鎳鈦旋轉器械在牙科廣為應用，研究指出應用表面處理技術，將氮離子導入鎳鈦旋轉器械表面，生成穩定的氮化鈦化合物，改善器械製程經研磨後產生的凹陷，並提升切削效率和抵抗磨耗能力。本實驗目的觀察比較經表面處理之鎳鈦旋轉器械對於根管修形後之根管偏差量之影響。本研究選用ProFile® 及ProTaperTM universal，應用電漿離子沈浸植入法分別在高濃度氮氣及低濃度氮氣的條件下，將氮離子導入表面，以掃描式電子顯微鏡觀察器械尖端型態，用電子能譜化學分析儀分析鍍膜成分和深度；以表面處理設定的兩種條件及未經處理的來分組，ProFile® 及ProTaperTM universal各有3小組，各組均修形5個樹脂模擬根管，故ProFile® 及ProTaperTM universal組，各需修形45個樹脂模擬根管。為擷取根管修形前後的平面影像，利用立體顯微鏡搭配數位相機的裝置，以Image-Pro Plus軟體分析計算根管偏差改變量，Kruskal-Wallis test統計分析。結果顯示，鍍膜前後器械尖端型態未產生明顯轟擊，高濃度氮氣組佈植深度達40nm，氮離子濃度最高在6nm；而低濃度氮氣組佈植深度達30nm，氮離子濃度最高在2nm。器械修形根管的完成數量，ProFile®完成44個，ProTaperTM universal完成32個。器械斷裂方面，ProFile®僅高濃度氮氣組斷裂1隻0.06/#30。ProTaperTM universal，總共斷裂6隻F3。樹脂模擬根管在縱切面的改變量，與原始器械相較，ProFile® 組別及ProTaperTM universal 組別均維持在根管原始路徑上，無統計上顯著差異出現在距離根尖處1至7釐米的測量點的內外側，兩組別在彎曲處的內側移除量均大於外側。氮離子藉由電漿浸沒式離子佈植法，於鎳鈦旋轉器械ProFile®和ProTaperTM universal表面形成氮化鈦化合物，於樹脂模擬彎曲根管修形的結果，兩組均無不良的根管偏差出現。

Ni-Ti rotary instruments were used generally in Endodontic treatment. However, suprafacial defects such as metal flash and roller were common in unused Ni-Ti instruments. The defects were formed due to the grinding process of Ni-Ti instrument. Some surface engineering techniques have been used to improve the surface defects. Implantation of nitrogen ion creates a surface layer of titanium nitride (TiN), which can significantly improve cutting efficiency and wear resistance. The purpose of this study was to evaluate the effects of nitrogen ion implanted nickel-titanium rotary instruments on canal shaping in simulated root canals.
The Ni-Ti rotary instruments ( ProFile® and ProTaperTM universal) have undergone a process of plasma ion immersion implantation (PIII) with high concentration nitrogen and low concentration nitrogen. Scanning electron microscopic (SEM) was used to evaluate the micromophology of cutting edge after ion implantation. Characteristics of the materials were analyzed by electron spectroscopy for chemical analysis (ESCA). Canal preparations were done by surface treated and untreated ProFile® and ProTaperTM universal instruments. The pre- and post-instrumentation images of longitudinal section of root canal were recorded by the stereomicroscopy and camera. The change of the root canal at 9 points from the apex were assessed with image pro plus 5.0. Incidence of instrument fracture and completed simulated root canals were recorded. The data were analyzed statistically using Kruskal-Wallis test.
SEM observations showed no significant changes in the micromorphology of the cutting edge of ion implanted ProFile® and ProTaperTM universal instruments. The ESCA revealed that the highest nitrogen were formed in depth of 2nm of low concentration group and 6nm of high concentration group. In ProFile® groups, 44 simulated root canals were completely prepared. In ProTaperTM universal groups, 32 simulated root canals were completely prepared. Only one instrument (0.06/#30) fractured in ProFile® groups. Six instruments of size F3 fractured in ProTaperTM universal groups. In canals prepared with ProFile® and ProTaperTM universal groups, all surface treated instruments were effective in maintaining the original canal path of curved simulated root canals. There were no statistically significant differences on canal wall reduction at 1-7mm from the apex among treated and untreated instruments in ProFile® and ProTaperTM universal groups.
In conclusion, nitrogen were successfully implanted in the surface of ProFile® and ProTaperTM universal. In this study, there were no adverse effect in canal shaping of nitrogen ion implanted Ni-Ti rotary instruments— ProFile® & ProTaperTM universal groups.

目 錄
中文摘要 i
英文摘要 iii
目錄 iv
一、緒論 1
二、文獻回顧 2
（一）鎳鈦器械的特性介紹 2
（二）鎳鈦根管器械表面處理的方法 4
（三）鎳鈦器械的表面處理 10
（四）根管偏差(Transportation)的臨床意義 13
（五）根管偏差(Transportation)測量方式 15
三、實驗動機與目的 20
四、材料與方法 21
五、結果 29
六、討論 34
七、結論 44
八、參考文獻 45

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