ニッケルチタンファイルFKGレイスによる湾曲根管形成実習の教育効果  [in Japanese] Investigation on Effective Education Methods for Preparing Curved Root Canals with FKG RaCe  [in Japanese]

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Author(s)

    • 山口 幹代 Mikiyo YAMAGUCHI
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 岡本 基岐 Motoki OKAMOTO
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 朝日 陽子 Yoko ASAHI
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 山田 朋美 Tomomi YAMADA
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 伊藤 祥作 Shousaku ITOH
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 林 美加子 Mikako HAYASHI
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 伊藤 勇紀 Yuki ITO
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 須崎 尚子 Naoko SUZAKI
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 堅田 千裕 Chihiro KATATA
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 外園 真規 Maki SOTOZONO
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 川西 雄三 Yuzo KAWANISHI
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 増田 晃一 Kouichi MASUDA
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 伊藤 善博 Yoshihiro ITOH
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 米田 直道 Naomichi YONEDA
    • 大阪大学大学院歯学研究科 口腔分子感染制御学講座 (歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry

Abstract

<p> 目的 : ニッケルチタン (NiTi) ファイルは弾性係数が小さいため, 湾曲根管への追従性に優れており, 根管治療において必要不可欠な器材となりつつある. 本研究では, 歯学部学生の臨床前基礎実習において, FKGレイス (FKG DENTAIRE, Switzerland) による湾曲根管形成実習を実施し, 習熟到達度を評価した.</p><p> 材料と方法 : 大阪大学歯学部3年生49名に対して, J型エポキシレジン製透明湾曲根管模型を用いてFKGレイスによる形成実習を2回行った. Kファイル#15にて根管長を測定後, プリレイスによる根管上部のフレアー形成とKファイル#15によるグライドパス形成を行った. 作業長は根管長から1mm引いた長さとし, レイス#30/6%, #30/4%, #25/4%, #20/4%を用いて根管形成を行った.</p><p> 形成前後の根管模型をマイクロCT (R_mCT2, RIGAKU) にて撮影し, 根管長軸方向に対して平行に根尖から1, 2, 3, 5, 7, 10mmの位置で内湾側および外湾側の根管幅径増加量を計測した. 根管幅径増加量および形成時間を学生1回目, 2回目, ならびに日本歯科保存学会専門医・認定医10名の結果と比較検討した.</p><p> 結果 : 学生1回目の根管形成においては, 28根管で根尖破壊, 1根管でファイル破折, 1根管で目詰まりを認めた. また, 学生2回目の根管形成においては, 5根管で根尖破壊, 1根管で目詰まりを認めた. 内湾側および外湾側の根管幅径増加量および形成時間は, 学生1回目, 2回目, ならびに専門医・認定医の間で統計学的有意差を認めなかった.</p><p> 結論 : NiTiファイルを用いた湾曲根管形成実習において, 根尖部の形成に特に注意を促すことにより, 習熟到達度が向上することが明らかとなった.</p>

<p> Purpose: Nickel-titanium (NiTi) files are becoming more popular for root canal treatments, since they have the clear advantage of maintaining the original shape of curved root canals because of their low elastic modulus and flexibility. The present study assessed the educational effectiveness of preparing curved root canals with FKG RaCe in dental students' hands-on practical classes.</p><p> Methods: A total of 49 third-year students in the School of Dentistry, Osaka University performed root canal preparation of J-shaped canals in transparent epoxy resin blocks with FKG RaCe twice. After measuring the length of root canals with a #15 K file, cervical preflaring was performed with a preRaCe and glide path preparation was performed with a #15 K file. Working length was determined by subtracting 1 mm from the root canal length and root canal preparation was performed with RaCe (#30/6%, #30/4%, #25/4%, and #20/4%). For evaluating the quality of root canal preparation, digital images of the epoxy resin blocks before and after the instrumentation were captured by micro-computed tomography. Using image analysis software, the images of pre- and post-instrumentation were superimposed and the distances between pre- and post-instrumentation were measured on both the inner and outer sides. Measuring levels were set at 1, 2, 3, 5, 7 and 10 mm from the root apex and the distances were compared between the outcomes by the students and by specialists accredited by the Japanese Society of Conservative Dentistry.</p><p> Results: In 49 root canals instrumented by the students for the first time, 28 apical perforations, one separated file, and one apical blockage were observed. In 49 root canals instrumented by the students for the second time, five apical perforations and one apical blockage were observed. The distances between pre- and post-instrumentation at the different levels and working time showed no significant differences among the first and second trials by the students and specialists.</p><p> Conclusion: In hands-on training of root canal preparation for dental students, successful root canal preparation was achieved by instructing students to pay attention especially when preparing a root apex.</p>

Journal

  • The Japanese Journal of Conservative Dentistry

    The Japanese Journal of Conservative Dentistry 60(5), 255-261, 2017

    The Japanese Society of Conservative Dentistry

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