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Evaluation of apical canal shapes produced sequentially during instrumentation with stainless steel hand and Ni-Ti rotary instruments using Micro-computed tomography

Stainless steel hand file과 Ni-Ti rotary file을 이용한 근관 형성시 근단부 근관 형태의 순차적 변화에 대한 평가

  • Lee, Woo-Jin (Department of Conservative Dentistry and Dental Research Institute, College of Dentistry, Seoul National University) ;
  • Lee, Jeong-Ho (Department of Conservative Dentistry and Dental Research Institute, College of Dentistry, Seoul National University) ;
  • Chun, Kyung-A (Department of Conservative Dentistry, Korea University Anam Hospital) ;
  • Seo, Min-Seock (Hanyang University Seoul Hospital) ;
  • Yoo, Yeon-Jee (Department of Conservative Dentistry and Dental Research Institute, College of Dentistry, Seoul National University) ;
  • Baek, Seung-Ho (Department of Conservative Dentistry and Dental Research Institute, College of Dentistry, Seoul National University)
  • 이우진 (서울대학교 치과대학 치과보존학교실) ;
  • 이정호 (서울대학교 치과대학 치과보존학교실) ;
  • 전경아 (고려대학교 안암의료원 치과보존과) ;
  • 서민석 (한양대학교 서울병원) ;
  • 유연지 (서울대학교 치과대학 치과보존학교실) ;
  • 백승호 (서울대학교 치과대학 치과보존학교실)
  • Received : 2011.04.11
  • Accepted : 2011.04.29
  • Published : 2011.05.31

Abstract

Objectives: The purpose of this study was to determine the optimal master apical file size with minimal transportation and optimal efficiency in removing infected dentin. We evaluated the transportation of the canal center and the change in untouched areas after sequential preparation with a #25 to #40 file using 3 different instruments: stainless steel K-type (SS K-file) hand file, ProFile and LightSpeed using microcomputed tomography (MCT). Materials and Methods: Thirty extracted human mandibular molars with separated orifices and apical foramens on mesial canals were used. Teeth were randomly divided into three groups: SS K-file, Profile, LightSpeed and the root canals were instrumented using corresponding instruments from #20 to #40. All teeth were scanned with MCT before and after instrumentation. Cross section images were used to evaluate canal transportation and untouched area at 1-, 2-, 3-, and 5- mm level from the apex. Data were statistically analyzed according to 'repeated nested design' and Mann-Whitney test (p = 0.05). Results: In SS K-file group, canal transportation was significantly increased over #30 instrument. In the ProFile group, canal transportation was significantly increased after preparation with the #40 instrument at the 1- and 2- mm levels. LightSpeed group showed better centering ability than ProFile group after preparation with the #40 instrument at the 1 and 2 mm levels. Conclusions: SS K-file, Profile, and LightSpeed showed differences in the degree of apical transportation depending on the size of the master apical file.

연구목적: 본 연구에서는 micro CT를 사용하여 SS K-file, Profile, LightSpeed로 #25부터 #40 크기까지 근관을 형성할 때 근단부 근관 형태의 연속되는 변화를 평가하였다. 연구 재료 및 방법: 30개 하악 대구치의 근심 근관을 ProFile, LightSpeed와 SS K-file로 #25번에서 #40번까지 순차적으로 근관 형성하였고, 매 단계 확대 후 micro CT를 시행하였다. 치근단 1, 2, 3, 5 mm 에서 근관 중심 변위와 삭제되지 않은 단면의 비율을 측정하여 'repeated nested design' 분석방법과 Mann-Whitney test로 유의 수준 p = 0.05에서 검정하였다. 결과: SS K-file군에서 #30 이상 근관 형성 후 유의할 만한 근관 중심 변위가 증가하였고, 근관 형성 과정 어느 단계에서도 삭제되지 않은 면적의 비율이 유의성 있게 감소되지 않았다. ProFile군에서는 치근단 1, 2 mm에서 #40 file로 근관 형성 후 근관 중심 변위가 크게 증가하였고, 치근단 1 mm에서 #35 크기로 근관 형성한 후에 삭제되지 않은 면적의 비율이 유의성 있게 감소하였다. LightSpeed군에서는 급격한 근관 중심 변위를 관찰할 수 없었고, 근관 중심 변위가 ProFile군보다 적게 관찰되었다. 결론: SS K-file, Profile, LightSpeed에서 형성되는 근관의 변이 정도는 근단부 근관 형성 크기에 따라 다르게 나타났다.

Keywords

Acknowledgement

Supported by : Seoul National University

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