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目的本文从根管充填质量及根管再治疗后急性反应发生率两方面,对比三种根管预备器械对根管再治疗的疗效。方法选取自2011年至2015年来开封市卫生学校附属医院牙体牙髓病科进行根管再治疗的上颌第一磨牙患牙180颗,按三种不同的根管预备方法将其随机分为三组。A组:采用Mtwo机用镍钛器械标准法预备根管;B组:采用Protaper手用镍钛锉逐步深入法预备根管;C组:采用不锈钢K锉逐步后退法预备根管,三组均釆用氢氧化钙糊剂消毒根管,冷牙胶尖侧压充填法永久充填根管,之后,拍摄术后X线片,观察根管充填效果,并在术后1周进行回访,了解患者急症反应发生情况。结果三组根管充填成功率和急症反应发生率分别是:A组95.1%,10%;B组94.8%,7%;C组81.7%,30%。(A组+B组)根管充填效果优于C组(χ2=8.25,P<0.05);而采用A组和B组进行根管预备后的根管充填效果无明显差异(χ2=0.088,P>0.05)。A组、B组急症反应发生率均显著小于C组,近期疗效优于C组,(P<0.05)。而采用A组和B组进行根管预备后的根管,其发生急性反应的几率无明显差异(P>0.05)。结论进行根管再治疗时,采用Mtwo机用镍钛器械标准法预备根管和Protaper手用镍钛锉逐步深入法预备根管可提高根管预备效果,完善根管充填质量,且术后急症反应发生率相对较低,为这两种方法的临床使用提供一些借鉴。
Objective To compare the curative effect of three root canal preparation instruments on root canal re-treatment from the quality of root canal filling and the incidence of acute reaction after root canal re-treatment. Methods From 2011 to 2015, Kaifeng City Health School Affiliated Hospital of Endodontics Department of root canal re-treatment of the maxillary first molar teeth 180, according to three different methods of root canal preparation were randomly divided into Three groups. Group A: The root canal was prepared by Mtwo machine with nickel-titanium instrument standard method; Group B: Protaper hand nickel-titanium file was used for stepwise root canal preparation. Group C: The stainless steel K-file was used for retrograde root canal preparation. Preclude the use of calcium hydroxide paste root canal disinfection, cold gutta-percha pressure filling permanent filling of the root canal, after which the X-ray film after surgery to observe the effect of root canal filling, and 1 week after the return visit to understand patients Emergency response to the situation. Results The success rates of root canal filling and emergency response were 95.1% in group A, 10% in group A, 94.8% in group B, 7% in group B, and 81.7% and 30% in group C, respectively. (Group A + group B) was better than group C (χ2 = 8.25, P <0.05). There was no significant difference in root canal filling between groups A and B (χ2 = 0.088, P> 0.05). The incidence of acute reaction in group A and group B was significantly less than that in group C, and the curative effect in group A and group B was better than that in group C (P <0.05). However, there was no significant difference in the incidence of acute root canal after root canal preparation with group A and group B (P> 0.05). Conclusions During root canal re-treatment, the preparation of root canal by Mtwo machine with NiTi standard instrument and Protaper hand with NiTi file can improve the effect of root canal preparation, improve the quality of root canal filling, and postoperative emergency The incidence of the reaction is relatively low, providing some references for the clinical use of these two methods.