本文選題：Protaper + Universal�。� 參考：《大連醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:本文采用病例報(bào)告的形式將機(jī)用Protaper Universal鎳鈦再治療器械與手用不銹鋼K銼去除根管內(nèi)牙膠尖的療效進(jìn)行對(duì)比,比較根管再通率、再治療的時(shí)間、再治療后的疼痛發(fā)生率及再治療后根充質(zhì)量,為Protaper Universal鎳鈦再治療器械的使用提供一定的臨床依據(jù)。方法:依照就診次序?qū)⒓{入研究的40例需要進(jìn)行再治療的患者(共40個(gè)需再治療的根管),隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組,每組各20例。所有患者身體健康,能配合治療,患者的年齡不小于18周歲,X-ray示根尖孔完全閉合,既往牙膠尖根充不完善,需要進(jìn)行再治療。術(shù)前記錄患者主觀癥狀及臨床檢查情況,并拍攝X線片,了解患牙原治療情況及根管情況。高速手機(jī)去除原充填物,明確根管口的位置。實(shí)驗(yàn)組:使用Protaper Universal鎳鈦再治療器械以冠向下技術(shù)去除根管內(nèi)牙膠尖,對(duì)照組:使用手用不銹鋼K銼去除根管內(nèi)牙膠尖。每次更換器械,用2ml 2%洗必泰溶液與2ml 17%EDTA溶液交替沖洗根管,當(dāng)達(dá)到以下條件時(shí)認(rèn)為完全去除充填物:(1)器械能到達(dá)工作長(zhǎng)度或不能再疏通;(2)器械的刃部及沖洗液均無(wú)肉眼可見(jiàn)的充填材料。疏通完成一個(gè)根管后,清洗器械并觀察其是否出現(xiàn)螺紋改變或折斷,如未出現(xiàn)則繼續(xù)使用;如出現(xiàn)則停止使用,每根器械的使用次數(shù)不超過(guò)10個(gè)根管。并記錄每個(gè)根管再治療的操作時(shí)間:從初始銼進(jìn)入根管口至終末銼離開(kāi)根管口(包括更換器械及沖洗根管的時(shí)間)。棉卷隔濕,紙尖干燥管腔,氯己定氫氧化鈣糊劑+氧化鋅封藥。囑患者如出現(xiàn)疼痛或腫脹情況應(yīng)及時(shí)就診。一周后復(fù)診,記錄患牙再治療后疼痛發(fā)生情況,在患牙無(wú)叩痛、無(wú)明顯滲出的情況下,去除原暫封,2%洗必泰溶液與0.9%生理鹽水溶液交替沖洗,棉卷隔濕,紙尖干燥管腔,插入主尖拍攝試尖片,確定主尖到達(dá)工作長(zhǎng)度后,氧化鋅碘仿糊劑配合冷牙膠側(cè)方加壓充填根管,并拍攝完成片。結(jié)果:在根管再通率方面,實(shí)驗(yàn)組與對(duì)照組相比,差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05);在操作時(shí)間方面,實(shí)驗(yàn)組完成根管再治療的時(shí)間明顯短于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);在疼痛發(fā)生率方面,實(shí)驗(yàn)組明顯低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);在根充質(zhì)量方面,術(shù)后X線片顯示,實(shí)驗(yàn)組恰充率90%,為對(duì)照組恰充率為70%,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:機(jī)用Protaper Universal鎳鈦再治療器械能較快速的去除根管內(nèi)原牙膠充填材料,再治療期間的疼痛發(fā)生率較低,根充質(zhì)量較好。
[Abstract]:Objective: to compare the curative effect of Protaper Universal nickel titanium retreatment instrument and stainless steel K file in removal of endodontic tip in root canal by case report, and to compare the rate of root canal reopening and the time of retreatment. The incidence of pain after retreatment and the root filling quality after retreatment provide a certain clinical basis for the use of Protaper Universal nickel titanium retreatment apparatus. Methods: according to the order of visit, 40 patients who needed retreatment were randomly divided into experimental group and control group with 20 cases in each group. All the patients were healthy and able to cooperate with the treatment. The patients' age was not less than 18 years old. X-ray showed that the apical foramen was completely closed, and the gum apical root filling was not perfect in the past, and needed to be retreated. The subjective symptoms and clinical examination were recorded before operation, and X-ray films were taken to understand the treatment of the affected teeth and the root canal. The high speed mobile phone removes the original filling and determines the location of the root canal orifice. The experimental group was treated with Protaper Universal nickel titanium retreatment device and the control group was treated with stainless steel K file. The root canal was washed alternately with 2ml 2% chlorhexidine solution and 2ml 17 TA solution. When the following conditions are met, it is considered that the complete removal of the filling material: 1) the device can reach the working length or can no longer be dredged) the edge of the device and the flushing fluid are not visible to the naked eye. After a root canal is cleared, clean the instrument and observe if the thread changes or breaks, and if not, continue to use it; if so, stop using the device, and no more than 10 root canals per instrument. The operating time of each root canal retherapy was recorded: from the initial file entering the root canal orifice to the end file leaving the root canal orifice (including the time of replacing the instrument and washing the root canal). Cotton roll wet, paper tip dry cavity, chlorhexidine calcium hydroxide paste zinc oxide sealing agent. Patients are advised to see a doctor in time for pain or swelling. One week later, the incidence of pain after retreatment was recorded. In the case of no percussion pain and no obvious exudation, the original temporary seal of 2% chlorhexidine solution and 0.9% saline solution were removed, cotton entrainment was wet, and the paper tip was dry. The root canal was filled with zinc oxide iodoform paste and cold gum side pressure after the test tip was inserted into the main tip to determine the working length of the main tip and the film was taken. Results: there was no significant difference in root canal recanalization rate between the experimental group and the control group (P 0.05), and in the operation time, the time of root canal retreatment in the experimental group was significantly shorter than that in the control group. The difference was statistically significant (P 0.05), the incidence of pain in the experimental group was significantly lower than that in the control group (P 0.05), and the root-filling quality was significantly lower in the experimental group than in the control group. The accuracy rate of the experimental group was 90 and that of the control group was 70. The difference was statistically significant (P 0.05). Conclusion: the mechanical Protaper Universal nickel titanium retreatment instrument can remove the root canal filling material quickly. The pain rate is lower and the root filling quality is better during the retreatment.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R781.05

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