發(fā)布時(shí)間：2018-04-14 23:14

  本文選題：WaveOne + Reciproc　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本研究第一部分通過(guò)采用系統(tǒng)評(píng)價(jià)及Meta-分析的研究方法,探討兩種往復(fù)運(yùn)動(dòng)器械Wave One和Reciproc與連續(xù)旋轉(zhuǎn)器械Pro Taper完成根管預(yù)備后造成牙本質(zhì)微裂的差異,從而為根管器械進(jìn)一步改進(jìn)和臨床醫(yī)師的工作提供參考意見(jiàn)。本研究第二部分根管預(yù)備前首先建立直線通道并預(yù)敞根管口,之后比較兩種往復(fù)運(yùn)動(dòng)器械Wave One和Reciproc與傳統(tǒng)的連續(xù)旋轉(zhuǎn)器械Pro Taper根管預(yù)備后造成牙本質(zhì)微裂的差異情況。方法:本研究第一部分首先制定了中英文檢索策略以及詳盡的納入與排除標(biāo)準(zhǔn),之后通過(guò)計(jì)算機(jī)檢索Pub Med、OVID、Springer Link、Cochrane Library、Science Direct、中國(guó)知網(wǎng)、萬(wàn)方數(shù)字化全文數(shù)據(jù)庫(kù)、中文科技期刊數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)數(shù)據(jù)庫(kù)自建庫(kù)至2016年10月期間公開(kāi)發(fā)表的相關(guān)隨機(jī)對(duì)照試驗(yàn)(RCTs)的文獻(xiàn),仔細(xì)篩選文獻(xiàn)、客觀評(píng)價(jià)研究質(zhì)量,最終將符合納入標(biāo)準(zhǔn)的研究導(dǎo)入Rev Man5.3軟件中,由兩名研究員獨(dú)立提取數(shù)據(jù)并進(jìn)行統(tǒng)計(jì)分析。本研究第二部分收集新鮮拔除的60顆下頜前磨牙,按隨機(jī)數(shù)字法將樣本隨機(jī)分為A、B、C、D 4個(gè)組(n=15):A組為空白對(duì)照組,不進(jìn)行根管預(yù)備;B組Pro Taper組,根管序列預(yù)備至F2;C組Wave One組,使用Primary(#25/.08)預(yù)備根管;D組Reciproc組,使用R25(#25/.08)預(yù)備根管。實(shí)驗(yàn)組根管預(yù)備前均使用Pathfile建立順暢的直線通道并使用開(kāi)口銼Sx預(yù)敞根管口。根管預(yù)備完成后距根尖3mm、6mm、9mm處做標(biāo)記,使用硬組織切片機(jī)垂直牙體長(zhǎng)軸在標(biāo)記處水平截?cái)?體視顯微鏡下放大25倍觀察和記錄各組樣本不同橫斷面的裂紋類型及數(shù)目。結(jié)果:第一部分通過(guò)計(jì)算機(jī)檢索中英文數(shù)據(jù)庫(kù),經(jīng)嚴(yán)格篩選,總共有14篇文獻(xiàn)納入研究,試驗(yàn)組(往復(fù)運(yùn)動(dòng)器械組)共350支,其中Wave One185支,Reciproc165支;對(duì)照組(Pro Taper組)225支。Meta-分析結(jié)果顯示:(1)兩種往復(fù)運(yùn)動(dòng)器械總體與Pro Taper相比根管預(yù)備后所造成的牙本質(zhì)微裂紋數(shù)目差異無(wú)統(tǒng)計(jì)學(xué)意義[RR=1.00,95%CI(0.75,1.32),P=0.99];(2)往復(fù)運(yùn)動(dòng)器械Wave One根管預(yù)備后造成牙本質(zhì)微裂紋數(shù)與Pro Taper差異無(wú)統(tǒng)計(jì)學(xué)意義[RR=0.74,95%CI(0.51,1.07),P=0.11];(3)往復(fù)運(yùn)動(dòng)器械Reciproc較Pro Taper根管預(yù)備后產(chǎn)生的牙本質(zhì)微裂紋數(shù)目多,差異有統(tǒng)計(jì)學(xué)意義[RR=1.47,95%CI(1.10,1.97),P=0.01];(4)往復(fù)運(yùn)動(dòng)器械中Wave One根管預(yù)備完成后造成牙本質(zhì)微裂紋數(shù)目比Reciproc少,差異有統(tǒng)計(jì)學(xué)意義[RR=0.74,95%CI(0.57,0.96),P=0.02];(5)兩種往復(fù)運(yùn)動(dòng)器械總體較Pro Taper根管預(yù)備后造成有微裂紋的牙根數(shù)少,差異有統(tǒng)計(jì)學(xué)意義[RR=0.34,95%CI(0.23,0.50),P0.00001]。第二部分結(jié)果顯示對(duì)照組未發(fā)現(xiàn)任何類型的牙本質(zhì)微裂紋產(chǎn)生,往復(fù)運(yùn)動(dòng)器械Wave One和Reciproc與連續(xù)旋轉(zhuǎn)器械Pro Taper根管預(yù)備后造成牙本質(zhì)微裂方面差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。往復(fù)運(yùn)動(dòng)器械Wave One和Reciproc根管預(yù)備所需時(shí)間明顯短于Pro Tape,差異有統(tǒng)計(jì)學(xué)意義(P0.05),Reciproc根管預(yù)備所用時(shí)間最短,但與Wave One相比差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1、往復(fù)運(yùn)動(dòng)器械Wave One與連續(xù)旋轉(zhuǎn)器械Pro Taper相比不增加牙本質(zhì)微裂發(fā)生風(fēng)險(xiǎn),兩種往復(fù)運(yùn)動(dòng)器械中,Wave One較Reciproc根管預(yù)備后在造成牙本質(zhì)微裂方面安全性更高。由于研究對(duì)象、測(cè)量方法的差異導(dǎo)致各亞組所納入文獻(xiàn)數(shù)目較少,希望今后通過(guò)更大樣本量的高質(zhì)量的隨機(jī)對(duì)照試驗(yàn)來(lái)進(jìn)一步驗(yàn)證本次系統(tǒng)評(píng)價(jià)的結(jié)果。2、往復(fù)運(yùn)動(dòng)器械Wave One和Reciproc根管預(yù)備時(shí)間短,較連續(xù)旋轉(zhuǎn)器械Pro Taper相比臨床操作更加簡(jiǎn)便,且不增加牙本質(zhì)微裂發(fā)生風(fēng)險(xiǎn)。
[Abstract]:Objective: the first part of this study by adopting the research method of system evaluation and Meta- analysis, discusses two kinds of reciprocating motion device Wave One and Reciproc Pro Taper with continuous rotary instruments to complete root canal dentin differences caused by micro crack, so as to provide reference for further improvement and clinical work for root canal instruments on the second. Part of the root canal preparation before the first set up the linear channel and pre open orifice after the comparison of two kinds of Wave devices and Reciproc One reciprocating motion with the traditional continuous rotary instruments Pro Taper root canal dentin micro crack caused by difference. Methods: the first part of this study was first made in English retrieval strategy and detailed inclusion and the exclusion criteria, followed by Med OVID, the computer retrieval Pub, Springer Link, Cochrane Library, Science Direct, China CNKI, Wanfang digital full-text database, Chinese scientific journal database, relevant randomized controlled trials China biomedical databases from published up to October 2016 (RCTs) literature, carefully screening literature, objective evaluation of the quality of the final, will meet the inclusion criteria of the research into Rev Man5.3 software, conducted by two researchers independently extracted data and statistical analysis of the second part of this study. Collect 60 freshly extracted mandibular premolars, the samples were randomly divided into A, B, C randomly, D group 4 (n=15): A group was the control group, no root canal preparation; B group Pro group Taper, root canal preparation sequence to F2; C group Wave group One the use of Primary (#25/.08), root canal preparation; D group, Reciproc group, R25 (#25/.08) in root canal preparation. The experimental group root canal preparation were established using the Pathfile linear channel smooth and use open file Sx pre open mouth. Root canal root canal after the completion of the apical 3mm 6mm, mark 9mm, the use of hard tissue slicing machine perpendicular to the tooth axis at the mark level truncation, stereo microscope magnified 25 times to observe and record the specimens in different sections of the crack type and number. Results: the first part English database retrieval by computer, the strict screening, a total of 14 papers are included in the study and the test group (reciprocating equipment group) with a total of 350, including Wave One185, Reciproc165; the control group (Pro Taper group) 225.Meta- analysis results showed that: (1) no significant number of [RR=1.00,95%CI micro cracks caused by two kinds of dental instruments in general and Pro Taper reciprocating motion phase root canal. The difference (0.75,1.32), P=0.99] (2); the reciprocating motion device Wave One root canal dentin caused by micro crack number and Pro Taper had no significant difference between [RR=0.74,95%CI (0.51,1.07), P=0.11] (3); the reciprocating motion device Rec The number of micro cracks in dentin iproc than Pro Taper after root canal preparation produced, there was a significant difference between the [RR=1.47,95%CI (1.10,1.97, P=0.01]); (4) caused by the number of micro cracks in dentin is less than Reciproc Wave One root canal preparation equipment in reciprocating motion, the difference was statistically significant (0.57,0.96), P=0.02] [RR=0.74,95%CI; (5) two kinds of instruments are generally Pro Taper reciprocating motion after root canal preparation caused by micro crack root number was less, the difference was statistically significant (0.23,0.50, [RR=0.34,95%CI) P0.00001]. second shows some results were not found in any type of dentin micro cracks, the reciprocating motion device Wave and Reciproc with One continuous rotary instruments Pro Taper root canal dentin caused by micro crack was no statistically significant differences (P0.05). Wave One and Reciproc instruments reciprocating motion of root canal preparation required time was significantly shorter than Pro Tape, difference There was statistical significance (P0.05), Reciproc root canal preparation with the shortest time, but Wave and One had no significant difference (P0.05). Conclusion: 1. Wave One and continuous reciprocating motion device Pro Taper rotary instruments do not increase the risk of dentin micro crack, two kinds of reciprocating devices, Wave One compared with Reciproc after root canal preparation in dentin caused by micro crack safety higher. As the research object, different measurement methods lead to various subgroups in literature are limited in number, hope that through high quality RCTs with larger samples to further verify the evaluation results of.2 reciprocating motion device Wave One and Reciproc in root canal preparation time is short, compared with the continuous rotary instruments Pro Taper compared the clinical operation more convenient, and does not increase the risk of dentin micro crack.

【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R781.05

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