3种镍钛锉预备弯曲根管时抗循环疲劳性能的体外研究

王渝鑫; 焦任天; 赵莹; 王天琪; 梁广智

doi:10.12016/j.issn.2096-1456.2024.02.003

口腔疾病防治 ›› 2024, Vol. 32 ›› Issue (2) : 101 -107. DOI: 10.12016/j.issn.2096-1456.2024.02.003

基础研究

3种镍钛锉预备弯曲根管时抗循环疲劳性能的体外研究

王渝鑫, 焦任天, 赵莹, 王天琪, 梁广智

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In vitro study on cyclic fatigue resistance of three types of nickel titanium files in preparation for bending root canals

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摘要

目的探究不同角度的弯曲根管模型中，不同尖端直径的Woride KS（WKS）、Protaper Gold（PTG）及Hyflex CM（HCM）机用镍钛器械抗循环疲劳性能的差异，为临床上预备弯曲根管时有针对性地选用合适的镍钛器械提供参考。方法选取不同尖端直径20#、25#（0.20 mm、0.25 mm）的3种全新镍钛锉，WKS（20/0.06）、WKS（25/0.06）、PTG（20/0.07）、PTG（25/0.08）、HCM（20/0.06）、HCM（25/0.06）各20支。根据推荐设置马达的转速和扭矩，于30°和 60°的不锈钢根管模型中测试镍钛锉的抗循环疲劳性能，用摄像机及计时器记录镍钛锉从开始旋转到疲劳折断的时间（time from ratation to fatigue fracture，TTF），用游标卡尺测量并记录折断碎片的长度（fragment length，FL）。结果同种锉的TTF比较，①WKS：尖端同直径锉在30°弯曲根管中的TTF均长于60°（P<0.05），同角度弯曲根管中25#锉的TTF均长于20#锉（P<0.05）；②PTG：20#锉在30°弯曲根管中的TTF长于60°（P<0.05），25#锉在30°弯曲根管中的TTF与60°无统计学差异（P>0.05），在30°弯曲根管中的20#锉TTF长于25#锉（P<0.05），在60°弯曲根管中20#锉的TTF与25#锉无统计学差异（P>0.05）；③HCM：尖端同直径锉在30°弯曲根管中的TTF均长于60°（P<0.05），同角度弯曲根管中20#锉的TTF均长于25#锉。不同锉的TTF比较：在30°弯曲根管中，3种20#锉的TTF无统计学差异（P>0.05），25#WKS的TTF长于其他锉（P<0.05）；在60°弯曲根管中，20#HCM的TTF长于尖端同直径的其他锉（P<0.05），25#WKS的TTF长于尖端同直径的HCM（P<0.05）。20#PTG、25#PTG、20#HCM在30°的弯曲根管模型中FL均分别显著长于60°（P<0.05），20#WKS、25#WKS、25#HCM在30°及60°的弯曲根管模型中FL无统计学差异。结论 WKS镍钛锉的抗循环疲劳性能在30°模拟弯曲根管内较PTG及HCM镍钛锉有明显优势；而在60°模拟弯曲根管内，20#镍钛锉中HCM镍钛锉的抗循环疲劳性能较其他锉有明显优势，25#镍钛锉中仅WKS镍钛锉的抗循环疲劳性能较HCM镍钛锉有明显优势。

Abstract

Objective The purpose of this study was to investigate the differences in the anti cyclic fatigue performance of Woride KS (WKS), Proteper Gold (PTG), and Hyflex CM (HCM) nickel titanium instruments with different tip diameters in curved root canal models, and to provide reference for the targeted selection of suitable nickel titanium instruments in clinical preparation of curved root canals. Methods Three kinds of new nickel titanium files with 20# and 25# (0.20 mm and 0.25 mm) tip diameters were selected, including WKS (20/0.06), WKS (25/0.06), PTG (20/0.07), PTG (25/0.08), HCM (20/0.06), and HCM (25/0.06), each with 20 files. According to the recommended speed and torque of the motor, the anti cycle fatigue performance of the nickel titanium file was tested in 30° and 60° stainless steel root canal models. The time from rotation to fatigue fracture (TTF) of the nickel titanium file was recorded with a camera and timer, and the fragment length (FL) was measured and recorded with a Vernier scale. Results Comparison of TTF of the same type of file. ① WKS: the TTF of files with the same tip diameter in a 30° curved root canal was longer than 60° (P<0.05); The TTF of 25# nickel titanium files in the same angle curved root canal was longer than that of 20# nickel titanium files (P<0.05). ②PTG: the 20# nickel titanium files had a TTF longer than 60° in a 30° curved root canal (P<0.05), while the 25# nickel titanium files had no statistically significant difference in TTF between the 30° curved root canal and 60° curved root canal (P>0.05); In a 30° curved root canal, the TTF of 20# nickel titanium files was longer than that of 25# nickel titanium files (P<0.05). In a 60° curved root canal, there were no statistically significant difference between the TTF of 20# nickel titanium files and 25# nickel titanium files (P>0.05). ③HCM: the TTF of files with the same tip diameter in a 30° curved root canal was longer than 60° (P<0.05); The TTF of 20# nickel titanium files in the same angle curved root canal is longer than that of 25# nickel titanium filea. Comparison of TTF of different files: in a 30° curved root canal, there was no statistically significant difference in TTF among the three types of 20# nickel titanium files (P>0.05). The TTF of 25# WKS was longer than that of other files (P<0.05); In a 60 ° curved root canal, the TTF of 20# HCM was longer than other files with the same tip diameter (P<0.05), and the TTF of 25# WKS was longer than HCM with the same tip diameter (P<0.05). The FL of 20# PTG, 25# PTG, and 20# HCM in the 30° curved root canal model is significantly longer than that of 60° (P<0.05), while there is no statistical difference in FL among 20# WKS, 25# WKS, and 25# HCM in the 30° and 60° curved root canal models. Conclusion The anti cyclic fatigue performance of WKS is significantly superior to PTG and HCM in a 30° curved root canal. In a 60° curved root canal, 20# HCM had a significant advantage in terms of anti cyclic fatigue performance compared to other files, while only 25# WKS had a significant advantage in anti cyclic fatigue performance compared to HCM.