發(fā)布時(shí)間：2018-11-15 14:18

【摘要】：目的通過CBCT對(duì)C1、C2型根管進(jìn)行掃描,測(cè)量比較頰舌側(cè)管壁最小厚度及分布,來指導(dǎo)臨床應(yīng)用,避免根管預(yù)備意外的發(fā)生;通過比較三種預(yù)備方法應(yīng)用于24顆根管類型為C1、C2型的下頜第二恒磨牙的預(yù)備效果,探索一種能夠相對(duì)有效的預(yù)備下頜第二恒磨牙C型根管的方法。方法收集根管類型為C1、C2型的下頜第二恒磨牙離體牙,各12顆。按不同分型將樣本采用區(qū)組隨機(jī)法分為Pro Taper鎳鈦旋轉(zhuǎn)根管銼與用NSK回旋手機(jī)載02錐度不銹鋼K銼聯(lián)合預(yù)備組(機(jī)用聯(lián)合組)、Pro Taper鎳鈦旋轉(zhuǎn)根管銼與手用不銹鋼K銼聯(lián)合預(yù)備組(手用聯(lián)合組)、Pro Taper鎳鈦旋轉(zhuǎn)根管銼預(yù)備組(Pro Taper組)。每組每種類型各4顆。在根管預(yù)備前進(jìn)行CBCT掃描和三維重建,測(cè)量C型根管距根尖2mm、5mm、8mm處影像頰舌側(cè)根管壁的最小厚度,進(jìn)行方差分析;記錄C型根管距根尖2mm、5mm、8mm處影像頰舌側(cè)根管壁的最小厚度的位置,進(jìn)行卡方檢驗(yàn)。根管預(yù)備后再進(jìn)行CBCT掃描和三維重建,將預(yù)備前后同一截面影像重疊,評(píng)價(jià)各組器械根管預(yù)備后根管未預(yù)備面積百分比。采用SPSS20.0軟件包進(jìn)行數(shù)據(jù)統(tǒng)計(jì)及方差分析。結(jié)果1.24顆下頜第二恒磨牙舌側(cè)根管壁最小厚度均小于頰側(cè)根管壁最小厚度(P0.05);根冠部及根中部的頰舌側(cè)根管壁最小厚度在根面溝中央?yún)^(qū)多見,根尖部則在近遠(yuǎn)中區(qū)多見。2.3種方法預(yù)備下頜第二恒磨牙的C1、C2型根管均有未預(yù)備區(qū)域。Pro Taper鎳鈦旋轉(zhuǎn)根管銼與用NSK回旋手機(jī)載02錐度不銹鋼K銼聯(lián)合預(yù)備組分別在根冠部[未預(yù)備面積百分比為(6.60±4.23)%]及根中部[未預(yù)備面積百分比為(13.87±2.61)%]未預(yù)備面積較小;Pro Taper鎳鈦旋轉(zhuǎn)根管銼與手用不銹鋼K銼聯(lián)合預(yù)備組分別在根中部[未預(yù)備面積百分比為(13.91±1.92)%]及根尖部[未預(yù)備面積百分比為(13.43±2.06)%]未預(yù)備面積較小。結(jié)論1.下頜第二恒磨牙C1、C2型根管的舌側(cè)根管壁較薄,是根管預(yù)備過程中側(cè)穿危險(xiǎn)區(qū)。2.對(duì)于下頜第二恒磨牙的C1、C2型根管的機(jī)械預(yù)備方式宜采用Pro Taper鎳鈦旋轉(zhuǎn)根管銼預(yù)備主根管,使用NSK回旋手機(jī)載02錐度不銹鋼K銼水平運(yùn)動(dòng)方向的預(yù)備方式預(yù)備峽區(qū)的根冠部,手用不銹鋼K銼沿根管方向提拉式預(yù)備峽區(qū)的根中部及根尖部。
[Abstract]:Objective to detect and compare the minimum thickness and distribution of C _ 1C _ 2 root canal by CBCT in order to guide clinical application and avoid accidental root canal preparation. By comparing the effects of three preparation methods applied to 24 mandibular second permanent molars with C1C _ 2 root canal type, a relatively effective method for the preparation of C type root canal of mandibular second permanent molar was explored. Methods the isolated mandibular second molars with C _ 1 C _ 2 type were collected, each with 12 teeth. According to different typing, the samples were randomly divided into two groups: Pro Taper nickel titanium rotary root canal file and NSK mobile phone carrying 02 taper stainless steel K file (machine combined group). Pro Taper nickel titanium rotary root canal file combined with hand stainless steel K file preparation group (hand combined group), Pro Taper nickel titanium rotary root canal file preparation group (Pro Taper group). Each group had 4 pieces for each type. Before root canal preparation, CBCT scanning and 3D reconstruction were performed, and the minimum thickness of the image of the lateral root wall of buccal and lingual root canal was measured at the distance of 2 mm to 5 mm or 8 mm from the root tip of type C root canal, and the variance analysis was carried out. The location of the minimum thickness of the lateral buccal and lingual root canal wall was recorded at the distance of 2 mm to 5 mm and 8 mm from the root tip of type C root canal, and chi-square test was performed. After root canal preparation, CBCT scanning and 3D reconstruction were performed, and the image of the same section before and after preparation was overlapped to evaluate the percentage of unprepared root canal area after root canal preparation in each group. Data statistics and ANOVA were carried out by SPSS20.0 software package. Results 1.The minimum thickness of lingual lateral canal wall of 24 mandibular second permanent molars was smaller than that of buccal lateral root canal wall (P0.05). The minimum thickness of the lateral buccal and lingual canals in the crown and the middle of the root was found in the central region of the facial sulcus, and in the proximal and distal region of the root tip. 2.3 methods were used to prepare the C _ 1 of the mandibular second permanent molar. Type C2 root canal all had unprepared area. Pro Taper nickel titanium rotary root canal file and combined preparation group with 02 taper stainless steel K file carried by NSK gyrotron cell phone [percentage of unprepared area was (6.60 鹵4.23)%] and root in root preparation group, respectively. The percentage of unprepared area was (13.87 鹵2.61)%. Pro Taper Ni-Ti rotary root canal file combined with hand stainless steel K file in the middle of root [percentage of unprepared area was (13.91 鹵1.92)%] and apical part [percentage of unprepared area was (13.43 鹵2.06)%] The unprepared area is small. Conclusion 1. The lateral lingual canals of the second mandibular permanent molar C _ 1 and C _ 2 are relatively thin, which is the dangerous area of lateral penetration during the preparation of root canals. 2. For the second mandibular permanent molar C _ 1C _ 2 root canal preparation, Pro Taper Ni-Ti rotary root canal file should be used to prepare the main root canal. The root crown of the isthmus region should be prepared by using the NSK rotary mobile phone with 02 taper stainless steel K file in horizontal motion direction. Hand stainless steel K file along the root canal along the root preparation isthmus center and root tip.
【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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