NiTi Rotary Instruments에 의한 근관형성이 치근단부 근관형태에 미치는 영향

THE EFFECT OF NITI ROTARY INSTRUMENTATION ON THE CONFIGURATION OF APICAL ROOT CANAL

During preparation of narrow curved canals, procedural accidents such as, ledge, zipping, and transportation are frequently encountered and may lead to failure of endodontic therapy. To reduce these procedural errors and efficiently manage curved canals, various modifications in instrumentation technique and the design and flexibility of instruments have been advocated. This study compared the maintenance of the original canal curvature, cross sectional canal shape, and preparation time during instrumentation with stainless steel hand (K-Flexo) file, and nickel-titanium rotary files (Profile and Lightspeed). Thirty resin blocks with simulated curved canals of 20~25 degrees were used and divided into three groups of 10 each. In group 1, canals were instrumented using a quarter turn/pull technique with K-Flexofiles. Group 2 canals were prepared with rotary NiTi Profiles. Group 3 was prepared with rotary NiTi Lightspeed instrument. Before and after instrumentation, all canals were scanned using stereo microcope, FlexCam camera, and Photoshop 3.0 computer program. The results were as follows : 1. All groups showed some loss of canal curvature after instrumentation. Average loss of canal curvature was 8.6 degrees for K-Flexofile, 7.7 degrees for Profile, and 5.8 degrees for Lightspeed. Lightspeed exhibited significantly less curvature loss than K-Flexofile (p<0.05). 2. At the apical 1-mm level, Profile produced significantly rounder canals than Lightspeed (p<0.05). At the 3-mm level, Profile and Lightspeed exhibited significantly rounder canals than K-Flexofile (p<0.05). 3. Preparation with Lightspeed was significantly faster than Profile and K-Flexofile, and Profile was faster than K-Flexofile (p<0.05). 4. There was no significant difference in incidence of zipping between the hand K-Flexofile and rotary NiTi (Profile and Lightspeed) instruments. Most of apical canals were slightly widened near the apical foramen. As a results of this study, rotary NiTi instruments are superior to the K-Flexofile in regard to the maintenance of original canal curvature, cross-sectional shape and preparation time. But more investigations and studies should be needed to evaluate the ideal canal instrumentation.