歯内療法再治療におけるケイ酸カルシウム系シーラーとレジン系シーラーとの封鎖性の比較．

Comparison of Obturation Quality between Calcium Silicate-Based Sealers and Resin-Based Sealers for Endodontic Re-treatment.

抄録

背景:

このマイクロCTを用いた研究の目的は，歯内療法と歯内療法再治療の充填品質を，シリケート系シーラー（エンドシールTCS）とシングルコーン法（SCT），レジン系シーラー（AH Plus）と連続波法（CWT）という2つのシーラーの間で比較することにある．

BACKGROUND: The objective of this micro-computed tomography (micro-CT)-based study was to compare the filling quality of endodontic treatment and endodontic Re-treatment between two sealers with matched obturation techniques: calcium silicate-based sealer (Endoseal TCS) with a single-cone technique (SCT) and resin-based sealer (AH Plus) with a continuous wave technique (CWT).

方法:

上顎前歯40本を選択し，初回歯内療法と再治療時の封鎖方法によって4群に分けた（＝10）．AP/AP群は，初回にAH Plus/CWTで治療し，その後AH Plus/CWTで再治療を行った．AP/ET群は、初回AH Plus/CWTで治療後、Endoseal TCS/SCTで再治療を行った。ET/AP群はEndoseal TCS/SCTで初回治療後、AH Plus/CWTで再治療、ET/ET群はEndoseal TCS/SCTで初回治療後、Endoseal TCS/SCTで再治療を行った。検体は、初回歯内療法後、ガッタパーチャ（GP）コーン除去後、再治療後の3時点においてマイクロCTを用いてスキャンした。根管閉塞の空隙体積と残存充填材の体積を算出した．データはStudent-testsとANOVAを用いて解析した．

METHODS: Forty maxillary premolars were selected and assigned into four groups, according to the obturation methods of the first endodontic treatment and Re-treatment ( = 10). The AP/AP group was first treated with AH Plus/CWT, then re-treated with AH Plus/CWT. The AP/ET group was first treated with AH Plus/CWT, then re-treated with Endoseal TCS/SCT. The ET/AP group was first treated with Endoseal TCS/SCT, then re-treated with AH Plus/CWT, and the ET/ET group was first treated with Endoseal TCS/SCT, then re-treated with Endoseal TCS/SCT. The specimens were scanned using micro-CT at three time points: after the first endodontic treatment, after gutta-percha (GP) cone removal, and after Re-treatment. The void volume of root canal obturation and the volume of the remaining filling materials were calculated. Data were analyzed using Student's -tests and ANOVA.

結果:

エンドシールTCS群（ET/AP群，ET/ET群）は，初回閉塞後，管全体および先端3分の1の空洞率がAHプラス群（AP/AP群，AP/ET群）より低かった（< 0.05）．また，エンドシールTCS群に比べ，AHプラス群ではGP除去後のremnantが有意に少なかった（< 0.05）．再治療群と初回治療群の空洞量はほぼ同じであった（＞0.05）．再治療後のボイドボリュームは、初回治療と再治療で使用したシーラーが同じか異なるかにかかわらず、有意差は認められなかった（< 0.05）。

RESULTS: The Endoseal TCS groups (ET/AP and ET/ET) showed a lower percentage of voids than the AH plus groups (AP/AP and AP/ET) on the whole canal and the apical third, after first obturation ( < 0.05). The AH plus group showed significantly fewer remnants than the Endoseal TCS group after GP removal ( < 0.05). Re-treated canals and initially treated canals had similar void volumes ( > 0.05). There was no significant difference in void volume after Re-treatment, regardless of whether the same or different sealers were used for the first treatment and Re-treatment ( < 0.05).

結論:

エンドシールTCSシーラーとAHプラスシーラーは、前回の治療で使用したシーラーに関係なく、再治療の効果は同等であった。

CONCLUSIONS: Endoseal TCS sealer and AH Plus sealer had a similar Re-treatment efficacy, regardless of which sealer was used in the previous treatment.