镍钛锉系统对长椭圆形根管清洁度与抗折性能关系的影响研究

doi:10.3969/j.issn.1674-8115.2026.04.003

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (4): 434-441.doi: 10.3969/j.issn.1674-8115.2026.04.003

• 论著 · 基础研究 • 上一篇

镍钛锉系统对长椭圆形根管清洁度与抗折性能关系的影响研究

张卓扬¹, 王易维¹, 陈希瑶¹, 王瑛¹, 孙顺涛², 唐子圣¹()

^1.上海交通大学医学院附属新华医院口腔科，上海 200092
^2.浙江省杭州市儿童医院口腔科，杭州 310005

收稿日期:2025-08-29 接受日期:2025-11-13 出版日期:2026-04-15 发布日期:2026-04-15
通讯作者: 唐子圣，主任医师，教授，博士；电子信箱：tangzisheng163@163.com。
基金资助:
国家重点研发计划(2022YFC2402105);上海交通大学医学院附属新华医院“学科攀峰计划”项目(XKPF2024B50021);上海交通大学医学院附属新华医院“学科攀峰计划”项目(XKPF2024B50024)

Effects of nickel-titanium file systems on relationship between cleanliness and fracture resistance of long-oval root canals

Zhang Zhuoyang¹, Wang Yiwei¹, Chen Xiyao¹, Wang Ying¹, Sun Shuntao², Tang Zisheng¹()

^1.Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
^2.Department of Stomatology, Hangzhou Children's Hospital, Zhejiang Province, Hangzhou 310005, China

Received:2025-08-29 Accepted:2025-11-13 Online:2026-04-15 Published:2026-04-15
Contact: TANG Zisheng, E-mail: tangzisheng163@163.com.
Supported by:
National Key Research and Development Program of China(2022YFC2402105);Construction Project of the "Discipline Peak-Climbing Plan" of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine(XKPF2024B50021)

摘要/Abstract

摘要：

目的·结合小视野锥形束CT（cone-beam CT，CBCT）、计算机辅助技术、万能试验机方法，分析长椭圆形根管清洁度与抗折性能的关系，探讨常用镍钛锉系统对二者关系的影响。方法·收集2024年4月至2025年4月于上海交通大学医学院附属新华医院口腔科因正畸拔除的单直根管下颌前磨牙。使用CBCT分析根管形态并筛选40颗长椭圆形根管牙，截冠制备13 mm长的标准牙根样本，平均随机分为A组（X-GOLD，n=10）、B组（Reciproc Blue，n=10）、C组（ProTaper Universal，n=10）和对照组（n=10）；A、B、C组分别使用不同镍钛锉系统进行根管预备。牙根样本使用CBCT扫描预备前后的形态，三维重建并比对前后模型，计算清洁度。实验组采用单尖法根管充填，对照组不充填，包埋固定牙根，使用万能试验机施加静态载荷，测量牙根样本的断裂载荷。分析各组清洁度与抗折性能的差异及变化趋势，以及清洁度与抗折性能的关系。结果·清洁度评测结果显示：C组的整体清洁度显著高于A组和B组，差异均有统计学意义（均P<0.05）；而A组与B组的整体清洁度比较，差异无统计学意义（P>0.05）。根管预备效果三维重建图展现了长椭圆形根管壁近远中向预备过量而颊舌向预备不足的特点。断裂载荷评测结果显示：对照组的断裂载荷显著高于A、B、C组，差异均有统计学意义（均P<0.05）；而A组与B组的断裂载荷比较，差异无统计学意义（P>0.05）；C组的断裂载荷显著低于A组和对照组，差异均有统计学意义（均P<0.05）。长椭圆形根管的清洁度与抗折性能呈负相关（r=-0.379，P=0.039）。结论·镍钛锉系统对长椭圆形根管的清洁度与抗折性能关系存在影响。长椭圆形单直根管的下颌前磨牙的清洁度与抗折性能呈负相关，使用ProTaper Universal镍钛锉系统预备长椭圆形单直根管下颌前磨牙时，具有较高的清洁度，并可保持一定的牙根抗折性能。

关键词: 长椭圆形根管, 计算机辅助技术, 根管预备, 清洁度, 抗折性能

Abstract:

Objective ·To investigate the relationship between the cleanliness and fracture resistance of long-oval root canals using small field-of-view cone-beam CT (CBCT), computer-aided technologies, and a universal testing machine, and to explore the effects of commonly used nickel-titanium (NiTi) file systems on this relationship. Methods ·Mandibular premolars with single straight roots extracted for orthodontic reasons between April 2024 and April 2025 in the Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, were collected. CBCT was used to analyze canal morphology, and 40 teeth with long-oval canals were selected. The crowns were removed to prepare standardized root samples with a length of 13 mm. The samples were randomly and equally divided into Group A (X-GOLD, n=10), Group B (Reciproc Blue, n=10), Group C (ProTaper Universal, n=10), and a control group (n=10). Root canal preparation was performed in Groups A, B, and C using different NiTi file systems. All samples were scanned before and after preparation using CBCT, and three-dimensional models were reconstructed to calculate canal cleanliness by comparing pre- and post-preparation morphologies. The experimental groups were obturated using the single-cone technique, while the control group was left unobturated. All roots were embedded and subjected to static loading using a universal testing machine to determine fracture load. Data were analyzed to evaluate differences and trends in cleanliness and fracture resistance among the groups, and to assess their relationship. Results ·Group C showed significantly higher overall cleanliness compared to Groups A and B, and the differences were statistically significant (P<0.05), while no statistically significant difference was observed between Groups A and B (P>0.05). CBCT-based 3D reconstruction illustrated that long-oval canals tended to be over-prepared in the mesiodistal direction and under-prepared in the buccolingual direction. The control group demonstrated significantly higher fracture resistance than Groups A, B and C, and the differences were statistically significant (P<0.05). There was no statistically significant difference in the fracture load between Group A and Group B (P>0.05). Group C had significantly lower fracture resistance compared to Group A and the control group, and the difference were statistically significant (P<0.05). A significant negative correlation was found between canal cleanliness and fracture resistance in long-oval root canals (r=-0.379, P=0.039). Conclusion ·NiTi file systems affect the relationship between cleanliness and fracture resistance in long-oval root canals. In mandibular premolars with long-oval single straight canals, cleanliness is negatively correlated with fracture resistance. The ProTaper Universal NiTi file system achieves higher cleanliness while maintaining a certain level of fracture resistance in such cases.

Key words: long-oval root canal, computer-aided technology, root canal preparation, cleanliness, fracture resistance

中图分类号:

R781.05

张卓扬, 王易维, 陈希瑶, 王瑛, 孙顺涛, 唐子圣. 镍钛锉系统对长椭圆形根管清洁度与抗折性能关系的影响研究[J]. 上海交通大学学报（医学版）, 2026, 46(4): 434-441.

Zhang Zhuoyang, Wang Yiwei, Chen Xiyao, Wang Ying, Sun Shuntao, Tang Zisheng. Effects of nickel-titanium file systems on relationship between cleanliness and fracture resistance of long-oval root canals[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(4): 434-441.

图/表 6

图1 包埋固定后的根管填充牙根样本

Fig 1 Embedded root specimens after root canal obturation

图2 万能试验机加压牙根

Fig 2 Compression testing of root specimens using a universal testing machine

表1 各组离体牙根测量数据（n=10）

Tab 1 Measured data of isolated root specimens in each group （n=10）

Group	Weight /g	Buccolingual diameter /mm	Mesiodistal diameter/mm
A	0.34±0.07	7.21±0.62	4.73±0.43
B	0.32±0.06	7.10±0.35	4.55±0.40
C	0.33±0.04	7.06±0.43	4.50±0.42
Control	0.35±0.05	7.41±0.57	4.67±0.78

表2 3种镍钛锉系统预备后的根管各部分清洁度

Tab 2 Cleanliness of different regions of the root canals after preparation with three nickel-titanium file systems

Group	Coronal 1/3/%	Middle 1/3/%	Apical 1/3/%
A	74.70±10.73	62.51±12.97^①⑤	61.78±13.64^②
B	74.54±10.52^③	65.80±12.21^④⑥	55.06±11.74
C	82.97±9.37	83.75±9.81	70.27±19.02

图3 根管预备效果三维重建图Note： The cleanliness of samples A1, B5, and C7 was 53.89%, 60.33%, and 81.16%, respectively.Yellow, green and blue indicate insufficient preparation. Orange indicates moderate preparation. Red indicates excessive preparation.

Fig 3 Three-dimensional reconstruction of root canal preparation

图4 不同镍钛锉系统预备的长椭圆形根管牙根样本的整体清洁度与断裂载荷的关系

Fig 4 Relationship between overall cleanliness and fracture load of long-oval root canal specimens prepared with different nickel-titanium file systems

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镍钛锉系统对长椭圆形根管清洁度与抗折性能关系的影响研究

Effects of nickel-titanium file systems on relationship between cleanliness and fracture resistance of long-oval root canals

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