.2治疗方法两组患牙均常规摄根尖片后开髓，清理髓腔，探查根管口，用15号K锉探查根管，拔髓、插诊断丝摄根尖片，确定工作长度。P组：患牙采用手用镍钛锉protaper(DentsoLy/MaiLLefer,瑞士)预备根管，protaper