パッシブ超音波洗浄がデブリス洗浄能と根管形状に及ぼす影響に関する研究

[Study on the influence of passive ultrasonic irrigation on debris cleaning ability and root canal shape].

抄録

目的:

湾曲根管におけるPassive Ultrasonic Irigation（PUI）の安全性と効果、および湾曲根管におけるPassive Ultrasonic Irigation（PUI）のデブリス洗浄能力と根管輸送量について評価すること。

PURPOSE: To evaluate the safety and effectiveness of passive ultrasonic irrigation(PUI) in curved root canals, and debris cleaning ability and the amount of root canal transportation of passive ultrasonic irrigation(PUI) in curved root canals.

方法:

曲率25°以上の下顎臼歯部中側湾曲根管36本を選択した．根管はXP-endo Shaper根管用ファイルを用いて作製した．サンプルはA1群（湾曲長＞3mm，シリンジ潅流），B1群（湾曲長＞3mm，PUI＋Kファイル），C1群（湾曲長＞3mm，PUI＋イリス）に分けた．3 mm、PUI+irrisafe）、A2群（湾曲長＜3 mm、シリンジ潅流）、B2群（湾曲長＜3 mm、PUI+Kファイル）、C2群（湾曲長＜3 mm、PUI+ irrisafe）（n=6） に分類された。全サンプルについてイリゲーション前後でマイクロCTスキャンを行い，イリゲーション後の根管内容積増加量と根管内輸送量を算出した．データの解析にはSPSS 22.0ソフトウェアパッケージを使用した．

METHODS: A total of 36 mesially curved root canals of mandibular molars with a curvature above 25° were selected. The root canals were prepared with XP-endo Shaper root canal file. The samples were divided into A1 group (curved length＞3 mm, syringe irrigation), B1 group(curved length＞3 mm, PUI+K file), C1 group(curved length＞3 mm, PUI+irrisafe), A2 group (curved length＜3 mm, syringe irrigation), B2 group (curved length＜3 mm, PUI+K file), and C2 group (curved length＜3 mm, PUI+ irrisafe) (n=6). Micro-CT scans were performed on all samples before and after irrigation, and the volume increase in the root canal after irrigation and the transportation of the root canal were calculated. SPSS 22.0 software package was used to analyze the data.

結果:

根管長3mm以上の湾曲部において，PUI+irrisafe群の根管容積増加量はPUI+Kファイルおよびシリンジ潅注群より有意に大きく（P＜0.05），5mm部ではPUI+irrisafeで形成した根管の輸送量はPUI+Kファイルより有意に低かった（P＜0.05）であったが，シリンジ潅流との有意差は認められなかった（P＞0.05）；湾曲長3mm未満の根管では，ファイル群の根管容積増分はシリンジ潅流より有意に大きかった（P＜0.05）ものの，根管輸送とシリンジ潅流に有意差は認められなかった（P＜0.05）．

RESULTS: In the apical area of the root canal with a curved length greater than 3 mm, the root canal volume increase in the PUI+irrisafe group was significantly greater than that of the PUI+K file and syringe irrigation (P＜0.05), and at 5 mm section, the transportation of the root canal formed by PUI+irrisafe was significantly lower than that of the PUI+K file (P＜0.05), but there was no significant difference from syringe irrigation (P＞0.05); in root canals with a curved length less than 3 mm, root canal volume increment of the file group was significantly greater than that of syringe irrigation (P＜0.05), but there was no significant difference between the root canal transportation and syringe irrigation(P＜0.05).

結論:

湾曲長が大きい根管では，Pre-curved fileとPassive ultrasonic irrigationの併用により，より優れた洗浄効果が得られ，湾曲長が小さい根管では，K fileとPre-curved fileとPassive ultrasonic irrigationはともに安全で効果的であった．

CONCLUSIONS: In root canals with larger curved length, passive ultrasonic irrigation combined with a pre-curved file can obtain a better cleaning effect, while in root canals with smaller curved length, both K file and pre-curved file with passive ultrasonic irrigation are safe and effective.