Experimental study on central location ability and clearance rate of three nickel-titanium instruments for root canal retreatment

doi:10.12016/j.issn.2096-1456.2020.08.003

Abstract

Abstract:

Objective Comparision of the central location ability and clearance rate of ProTaper retreatment, Fengdu O-file and M3-RT three kinds of nickel-titanium instruments and hand stainless instruments K-file, H-file. Observe the form of the root canal wall. To provide experimental basis and reference for the clinical application of nickel-titanium instruments for root canal retreatment. Methods 40 simulated resin blocks with the same specification were randomly divided into four groups (n=10). Each group was separately prepared with hand stainless instruments K-file and H-file (group A₁), ProTaper retreatment (group B₁), Fengdu O-file (group C₁), and M3-RT (group D₁). Using scanner to obtain the pre- and post-operative images and overlapping the images through Photoshop. Measuring the root canal inner and outer wall resin removal with Image J, compared the central location ability of the four group. A total of 60 mandibular single canal premolars extracted due to orthodontics were collected. The teeth were randomly divided into four groups (n=15) after filling the root canal. Use hand stainless instruments K-file,H-file(group A₂), ProTaper retreatment (group B₂), Fengdu O-file(group C₂) , M3-RT(group D₂) to remove the filling materials. The roots were longitudinally sectioned, and the image of the root surface was photographed under the 10 × magnification microscope. The software was used to trace the area of the root canal wall and residual root filling, and the root filling clearance rate of each group was calculated. Two teeth were randomly selected in each group and observed under scanning electron microscope. Results Within 9 mm from the root tip hole, the central location ability of group B₁, C₁, D₁ was better than that of group A₁(P ＜ 0.05). At 4 mm from the root tip hole, group D₁ has the best central location ability(P ＜ 0.05). There was no difference of the four instruments at a distance of 10 mm from the root tip hole（P ＞ 0.05）. There were various degree of filling material remained in the root canal after the four groups of instruments for retreatment canal preparation. There was no significant difference between group B₂, C₂, D₂（P ＞ 0.05）, and both were higher than group A₂(P ＜ 0.05). Scanning electron microscope observation results shown that the root canal wall prepared by group B₂, C₂, D₂ was more smooth and continuous than group A₂, and the residual filling material was less. Conclusion The central location ability of three kinds of nickel-titanium root canal retreatment instruments were significantly better than that of hand stainless instruments. ProTaper retreatment, Fengdu O-file and M3-RT three kinds of nickel-titanium root canal retreatment instruments showed good performance, the central location ability of M3-RT was slightly better. Nickel-titanium root canal retreatment instruments are more efficient than traditional hand stainless instruments in removing root fillings and the root canal wall after preparation is smoother and has good continuity.

Key words: root canal retreatment, nickel-titanium instrument, simulated resin blocks, central positioning ability, root canal preparation, root filling, clearance rate, scanning electron microscope

摘要：

目的比较ProTaper Retreatment、锋度O-file、M3-RT 3种机用镍钛器械与手用不锈钢器械K锉、H锉的中心定位能力以及根充物的清除率,观察预备后的根管壁形态,以期为根管再治疗3种镍钛器械的临床应用提供参考。方法 40个规格相同的透明树脂单根管模块随机分为4组（n=10）,分别使用手用器械K锉、H锉（A₁组）,ProTaper Retreatment镍钛锉（B₁组）,锋度O-file镍钛锉（C₁组）,M3-RT镍钛锉（D₁组）进行根管预备;扫描仪记录各组模块预备前后的图像,使用Photoshop软件将图像重叠,Image J软件测量模拟根管内外壁树脂的去除量,比较4组器械的中心定位能力。收集因正畸拔除的下颌单根管前磨牙60颗,标准技术预备至35号后充填根管,玻璃离子封根管口,保存4周备用;随机分为4组（n=15）,分别使用手用器械K锉、H锉（A₂组）、ProTaper Retreatment镍钛锉（B₂组）、锋度O-file镍钛锉（C₂组）、M3-RT镍钛锉（D₂组）清除根充物,将处理后的牙根沿近远中向劈开,10倍放大显微镜下照相,电脑软件描记根管壁和残留根充物的面积,计算每组的根充物清除率,每组随机选取两颗牙齿置于扫描电子显微镜下观察根管壁形态。结果 4组根管模块在距离根尖孔9 mm以内,B₁、C₁、D₁ 3组的中心定位能力优于A₁组（P＜0.05）,D₁组在距离根尖孔4 mm根管转弯处的偏移小于其他3组,中心定位能力最好（P＜0.05）;在距离根尖孔10 mm处,4组器械的中心定位能力无差异（P＞0.05）。4组器械进行根管再治疗根管预备后,根管内均有不同程度的根充物剩余,B₂、C₂、D₂组根充物清除率无明显差异（P＞0.05）,但均高于A₂组（P＜0.05）。扫描电子显微镜结果显示,经B₂、C₂、D₂组器械预备后的根管壁较A₂组更为光滑连续,残留的细小牙胶碎屑较少。结论根管再治疗3种镍钛器械的中心定位能力优于手用器械,根管再治疗镍钛器械ProTaper Retreatment、锋度O-file、M3-RT在研究中显示出较好的性能,M3-RT中心定位能力略优。根管再治疗3种镍钛器械相比传统的手用不锈钢器械根充物清除率高,预备后的根管壁更为平滑,连续性好。

关键词: 根管再治疗, 镍钛器械, 树脂模块, 中心定位能力, 根管预备, 根充物, 清除率, 扫描电镜

CLC Number:

R781.05

KONG Jingjing,LI Chunnian,YIN Liangliang,DAI Xinpeng. Experimental study on central location ability and clearance rate of three nickel-titanium instruments for root canal retreatment[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(8): 494-498.

孔晶晶,李春年,殷亮亮,代鑫鹏. 根管再治疗3种镍钛器械中心定位能力和清除率的实验研究[J]. 口腔疾病防治, 2020, 28(8): 494-498.

Figures/Tables 4

Figure 1 Schematic diagram of the root canal wall and residual root filling Computer software maps the area of the root canal wall and the remaining root filling

Figure 2 Resin root canal superimposed pre- and post-preparation images of the 4 groups a: hand stainless instruments （group A1）; b: ProTaper retreatment （group B1）; c: Fengdu O-file （group C1）; d: M3-RT （group D1）

Table 1 Central positioning capability of the four instruments n=10

Distance from measurement site to apical foramen（mm）	Group A₁	Group B₁	Group C₁	Group D₁	F	P
1	0.318 ± 0.026^a	0.152 ± 0.039^b	0.125 ± 0.024^b	0.056 ± 0.041^d	56.552	< 0.001
2	0.289 ± 0.066^a	0.116 ± 0.130^b	0.172 ± 0.102^c	0.062 ± 0.042^d	17.467	*0.001
3	0.302 ± 0.043^a	-0.106 ± 0.015^b	0.179 ± 0.026^c	0.038 ± 0.024^d	183.607	< 0.001
4	-0.073 ± 0.025^a	-0.073 ± 0.015^a	-0.069 ± 0.012^a	0.046 ± 0.032^b	144.591	< 0.001
5	0.021 ± 0.035^a	-0.036 ± 0.007^b	-0.069 ± 0.014^c	0.052 ± 0.012^d	208.290	< 0.001
6	0.015 ± 0.021^a	-0.057 ± 0.016^b	-0.072 ± 0.016^b	0.155 ± 0.044^a	107.169	< 0.001
7	0.299 ± 0.042^a	-0.130 ± 0.037^b	0.058 ± 0.028^c	0.038 ± 0.018^c	34.088	< 0.001
8	0.071 ± 0.036^a	-0.041 ± 0.017^b	-0.045 ± 0.039^b	-0.053 ± 0.029^b	11.343	*0.01
9	0.132 ± 0.044^a	-0.037 ± 0.048^b	-0.062 ± 0.027^b	0.054 ± 0.014^c	29.962	< 0.001
10	0.051 ± 0.042	0.049 ± 0.049	-0.044 ± 0.008	0.045 ± 0.006	1.410	0.276

Figure 3 Scanning electron microscope pictures of the root canal wall after preparation of 4 instruments group A2: the root canal wall prepared with hand stainless instruments;group B2:the root canal wall prepared with ProTaper retreatment;group C2:the root canal wall prepared with Fengdu O-file;group D2: the root canal wall prepared with M3-RT; the root canal wall after the preparation of instruments in groups B2, C2, and D2 was smoother and continuous compared with that in group A2, and there was less residual fine filling debris: in each group, a small amount of filler can be seen entering the dentin tubules, and in some of the tubules, root fillings are not seen

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