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研究生:葉沛盈
研究生(外文):Pei-Ying Yeh
論文名稱:重複使用對鎳鈦旋轉器械的斷裂模式與扭力性質的影響
論文名稱(外文):Fracture patterns and torsional properties of rotary nickel-titanium instruments after repeated use
指導教授:李士元 
指導教授(外文):Shyn-Yuan Lee
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:臨床牙醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
論文頁數:118
中文關鍵詞:鎳鈦旋轉器械彎曲根管重複使用斷裂模式斷裂扭力值
外文關鍵詞:rotary nickel-titanium instrumentscurved canalrepeated usesfracture patterntorque at fracture
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鎳鈦旋轉器械的斷裂是許多臨床操作者在使用上的顧慮,因此,為了使根管治療更有效率更安全,許多不同設計的鎳鈦旋轉器械也陸續被發展出來。本實驗的目的在比較三種不同設計的鎳鈦旋轉器械:ProFile、RaCe、ProTaper,在經過不同使用次數後,斷裂器械的發生率,並使用掃描式電子顯微鏡觀察其斷裂模式。另外,藉由測試經過不同使用次數的鎳鈦旋轉器械的斷裂扭力值,以評估斷裂扭力值是否會因使用次數的不同而有所改變。
實驗使用標準化樹脂彎曲根管來模擬臨床彎曲的牙齒根管,並選用三種鎳鈦旋轉器械:ProFile、RaCe、ProTaper各四十組。分別以十組器械試著完成一、五、十個根管修形,另外十組不做任何根管修形的器械,則作為對照組。所有操作依廠商的臨床使用建議,並由同一人操作完成。結果顯示,三種器械進行一個根管修形的十組器械都可順利完成,而只有ProFile可完成所有五個根管的修形,但沒有任何器械可全部完成十個根管而不產生斷裂。在所有修形測試中,ProFile為三種廠牌中斷裂器械最少、使用次數最多、完成最多根管修形的器械。器械斷裂位置則因廠牌不同而有所差異,且所有斷裂器械皆無形變的發生,而掃描式電子顯微鏡下的觀察發現,大部分的器械斷裂形式為彎曲斷裂。
至於未斷裂的器械,固定尖端3mm處,記錄斷裂時的扭力值,發現器械斷裂時的扭力值與器械直徑高度相關(r2=0.75~0.96),且不同廠牌器械在相同直徑下的扭力值有顯著差異。使用次數對不同器械的斷裂扭力值的影響不一,可見斷裂時的扭力值並非重複使用對鎳鈦旋轉器械主要影響的因素。
Separation of rotary nickel-titanium (NiTi) instruments is a serious concern in root canal treatment. It is important for the clinician to have detailed research information to provide a rational basis for instrument selection. The purposes of this study were to evaluate the failure patterns of different rotary NiTi instruments in multiple simulated root canal preparations. The fractured instruments were examined under scanning electron microscope (SEM). The torque at fracture of rotary NiTi instruments after multiple uses were also investigated.
In this study, the effects of the canal curvature on NiTi files were standardized by a resin block with a curved canal. Three commonly used rotary NiTi systems: ProFile, RaCe, and ProTaper were investigated. Forty sets of instruments of each brand were divided into four groups. The group without instrumentation is served as control, and the rests are subjected to root canal preparation of 1, 5, 10 resin blocks respectively. All canal preparations followed the manufacturers’ instructions and were performed by a single operator. The results showed that none of the three systems can finish all the canal preparations without instrument breakage. There were least instrument breakage and most canal preparation finished for the ProFile system. All instruments separated at 1.5~4.5 mm from the tip. No instrument deformations were noted under scanning electronic microscope (SEM), and most fractured files were flexural fracture.
The remaining files were subjected to torsional test in a torquemeter. A strong relationship was found between the size of the file and the torque at fracture (r2=0.75~0.99). The differences of torque at fracture between new and used instrument were not consistent. The results showed that torque at fracture of rotary NiTi instruments was not affected mainly by multiple uses.
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