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Shaping efficiency versus dentin conservation: a micro-CT taper-based analysis

delete2026-04-01
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E
Emmanuel João Nogueira Leal da Silva *
T
Thiago Moreira Soares e Silva
A
Ana Flávia Almeida Barbosa
G
Graziela dos Santos Massa
C
Carolina Oliveira de Lima
M
Marco A. Versiani
DOI:10.1007/s00784-026-06843-6delete
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摘要

摘要

En 中文
为评估尖端直径相同但锥度递增的器械对下颌磨牙根管塑形效率和牙本质保留的影响,本研究采用微CT技术。选取12颗拔除的下颌磨牙,其近中根管为Vertucci Type III型,远中根管为Type I型,并在每次器械预备步骤前后进行微CT扫描。近中根管依次使用25/0.03、25/0.05、25/0.06和25/.08v器械预备,远中根管则使用40/0.03、40/0.05和40/.06v器械预备。通过配准数据集定量分析根管体积、表面积、未预备根管表面积百分比、牙本质去除量和最小牙本质厚度。此外,牙本质厚度值根据临床相关阈值(<0.5 mm、0.5–1.0 mm和>1.0 mm)进行分类。数据采用广义线性混合效应模型分析(α=0.05)。在近中根管中,未预备区域面积随锥度增大显著减少;25/0.06(–21.9%)和25/.08v(–37.9%)组显著降低,但25/0.05组无显著差异。牙本质去除量随锥度增加显著且逐步增加,25/.08v组较25/0.03组增加约350%(p<0.001)。在远中根管中,锥度对未预备区域无显著影响,但40/0.05和40/.06v组的牙本质去除量显著增加。方向性分析证实,牙本质去除量呈阶梯式增加,模式为近颊>近舌>远中,各水平均一致。阈值分析显示,0.5–1.0 mm范围内牙本质厚度测量比例随锥度增大而增加,尤其在近中根的远侧更明显。增大器械锥度可提高近中根管的塑形效率,但显著增加牙本质去除量,并将牙本质厚度向潜在脆弱范围偏移。因此,在磨牙中保守选择锥度可能更好地平衡塑形效果和结构保留。大锥度可能改善与根管壁的接触,但在解剖脆弱区域会显著减少牙本质厚度,强调在根管预备中应重视解剖引导的锥度选择。
Keyword:
Dentin removal
Instrument taper
Mandibular molars
Micro-CT
Nickel-titanium
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Clinical Oral Investigations 封面图
Clinical Oral Investigations
IF:
3.1
论文数:
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被引数:
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D
department of endodontics
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121
论文数: 59
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oral health center
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unigranrio
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