目的：探讨逐层后退预备根管法、逐层深入预备根管法、ProTaper冠向下预备根管法对根管治疗患者牙齿冠部玷污层的去除效果。方法选取本院2011年10月~2013年10月诊治的牙齿冠部玷污层患者273例，采用数字随机法分为3组：91例患者采用逐层后退预备根管法治疗为Ⅰ组，91例患者采用逐层深入预备根管法治疗为Ⅱ组，91例患者采用ProTaper冠向下预备根管法治疗为Ⅲ组，比较3组患者治疗前后的根管壁污层评分、根管内玷污层菌落数以及不良事件发生率。结果治疗后，3组患者的根管壁污层评分、根管内玷污层菌落数、不良事件发生率均显著降低。Ⅱ组患者根管壁污层评分、根管内玷污层菌落数、不良事件发生率均明显低于Ⅰ组，Ⅲ组患者根管壁污层评分、根管内玷污层菌落数、不良事件发生率均明显低于Ⅰ组和Ⅱ组，差异均有统计学意义（P＜0.05）。结论3种方法均是根管治疗患者牙齿冠部玷污层的有效去除方法，其中ProTaper冠向下预备根管法的去除效果最佳。%ObjectiveToinvestigatetheremovaleffectofsmearlayeronpaients'toothcrownwith layer back root canal preparation method, layer-depth root canal preparation method and ProTaper crowndownrootcanalpreparationmethod.Methods 273patientswithtoothcrownsmearlayer wereselectedinourhospitalfromOctober 2011toOctober 2013.Thesepatientswererandomly dividedintothreegroups.Inthefirstgroup, 91patientsweretreatedwithlayerbackrootcanal preparationmethod.Inthesecondgroup, 91patientsweretreatedwithlayer-depthrootcanal preparationmethod.Inthethirdgroup, 91patientsweretreatedwithProTapercrowndownrootcanal preparation method. Then root canal wall smear layer scores, colony numbers of root canal smear layer and the occurence rates of adverse events before and after treatment were compared within three groups. ResuIts After treatment, root canal wall smear layer scores, colony numbers of root canal smear layer and the occurence rates of adverse events significantly decreased in three groups. Root canal wall smear layer score, colony number of root canal smear layer and the occurence rate of adverse events in the secondgroupweresignificantlylowerthanthoseinthefirstgroup (P<0.05).Rootcanalwallsmearlayer score, colony number of root canal smear layer, and the occurence rate of adverse events in the third groupweresignificantlylowerthanthoseinthefirstgroupandthesecondgroup (P<0.05).ConcIusion These three methods are effective in removing smear layer on the tooth crown of patients, while the removal effect of ProTaper crown down root canal preparation method is the best of all.
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