国际口腔医学杂志 ›› 2014, Vol. 41 ›› Issue (3): 320-323.doi: 10.7518/gjkq.2014.03.017

• 综述 • 上一篇    下一篇

三维自调节根管预备锉

刘昭慧 凌均棨   

  1. 中山大学光华口腔医学院•附属口腔医院牙体牙髓病科;广东省口腔医学重点实验室 广州 510055
  • 收稿日期:2013-04-16 修回日期:2014-01-09 出版日期:2014-05-01 发布日期:2014-05-01
  • 通讯作者: 凌均棨,教授,博士,Email:lingjq@mail.sysu.edu.cn
  • 作者简介:刘昭慧,主治医师,博士,Email:lzhh322@163.com
  • 基金资助:

    卫生部临床学科重点项目(2010439)

Self-adjusting file for root canal preparation

Liu Zhaohui, Ling Junqi   

  1. Dept. of Conservative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2013-04-16 Revised:2014-01-09 Online:2014-05-01 Published:2014-05-01

摘要:

镍钛旋转器械预备后的根管横切面为圆形,普遍存在近远中壁过度预备,颊舌侧壁和靠近峡区的泪滴状区域及峡区未被清理等问题,而三维自调节锉(SAF)则可解决上述问题。SAF由中空可压缩的薄镍钛网丝制作而成,不仅在纵向上能顺应根管弯曲方向,在横断面上亦能适应根管形态,自动调整为圆形、扁形或椭圆形等对根管壁牙本质进行均匀的往复式切削。SAF连接冲洗系统VATEA后以持续低压传递冲洗液至根管深处,收到机械预备和化学预备同期进行的效果,有利于去除涂层,遗留的未预备面积较旋转器械少,但其去除根管内感染物质的能力尚存争议:SAF较旋转器械更容易清除椭圆形根管中的细菌,但却不能有效地预备根尖段,冲洗液也难以传递至根尖区域,导致其不能有效去除根管壁碎屑、涂层,亦不能有效地清除根尖的感染细菌。SAF的通畅能力较弱,在再治疗中主要起辅助冲洗的作用,可以去除更多的牙胶残留物。SAF不易出现器械完全分离,偶尔网状镍钛丝的一端分离,另一端仍与器械主体相连,不会出现分离端遗留根管内造成根管堵塞。以SAF联合手用锉预备根管,牙本质壁则几乎无任何微裂纹。简而言之,SAF的出现对于进一步研发和改良器械,提高根管预备效率,减少并发症具有重要的意义。

关键词: 三维自调节锉, 根管预备, 镍钛器械

Abstract:

All current rotary files cut the root canal into a form that has a round cross section. Substantial untouched areas may be left on the buccal and lingual sides of a flat root canal or on the side facing the isthmus in tear-shaped root canals. However, the self-adjusting file(SAF) can address these problems. SAF is a hollow file designed as a compressible, thin-walled, pointed cylinder composed of a nickel-titanium lattice. When inserted into a root canal, SAF adapts itself to the canal’s shape both longitudinally and along the cross section and removes a relatively uniform dentin layer with a reciprocating movement. A special irrigation device, VATEA, is connected to SAF to provide a continuous flow of irrigation into the recess of the canal at low pressure. Debris and the smear layer can be removed efficiently during the simultaneously mechanical and chemical preparations. Compared with popular rotary instruments, SAF can cut more of the root canal area. However, its efficiency in eliminating viable bacteria is debatable. SAF can easily remove bacteria in oval root canals. However, insufficient apical preparation and inadequate apical irrigation has also been reported. Hence, the removal of debris, smear layer, and bacteria in the apical region of the root canal is difficult for SAF. Furthermore, SAF plays only an additional flushing role in root canal retreatment because of its poor negotiation ability. The use of SAF with rotary instruments results in a significant reduction in the amount of filling residual. SAF cannot be totally separated, and the detachment of one of the arches at either of its ends is a common mechanical failure. Furthermore, the damaged file can easily be retrieved from the canal. The combination of SAF and hand instruments rarely results in dentinal microcracks. In conclusion, the emergence of SAF is important for the further improvement of the instruments that enhance the efficiency of root canal preparation as well as for reducing complications.

Key words: self-adjusting file, root canal preparation, nickel titanium instrument

中图分类号: 

  • R 781.05
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