【摘要】：在實(shí)際臨床操作中我們發(fā)現(xiàn)，大部分根管都存在著不同程度的彎曲。隨著根管彎曲程度的加大，根管預(yù)備困難增加，出現(xiàn)器械分離、側(cè)壁穿孔、臺階、原有根管形態(tài)改變的可能性增加，同時(shí)根管充填的困難也相應(yīng)增加。而根尖1/3的封閉是根管治療取得成功的關(guān)鍵。根管微滲漏的大小反映根管充填材料對根管的封閉能力。在根尖部根管的偏移率增大，可能會增加根管充填后的根尖孔微滲漏。因此，彎曲根管的預(yù)備和充填一直是臨床上操作的難點(diǎn)之一。由于彎曲根管預(yù)備后形成的三維結(jié)構(gòu)較直根管更復(fù)雜，使得根管充填材料對彎曲根管的根管壁不能完全貼合，本研究旨在找到最佳的預(yù)備號數(shù)和錐度，使得牙膠尖對彎曲根管的根管壁適應(yīng)性最佳，為臨床治療提供指導(dǎo)意義。 目的：評價(jià)牙膠尖對機(jī)用鎳鈦器械預(yù)備彎曲根管的適應(yīng)性，探討牙膠尖與彎曲根管根管壁的適應(yīng)性的最佳效果。 方法：將塑料彎曲根管模型隨機(jī)分為8組，其中4組為MTwo組、4組為Sendoline組，分別預(yù)備至0.06/20#、0.06/25#、0.04/35#、0.04/40#和0.04/20#、0.04/25#、0.04/30#、0.06/30#。單尖法充填根管，靜置一周，將模型的根尖孔以上1、2、3、4和5mm處垂直于模型長軸方向用慢速切割機(jī)橫切，，并用顯微鏡照相，繪圖軟件測量各截面牙膠尖的充填率及糊劑的最大寬度。 結(jié)果：距根尖孔1mm處，牙膠尖的充填率最小，越接近根管口，充填率越大，距根尖孔5mm處，各組根尖部充填率均為最大值。隨號數(shù)的增大，充填率減小，糊劑的寬度增大，當(dāng)根管預(yù)備的號數(shù)≤30#時(shí)，差異無統(tǒng)計(jì)學(xué)意義（P0.05）；≥30#時(shí)，與0.04/30#組比較，0.04/35#組和0.04/40#組根尖部充填率減小（P0.05）；與0.04/35#組比較，0.04/40#組根尖部充填率減小，在1mm和4mm處差異有統(tǒng)計(jì)學(xué)意義（P0.05），在2mm、3mm和5mm處差異無統(tǒng)計(jì)學(xué)意義（P0.05）。與0.04/30#組比較，0.04/35#組根尖部糊劑的寬度增大，在1mm、2mm和3mm處差異無統(tǒng)計(jì)學(xué)意義（P0.05），在4mm和5mm處差異有統(tǒng)計(jì)學(xué)意義（P0.05），0.04/40#組根尖部糊劑的寬度增大，在1mm、2mm、4mm和5mm處差異有統(tǒng)計(jì)學(xué)意義（P0.05），在3mm處差異無統(tǒng)計(jì)學(xué)意義（P0,05）；與0.04/35#組比較，0.04/40#組根尖部部糊劑的寬度增大，在1mm處差異有統(tǒng)計(jì)學(xué)意義（P0.05），在2mm、3mm、4mm和5mm處差異無統(tǒng)計(jì)學(xué)意義（P0.05）。0.04錐度組比0.06錐度組相同號數(shù)充填率大、根尖部糊劑的寬度小，但差異無統(tǒng)計(jì)學(xué)意義（P0.05）。 結(jié)論：根管預(yù)備終末號數(shù)≤30#時(shí)，牙膠尖對根管壁的適應(yīng)性最佳，充填效果最好。
[Abstract]:In clinical practice, we found that most root canals have varying degrees of curvature. With the increase of root canal bending degree, the difficulty of root canal preparation increased, the possibility of instrument separation, lateral wall perforation, step, and root canal shape change increased, and the difficulty of root canal filling increased accordingly. A third of the apical closure is key to the success of root canal therapy. The microleakage of root canal reflects the sealing ability of root canal filling material. The increase of root canal deviation may increase the microleakage of root canal after root canal filling. Therefore, the preparation and filling of curved root canal is always one of the difficulties in clinical operation. Because the three-dimensional structure formed by curved root canal preparation is more complex than that of straight root canal, the root canal filling material can not completely fit the root canal wall of curved root canal. The purpose of this study is to find out the best preparation number and taper. The canaliculus tip has the best adaptability to the curved root canal wall, which provides guidance for clinical treatment. Objective: to evaluate the adaptability of gum tips to the preparation of curved root canals with machine-used nickel-titanium instruments, and to explore the best effect of the adaptation of gum tips and curved root canal walls. Methods: the plastic curved root canal model was randomly divided into 8 groups: MTwo group (n = 4) and Sendoline group (n = 4). 0.04/25#,0.04/30#,0.06/30#. The root canal was filled with a single tip method, and the root canal was statically set for one week. Perpendicular to the long axis of the model, the above apical foramen of the model was cut perpendicular to the long axis of the model with a slow cutting machine, and a microscope was used to photograph the root canal. The filling rate and the maximum width of paste were measured by drawing software. Results: the filling rate of gum tip was the smallest from apical foramen to 1mm. The closer the root canal orifice, the greater the filling rate was, and the maximum filling rate was from 5mm to apical foramen. With the increase of the number, the filling rate decreased, the width of paste increased, when the number of root canal preparation 鈮

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