Uticaj različitih tehnika mašinske preparacije na originalnu anatomiju kanala korenova prvih maksilarnih molara
Effect of different machine driven instrumentation techniques on the original root canal anatomy of the first maxillary molars
Author
Beljić-Ivanović, Katarina R.Mentor
Teodorović, NevenkaCommittee members
Vujašković, MirjanaMarković, Aleksa
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Petrović, Ljubomir
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Show full item recordAbstract
Ideja za istraživanje proizašla je iz problematike sa kojom se susreću terapeuti u
kliničkom radu tokom endodontske preparacije zuba sa komplikovanim kanalnim
sistemima i nedostataka literaturinih podataka o uticaju mašinskih tehnika
instrumentacije na originalnu anatomiju kanalnog sistema prvih maksilarnih molara.
Osnovni cilj ove disertacije je pratio ideju istraživanja, na osnovu čega su
postavljeni i konkretni zadaci, koji su rukovodili odabir relevantnih grupa prvih
maksilarnih molara: I – zubi sa tri odvojena korena i morfološkim tipom Vertucci IV
kanala u mezio-bukalnom korenu i II – zubi sa fuzionisanim korenovima. Na njima su
sprovedena proučavanja parametara koji će definisati promene anatomskih detalja pre i
posle instrumentacije kanala korena koristeći pet specifičnih sistema mašinske obrade:
ProTaper Next, Revo-S, WaveOne, Tilos i Self Adjusting File (SAF).
Koristeći kompjuterizovanu tomografiju konusnog zraka (CBCT), uvedenu u
endodonciju pre nepune decenije, na rastojanj...u od 1,0 i 0,1 mm duž svakog kanala
merene su: debljine zidova korenskih kanala, dimenzije prečnika kanala iz dva osnovna
pravca i površine poprečnih preseka kanala pre i posle mašinske preparacije.
Statističkim metodima analizirano je da li i na koji način primenjeni sistemi za
mašinsku preparaciju utiču na originalnu anatomiju prvih maksilarnih molara i da li
između njih postoje razlike.
Rezultati antomskih karaktersitika dve grupe prvih maksilarnih molara pokazali
su da su sve dimenzije krunice zuba na nivou dna krunične komore veće u grupi sa tri
odvojena nego u grupi sa fuzionisanim korenovima. Takođe je pokazano da su
rastojanja između cenatara ulaza u korenske kanale statistički zančajno različite između
ove dve grupe prvih maksilarnih molara, što je od izuzetnog kliničkog značaja, a bez
sličnih nalaza u dostupnoj literaturi.
Promene dimenzije prečnika kanala posle preparacije su bile najmanje u
njihovoj apeksnoj trećini, a statistički značajno veće na ulazu i u koronarnoj trećini
kanala. Stepen promena dimenzija prečnika razlikovao se između grupe sa tri odvojena i
grupe sa fuzionisanim korenovima. U obe grupe zuba su najizrazitije promene vrednosti
prečnika kanala bile na njihovom ulazu, a najmanje u apeksnoj trećini, i to posle
primene svih pet tehnika instrumentacije...
The idea for this study emerged from everyday problems that practitioners are
faced in their clinical work during endodontic therapy of teeth with complex root canal
anatomy, and due to a lack of information and sufficient data from the literature about
influence of machine driven instrumentation techniques on the original anatomy of the
root canal system of first maxillary molars.
Crucial aim of this dissertation followed the idea of the study, and upon that fact
the major tasks were given in order to choose relevant group of maxillary first molars:
A) teeth with three distinctive roots and with canal configuration of Vertucci type IV in
the mesiobuccal root, and B) teeth with fused roots. Detailed evaluation of several
parameters that will define changes of anatomical details were conducted before and
after root canal preparation with five machine driven instrumentation techniques:
ProTaper Next, Revo-S, WaveOne, Tilos and Self Adjusting File (SAF).
With the aid of Cone Beam Computed... Tomography (CBCT), introduced in
endodontics in the last decade, at the distance of 1.0 mm and 0.1 mm along each root
canal the following measurements were conducted: canal walls thickness, dimensions of
root canal diameters measured from two directions, and surface area of the root canal
cross sections before and after mechanical preparation.
The influence, mode of effects and differences of those effects between applied
machine driven techniques on the original anatomy of root canals in first maxillary
molars were analyzed using appropriate statistical methods.
Results of the studies of the anatomical features of two groups of maxillary first
molars showed that all dimensions of the tooth crown measured at the level of the pulp
chamber floor were significantly greater in teeth with three distinctive roots than in
those with fused roots. It was also shown that distances between centers of the canal
orifices were significantly different between the two groups of maxillary first molars.
These results are of great clinical importance, and with no similar findings in available
endodontic literature.
Changes in the root canal diameters after mechanical preparation were least in
the apical third, and significantly greater at the orifice and in the coronal third of all root
canals irrespective to the instrumentation technique. Degree of changes in dimensions of
canal diameter was different between the group with three distinctive roots and group
with fused roots...