Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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SCANNING ELECTRON MICROSCOPIC STUDY ON THE EFFICACY OF ROOT CANAL WALL DEBRIDEMENT OF ROTARY NI-TI INSTRUMENTS WITH DIFFERENT CUTTING ANGLE

엔진 구동형 니켈-타이타늄 합금파일의 절삭각에 따른 근관성형 효과에 관한 전자현미경적 연구

  • Jeon, In-Soo (Department of Conservative Dentistry, Oral Research Institute, Yonsei University) ;
  • Yoon, Tai-Cheol (Department of Conservative Dentistry, Oral Research Institute, Yonsei University) ;
  • Park, Seong-Ho (Department of Conservative Dentistry, Oral Research Institute, Yonsei University) ;
  • Kum, Kee-Yeon (Department of Conservative Dentistry, Oral Research Institute, Yonsei University)
  • 전인수 (연세대학교 치과대학 보존학교실) ;
  • 윤태철 (연세대학교 치과대학 보존학교실) ;
  • 박성호 (연세대학교 치과대학 보존학교실) ;
  • 금기연 (연세대학교 치과대학 보존학교실)
  • Published : 2002.11.01
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Abstract

The purpose of this in vitro study was to compare the effects of root canal cleanness following two Ni-Ti rotary instruments with different rake angle. Thirty-six sound, extracted human premolars with single root were randomly divided into three groups. The used rotary instruments were HEROShaper (Group 1, Micro-Mega, Besancon, France, n=12) and ProFile (Group 2, Maillefer, Ballaigues, Switzerland, n=12). Control group (n=12) was only extirpated with barbed broach (Mani, Matsutani Seisakusho Co., Japan) Group 1 & 2 teeth were prepared to a #40/.04 taper at the apex followed by 1 mm using crown-down technique. After canal preparation and frequent irrigation with 5.25% sodium hypochlorite, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. All root specimens were processed for SEM investigation and photographed. Separate evaluations by one endodontist were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. The penetration depth of smear layer into dentinal tubules was also estimated in the other halves. Following results were obtained: 1. Smear layer was observed on all the prepared walls with two experimental groups except control group. 2. Smear layer characteristics in two experimental groups; 1) HEROShaper group showed snowy, dusty appearance and were shown open dentinal tubuli on the prepared walls of almost specimens, and the thickness of smear layer covering onto dentinal surfaces was within 1-2 ${\mu}m$ in a few specimens. 2) ProFile group showed shiny, burnished appearance and complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli in all specimens. The penetration of smear layer into dentinal tubules was found in all specimens and the thickness was at 2-4 ${\mu}m$ in all specimens. These results demonstrated that a completely clean root canal could not be achieved regardless of positive or negative rake angle, which is in accordance with the majority of previous studies on root canal cleanliness In conclusion, through irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal wall in spite of Ni-Ti instrumentation.

본 연구는 엔진구동형 Ni-Ti 합금 파일의 삭제날 각의 차이가 근관 성형 후 근관 내 절삭 면에 형성되는 도말층의 분포, 형태 및 상아세관 내로의 침투 정도 등에 어떤 차이를 보이는가를 알아보기 위함이다. 건전한 36개의 단근관을 갖는 발치된 사람의 단근치를 선택하고 positive cutting angle을 갖는 HEROShaper 파일과 negative cutting angle로 된 ProFile 파일을 이용하여 근관성형 후 절단면에서의 도말층의 양, 분포 형태 및 상아세관내로의 침투 빈도를 주사전자 현미경을 이용하여 사진촬영 후 다음과 같은 결과를 얻었다. 1. 사용된 엔진구동형 합금 파일의 삭제날 각의 차이에 관계없이 모든 군에서 도말층이 형성되었다. 2. 근관 성형 후 절삭면상에 나타난 도말층 형태는 삭제날 각의 차이에 따라 형태학적인 차이를 보였으며, positive cutting angle과 radial land가 없는 니켈-티타늄 전동통파일에서 상대적으로 적은 양의 도말층 형성을 보였다(p < 0.05). 결론적으로, 본 연구는 삭제날의 각이나 radial land의 유무에 관계없이 사용된 모든 엔진구동형 파일에서 도말층이 형성된 것으로 미루어 근관 성형 시 liquid EDTA와 같은 chealting agent의 사용의 필요성을 시사한다.

Keywords

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