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目的:热垂直加压技术是目前应用广泛的根管充填技术。它利用牙胶加热后良好的流动性,严密的充填根管系统。成功的根管治疗需要性能良好的根管糊剂和规范的临床操作。基于以上特点,本实验探索两种不同根管糊剂及System B携热器工作尖与根尖孔的距离对热牙胶垂直加压充填根管根尖封闭能力的影响。方法:离体单根牙96颗,在釉牙骨质界处截去牙冠,采用冠向下法将根管预备至F3,冲洗后备用。将所有预备后的标本随机分为10组,其中实验组6组,对照组4组。分别采用美松和AH-Plus两种糊剂,System B携热器工作尖与根尖孔的距离分别为4 mm、5 mm、6 mm。在根管壁上涂布少量的根管糊剂,插入预先试好的大锥度牙胶尖,用System B技术充填根管的根尖部分,冠方用ObturaⅡ技术充填。对标本进行染色及透明化处理后分析染料渗入长度进行分析,并通过扫描电镜观察根尖区根管充填材料与根管壁之间的结合形态。结果:AH-Plus组的染料渗入长度明显小于美松组,两者差距有统计学意义(P<0.05).System B携热器工作尖与根尖孔的距离为4 mm时微渗漏值较小,且与其它两组比较有统计学差异(P<0.05)。扫描电镜下观察各实验组的根管充填材料与根管壁之间都存在缝隙。结论:在临床操作中建议使用AH-Plus糊剂,并且将System B携热器工作尖与根尖孔的距离设置为4 mm,以提高根管封闭性能、规范临床操作。
Objective: Thermal vertical compression technology is currently widely used root canal filling technology. It utilizes good fluidity after teethed heating and a tight filling of the root canal system. Successful root canal therapy requires well-functioning root canal paste and standardized clinical practice. Based on the above characteristics, the experiment explored the effect of the distance between tip and apical foramen of two different root canal paste and System B on the apical sealing ability of vertical gland filling with hot-dentin. Methods: Ninety-six single root teeth were excised and the crown was cut off in the enamel cementum. The root canal was prepared to crown F3 by crown-down method and rinsed for later use. All prepared specimens were randomly divided into 10 groups, including 6 experimental groups and 4 control groups. Respectively, the United States pine and AH-Plus two paste, SystemB portable tip and the apical foramen were 4 mm, 5 mm, 6 mm. A small amount of root canal paste was applied to the wall of the root canal, a large preformed taper gutta percha was inserted, the apical portion of the root canal was filled with System B technique, and the crown was filled with Obtura II technique. The specimens were stained and clarified. The infiltration length of the dye was analyzed. The morphology of the root canal filling material and the root canal wall was observed by scanning electron microscopy. Results: The dye infiltration length of AH-Plus group was significantly smaller than that of the Metoprolol group (P <0.05), and the microleakage value of the tip of the System B was 4 mm Smaller, and with the other two groups were statistically significant (P <0.05). Scanning electron microscopy observation of each experimental group of root canal filling material and the root canal wall between the existence of gaps. Conclusions: AH-Plus paste is recommended in clinical practice and the distance between the working tip and the apical foramen of System B is set to 4 mm in order to improve the performance of root canal occlusion and standardize the clinical operation.