【作者】 李强； 邹晓英； 岳林；

【Author】 Li Qiang;Zou Xiaoying;Yue Lin;Department of Cariology and Endodontology,Peking University School and Hospital of Stomatology;

【机构】 北京大学口腔医学院牙体牙髓科；

【摘要】 目的比较四种终末冲洗方法的根管壁表面玷污层清理能力和深部抑菌效果。方法收集上颌前磨牙30颗,建立粪肠球菌感染模型,根管预备后进行终末冲洗。随机分成6组(n=5):(1)空白对照组:即感染基线组,不进行根管预备;(2)预备后基线组:不进行终末冲洗;(3)传统冲洗器组;(4)声波荡洗组;(5)超声荡洗组;(6)M3-Max机械荡洗组。采用扫描电镜观察根管壁表面玷污层,记录玷污层评分;激光共聚焦显微镜观察根管壁牙本质小管内死菌深度,统计分析。结果声波荡洗、超声荡洗和M3-Max机械荡洗的根管壁整体玷污层清理效果无统计学差异(P>0.05),均显著优于冲洗器组(P<0.05)。在根尖1/3,声波荡洗组的玷污层清理效果最佳。激光共聚焦显微镜观察结果表明,超声荡洗在根颈1/3(174.27±31.63μm)、根中1/3(160.94±37.77μm)及根尖1/3(119.53±28.49μm)的死菌深度均最大(P<0.05)。结论对于根管壁整体,声波荡洗、超声荡洗和M3-Max机械荡洗具备相近的玷污层清理能力。超声荡洗具有最佳的根管壁深部抑菌效果。更多还原

【Abstract】 Objectives:To compare the efficiency of four final irrigation protocols in smear layer removal and bacterial inhibition in root canal systems.Methods:Thirty autoclaved premolars were inoculated with Enterococcus faecalis for 3 weeks.After root canal preparation,teeth were disinfected by conventional needle irrigation(CNI),sonic agitation using the EndoActivator device(EA),passive ultrasonic irrigation(PUI),or M3 Max file(M3 Max).Teeth with no root canal preparation served as blank control.Teeth with root canal preparation but no final irrigation served as post-instrumentation baseline.Scanning electron microscopy(SEM) and a five-point scale score was used to assess smear layer removal.Confocal laser scanning microscopy(CLSM) was applied to evaluate the depth of bacterial inhibition in dentinal tubules.Results:SEM analyses revealed no significant differences in smear layer removal throughout the whole canal among the EA,PUI,and M3 Max groups(P > 0.05),but significantly greater effectiveness of these three treatments than CNI(P < 0.05).EA showed the most efficient smear layer removal in the apical third.CLSM revealed that PUI achieved the greatest bacterial inhibition depth in the coronal(174.27 ± 31.63 urn),middle(160.94 ± 37.77 urn),and apical(119.53 ± 28.49 urn) thirds of the canal(all P < 0.05 vs.other groups).Conclusions:EA,PUI,and M3 Max achieve similar degrees of smear layer removal in root canals.PUI appears to have best efficiency of bacterial inhibition in dentinal tubules.更多还原