3种机用镍钛系统对3D打印的下颌第一磨牙近中颊根危险区形态的影响

doi:10.13591/j.cnki.kqyx.2025.06.006

摘要/Abstract

摘要：

目的运用Micro-CT和3D打印技术评价ProTaper Next、TruNatomy、VDW.ROTATE 3种镍钛系统对下颌第一磨牙近中颊根危险区形态的影响。方法选用3D打印的下颌第一磨牙模型为研究样本,根据选用镍钛系统将其随机分为3组(n=20),Micro-CT扫描根管预备前后近颊根管根分叉下方2 mm危险区的横断面图像,观察危险区根管壁厚度、根管体积、表面积、横截面积、根管偏移的变化。采用单因素方差分析(ANOVA)比较各组间差异,显著性水平设定为P<0.05。结果 3组之间根管预备前后危险区形态的变化差异均有统计学意义(P<0.05),其中,ProTaper Next组根管壁厚度减少量、根管体积及表面积增加量最大,VDW.ROTATE组次之,TruNatomy组变化差异最小。结论 ProTaper Next系统对危险区形态影响最为显著,而TruNatomy系统表现出更保守的预备特性,临床可根据根管解剖特征及微创需求选择合适的镍钛系统。

关键词: 根管预备, 镍钛器械, 3D打印, 危险区, 微型计算机断层扫描

Abstract:

Objective To compare the effects of three nickel-titanium file systems, ProTaper Next, TruNatomy, and VDW. ROTATE, on the morphology of the Danger Zone of the mesial buccal root of mandibular first molar after root canal preparation using Micro-CT and 3D printing technology. Methods 3D-printed mandibular first molars were selected and designed for purpose. They were randomly divided into three groups according to the used NiTi files(n=20). Micro-CT was used to scan the cross-sectional images of the Danger Zone 2 mm below the furcation of the mesial buccal root before and after root canal preparation. The changes in the root canal wall thickness, root canal volume, surface area, cross-sectional area, and root canal transportation in the Danger Zone were observed. Statistical analysis was performed using one-way ANOVA(P<0.05). Results Statistically significant differences were observed before and after root canal preparation in the Danger Zone among the three groups(P<0.05). Among the three groups, the PTN files caused the largest change before and after preparation, followed by VDW files, and the TRU files had the smallest change. Conclusion The study highlights TruNatomy’s conservative shaping capacity, advocating its use in minimally invasive endodontics, whereas ProTaper Next may be reserved for cases requiring aggressive canal preparation.

Key words: endodontic instrumentation, nickel-titanium instruments, three-dimensional printing, danger zone, micro-computed tomography

中图分类号:

R783.1

刘雨晴, 戴佳韵, 周朵, 王星阳, 许福路, 王娟. 3种机用镍钛系统对3D打印的下颌第一磨牙近中颊根危险区形态的影响[J]. 口腔医学, 2025, 45(6): 430-435.

LIU Yuqing, DAI Jiayun, ZHOU Duo, WANG Xingyang, XU Fulu, WANG Juan. Morphological study on the Danger Zone of the mesiobuccal canal prepared by three nickel-titanium rotary systems using three-dimensional printed mandibular first molars[J]. Stomatology, 2025, 45(6): 430-435.

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组别	预备前体积	预备后体积	体积变化量
TRU	4.44±0.21	4.81±0.29^c	0.38±0.26^c
VDW	4.45±0.15	5.34±0.44^b	0.9±0.44^b
PTN	4.44±0.22	7.09±0.48^a	2.65±0.48^a
P	>0.05	<0.05	<0.05

组别	预备前表面积	预备后表面积	表面积变化值
TRU	39±0.06	42.45±1.24^c	3.45±1.24^c
VDW	39±0.12	44.42±1.16^b	5.42±0.95^b
PTN	39±0.15	46.43±0.3^a	7.43±0.3^a
P	>0.05	<0.05	<0.05

组别	预备前横截面积	预备后横截面积	横截面积变化值
TRU	0.38±0.13	0.46±0.04^c	0.14±0.08^c
VDW	0.38±0.04	0.61±0.05^b	0.23±0.05^b
PTN	0.38±0.05	0.74±0.02^a	0.36±0.02^a
P	>0.05	<0.05	<0.05

组别	预备前根面凹厚度	预备后根面凹厚度	根面凹厚度变化值
TRU	1.00±0.14	0.78±0.06	0.22±0.06
VDW	1.00±0.05	0.67±0.10	0.33±0.10
PTN	1.00±0.11	0.61±0.07	0.39±0.07
P	>0.05	<0.05	<0.05