調製方法の違いが根管治療のアポ間緊急事態と充填効果に及ぼす影響

[The influence of different preparation methods on interappointment emergency and filling effect of root canal therapy].

抄録

目的:

異なる根管準備方法が、インターアポイントメントエマージェンシー（IAE）および根管充填の発生率に及ぼす影響を比較すること。

PURPOSE: To compare the effect of different root canal preparation methods on the incidence of interappointment emergencies (IAE) and root canal filling.

方法:

2018年8月から2021年8月までに歯髄炎または根尖性歯周炎により根管治療を必要とした計96歯を選択した。無作為に2群に分けた：MT群はMtwo根管準備法をMtwo機械ニッケルチタンファイルで修正し、同期群は修正Mtwo準備法と同期根管長測定で治療した。根管準備後、トライアルポイントフィルムを撮影し、水酸化カルシウムを用いて根管を封鎖し、経過観察中にルーチンの熱可塑性ガッタパーチャ根管充填を行った。SPSS 22.0ソフトウェアパッケージを用いて、根管治療後のIAEの発生率と充填効果を分析した。

METHODS: A total of 96 teeth requiring root canal therapy due to pulpitis or periapical periodontitis from August 2018 to August 2021 were selected. They were randomly divided into 2 groups: MT group was treated with Mtwo root canal preparation method modified by Mtwo machine nickel-titanium file, while synchronous group was treated with modified Mtwo preparation method and synchronous root canal length measurement. After root canal preparation, the trial point film was taken, calcium hydroxide was used to seal the root canal, and routine thermoplasticizied gutta-percha root canal filling was performed during the follow-up visit. SPSS 22.0 software package was used to analyze the incidence of IAE and filling effect after root canal therapy.

結果:

術直後、術後3日後、術後1週間後のIAE発生率に有意差はなかった(P＞0.05)。術後1日後と2日後のIAE発生率は、同期群がMT群より有意に低かった(P＜0.05)。根管充填の適合率は、同期群がMT群より有意に高かった（P＜0.05）。

RESULTS: There was no significant difference in the incidence of IAE between the two groups immediately after operation, three days and 1 week after operation(P＞0.05); the incidence of IAE in synchronous group was significantly lower than that in MT group at 1 and 2 days after operation(P＜0.05). The qualified rate of root canal filling in synchronous group was significantly higher than that in MT group (P＜0.05).

結論:

同期法は、根管形成時の根尖部への機械的刺激を低減し、根管の作業長を厳密に制御し、根尖バリアを維持することができるため、IAEの発生率を低減し、根管充填の適格率を効果的に向上させることができる。

CONCLUSIONS: Synchronous method can reduce mechanical stimulation of apical area during root canal preparation, strictly control the working length of root canal and maintain apical barrier, thus reducing the incidence of IAE and effectively improving the qualification rate of root canal filling.