不同材料充填根管后即刻与延迟桩道预备对根尖封闭性能的影响

摘要

背景:根尖封闭性是确保根管治疗远期疗效的关键,由于桩道预备对根管封闭性能带来的影响不可避免,因此如何能将这一影响降至最低成为学者们热议的话题.目的:探讨使用不同根管充填材料后,即刻桩道预备和延迟桩道预备对根尖封闭性能的影响.方法:获取48颗人单根管前磨牙,截冠后随机分为3组,每组16颗牙齿:A组于根管充填后进行即刻桩道预备,B组于根管充填后进行延迟桩道预备,C组根管充填后不进行桩道预备,3组内再随机各分为2个亚组,采用不同的根管充填材料,即AH-plus糊剂+牙胶尖组(分别记为A1组、B1组、C1组)与矿物三氧化物凝聚体糊剂+牙胶尖组(分别记为A2组、B2组、C2组).通过加压染料渗透法测量根管根方微渗漏的长度.结果与结论:A1组与B1组,A2组与B2组,C1组与C2组根方微渗漏值比较差异无显著性意义(P>0.05);A1组根方微渗漏值大于A2组(P<0.05),B1组根方微渗漏值大于B2组(P<0.05);结果表明,以矿物三氧化物凝聚体糊剂对离体牙进行根管充填后,无论行即刻桩道预备还是延迟桩道预备,根管根方微渗漏均较小,较AH-plus体现出更好的根尖封闭性.%BACKGROUND: Apical sealing ability is the key to ensure the long-term curative effect of root canal therapy. The post space preparation exposes some inevitable influence on root canal sealing ability, so how to minimize this effect becomes a hot spot.OBJECTIVE: To explore the effects of immediate or delayed post space preparation on the apical sealing ability of different root canal sealers.METHODS: Forty-eight extracted human premolar teeth were obtained, and the tooth crown was cut off. The samples were randomly divided into three groups (n=16 teeth per group). Group A underwent the immediate post space preparation; group B underwent the delayed post space preparation; group C without the post space preparation. Then all groups were subdivided into two groups, and then were filled with the gutta-percha/AH-Plus (groups A1, B1 and C 1)or the gutta-percha/mineral trioxide aggregate (groups A2, B2 and C2). The depth of apical dye penetration was measured using pressure-driven system. RESULTS AND CONCLUSION: There were no significant differences in the apical microleakage between groups A1 and B1, A2 and B2, C1 and C2 (P > 0.05). The apical microleakage in the group A1 was significantly higher than that in the group A2, and the group B1 also showed higher apical microleakage than the group B2 (P < 0.05). Our findings suggest that either immediate or delayed post space preparation exposes little influence on the apical microleakage after root canal filling with gutta-percha/mineral trioxide aggregate, which exhibits better apical sealing ability than the AH-plus.