本文選題：鎳鈦器械 + 根管再治療　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:運(yùn)用Meta分析的研究方法,比較鎳鈦再治療器械(選取Pro Taper Universal Retreatment,PTUR)和不銹鋼器械(ISO K銼、H銼)去除根管充填物的效果,以期對(duì)臨床工作中去除根管充填物時(shí)選擇器械提供依據(jù)。方法:1.文獻(xiàn)檢索采用計(jì)算機(jī)檢索與手工檢索相結(jié)合的方法,檢索7個(gè)數(shù)據(jù)庫(kù)自建庫(kù)至2017年3月,所有有關(guān)鎳鈦再治療器械和不銹鋼器械去除根管充填物效果的研究。2.文獻(xiàn)篩選根據(jù)PICOS原則、排除標(biāo)準(zhǔn)及質(zhì)量評(píng)價(jià)手冊(cè)篩選、評(píng)價(jià)文獻(xiàn)。3.統(tǒng)計(jì)分析應(yīng)用Rev Man 5.3對(duì)相關(guān)研究數(shù)據(jù)進(jìn)行Meta分析。結(jié)果:最終共有符合納入標(biāo)準(zhǔn)的文獻(xiàn)9篇,共納入實(shí)驗(yàn)牙齒294顆,不銹鋼器械組共計(jì)147顆,PTUR組共計(jì)147顆。結(jié)果顯示,比較PTUR和不銹鋼器械去除彎曲根管充填物后殘留物量,PTUR組高于手用不銹鋼器械組,差異存在統(tǒng)計(jì)學(xué)意義[SMD=0.36,95%CI(0.01,0.72),P=0.04];比較PTUR和不銹鋼器械去除直根管充填物后殘留物量,手用不銹鋼器械組高于PTUR組,差異存在統(tǒng)計(jì)學(xué)意義[SMD=-1.28,95%CI(-1.77,-0.78),P0.00001]。比較PTUR和不銹鋼器械去除充填物所用時(shí)間,使用溶劑情況下,手用不銹鋼器械組比PTUR組用時(shí)長(zhǎng),差異存在統(tǒng)計(jì)學(xué)意義[SMD=-1.62,95%CI(-2.12,-1.12),P0.00001];不用溶劑情況下手用不銹鋼器械組比PTUR組用時(shí)長(zhǎng),差異存在統(tǒng)計(jì)學(xué)意義[SMD=-3.11,95%CI(-3.84,-2.39),P0.00001]。因此無(wú)論是否使用溶劑,不銹鋼器械所用時(shí)間均比PTUR長(zhǎng)。推出根尖孔碎屑量由于納入研究異質(zhì)性過(guò)大,因此不做meta分析。結(jié)論:1.在彎曲根管中,使用不銹鋼器械去除根管充填物后殘留物量比使用PTUR少。2.在直根管中,使用PTUR去除根管充填物后殘留物量比使用不銹鋼器械少。3.無(wú)論是否使用溶劑,使用PTUR去除根管充填物所用時(shí)間都比使用不銹鋼器械短。4.綜上,臨床操作中去除根管充填物時(shí),為縮短操作時(shí)間同時(shí)達(dá)到更好的根管清理效果,直根管中可采用PTUR,彎曲根管可先使用PTUR再使用不銹鋼器械。
[Abstract]:Objective: to compare the results of removing root canal filling with Pro Taper Universal RetreatmentPTUR and ISO K file by Meta-analysis. In order to provide a basis for the selection of instruments for removing root canal filling in clinical work. Method 1: 1. Through the combination of computer retrieval and manual retrieval, 7 databases were searched until March 2017. All the studies on the effect of removing root canal filling with nickel titanium retreatment instruments and stainless steel instruments were studied. Literature screening according to PICOS principle, exclusion criteria and quality evaluation manual screening, evaluation document. 3. 3. Rev Man 5.3 was used to analyze the relevant data. Results: a total of 9 articles were included, including 294 experimental teeth, 147 stainless steel instruments group and 147 PTUR groups. The results showed that the residual amount of PTUR and stainless steel instruments after removal of curved root canal filling and PTUR group was higher than that of hand stainless steel instrument group, and the difference was statistically significant [SMDN 0.36 ~ 9595 CI (0.01 ~ 0.72) Pu 0.04], and the residual amount of PTUR and stainless steel instrument after removing straight root canal filling was compared. The difference between the stainless steel instrument group and PTUR group was statistically significant [SMD-1.28595 CI (-1.77-0.78) (P0.00001)]. The time taken to remove the filling was compared between PTUR and stainless steel instruments. When the solvent was used, the time used in the manual stainless steel instrument group was longer than that in the PTUR group. The difference was statistically significant [SMD-1.62N95 CI (-2.12 ~ 1.12) CI (-2.12 ~ -1.12)] P 0.00001, and the time used in the stainless steel instrument group without solvent was longer than that in the PTUR group. The difference was statistically significant [SMD-3.1195 CI (-3.84 -2.39) P 0.00001]. Therefore, stainless steel instruments take longer time than PTUR whether or not solvent is used. The amount of root apical foramen debris was not analyzed by meta because the heterogeneity of the study was too large. Conclusion 1. In curved root canal, the residual amount after removing root canal filling with stainless steel instrument was less than that with PTUR. In the direct root canal, the residual amount of PTUR after removing root canal filling was less than that of stainless steel instrument. With or without solvent, it takes less time to remove root canal fillers with PTUR than with stainless steel. In conclusion, in order to shorten the operation time and achieve better root canal cleaning effect, PTURs can be used in the straight root canal, and PTUR then stainless steel instrument can be used in the curved root canal.
【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(lèi)號(hào)】：R781.05

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