湾曲根管治療におけるNeoNiTi、ProTaper、およびReciprocファイルの有効性の比較：CBCTによる評価

Comparison of the Efficacy of NeoNiTi, ProTaper, and Reciproc Files in the Retreatment of Curved Root Canals: a CBCT Assessment.

抄録

目的:

根管治療では，根管充填材を除去し，初期根管構造を保存するために効果的な器具や方法が適用される．本研究では，湾曲根管治療におけるReciproc，Neoniti，ProTaper，Hedstromファイルの有効性を比較検討した．

OBJECTIVE: Effective tools and methods are applied during root canal retreatment to eliminate root canal obturation materials and preserve the initial root canal anatomy. The present study compared the efficacy of Reciproc, Neoniti, ProTaper, and Hedstrom files in the retreatment of curved root canals.

材料と方法:

本研究では、曲率25～45ºの根管100本を使用した。最初にサンプルを作製し、CBCTで検査した後、根管をガッタパーチャでオブチュレーションし、無作為に4群（n=25）に割り付けた。各群にNeoNiTi，ProTaper，Reciproc，Hedstromファイルを用いて再治療を施行した．CBCT検査は同条件で再度実施した．1回目と2回目のCBCT画像で根尖から3mm，6mm，9mmの距離で根管輸送と根管内のガッタパーチャの残存を評価した．各サンプルの各根管の退縮に要した時間を記録した．データ解析には，一元配置分散分析およびノンパラメトリック検定を適用した．

MATERIAL AND METHODS: In the present study, 100 root canals with 25‒45º curvatures were used. After the samples were initially prepared and examined by CBCT, the root canals were obturated with gutta-percha and randomly assigned to four groups (n=25). A retreatment was carried out in each group with NeoNiTi, ProTaper, Reciproc, and Hedstrom files. CBCT examinations were carried out again under the same conditions. The samples were evaluated at 3-, 6-, and 9-mm distances from the apex on the first and the second CBCT image for root canal transportation and remaining gutta-percha in the root canals. The time required for retreating each canal in each sample was recorded. One-way ANOVA and corresponding non-parametric tests were applied for data analysis.

結果:

NeoNiTi群の根管輸送量は他群より少なく，ProTaper群とは有意差があった（P<0.05）．再治療後のガッタパーチャの残存は4群ともあったが，統計学的に有意ではなかった（P>0.05）．

RESULTS: The root canal transportation in the NeoNiTi group was lower than that in the other groups and significantly different from the ProTaper group (P<0.05). There was a remaining gutta-percha after retreatments in all the four groups, which was not statistically significant (P>0.05).

結論:

NeoNiTiファイルは，湾曲根管の再治療において，評価した他のファイルシステムよりも輸送量が少なかったが，すべてのファイルが臨床的に許容できるレベルで非常に有効であった．

CONCLUSION: Despite the fact that the NeoNiTi file produced less transportation than other file systems evaluated in the retreatment of curved root canals, all the files were very effective at the clinically acceptable levels.