不同声能冲洗激活器辅助清理弯曲根管玷污层的扫描电镜研究

doi:10.13591/j.cnki.kqyx.2023.07.005

Abstract

Abstract:

Objective To evaluate the efficacy of different acoustic irrigation activators assisted with smear layer removal in curved root canals. Methods Sixty-six extracted human mature molars with L-shaped root canals in Vertucci type Ⅰ configuration system were chosen. The mean angles of curvature, radius and curve length after ProTaper Next instrumentation were 39.9°±8.4°, (2.5±1.1) mm and (4.7±0.5) mm respectively. They were randomly assigned to one control group(n=6) and five experimental groups(n=12) for final irrigation as follows: no additional irrigation, Manual dynamic irrigation (MDI), Ultrasonic activation with a K-type file size 15/.02 (U-K) and Irrisafe20/.00 (U-IRR), Sonic activation with EndoActivator25/.04 (EA) and EDDY20/.04 (ED). The apical 6 mm of root canals were cleaved in half as the curved outer and inner sidewalls, and observed with scanning electron microscopy (SEM) in three 2 mm segments each as coronal-middle-apical thirds. The smear layer was evaluated using a five-score scale and a statistical analysis was conducted. Results All tested groups had a cleaner canal wall than the control group at any level of the root canal curved portion (P<0.05). At the coronal-third of outer canal wall, both U-IRR and ED scored smaller than others, and had a significant difference with MDI and EA (P<0.05); at the inner wall, U-K scored the highest and was inferior to both U-IRR and the two sonic activators (P<0.05). At the middle-third part and also the most curved canal area, ED was superior to U-K at two sidewalls and to EA at the inner wall (P<0.05). At the apical-third of outer canal wall, U-IRR and ED were superior to MDI (P<0.05); at the inner wall, there was no statistical difference among them. The cleanliness at apical outer wall was unsatisfactory, which was inferior to coronal inner wall in MDI/EA/ED and to apical inner wall in U-K/U-IRR (P<0.05). Conclusion ED and U-IRR assisted with smear layer removal have better performance in curved root canal, and the cleanliness at apical outer canal wall needs to be enhanced.

Key words: irrigant activation, smear layer, canal curvature

CLC Number:

R781.05

WANG Yanru, LU Yaqian, ZHAO Qitong, LI Jin. Efficacy of different acoustic irrigation activators assisted with smear layer removal in curved root canals: A SEM evaluation[J]. Stomatology, 2023, 43(7): 608-613.

Figures/Tables 8

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References 37

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组别	弯曲角度α/(°)	弯曲半径r/mm	弯曲长度L/mm
MDI	39.5±9.1	2.6±0.9	4.7±0.5
U-K	39.8±8.9	2.3±1.2	4.5±0.4
U-IRR	39.6±8.9	2.3±1.2	4.8±0.4
EA	40.3±7.9	2.5±0.9	4.7±0.5
ED	40.4±8.3	2.8±1.2	4.8±0.7
合计	39.9±8.4	2.5±1.1	4.7±0.5

组别	上段2 mm		中段2 mm		下段2 mm
组别	外侧壁	内侧壁	外侧壁	内侧壁	外侧壁	内侧壁
MDI	4.0(3.1,4.4)^a	3.5(2.5,4.0)^ab*	4.0(3.5,4.4)^ab	2.8(2.0,4.0)^ab*	4.3(4.0,4.9)^a	2.8(1.6,4.9)
U-K	4.0(1.8,4.5)^abc	4.0(3.5,4.5)^a#	4.0(3.5,4.4)^a#	4.0(3.1,4.5)^a	4.0(3.1,4.4)^ab#	3.0(1.1,3.9)
U-IRR	3.0(2.1,3.9)^bc	3.0(2.5,3.5)^b	3.0(2.0,4.0)^ab#	2.5(1.5,4.4)^ab	3.8(2.8,4.0)^b#	2.0(1.5,3.0)
EA	4.0(3.5,4.0)^ab	2.8(2.1,3.9)^b	4.0(3.1,4.4)^ab&	3.8(3.0,4.0)^a	4.0(3.1,4.5)^ab&	3.5(2.0,4.5)
ED	2.0(1.5,3.3)^c*	3.0(2.1,3.2)^b*	3.0(2.1,3.5)^b*	2.5(2.0,3.0)^b*	4.0(3.1,4.0)^b	3.0(2.1,3.5)^*

Efficacy of different acoustic irrigation activators assisted with smear layer removal in curved root canals: A SEM evaluation

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