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目的探讨根管预备技术和根管充填技术对中重度弯曲根管治疗后根管封闭性的影响。方法选取中重度弯曲单根管前磨牙60颗,随机分为A、B、C、D四个实验组(各12颗)及阳性对照E组和阴性对照F组(各6颗)。实验组分别用ProTaper/crown-down法、K锉逐步后退法对根管进行预备(各24颗牙),每种预备方法分别行冷侧方加压加AH-plus糊剂和热牙胶垂直加压加AH-plus糊剂充填根管(各12颗牙),建立微渗漏模型,应用邻甲苯胺(O-TB)法测量其葡萄糖浓度。结果 A、B、C、D四个组均测得葡萄糖浓度分别为:(3.69±1.01)mmol/L、(4.59±0.98)mmol/L、(2.86±0.82)mmol/L、(3.70±0.62)mmol/L,E组测得葡萄糖浓度最高为(5.89±1.69)mmol/L,F组没有测得葡萄糖浓度,在相同的充填技术下,ProTaper/crown-down法和K锉逐步后退法之间的微渗漏值差异有统计学意义(P<0.05);在相同的预备方法下,热牙胶充填技术和冷测压充填技术之间的微渗漏值差异有统计学意义(P<0.05)。结论应用ProTaper/crown-down法加热牙胶充填中重度弯曲根管,有利于提高中重度弯曲根管充填后根管的封闭能力。
Objective To investigate the effects of root canal preparation and root canal filling techniques on root canal sealing after moderate and severe curved root canal therapy. Methods Sixty premolar canals of moderately and severely bent canals were randomly divided into four groups (A, B, C and D) (12 each), positive control E group and negative control F group (6 each). In the experimental group, the root canal was prepared by ProTaper / crown-down method and K-file step-by-step retrograde method. Each preparation method was followed by cold lateral pressure plus AH-plus paste and hot denture vertical Pressure plus AH-plus paste filling root canal (12 teeth each), the establishment of microleakage model, the application of o-toluidine (O-TB) method to measure the glucose concentration. Results The concentrations of glucose in the four groups were (3.69 ± 1.01) mmol / L, (4.59 ± 0.98) mmol / L, (2.86 ± 0.82) mmol / L, ) mmol / L, the highest glucose concentration in group E was (5.89 ± 1.69) mmol / L, and the glucose concentration was not measured in group F. Under the same filling technique, ProTaper / crown- (P <0.05). There was significant difference in microleakage value between the hot denture filling technique and cold manometry filling technique under the same preparation method (P < 0.05). Conclusions The use of ProTaper / crown-down method for heating medium and severe curved root canals is helpful to improve the ability of root canal sealing after medium and severe curved root canal filling.