[Clinical evaluation of the voltage gradient method for root canal measurement].

M Nakamura, Y Nakamura
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Abstract

The voltage gradient method for root canal measurement was evaluated in vivo and in vitro. For the evaluation in vivo, 25 single root teeth, were employed. The working length was measured by bipolor or monopolor electrode. After measurement, the electrode was fixed on the tooth, and the tooth was extracted. Radiograph was taken from 12 directions perpendicular to longer axis of tooth, and the relation between anatomical foramen, physiological foramen and the attained position of electrode tip was assessed. In the evaluation in vitro, 7 extracted teeth were used, for which the positions of anatomical foramen and physiological foramen had been determined in advance from radiograph, in order to determine the influence of the root canal irrigants and medicaments. The electrode was fixed on electronic calipers and direct reading of the movement. Root canal irrigants and medicaments were injected into root canal, and the measurements were evaluated. The results were as follows: (1) In the cases of 22 teeth measured by monopolar electrode in vivo, the electrode tip was within 0.5mm from physiological foramen except one tooth. (2) In the cases of 3 teeth measured by monopolar electrode in vivo, the electrode tip was within 0.4mm from anatomical foramen. (3) In the cases, where electrolyte solution was filled in root canal and measurement was made by bipolar in the evaluation in vitro, the results of measurement were stable, and the electrode tip tended to be slightly closer to coronal direction from physiological foramen. (4) In the cases where non-electrolyte solution was filled in root canal and measurement was made by bipolar electrode in the evaluation in vitro, the results of measurement were not stable, and the electrode tip tended to be closer to the apex from physiological foramen. (5) In the case of the evaluation in vitro, where electrolyte solution was filled in root canal and measurement was made by monopolar electrode, the electrode tip tended to be a little closer to the front than the anatomical foramen. (6) In the evaluation in vitro, where non-electrolyte solution was filled in root canal and measurement was made by monopolar, the measurement was not achievable. (7) 10% NaOCl solution was found to be very useful as electrolyte solution filled in root canal to search physiological foramen by this measurement method. The above results suggest that the voltage gradient method for root canal measurement is highly reliable because root canal morphology at the apex can be directly in identified.

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【电压梯度法测量根管的临床评价】。
在体内和体外对电压梯度法测量根管进行了评价。为了在体内进行评估,我们使用了25颗单根牙。工作长度采用双极或单极电极测量。测量完成后,将电极固定在牙齿上,拔牙。从垂直于牙长轴的12个方向拍摄x线片,评估解剖孔、生理孔与电极尖端位置的关系。在离体评价中,使用7颗拔牙,通过x线片提前确定解剖孔和生理孔的位置,以确定根管冲洗剂和药物的影响。电极固定在电子卡尺上,直接读取运动。根管内注射根管冲洗剂和药物,并对测量结果进行评价。结果表明:(1)单极电极在体测量的22颗牙齿中,除1颗牙齿外,电极尖端距生理孔均在0.5mm以内。(2)单极电极在体测量3颗牙时,电极尖端距解剖孔0.4mm以内。(3)在体外评估中,在根管内填充电解质溶液并采用双极测量的情况下,测量结果稳定,电极尖端从生理孔向冠状方向略微靠近。(4)在体外评价中,在根管内填充非电解质溶液并采用双极电极测量的情况下,测量结果不稳定,电极尖端离生理孔更靠近根尖。(5)体外评价时,在根管内填充电解质溶液,单极电极测量时,电极尖端比解剖孔更靠近前方。(6)在体外评价中,在根管内填充非电解质溶液,单极子测量时,无法测量。(7) 10%的NaOCl溶液可以作为电解质溶液填充在根管中,用于寻找生理性根孔。上述结果表明,电压梯度法测量根管的可靠性较高,因为可以直接识别根管顶端的形态。
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