구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제28권4호
  • /
  • Pages.371-383
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  • 2012
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
권호 표지

Continuous rotary system과 single file system의 만곡 근관 형태 유지능에 대한 비교 연구

Comparative Study on the Ability of Instruments to Maintain Original Canal Curvature of Continuous rotary System and Single File System

  • 박상희 (전북대학교 치의학전문대학원 치과보존학 교실) ;
  • 김덕중 (전북대학교 치의학전문대학원 치과보존학 교실) ;
  • 송용범 (전북대학교 치의학전문대학원 치과보존학 교실) ;
  • 이혜윤 (전북대학교 치의학전문대학원 치과보존학 교실) ;
  • 김형선 (전북대학교 치의학전문대학원 치과보존학 교실) ;
  • 이광원 (전북대학교 치의학전문대학원 치과보존학 교실) ;
  • 유미경 (전북대학교 치의학전문대학원 치과보존학 교실)
  • Park, Sang-Hee (Dept. of Conservative Dentistry, Chonbuk National University) ;
  • Kim, Deok-Joong (Dept. of Conservative Dentistry, Chonbuk National University) ;
  • Song, Yong-Beom (Dept. of Conservative Dentistry, Chonbuk National University) ;
  • Lee, Hye-Yun (Dept. of Conservative Dentistry, Chonbuk National University) ;
  • Kim, Hyoung-Sun (Dept. of Conservative Dentistry, Chonbuk National University) ;
  • Lee, Kwang-Won (Dept. of Conservative Dentistry, Chonbuk National University) ;
  • Yu, Mi-Kyung (Dept. of Conservative Dentistry, Chonbuk National University)
  • 투고 : 2012.10.03
  • 심사 : 2012.12.25
  • 발행 : 2012.12.30
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초록

성공적인 근관치료를 위하여 원래 근관 형태를 따르는 근관 성형 과정이 중요하다. 그러나 대부분의 근관은 만곡되어 있고, 근관 성형 기구는 직선의 금속을 기본으로 만들어지기 때문에 근관 성형 후 만곡 근관이 원래 근관 형태를 벗어나는 오류가 나타날 수 있다. 이런 오류들로 인하여 근관 치료가 실패할 수 있으므로 근관 성형시 원래 만곡형태를 유지할 수 있는 다양한 기술과 방법들이 소개되고 있다. 본 연구의 목적은 만곡 근관 형태의 레진 모형을 이용하여 기구의 형태와 사용방법이 다른 세 가지 Ni-Ti 파일을 사용하여 Ni-Ti 파일 종류에 따른 만곡 근관에 대한 성형 후 형태 유지능을 비교하는 것이다. 직경과 경사도가 ISO 15, 0.02인 30개의 레진모형을 사용하였다. 그룹 1은 Profile을 이용하여 #20/.06까지 근관 성형하였고, 그룹 2는 Mtwo를 이용하여 #35/.04까지 근관 성형하였으며, 그룹 3은 PathFile을 이용하여 glide path를 만들어준 다음 WaveOne 파일 중 Primary을 사용하여 근관 성형하였다. 기구 사용 전과 후의 레진모형을 스캔하여 디지털 이미지로 만들었다. 각 이미지를 중첩시킨 다음 Matlab r2010b 소프트웨어를 이용하여 곡률반경의 비(CRr)를 계산하였다. 이를 바탕으로 Ni-Ti file 간 성형 후 형태 유지능을 비교하기 위하여 1-way ANOVA를 이용하여 세 그룹의 CRr의 차이에 대한 유의성 검정을 시행하였다.(P<.05) 또한 continuous rotary system과 single file system간의 형태 유지능을 비교하기 위하여 independent t-test를 이용하였다.(P<.05) 곡률반경의 비(CRr)를 이용하여 Ni-Ti 파일 종류에 따른 만곡 근관의 형태 유지능을 비교한 결과 Ni-Ti file 간에는 통계적으로 유의한 차이가 있었다.(P<0.05) ProFile과 WaveOne은 Mtwo에 비해서 만곡 근관에서의 형태 유지능이 우수하게 나타났다.Ni-Ti 기구 사용 방법에 따른 만곡 근관 형태 유지능을 비교한 결과 continuous rotary system과 single file system 간에는 통계적으로 유의한 차이를 보이지 않았다.(P>0.05) 본 연구결과에 따르면, ProFile과 WaveOne은 Mtwo에 비하여 만곡 근관에서의 형태 유지능이 통계적으로 유의하게 높게 나타났으므로, ProFile과 WaveOne이 만곡근관에 대한 형태 유지능이 우수하다고 할 수 있다. 만곡근관에서의 형태 유지능에 있어서 continuous rotary system과 single file system은 만곡근관에서의 형태 유지능에 차이가 없다.

Shaping the root canal system to maintain original canal curvature is essential to clinical success in endodontic treatment. Opposed to most root canals that are curved, endodontic instruments are made from straight metal blanks. They have a tendency of straightening the root canal during preparation and frequently result in procedural errors. A new treatment method to maintain original canal curvature during shaping has been introduced for preventing procedural errors. The aim of this study was to compare the ability of instruments to maintain original canal curvature of continuous rotary system and single file system. Thirty ISO 15, 0.02 taper, Endo Training Blocks(Dentsplay Maillefer) were used. Specimens were assigned to 1 of 3 groups for shaping: specimens in group 1 were shaped with ProFile #20/.06 at the WL. Specimens in group 2 were shaped with Mtwo #35/.04 at the WL. Specimens in group 3 were shaped with WaveOne Primary reciprocating files at the WL after the glide path was achieved with PathFile. Pre- and postinstrumentation digital images were superimposed and processed with Matlab r2010b(The MathWorks Inc, Natick, MA) software to analyze the curvature-radius ratio(CRr), representing canal curvature modification. Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file were analyzed with 1-way ANOVA(P<.05). Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file system were analyzed with independent t-test(P<.05). A statistically significant difference(P<0.05) was noted on each Ni-Ti file. ProFile and WaveOne instrumentations maintained the original canal curvature significantly better(P<0.05) than Mtwo file. There were no significant difference(P>0.05) between continuous rotary system and single file system. Under the conditions of this study, ProFile and WaveOne instruments maintained the original curvature significantly better than Mtwo file and were less modification of the canal curvature compared. There was no significant difference between continuous rotary system and single file system in shaping of simulated canals. As clinical practitioners, it may be advantages to use hybrid approach when root canal shapes depending on the design and usage of Ni-Ti files.

키워드

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