°È· ÙȘ ÚÒÙ˜ 3 ÎÏÈÓÈΤ˜ ÌÂϤÙ˜ ÙÔ Ì‹-ÎÔ˜ Ù˘ ̇Ï˘ Î·È Ú›˙·˜ 858 ÙÔ̤ˆÓ Ù˘
¿Óˆ ÁÓ¿ıÔ˘ 237 ÔÚıÔ‰ÔÓÙÈÎÒÓ ·ÛıÂÓÒÓ ÌÂÙÚ‹ıËÎ·Ó Û ÔÈÛıÔÊ·ÙÓȷο ·ÎÙÈÓÔ-ÁÚ·Ê‹Ì·Ù· ÚÔ Î·È ÌÂÙ¿ ÙË ıÂڷ›·
Î·È ‰ÈÔÚıÒıËÎ·Ó ÁÈ· ·Ú·ÌfiÚʈÛË Ïfi-Áˆ ÚÔ‚ÔÏ‹˜. ÀÔÏÔÁ›ÛÙËΠÙÔ ÔÛÔÛÙfi Ì›ˆÛ˘ ÙÔ˘ Ì‹ÎÔ˘˜ Ù˘ Ú›˙·˜ Û ۯ¤ÛË Ì ÙÔ ·Ú¯ÈÎfi, ηıÒ˜ Î·È Ë Ì›ˆÛË ÙÔ˘
ÚÈ-˙ÈÎÔ‡ Ì‹ÎÔ˘˜ Û ¯ÈÏÈÔÛÙ¿. ∞fi ÙÔ ÈÛÙÔÚÈ-Îfi οı ·ÛıÂÓÔ‡˜ ηٷÁÚ¿ÊËÎÂ Ë ·-ÚÔ˘Û›· ·ÈÙÈÔÏÔÁÈÎÒÓ ÁÈ· ÚÈ˙È΋ ·ÔÚÚfi-ÊËÛË ·Ú·ÁfiÓÙˆÓ, fiˆ˜ ʇÏÔ, ËÏÈΛ·, ÁˆÓ›· ∞¡µ, ÔÚÈ˙fiÓÙÈ· Î·È Î·Ù·ÎfiÚ˘ÊË
ÚfiÙ·ÍË, ÚÔËÁËı¤Ó ÙÚ·‡Ì·, ¤ÍÂȘ, Ô‰Ô-ÓÙÈÎfi˜ ÂÁÎÔÏ·ÛÌfi˜, Û˘ÁÁÂÓ›˜
ÂÏÏ›-¢È‰·ÎÙÔÚÈ΋ ‰È·ÙÚÈ‚‹
¶∂ƒπ§∏æ∂π™ ¢π¢∞∫∆√ƒπ∫ø¡ ¢π∞∆ƒπµø¡ - ¢π¶§øª∞∆π∫ø¡ ∂ƒ°∞™πø¡
√ÚıÔ‰ÔÓÙÈ΋ ÚÈ˙È΋ ·ÔÚÚfiÊËÛË:
ÎÏÈÓÈΤ˜ Î·È ÂÈÚ·Ì·ÙÈΤ˜ Û ˙Ò· ÌÂϤÙ˜, Û¯ÂÙÈΤ˜ Ì ·ÈÙÈÔÏÔÁÈÎÔ‡˜ ·Ú¿ÁÔÓÙ˜, ÈÛÙÔÏÔÁÈΤ˜ ÌÂÙ·‚ÔϤ˜ Î·È ÙËÓ Â›‰Ú·ÛË
Ù˘ ‰Ô͢΢ÎÏ›Ó˘*
* ¢È‰·ÎÙÔÚÈ΋ ¢È·ÙÚÈ‚‹, ¶·ÓÂÈÛÙ‹ÌÈÔ Bergen, ¡ÔÚ‚ËÁ›·, 2004.
**√ÚıÔ‰ÔÓÙÈÎfi˜.
ª. ª·˘Ú·Á¿ÓË**
À‡ı˘ÓÔÈ ÛÙ‹Ï˘: ª. °. ÷̿˙, ¡. √ÈÎÔÓÔÌ›‰Ë˜
„ÂȘ ‰ÔÓÙÈÒÓ, ÌÂÙ¿‚·ÛË ÛÙË ÌfiÓÈÌË Ô‰Ô-ÓÙÔÊ˘˝·, ÂÍ·ÁˆÁ¤˜, ‰È¿ÚÎÂÈ· ıÂڷ›·˜,
¯Ú‹ÛË ‰È·ÁÓ·ıÈÎÒÓ ÂÏ·ÛÙÈÎÒÓ ‰Â‡ÙÂÚ˘
Ù¿Í˘, ۈ̷ÙÈÎfi˜ Ù‡Ô˜, ÁÂÓÈÎÔ› ·Ú¿-ÁÔÓÙ˜, ‡·ÚÍË ÂÁÎÏ›ÛÙˆÓ Î˘ÓÔ‰fiÓÙˆÓ Î·È ·ÓÒÌ·ÏÔ Û¯‹Ì· Ú›˙·˜. ™ÙË ‰Â‡ÙÂÚË ÌÂϤÙË Î·Ù·ÁÚ¿ÊËΠÂÈϤÔÓ ÙÔ ÛÙ¿‰ÈÔ Ù˘ ÚÈ˙È΋˜ ‰È¿Ï·Û˘.
∆· ÂÚ¢ÓËÙÈο ÚˆÙfiÎÔÏÏ· ÙˆÓ ‰‡Ô ÙÂ-ÏÂ˘Ù·›ˆÓ ÂÈÚ·Ì·ÙÈÎÒÓ ÂÚÁ·ÛÈÒÓ Û 92 Ó·ÚÔ‡˜ Â›Ì˘Â˜ Wistar ·ÚÛÂÓÈÎÔ‡ Á¤-ÓÔ˘˜ ÂÁÎÚ›ıËÎ·Ó ·fi ÙËÓ ∂ÈÙÚÔ‹ ∏ıÈ-΋˜ ÙÔ˘ ¡ÔÚ‚ËÁÈÎÔ‡ ™˘Ì‚Ô˘Ï›Ô˘ ÁÈ·
ÂÈÚ¿Ì·Ù· Û ˙Ò·. ™ÙȘ ‰‡Ô ·˘Ù¤˜ ÂÚÁ·-ۛ˜, Ë ¿ÛÎËÛË ÔÚıÔ‰ÔÓÙÈ΋˜ ‰‡Ó·Ì˘
·Ú¯ÈÎÔ‡ ÌÂÁ¤ıÔ˘˜ 50 g ¤ÁÈÓ Ì ·Î›ÓËÙË ÔÚıÔ‰ÔÓÙÈ΋ Û˘Û΢‹ ÁÈ· ÂÁÁ‡˜ ÌÂٷΛ-ÓËÛË ÙÔ˘ ‰ÂÍÈÔ‡ ÚÒÙÔ˘ ÁÔÌÊ›Ô˘ Ù˘
¿Óˆ ÁÓ¿ıÔ˘9 (∂ÈÎ. 1), ÂÓÒ ÛÙËÓ ¤ÌÙË ÌÂϤÙË ¯ÔÚËÁ‹ıËΠÂÈϤÔÓ ÌÈÎÚ‹ ‰fi-ÛË ‰Ô͢΢ÎÏ›Ó˘ Ì ˘Ô‰fiÚÈ· ÂÌʇÙ¢-ÛË ·ÓÙÏ›·˜ ÒÛ̈ÂÌʇÙ¢-Û˘. ∏ ÂÁÁ‡˜ ÂÈÊ¿ÓÂÈ·
Ù˘ ÂÁÁ‡˜ ·ÚÂȷ΋˜ Ú›˙·˜ ÂÍÂÙ¿ÛıËΠοو ·fi ËÏÂÎÙÚÔÓÈÎfi ÌÈÎÚÔÛÎfiÈÔ Û¿-ÚˆÛ˘ Î·È ÔÙÈÎfi ÌÈÎÚÔÛÎfiÈÔ, ÛÙËÓ Ù¤-Ù·ÚÙË ÌÂϤÙË. ∏ ÂÚÈÔ¯‹ Ô˘
ηٷϿÌ-‚·Ó·Ó ÙÚÂȘ ‰È·ÎÚÈÙÔ› Ù‡ÔÈ ÎÔÈÏÔÙ‹ÙˆÓ (ÌÈÎÚ¤˜ ·ÔÌÔӈ̤Ó˜, ÂÈÊ·ÓÂȷΤ˜
ÂÎÙÂٷ̤Ó˜ ÂÓÙfi˜ Ù˘ ÔÛÙ½Ó˘ Î·È ‚·-ıȤ˜ ÂÎÙÂÈÓfiÌÂÓ˜ ÛÙËÓ Ô‰ÔÓÙ›ÓË), ·ÏÏ¿
Î·È Ë ‰È¿ÌÂÙÚÔ˜ ÙˆÓ ÚÒÙˆÓ, ÌÂÙÚ‹ıË-Î·Ó ÁÈ· οı ÂÈÚ·Ì·Ùfi˙ˆÔ Ì ÛÙ·ıÂÚfi ÙÚfiÔ Û ËÏÂÎÙÚÔÓÈΤ˜ ÌÈÎÚÔÁڷʛ˜.
∂ÍÂÙ¿ÛıËΠÛÙ·ÙÈÛÙÈο Â¿Ó ·˘Ù¤˜ ‰È¤-ÊÂÚ·Ó ÌÂٷ͇ ÙˆÓ ‰È·ÊÔÚÂÙÈÎÒÓ
ÂÚÈfi-‰ˆÓ ·Ú·Ù‹ÚËÛ˘. ∆Ô Â›‰Ô˜ ÙˆÓ Î˘ÙÙ¿-ÚˆÓ Ô˘ Û¯ÂÙ›˙ÔÓÙ·Ó Ì ÙȘ ÎÔÈÏfiÙËÙ˜
·˘Ù¤˜ ÌÂÏÂÙ‹ıËΠÛÙÔ ÔÙÈÎfi
ÌÈÎÚÔÛÎfi-ÈÔ. ™ÙËÓ ¤ÌÙË ÌÂϤÙË, ÂÚÈÔ¯‹ Ô˘
ÂÚÈÂÏ¿Ì‚·Ó ÙËÓ ÂÁÁ‡˜ ÏÂ˘Ú¿ Ù˘
¿ˆ-·ÚÂȷ΋˜ Ú›˙·˜ Î·È ÙÔ ÌÂÛÔÚÈ˙ÈÎfi Ê·ÙÓÈ·Îfi ÔÛÙfi ÂÍÂÙ¿ÛıËΠοو ·fi ÔÙÈÎfi ÌÈÎÚÔÛÎfiÈÔ, ÌÂÙ¿ ·fi ¯ÚÒÛË ·È-Ì·ÙÔÍ˘Ï›Ó˘-ˈۛÓ˘ Î·È Tartrate Resis-tant Acid Phosphatase (TRAP). ∏ ÙÂÏ¢-Ù·›· ˘Ô‰ÂÈÎÓ‡ÂÈ Î‡ÙÙ·Ú· ÎÏ¿ÛÙ˜ ηÈ
ÚfiÁÔÓ· ·‰È·ÊÔÚÔÔ›ËÙ· ·ÙÙ·Ú·. ∏
¤ÎÙ·ÛË Ù˘ ÚÈ˙È΋˜ ·ÔÚÚfiÊËÛ˘, Ë Ï˘ÙË ÂÚÈÔ¯‹ Ê·ÙÓÈ·ÎÔ‡ ÔÛÙÔ‡, Ë ·fi-ÛÙ·ÛË ÌÂٷ͇ ÚÒÙÔ˘ Î·È ‰Â˘Ù¤ÚÔ˘ ÁÔÌ-Ê›Ô˘, Ô ·ÚÈıÌfi˜ ÙˆÓ Ô‰ÔÓÙÈÓÔÎÏ·ÛÙÒÓ, ÔÛÙÂÔÎÏ·ÛÙÒÓ, ÌÔÓÔ‡ÚËÓˆÓ Î˘ÙÙ¿ÚˆÓ ÛÙË Ú›˙·, ∆RAP ıÂÙÈÎÒÓ Î˘ÙÙ¿ÚˆÓ ÛÙË Ú›˙·, ÙÔ ÔÛÙfi Î·È ÙÔ ÂÚÈÚÚ›˙ÈÔ Û˘ÁÎÚ›-ıËÎ·Ó ÌÂٷ͇ ÂÈÚ·Ì·Ùfi˙ˆˆÓ Ô˘
˘Ô-‚Ï‹ıËÎ·Ó Û ÔÚıÔ‰ÔÓÙÈ΋ ÌÂٷΛÓËÛË
ÌfiÓÔ Î·È ·˘ÙÒÓ ÛÙ· ÔÔ›· ¯ÔÚËÁ‹ıËΠÂÈϤÔÓ ‰Ô͢΢ÎÏ›ÓË.
∞ÔÙÂϤÛÌ·Ù·
√È ÎÏÈÓÈΤ˜ ÌÂϤÙ˜ ¤‰ÂÈÍ·Ó ÛËÌ·ÓÙÈο
ÛÔ‚·ÚfiÙÂÚË ÚÈ˙È΋ ·ÔÚÚfiÊËÛË ÙˆÓ ÎÂ-ÓÙÚÈÎÒÓ ÙÔ̤ˆÓ Ù˘ ¿Óˆ ÁÓ¿ıÔ˘ ÁÈ· ÙË
«standard» ·Ú¿ ÁÈ· ÙË «straight-wire edgewise» Ù¯ÓÈ΋ (¶›Ó·Î·˜ 1). ∏ ÙÂÏ¢-Ù·›· ÚÔÛʤÚÂÈ ÙË ‰˘Ó·ÙfiÙËÙ· ÁÈ· ËÈfi-ÙÂÚ˜ Î·È ÛÙ·ıÂÚfiËÈfi-ÙÂÚ˜ ηٿ ÙËÓ ·ÏÏ·-Á‹ Û˘ÚÌ¿ÙˆÓ ‰˘Ó¿ÌÂȘ, Ì ÏÈÁfiÙÂÚË ·-ϛӉÚÔÌË ÌÂٷΛÓËÛË, Ë ÔÔ›· ›ӷÈ
ÂÈ-˙‹ÌÈ· ÁÈ· ÙË ‰È·Ù‹ÚËÛË ÙÔ˘ Ì‹ÎÔ˘˜ Ù˘
Ú›˙·˜.
∏ ·Ó¿Ï˘ÛË ÙˆÓ ·Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘
Ô˘ ÂÍÂÙ¿ÛıËηÓ, ¤‰ÂÈÍ fiÙÈ Ë ÚÈ˙È΋
·ÔÚÚfiÊËÛË ÙˆÓ Ï·Á›ˆÓ ÙÔ̤ˆÓ Ù˘
¿Óˆ ÁÓ¿ıÔ˘ Û¯ÂÙÈ˙fiÙ·Ó Ì ÙËÓ ËÏÈΛ·, ÙË Û˘ÁÁÂÓ‹ ¤ÏÏÂÈ„Ë ‰ÔÓÙÈÒÓ, ÙË ‰È¿ÚÎÂÈ·
Ù˘ ˘ÂÚÒÈ·˜ ÌÂٷΛÓËÛ˘ ÙˆÓ ÙÔ̤ˆÓ Î·È ÙÔÓ Ô‰ÔÓÙÈÎfi ÂÁÎÔÏ·ÛÌfi (·ÚÓËÙÈ΋
ª·˘Ú·Á¿ÓË
EÈÎ. 1: √ÚıÔ‰ÔÓÙÈ΋ Û˘Û΢‹ in situ:
ÎÏÂÈÛÙfi ÂÏ·Ù‹ÚÈÔ ÚÔۉ‰Â̤ÓÔ Û ‰·-ÎÙ‡ÏÈÔ ÙÔ̤ˆÓ Î·È ÛÙÔÓ ÚÒÙÔ ÁÔÌÊ›Ô, Ô ÔÔ›Ô˜ ÌÂÙ·ÎÈÓÂ›Ù·È ÂÁÁ‡˜.
EÈÎ. 2: ¶ÚÔ Î·È ÌÂÙ¿ ÙË ıÂڷ›· ·ÎÙÈÓÔÁÚ·Ê‹Ì·Ù· Ï·Á›Ô˘ ÙÔ̤· Ô˘ ÔÏÔÎÏ‹ÚˆÛ ÙËÓ ·‡ÍËÛË ÙÔ˘ Ì‹ÎÔ˘˜ Ù˘ Ú›˙·˜ ÙÔ˘ ηٿ ÙË ‰È¿ÚÎÂÈ· Ù˘ ıÂڷ›·˜.
Û˘Û¯¤ÙÈÛË). °È· ÙÔ˘˜ ÎÂÓÙÚÈÎÔ‡˜ ÙÔÌ›˜
ÛËÌ·ÓÙÈ΋ Û˘Û¯¤ÙÈÛË ‚Ú¤ıËΠ̠ÙÔ
›-‰Ô˜ Ù˘ ıÂڷ›·˜, ÙÔ ÈÛÙÔÚÈÎfi ÙÚ·‡Ì·-ÙÔ˜ Î·È ÙË ‰È¿ÚÎÂÈ· ¯Ú‹Û˘ ÙˆÓ ‰È·ÁÓ·-ıÈÎÒÓ ÂÏ·ÛÙÈÎÒÓ ‰Â‡ÙÂÚ˘ Ù¿Í˘.
∏ ËÏÈΛ· ÙÔ˘ ·ÛıÂÓ‹ ÚÈÓ ·fi ÙË
ıÂÚ·-›· Î·È ÙÔ ÛÙ¿‰ÈÔ Ù˘ ÚÈ˙È΋˜ ‰È¿Ï·-Û˘ Û¯ÂÙ›˙ÔÓÙ·Ó ÛËÌ·ÓÙÈο (p≤0.05) Ì ÙËÓ Î·Ù‡ı˘ÓÛË Ù˘ ·ÏÏ·Á‹˜ ÙÔ˘ Ì‹ÎÔ˘˜
Ù˘ Ú›˙·˜ ηٿ ÙË ıÂڷ›· (ÂÏ¿ÙÙˆÛË ‹
·‡ÍËÛË), Ì ÏÂÔÓ¤ÎÙËÌ· ÁÈ· Ù· Ó·Úfi-ÙÂÚ· ‰fiÓÙÈ·. ∆· ÙÂÏÂ˘Ù·›· ¤ÊÙ·Ó·Ó Û ÌÂÁ·Ï‡ÙÂÚÔ ÙÂÏÈÎfi Ì‹ÎÔ˜ Ú›˙·˜, ÙÔ ÔÔ›Ô
‹Ù·Ó ›‰ÈÔ Ì ·˘Ùfi ÙˆÓ ÌË ıÂÚ·Â˘Ì¤ÓˆÓ
‰ÔÓÙÈÒÓ ›‰È·˜ ËÏÈΛ·˜(∂ÈÎ. 2). ∆· ‰fiÓÙÈ·
·˘Ù¿ ‰Â ‰È¤ÊÂÚ·Ó ·fi Ù· ÌË ıÂÚ·Â˘Ì¤-Ó· Ô‡Ù ÛÙÔ ÔÛÔÛÙfi Ù˘ ÚÈ˙È΋˜ ·‡ÍË-Û˘, Û ·ÓÙ›ÛÙÔÈ¯Ô Ù˘ ıÂڷ›·˜ ¯ÚÔÓÈ-Îfi ‰È¿ÛÙËÌ·.
√‰ÔÓÙÈÎfi˜ ÂÁÎÔÏ·ÛÌfi˜, ̤ÙÚÈ·˜ ¤ÎÙ·-Û˘ ‚Ú¤ıËÎÂ Û˘¯Ó¿ ÛÙÔ˘˜ ÔÚıÔ‰ÔÓÙÈ-ÎÔ‡˜ ·ÛıÂÓ›˜. ∏ ¤ÎÙ·Û‹ ÙÔ˘ ‰Â Û¯ÂÙ›-ÛÙËΠ̠ÙË ÛÔ‚·ÚfiÙËÙ· Ù˘ ·ÔÚÚfiÊË-Û˘. ¢ÂÓ ÌÔÚ› Ó· ıˆÚËı› ·Ú¿ÁÔ-ÓÙ·˜ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ÙËÓ ÔÚıÔ‰ÔÓÙÈ΋ ÚÈ˙È-΋ ·ÔÚÚfiÊËÛË.
∆· ‰fiÓÙÈ· Ì ÂÁÎÔÏ·ÛÌfi ÂÌÊ¿ÓÈ˙·Ó ÛË-Ì·ÓÙÈο Û˘¯ÓfiÙÂÚ· ·ÓˆÌ·Ï›Â˜ Ù˘ ÌÔÚ-Ê‹˜ ÙÔ˘ ·ÎÚÔÚÚÈ˙›Ô˘ (p≤0.05), ˘Ô‰ÂÈ-ÎÓ‡ÔÓÙ·˜ Û¯¤ÛË ÌÂٷ͇ ÌÔÚÊÔÏÔÁÈÎÒÓ
·ÓˆÌ·ÏÈÒÓ Ì‡Ï˘ Î·È Ú›˙·˜ (∂ÈÎ. 3).
∞fi ÙȘ ÂÈÚ·Ì·ÙÈΤ˜ ÌÂϤÙ˜
·Ú·ÙË-Ú‹ıËÎÂ fiÙÈ Ë ÂÊ·ÚÌÔÁ‹ ÔÚıÔ‰ÔÓÙÈÎÒÓ
‰˘Ó¿ÌÂˆÓ ÛÂ Â›Ì˘Â˜ ÚÔηÏ› ÙË ‰ËÌÈ-Ô˘ÚÁ›· ÙÚÈÒÓ ÌÔÚÊÔÏÔÁÈο ‰È·ÎÚÈÙÒÓ
Ù‡ˆÓ ·ÔÚÚfiÊËÛ˘: ·ÔÌÔӈ̤Ó˜ ÌÈ-ÎÚ¤˜ ÎÔÈÏfiÙËÙ˜, ÂÈÊ·ÓÂȷΤ˜ ÂÓÙfi˜ Ù˘
ÔÛÙ½Ó˘ ÂÎÙÂٷ̤Ó˜ ÎÔÈÏfiÙËÙ˜, ηıÒ˜
¢È‰·ÎÙÔÚÈ΋ ‰È·ÙÚÈ‚‹
¶›Ó·Î·˜ 1
STANDARD
N Mean SE Min Max N Mean SE Min Max P
STRAIGHT
¢fiÓÙÈ 12
% mm
¢fiÓÙÈ 11
% mm
¢fiÓÙÈ 21
% mm
¢fiÓÙÈ 22
% mm
35
37
35
37
37
35
32
32 12,8
2,33 13,5 2,4 14,0 2,48 11,0 1,84
8,8 1,41 6,9 1,20 7,1 1,32 9,3 1,69
2,3 0,41 1,6 0,29 2,1 0,31 2,4 0,42
-22,27 -3,82 -15,26 -3,01 -38,73 -5,7 -12,87 -2,22
42,40 6,54 28,97 5,09 23,23 4,36 40,20 7,48
0,18 0,068 0,019*
0,02*
0,018*
0,016*
0,67 0,82 1,8
0,28 2,2 0,41 2,0 0,36 2,9 0,51
-28,0 -2,11 -22,31 -3,82 -16,8 -3,25 -49,3 -8,39
34,43 6,09 42,65 8,91 34,08 6,27 37,85 7,46
ƒÈ˙È΋ ·ÔÚÚfiÊËÛË Û ÔÛÔÛÙfi › ÙÔ˘ ·Ú¯ÈÎÔ‡ Ì‹ÎÔ˘˜ Î·È Û ¯ÈÏÈÔÛÙ¿, Û‡Ìʈӷ Ì ÙËÓ ÔÚıÔ‰ÔÓÙÈ΋ Ù¯ÓÈ΋ Ô˘ ÂÊ·ÚÌfiÛÙËÎÂ
* P ≤ 0,05
EÈÎ. 3: ¢Â‡ÙÂÚÔ˜ Ù‡Ô˜ ÂÁÎÔÏ·ÛÌÔ‡ Ï·Á›ˆÓ ÙÔ̤ˆÓ. √ÈÛıÔÊ·ÙÓȷο ·ÎÙÈÓÔÁÚ·-Ê‹Ì·Ù· ÚÔ Î·È ÌÂÙ¿ ÙË ıÂڷ›·. ∞ÔÚÚfiÊËÛË Ù˘ ·Ú¯Èο ·ÓˆÌ¿ÏÔ˘ Û¯‹Ì·ÙÔ˜
Ú›-˙·˜ ÙÔ˘ 12.
Î·È ‚·ı›˜ ÎÔÈÏfiÙËÙ˜ ÂÎÙÂÈÓfiÌÂÓ˜ ÛÙËÓ Ô‰ÔÓÙ›ÓË. ∂ÌÊ·Ó›˙ÔÓÙ·Ó ÌÂ Û˘ÁÎÂÎÚÈ̤-ÓË ·ÏÏËÏÔ˘¯›·: ∞Ú¯Èο ·Ú·ÙËÚÔ‡ÓÙ·Ó
·ÔÌÔӈ̤Ó˜ ÌÈÎÚ¤˜ ÎÔÈÏfiÙËÙ˜. ∞˘Ù¤˜
Û˘¯Ó¿ ‚Ú›ÛÎÔÓÙ·Ó ÛÂ Û˘Ó¤¯ÂÈ· Ì ÙȘ
ÂÈÊ·ÓÂȷΤ˜ ÂÎÙÂٷ̤Ó˜ ÎÔÈÏfiÙËÙ˜.
∆ÂÏÂ˘Ù·›Â˜, Î·È ¿ÓÙÔÙ Û ¤‰·ÊÔ˜ ÂÈ-Ê·ÓÂÈ·ÎÒÓ ‚Ï·‚ÒÓ ·ÔÚÚfiÊËÛ˘, ‰ËÌÈ-Ô˘ÚÁÔ‡ÓÙ·Ó ÔÈ ‚·ı›˜ ÂÎÙÂÈÓfiÌÂÓ˜ ÛÙËÓ Ô‰ÔÓÙ›ÓË ÎÔÈÏfiÙËÙ˜ (∂ÈÎ. 4). ªÔÓÔ‡-ÚËÓ· ·ÙÙ·Ú· Ô˘ ÌÔÈ¿˙Ô˘Ó Ì ̷ÎÚÔ-Ê¿Á· Û¯ÂÙ›˙ÔÓÙ·Ó Ì ÙȘ ÌÈÎÚ¤˜ ·ÔÌÔ-ӈ̤Ó˜ Î·È ÙȘ ÂÈÊ·ÓÂȷΤ˜ ÎÔÈÏfiÙË-Ù˜ ·ÔÚÚfiÊËÛ˘, ÂÓÒ ÔÏ˘‡ÚËÓ· ·Ù-Ù·Ú· (Ô‰ÔÓÙÔÎÏ¿ÛÙ˜) ‰ËÌÈÔ˘ÚÁÔ‡Û·Ó ÙȘ ‚·ıȤ˜ ÎÔÈÏfiÙËÙ˜ (∂ÈÎ. 5). ∏ ·ÏÏË-ÏÔ˘¯›· ÙˆÓ ‰È·ÊfiÚˆÓ Ù‡ˆÓ ÎÔÈÏÔÙ‹ÙˆÓ Î·Ù¿ Ù· ·Ú¯Èο ÛÙ¿‰È· Ù˘ ÔÚıÔ‰ÔÓÙÈ΋˜
ÚÈ˙È΋˜ ·ÔÚÚfiÊËÛ˘ ˘Ô‰ÂÈÎÓ‡ÂÈ fiÙÈ
‰È·ÊÔÚÂÙÈÎÔ› Ù‡ÔÈ Î˘ÙÙ¿ÚˆÓ Ì ‰È·ÊÔ-ÚÂÙÈÎfi ‰˘Ó·ÌÈÎfi ·ÔÚÚfiÊËÛ˘, Èı·Ó¿
Û¯ÂÙÈ˙fiÌÂÓÔÈ ÏÂÈÙÔ˘ÚÁÈο, ÌÂÙ¤¯Ô˘Ó ÛÙË
‰È·‰Èηۛ· ·˘Ù‹.
∏ Û˘ÛÙËÌ·ÙÈ΋ ¯ÔÚ‹ÁËÛË ¯·ÌËÏ‹˜ ‰fi-Û˘ ‰Ô͢΢ÎÏ›Ó˘ Û ›ÌÂȘ ÂÏ¿ÙÙˆÛ ÙË Ê˘ÛÈÔÏÔÁÈ΋ ÚÈ˙È΋ ·ÔÚÚfiÊËÛË, ÙÔÓ
·ÚÈıÌfi ÙˆÓ ÌÔÓÔ‡ÚËÓˆÓ Î˘ÙÙ¿ÚˆÓ ÛÙË ÚÈ˙È΋ ÂÈÊ¿ÓÂÈ· Î·È ÙˆÓ ÔÛÙÂÔÎÏ·ÛÙÒÓ ÛÙ· ˙Ò· Ì¿ÚÙ˘Ú˜. ÷ÌËÏ‹ ‰fiÛË ‰Ô͢-΢ÎÏ›Ó˘ ÛÂ Â›Ì˘Â˜ ›¯Â ›Û˘ ·Ó·-ÛÙ·ÏÙÈÎfi ·ÔÙ¤ÏÂÛÌ· ÛÙËÓ ÔÚıÔ‰ÔÓÙÈο
ÚÔηÏÔ‡ÌÂÓË ·ÔÚÚÔÊËÙÈ΋ ‰Ú·ÛÙË-ÚÈfiÙËÙ·: ÂÏ¿ÙÙˆÛ ÙËÓ ·ÔÚÚfiÊËÛË
Ú›-˙·˜ Î·È Ê·ÙÓÈ·ÎÔ‡ ÔÛÙÔ‡, ÙÔÓ ·ÚÈıÌfi ÙˆÓ Ô‰ÔÓÙÔÎÏ·ÛÙÒÓ, ÔÛÙÂÔÎÏ·ÛÙÒÓ, ÌÔ-ÓÔ‡ÚËÓˆÓ Î˘ÙÙ¿ÚˆÓ Î·È ÙˆÓ TRAP ıÂ-ÙÈÎÒÓ Î˘ÙÙ¿ÚˆÓ Û ڛ˙· Î·È ÔÛÙfi (∂ÈÎ.
6). ∂ÓÙÔ‡ÙÔȘ, ÂÚÈÛÛfiÙÂÚ˜ ¤Ú¢Ó˜
··ÈÙÔ‡ÓÙ·È ÚÈÓ ·fi ÙËÓ ÎÏÈÓÈ΋ ÂÊ·Ú-ÌÔÁ‹ ÙˆÓ ·ÔÙÂÏÂÛÌ¿ÙˆÓ ·˘ÙÒÓ.
™˘ÌÂÚ¿ÛÌ·Ù·
1. ∏ ÔÚıÔ‰ÔÓÙÈ΋ Ù¯ÓÈ΋ «straight-wire edgewise» ÚÔηÏ› ÌÈÎÚfiÙÂÚË ÚÈ˙È΋
·ÔÚÚfiÊËÛË ·fi ÙË «standard edgewise» Ù¯ÓÈ΋, Èı·ÓfiÓ ÏfiÁˆ Ù˘
‰˘Ó·ÙfiÙËÙ·˜ Ô˘ ÚÔÛʤÚÂÈ ÁÈ· ÙËÓ ÂÊ·ÚÌÔÁ‹ ÛÙ·ıÂÚfiÙÂÚˆÓ Î·È ËÈfiÙÂ-ÚˆÓ ‰˘Ó¿ÌˆÓ.
2. ¡Â·Ú¿ ‰fiÓÙÈ· Ì ·‰È¿Ï·ÛÙÔ ·ÎÚÔÚ-ª·˘Ú·Á¿ÓË
EÈÎ. 4: ∆‡ÔÈ ÎÔÈÏÔÙ‹ÙˆÓ ÚÈ˙È΋˜ ·ÔÚÚfiÊËÛ˘: ÌÈÎÚ¤˜-·ÔÌÔӈ̤Ó˜ (·),
ÂÈÊ·ÓÂÈ-·Î¤˜ (‚) Î·È ‚·ıȤ˜ (Á). ªÈÎÚ‹ ÎÔÈÏfiÙËÙ· (ÌÈÎÚfi ‚¤ÏÔ˜) ÛÂ Û˘Ó¤¯ÂÈ· Ì ÂÈÊ·ÓÂȷ΋
ÎÔÈÏfiÙËÙ· ·ÔÚÚfiÊËÛ˘ (ÌÂÁ¿ÏÔ ‚¤ÏÔ˜). º˘ÛÈÔÏÔÁÈ΋ ÔÛÙ½ÓË (√). (∏̤ڷ 1-SEM, Ì¿Ú·=100 Ìm).
EÈÎ. 5: ¶ÔÏ˘‡ÚËÓ· ·ÙÙ·Ú· - Ô‰ÔÓÙÔÎÏ¿ÛÙ˜ (‚¤ÏË) Û ‚·ı›˜ ÎÔÈÏfiÙËÙ˜, Ô˘ ‰ËÌÈ-Ô˘ÚÁ‹ıËÎ·Ó Û ÂÚÈÔ¯‹ ÂÈÊ·ÓÂȷ΋˜ ·ÔÚÚfiÊËÛ˘ ÔÛÙ½Ó˘. ∞ÁÁ›· (∞) Û ÎÔÓÙÈÓ‹
Û¯¤ÛË Ì ÙË ÚÈ˙È΋ ÂÈÊ¿ÓÂÈ·, ˘·Ï҉˘ ÈÛÙfi˜ (À), Ô‰ÔÓÙ›ÓË (√), ÂÚÈÚÚ›˙ÈÔ (PDL) (∏̤ڷ 4).
Ú›˙ÈÔ Û˘Ó¯›˙Ô˘Ó ÙËÓ ·‡ÍËÛË Ù˘ Ú›˙·˜
ÙÔ˘˜ ηٿ ÙË ‰È¿ÚÎÂÈ· Ù˘ ÔÚıÔ‰ÔÓÙÈ-΋˜ ÌÂٷΛÓËÛ˘ ̤¯ÚÈ Ê˘ÛÈÔÏÔÁÈÎÔ‡
ÙÂÏÈÎÔ‡ Ì‹ÎÔ˘˜, ˘Ô‰ÂÈÎÓ‡ÔÓÙ·˜ ÙËÓ
‡·ÚÍË Ì˯·ÓÈÛÌÔ‡ ÚÔÛÙ·Û›·˜ ·fi ÙËÓ ·ÔÚÚfiÊËÛË Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· Ù˘
ÔÚıÔ‰ÔÓÙÈ΋˜ ıÂڷ›·˜.
3. ◊È·˜ ‚·Ú‡ÙËÙ·˜ Ô‰ÔÓÙÈÎfi˜ ÂÁÎÔÏ·-ÛÌfi˜ ‰ÂÓ ÌÔÚ› Ó· ıˆÚËı› ·Ú¿-ÁÔÓÙ·˜ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ÙËÓ ·ÔÚÚfiÊËÛË Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· Ù˘ ÔÚıÔ‰ÔÓÙÈ΋˜ ıÂ-ڷ›·˜.
4. ∏ ·ÏÏËÏÔ˘¯›· ÛÙËÓ ÂÌÊ¿ÓÈÛË ÌÔÚÊÔ-ÏÔÁÈο ‰È·ÎÚÈÙÒÓ Ù‡ˆÓ ·ÔÚÚfiÊË-Û˘ ÛÙËÓ ÂÈÊ¿ÓÂÈ· ÔÚıÔ‰ÔÓÙÈο ÌÂ-Ù·ÎÈÓË̤Ó˘ Ú›˙·˜ ˘Ô‰ËÏÒÓÂÈ fiÙÈ ÛÙË ‰È·‰Èηۛ· Û˘ÌÌÂÙ¤¯Ô˘Ó Ù‡ÔÈ Î˘ÙÙ¿ÚˆÓ Ì ‰È·ÊÔÚÂÙÈÎfi ‰˘Ó·ÌÈÎfi
·ÔÚÚfiÊËÛ˘, Ô˘ ÏÂÈÙÔ˘ÚÁÈο Û¯Â-Ù›˙ÔÓÙ·È ÌÂٷ͇ ÙÔ˘˜.
5. ™˘ÛÙËÌ·ÙÈ΋ ¯ÔÚ‹ÁËÛË ÌÈÎÚ‹˜ ‰fiÛ˘
‰Ô͢΢ÎÏ›Ó˘ ÂÏ·ÙÙÒÓÂÈ ÛËÌ·ÓÙÈο
ÙËÓ ·ÔÚÚfiÊËÛË Ú›˙·˜ Î·È Ê·ÙÓÈ·ÎÔ‡
ÔÛÙÔ‡ Ô˘ Û¯ÂÙ›˙ÔÓÙ·È Ì ÙËÓ ÔÚıÔ‰Ô-ÓÙÈ΋ ÌÂٷΛÓËÛË.
µπµ§π√°ƒ∞ºπ∞
1. Kurol J, Owman-Moll P, Lundgren D: Time-related root resorption after application of controlled continuous orthodontic force. Am J Orthod Dentofac Orthop. 1996; 110: 303-10.
2. Taithongchai R, Sookkorn K, Killiany D M:Facial and dentoalveolar structure and the prediction of apical root shortening. Am J Orthod Dentofac Orthop. 1996;110:296-302.
3. Killiany D M: Root resorption caused by orthodontic treatment: An Evidence-Based review of literature. Semin Orthod 1999;5:128-133.
4. Mavragani M, Vergari A, Selliseth NJ, Boe OE, Wisth PL:A radiographic comparison of apical root resorption after orthodontic treatment with a standard edgewise and a straight-wire edgewise technique. Eur J Orthod 2000;22:665-74.
5. Mavragani M, Boe OE, Wisth PJ, Selvig KA:
Changes in root length during orthodontic treatment: advantages for immature teeth. Eur J Orthod 2002;24:91-7.
6. Mavragani M, Amundsen OC, Selliseth NJ, Brudvik P, Selvig KA:Early root alterations after orthodontic force application studied by light and scanning electron microscopy. Eur J Orthod 2004;26:119-28.
7. Mavragani M, Brudvik P, Selvig KA: Ortho-dontically induced root and alveolar bone resorption: inhibitory effect of systemic doxycycline administration in rats. Eur J Orthod 2005;27:215-25.
8. Mavragani M, Apisariyakul J, Brudvik P, Selvig KA:Is mild dental invagination a risk factor for apical root resorption in orthodontic patients?
Eur J Orthod 2006;28:307-12.
9. Brudvik P, Rygh P: The initial phase of orthodontic root resorption incident to local compression of the periodontal ligament. Eur J Orthod 1993;15:249-63.
SYMMARY M. Mayragani*
Orthodontically induced inflammatory root resorption: Clinical and animal studies on contributing factors, histo-logical alterations and the effect of doxycycline
The purpose of this research project was to improve the knowledge of aetiology, mechanism, and prevention of orthodo-ntic root resorption. It comprised three clinical studies on 237 patients and two experimental studies using 92 male Wistar rats. In the clinical studies, apical root resorption of the maxillary incisors was evaluated on pre- and post-treat-ment radiographs, by examining one treatment- and two patient-related risk factors. Root resorption after experimental tooth movement in rats was studied by scanning electron and light microscopy, while doxycycline was administered in 34 of the animals.
It was shown that "standard edgewise"
orthodontic technique created significan-tly more root resorption for the central incisors than "straight-wire edgewise"
technique. Root shortening of the lateral incisors was associated with age, agenesis, duration of contraction period and invagination, while root shortening of the central incisors was related to treatment group and trauma. A definite advantage in regard to post-treatment root length was found for younger teeth.
Roots that were incompletely developed before treatment reached a significantly greater length than those that were fully developed at the start of the treatment and their final length did not differ from the untreated teeth. In the third clinical study, mild type dental invagination failed to prove a risk factor for orthodontic root resorption. However,
¢È‰·ÎÙÔÚÈ΋ ‰È·ÙÚÈ‚‹
EÈÎ. 6: ∏̤ڷ 10. ∞. ¶ÂÈÚ·Ì·Ùfi˙ˆÔ ÌÂÙ¿ ·fi ÔÚıÔ‰ÔÓÙÈ΋ ÌÂٷΛÓËÛË. ŒÓÙÔÓË TRAP
¯ÚÒÛË. ∆RAP ıÂÙÈο ·ÙÙ·Ú· ·ÔÌ·ÎÚ‡ÓÔ˘Ó ÓÂÎÚˆÙÈÎfi ÈÛÙfi (Ì¿Ú·=100 Ìm).
µ. ¶ÂÈÚ·Ì·Ùfi˙ˆÔ ÌÂÙ¿ ·fi ÔÚıÔ‰ÔÓÙÈ΋ ÌÂٷΛÓËÛË Î·È ¯ÔÚ‹ÁËÛË ‰Ô͢΢ÎÏ›Ó˘. §›-Á· TRAP ıÂÙÈο ·ÙÙ·Ú· ·ÔÌ·ÎÚ‡ÓÔ˘Ó ÓÂÎÚˆÙÈÎfi ÈÛÙfi (Ì·ÎÚ‡ ‚¤ÏÔ˜). ∏ ÌÈÎÚ‹
¤ÓÙ·ÛË ¯ÚÒÛ˘ Û ڛ˙· Î·È ÔÛÙfi Â›Ó·È ÂÓ‰ÂÈÎÙÈ΋ ΢ÙÙ¿ÚˆÓ-ÎÏ·ÛÙÒÓ ÂÚÈÔÚÈṲ̂Ó˘
‰Ú·ÛÙËÚÈfiÙËÙ·˜ (Ì¿Ú·=200 Ìm). ªÂÛÔÚÚÈ˙ÈÎfi Ê·ÙÓÈ·Îfi ÔÛÙfi (√), Ú›˙· (ƒ), ÂÚÈÚ-Ú›˙ÈÔ (PDL).
∞ µ
invaginated teeth more frequently exhibited malformed roots than non-invaginated teeth.
Three morphologically distinct types of resorption defects were observed in the roots of the orthodontically moved rat molars, with the following sequence:
isolated small lacunae, wide shallow
resorption bays and deep resorption lacunae. The two first were often seen in conbination with each other and were associated with mononucleated macro-phage-like cells, while the third type always occurred within shallow resorption bays and was created by multinucleated cells. Systemic
administ-ration of low-dose doxycycline in rats had an inhibitory effect on orthodontically induced resorptive activity, including root and alveolar bone resorption, number of odontoclasts, osteoclasts, mononuclear cells on root and TRAP-positive cells on root and bone.
ª·˘Ú·Á¿ÓË
* Orthodontist.
** Doctoral Thesis, Faculty of Dentistry, University of Bergen, Norway 2004.
∂ÈÛ·ÁˆÁ‹
∏ ¤ÌÊÚ·ÍË ·ÔÙÂÏ› ÙÔ ÙÂÏÂ˘Ù·›Ô
ÛÙ¿-‰ÈÔ Ù˘ ÂÓ‰Ô‰ÔÓÙÈ΋˜ ıÂڷ›·˜ ηÈ
·ÎÔÏÔ˘ı› ÙËÓ ·Ôχ̷ÓÛË Î·È ÙË ‰È·-ÌfiÚʈÛË ÙÔ˘ ÚÈ˙ÈÎÔ‡ ۈϋӷ. ∆Ô ˘ÏÈÎfi
Ô˘ ¯ÚËÛÈÌÔÔÈÂ›Ù·È Î·Ù¿ ·ÚÈÔ ÏfiÁÔ Û‹ÌÂÚ· ÛÙËÓ ÂÓ‰Ô‰ÔÓÙ›· ÁÈ· ÙËÓ ¤ÌÊÚ·-ÍË ÙÔ˘ ÚÈ˙ÈÎÔ‡ ۈϋӷ Â›Ó·È Ë ÁÔ˘Ù·¤Ú-η ÛÂ Û˘Ó‰˘·ÛÌfi Ì οÔÈÔ Ê‡Ú·Ì·.
¶Ï‹ıÔ˜ Ù¯ÓÈÎÒÓ ¤¯Ô˘Ó ÚÔÙ·ı› ηٿ
ηÈÚÔ‡˜ ÁÈ· ÙËÓ ¤ÌÊÚ·ÍË ÙÔ˘ ÚÈ˙ÈÎÔ‡
ۈϋӷ1,2. ∏ Ù¯ÓÈ΋ Ù˘ Ï¿ÁÈ·˜ Û˘Ì‡-ÎÓˆÛ˘ ·ÔÙÂÏ› ÙËÓ ÈÔ Û˘¯Ó¿ ‰È‰·ÛÎfi-ÌÂÓË Î·È ÂÊ·ÚÌÔ˙fi‰È‰·ÛÎfi-ÌÂÓË Ì¤ıÔ‰Ô ¤ÌÊÚ·-͢ Î·È ıˆÚÂ›Ù·È Ë Ù¯ÓÈ΋ Û ۯ¤ÛË Ì ÙËÓ ÔÔ›·, ÔÈ ˘fiÏÔȘ Ù¯ÓÈΤ˜ ¤ÌÊÚ·-͢ ı· Ú¤ÂÈ Ó· ·ÍÈÔÏÔÁÔ‡ÓÙ·È3,4. ªÂ ÙËÓ ÂÈÛ·ÁˆÁ‹ ÙˆÓ Ì˯·ÓÔΛÓËÙˆÓ ÂÚÈ-ÛÙÚÂÊfiÌÂÓˆÓ ÌÈÎÚÔÂÚÁ·Ï›ˆÓ ÓÈÎÂÏ›Ô˘-ÙÈÙ·Ó›Ô˘ (Ni-Ti) ÁÈ· ÙËÓ ÚÔ·Ú·Û΢‹
ÙˆÓ ÚÈ˙ÈÎÒÓ ÛˆÏ‹ÓˆÓ ÌÂÈÒıËΠÛËÌ·ÓÙÈ-ο Ô ··ÈÙÔ‡ÌÂÓÔ˜ ÁÈ· ÙË ¯ËÌÈÎÔÌ˯·ÓÈ-΋ ÚÔ·Ú·Û΢‹ ¯ÚfiÓÔ˜ Î·È ¤ÁÈÓ Ϥ-ÔÓ ‰˘Ó·Ù‹ Ë ·fi‰ÔÛË ÂÓfi˜ ÚԂϤ„ÈÌ·
ÎÂÓÙÚÈÎÔ‡ Î·È Î˘ÎÏÈÎÔ‡ Û¯‹Ì·ÙÔ˜
ÚÔ-·Ú·Û΢‹˜ ·ÎfiÌ· Î·È Û ÎÂη̤ÓÔ˘˜
ÚÈ˙ÈÎÔ‡˜ ۈϋÓ˜5,6. ∆Ô Û‡ÛÙËÌ·
ProTaper (Dentsply, Maillefer, Ballai-gues, Switzerland) ·ÔÙÂÏ› ¤Ó· ·fi Ù·
ϤÔÓ ‰ËÌÔÊÈÏ‹ Ì˯·ÓÔΛÓËÙ· Û˘ÛÙ‹Ì·-Ù· ÚÔ·Ú·Û΢‹˜. ∂ÈϤÔÓ, ΢ÎÏÔÊfi-ÚËÛ·Ó ·fi ÙËÓ ÂÙ·ÈÚ›· Dentsply, Mail-lefer ÎÒÓÔÈ ÁÔ˘Ù·¤Úη˜ (ProTaper Gutta-percha Point, Dentsply, Maillefer) Ì ۯ‹Ì· Î·È Ì¤ÁÂıÔ˜ ›‰ÈÔ Ì ·˘Ùfi ÙˆÓ ÌÈÎÚÔÂÚÁ·Ï›ˆÓ ÙÂÏÈ΋˜ ‰È·ÌfiÚʈÛ˘
(F1, F2, F3, F4, F5). ™‡Ìʈӷ Ì ÙÔÓ Î·-Ù·Û΢·ÛÙ‹ ÔÈ ÎÒÓÔÈ ·˘ÙÔ› Ù·ÈÚÈ¿˙Ô˘Ó Ì ÙÔ Û¯‹Ì· Ô˘ ·Ô‰›‰ÂÈ ÙÔ ÙÂÏÂ˘Ù·›Ô ÌÈÎÚÔÂÚÁ·ÏÂ›Ô ÚÔ·Ú·Û΢‹˜ Î·È Ë
¤ÌÊÚ·ÍË ÌÔÚ› Ó· ÂÈÙ¢¯ı› ÁÚ‹ÁÔÚ·
Ì ¤Ó·Ó ÌfiÓÔ ÎÒÓÔ ÁÔ˘Ù·¤Úη˜. ¶Úfi-ÛÊ·Ù· Ë ÂÙ·ÈÚ›· SybronEndo ÂÈÛ‹Á·Á ÌÈ· Ó¤· Û˘Û΢‹ ¤ÌÊڷ͢ ÚÈ˙ÈÎÒÓ Ûˆ-Ï‹ÓˆÓ, ÙË Û˘Û΢‹ Elements Obturation Unit (SybronEndo, Orange, CA, USA).
∏ Ó¤· ·˘Ù‹ Û˘Û΢‹ Û˘Ó‰˘¿˙ÂÈ ÙËÓ
ÙÂ-¯ÓÔÏÔÁ›· ÙÔ˘ Û˘ÛÙ‹Ì·ÙÔ˜ System B, ‚ÂÏ-ÙȈ̤ÓË Û ·ÚÎÂÙ¿ ÛËÌ›·, Ì ¤Ó· Û‡-ÛÙËÌ· ¤Á¯˘Û˘ ıÂÚÌ‹˜ ÁÔ˘Ù·¤Úη˜.
™ÎÔfi˜
™ÎÔfi˜ Ù˘ ·ÚÔ‡Û·˜ ÌÂϤÙ˘ Â›Ó·È Ë Û‡ÁÎÚÈÛË Ù˘ ·ÔÊÚ·ÎÙÈ΋˜ ÈηÓfiÙËÙ·˜
ÌÂٷ͇ 4 ‰È·ÊÔÚÂÙÈÎÒÓ ÌÂıfi‰ˆÓ ¤ÌÊÚ·-͢ (Ï¿ÁÈ· Û˘Ì‡ÎÓˆÛË Ì ·ÚÈÔ ÎÒÓÔ ÎˆÓÈÎfiÙËÙ·˜ 0,2, Ï¿ÁÈ· Û˘Ì‡ÎÓˆÛË Ì ·ÚÈÔ ÎÒÓÔ ProTaper, Ù¯ÓÈ΋ ÌÔÓÔ‡
ÎÒÓÔ˘ ProTaper, ¤ÌÊÚ·ÍË Ì ÙÔ Û‡ÛÙË-Ì· Elements Obturation Unit) Û 3 ¯Úfi-ÓÔ˘˜ ÂϤÁ¯Ô˘ (1 ‚‰., 1 Ì., 3 Ì.) Ì ÙË Ì¤-ıÔ‰Ô ÌÂÙ·ÊÔÚ¿˜ ˘ÁÚÔ‡.