兩種根管充填方式與不同根管修形錐度其根尖封閉性之比較

Comparison of sealing ability between two obturationmethods in canals shaping with different tapering.

黃彥豪(Yen-Hao Huang)

指導教授 ： 阮榮泰 教授

高雄醫學大學/口腔醫學院/牙醫學研究所/碩士(2003年)

摘要

中文摘要
根管充填的目的是將清潔及修形完成的根管作三度空間的封閉。如何提升根管充填的封閉性一直是根管治療醫師相當感興趣的研究課題。而根管充填的封閉性受到許多因素的影響，包括充填之方式、選用之材料及根管之修形。本研究之目的在探討根管修形與不同充填方式對根尖封閉性之影響。
本實驗包括四個實驗組，A組之牙齒使用0.5公厘間隔之退展法修形，用側方充填法充填。B組使用0.5公厘間隔之退展法修形，用Thermafil®充填。C組使用1.0公厘間隔之退展法修形，用側方充填法充填。D組使用1.0公厘間隔之退展法修形，用Thermafil®充填。
將所有實驗牙齒置於37°C百分之百溼度的環境下30天。之後將牙齒浸泡於墨汁中48小時。置於通風處24小時風乾。接下來將牙齒脫鈣、脫水並浸泡於冬綠油中使其透明，用32倍實體顯微鏡觀察並紀錄其結果。將結果使用統計軟體加以分析。
結果顯示在主根管墨汁滲漏方面，A組及B組之根尖滲漏較D組輕微。將結果加以分析顯示根管修形為顯著之影響因素，而充填方式則否。側根管充填品質方面D組之充填品質最佳，而分析之結果顯示根管修形及充填方式皆為顯著之影響因素。而側根管之墨汁滲漏則顯示四組之間沒有差異。
由以上結果得到結論：較大的根管修形錐度可改善根管充填之根尖滲漏之現象，但其側根管充填的表現則較差。而在側根管之滲漏方面則不受其影響。Thermafil®充填法於側根管之充填效果較側方充填法為佳。但是在主根管及側根管之墨汁滲漏的表現則與側方充填法沒有差異。

關鍵字

根管充填 ； 根尖封閉性 ； 側方充填法 ； 柱心攜帶充填法 ； 修形錐度 ； 根管修形 ； 側根管 ； 根尖滲漏

並列摘要

英文摘要
The object of root canal filling is to complete obturate cleaned and shaped root canal three-dimensionally. How to improve the sealing ability of root canal obturation was interested by dentists. The sealing ability of root canal obturation was influenced by many factors, including obturation technique, filling material and root canal shaping methods. The aim of this study was to investigate the sealing ability between two obturation methods used in canals shaping with different tapering techniques.
Four groups were included in this study. Group A used lateral compaction to fill root canals shaped with 0.5 mm interval step back method. Group B used Thermafil technique to fill root canals shaped with 0.5 mm interval step back method. Group C used lateral compaction to fill root canals shaped with 1.0 mm interval step back method. Group D used Thermafil technique to fill root canals shaped with 0.5 mm interval step back method. The teeth were then stored in 37℃ 100％ humidity for 30 days, then were soaked in India ink for 48 hours. The teeth were exposed to air 24-hour to let the teeth dry, decalcified and dehydrated the teeth and putted in winter green oil to make the teeth transparent, measured and recorded the apical leakage under 32X stereo microscope. The data were analyzed with computer.
Group A and B significantly leaked less than group D in main canals. Effect test revealed that canal shaping was a significant factor but filling technique was not. Group D showed best lateral canals obturation quality. The effect test showed that both canal shaping and obturation technique were significant factors. There was no significant difference among four groups in dye leakage of lateral canals.
The result revealed that canal shaping with greater taper may show less main canal leakage but worse lateral canal’s obturation quality. The shaping tapering of the canal will not affect the sealing ability of lateral canals.
Thermafil technique showed better obturation quality than lateral compaction in lateral canals but showed no difference in sealing ability in main canals and lateral canals.

並列關鍵字

root canal treatment ； sealing ability ； lateral condensation ； thermafil ； step back ； root canal shaping ； lateral canal ； apical leakage

參考文獻

參考文獻

1. Schilder H. Filling root canals in three dimension. Dent Clin North Am, 11: 723-44, 1967.

2. Gutmann JL, Witherspoon DE . Obturation of the cleaned and shaped root anal system. Pathway of the pulp, 8th edition: 293-364, 2002.

3. Gutmann JL. Clinic, radiographic, and histologic perspectives on success and failure in Endodontics. Dent Clin North Am, 36: 379, 1992.

4. Naidorf IJ. Clinical microbiology in endodontics. Dent Clin North Am, 18: 329-44, 1974.