目的 通过对ProTaper机用镍钛锉(后简称ProTaper锉)预备根管流程的改良,在确保临床疗效的同时,提高临床安全使用次数.方法 选取患牙162颗,其中前牙、前磨牙和磨牙分别为23颗、28颗和111颗,按照探查根管、确定工作长度、初步疏通根管、GG钻预敞开根管上段以及ProTaper锉扩大成形的流程预备根管,侧方加压充填根管,通过术前、中、后X片来评价根管预备和充填的效果.结果 ProTaper锉能很好的维持根管的形态,术后反应少而轻.使用的9套ProTaper锉最多预备51个根管,最少预备35个根管,平均预备41个根管；SX、S1、S2、F1、F2、F3分别平均用了19.4、43.3、43.3、43.2、38.3、6.7个根管；有2套锉最终出现F1折断,2套出现S1和F1解螺旋,其余5套表现为锉柄、锉刃的老化.结论 根管预备流程的改良、熟练的操作、详细的使用记录和妥善保管是提高ProTaper锉安全使用次数的保障,建议使用ProTaper锉混合预备前后牙根管总数不超过35个.%Objective To increase clinical use times of ProTaper rotary nickel-titanium instruments by improvement of root canal preparation,which ensuring clinical effect at the same time. Methods A total of 162 human teeth including 23 front teeth, 28 premo-lars and 111 molars were mainly managed with ProTaper rotary instruments followed by the sequence of root canal exploration,working length measurement,root canal dredging with hand file,coronal preflaring on the third of root canal with GG rotary files. Lateral condensation was used for root canal obturation. The effect of preparation and obturation were analyzed with radiographs before, during and after operation. Results ProTaper rotary instruments kept original shape of root canal very well, and endodontic flare-up seldom occurred. The most, lest and average root canal numbers prepared by all 9 series of ProTaper rotary instruments were 51, 35 and 41 respectively. TypeSX, S1, S2, F1, F2, F3 had been used to 19.4, 43.3, 43.3, 43.2, 38.3, 6.7 root canals respectively. Finally, two series were broken, tip ends of two series were distorted and another five series showed aging differently on file blade and handle. Conclusions Improvement of root canal preparation, skillful practice, particular records and well-done storage guaranteed the in-creasement of clinical use count of ProTaper rotary nickel-titanium instruments. The suggestion is that no more than 35 root canals involving anterior and posterior teeth be prepared with ProTaper rotary instruments.
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