不同根管冲洗方法对Vitapex清除及根尖封闭的效果研究OACSTPCD

Objective To compare the effects of 3 root canal irrigation methods on the removal of Vitapex in the root ca-nal and apical sealing,providing a basis for selecting appropriate root canal irrigation methods in clinical practice.Meth-ods Collect 80 mandibular single premolars to be extracted for orthodontic treatment at the Oral and Maxillofacial Sur-gery Outpatient Department of Changsha Stomatological Hospital from March to May 2023,and randomly divide them in-to 4 groups,with 20 teeth in each group.The control group was not treated with Vitapex paste and root canal irrigation,while the other three experimental groups were treated with Vitapex paste and recorded as the conventional needle irriga-tion(CNI)group,passive ultrasound irrigation(PUI)group,and Er∶YAG laser group according to the root canal irrigation method.Ten detached teeth were randomly selected from each group and were observed under a scanning electron micro-scope(SEM)for parallel Vitapex residual score after longitudinal dissection.After root canal filling,another 10 extracted teeth underwent methylene blue dye penetration ex-periments,and the longest dye penetration length was observed and measured under an oral micro-scope after longitudinal dissection of the extracted teeth.Results SEM observation showed that differ-ent degrees of residue of Vitapex paste and a small amount of smear layer were visible on the surface of the root canal in the experimental group.Compared with the cervical 1/3 and middle 1/3,the residue score of Vitapex in the apical 1/3 was higher,and the differences were statistically significant(all P＜0.05).The comparison of Vitapex residue score and total longest penetration length in the same site among different groups showed statistically significant differences(all P＜0.05).Among them,the Er∶YAG group,PUI group,and CNI group had higher residual scores of Vitapex in the same area compared to the control group.At cervical 1/3 and middle 1/3,the residual scores of Vitapex in the PUI group and Er∶YAG group were lower than those in the CNI group;at apical 1/3,the residual score of Vitapex in the Er∶YAG group was lower than that in the PUI and CNI groups;the above differences were statistically significant(all P＜0.05).The maximum penetration length of dye in the Er∶YAG group[(0.58±0.05)mm]was shorter than that in the CNI group[(1.07±0.13)mm]and the PUI group[(0.94±0.17)mm],and the differences were statistically significant(all P＜0.001).Comparing the Er∶YAG group with the control group[(0.45±0.04)mm],there was no statistically signifi-cant difference(P=0.105).Conclusion Compared to CNI and PUI for root canal cleaning,Er∶YAG laser can more ef-fectively remove the Vitapex paste at apical 1/3 and has a better apical sealing effect.