国际口腔医学杂志

国际口腔医学杂志 ›› 2025, Vol. 52 ›› Issue (5): 561-571.doi: 10.7518/gjkq.2025081

• 专家笔谈 •    下一篇

手用根管锉的使用技术及临床应用

薛晶()   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心四川大学华西口腔医院牙体牙髓病科 成都 610041
  • 收稿日期:2025-01-03 修回日期:2025-05-10 出版日期:2025-09-01 发布日期:2025-08-27
  • 通讯作者: 薛晶
  • 作者简介:薛晶，博士，四川大学华西口腔医院牙体牙髓病科副主任医师。2009年毕业于四川大学华西口腔医学院，获口腔医学博士学位，曾赴澳大利亚悉尼大学牙学院、美国加州大学洛杉矶分校牙学院、美国华盛顿克雷格研究所、日本北海道大学牙学院、香港大学牙学院及瑞士日内瓦大学牙学院等机构研修。长期致力于牙体牙髓疾病的基础与临床研究，口腔微生物菌群研究及牙体硬组织早期病变的修复研究。已在国内外相关牙体牙髓学术刊物发表论著20余篇，参编牙体牙髓相关专著7部，主译《流动复合树脂修复》《实用牙体修复临床指南》《儿童与青少年牙齿急症治疗》《口腔医生执业健康指南：操作及体位的人体工程学》《牙髓病诊疗：原理与实践》专著5部。任职中华口腔医学会牙体牙髓专业委员会青年委员，四川省口腔医学会牙体牙髓专业委员会委员，四川省口腔医学会口腔镇静镇痛专业委员会常务委员，四川省口腔医学会口腔美学专业委员会常务委员。在牙体牙髓病学领域一直致力于医、教、研工作，对牙髓病和龋病的诊治有较深入的研究和丰富的临床经验。

The technique and clinical application of root canal hand files

Jing Xue()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2025-01-03 Revised:2025-05-10 Online:2025-09-01 Published:2025-08-27
  • Contact: Jing Xue

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摘要：

手用根管锉通常又称为手用锉，是一种在根管治疗中通过冠根向进出运动来清理、成形根管的器械。现代根管治疗技术中根管预备以镍钛器械为主，但手用器械仍然发挥了不可替代的作用，包括根管探查、根管疏通、根尖通畅、根管长度测量等。本文回顾了手用锉的发展，制作材质由最初的碳钢到不锈钢，再到镍钛，制作标准由最初的不统一到国际标准化组织（ISO）标准，再到各类改良器械问世，手用锉越来越好地满足各类临床需要，成为根管治疗中不可或缺的一类器械。选择合适的手用锉，结合正确的使用方式，做到充分冲洗清洁、超声荡洗，避免包括术后肿胀、根管侧穿、器械分离、台阶等并发症的发生，已成为根管治疗的必修课。

关键词: 手用根管锉, 根管预备, 镍钛, 器械分离

Abstract:

Root-canal hand instruments, often referred to as hand files, are tools utilized in endodontic therapy to clean and enlarge the root canal through a push-pull motion from the crown to the root. In modern endodontic techniques, nic-kel-titanium instruments predominantly facilitate root canal preparation. However, hand instruments continue to play an irreplaceable role in various procedures, including canal exploration, canal patency, apical clearance, and root canal length measurement. This article reviews the evolution of hand files, tracing the development of materials from the initial use of carbon steel to stainless steel and now to nickel-titanium. The manufacturing standards have progressed from irregularities to ISO standards, alongside the emergence of various modified instruments. As a result, hand files increasingly meet diverse clinical needs, establishing themselves as indispensable tools in root canal therapy. Selecting appropriate hand instruments and employing proper techniques—such as thorough irrigation; and cleaning, along with ultrasonic irrigation; helps prevent complications such as postoperative swelling, root canal perforation, instrument separation, and ledge formation. This has become an essential component of root canal therapy.

Key words: root canal hand file, root canal preparation, nickel-titanium, instrument separation

中图分类号: 

  • R781
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