【作者】 黄滢； 张晔； 金曼曼； 刘颖；

【Author】 Ying Huang;Ye Zhang;Manman Jin;Ying Liu;Department of Stomatology, Hospital of Stomatology, Tianjin Medical University;

【机构】 天津医科大学口腔医院牙体牙髓科；

【摘要】 目的:研究原花青素联合CMC/ACP作为辅助终末冲洗药物对化学预备后的根管牙本质的显微结构、机械性能等影响,以期完善现有冲洗方案的效能。方法:选取人离体恒前磨牙制备成牙本质片,采用以下冲洗方案进行处理:①NS组:0.9%生理盐水(阴性对照组);②EN组:17%EDTA+3%NaOCl;③ENP组:17%EDTA+3%NaOCl+6.5%PA;④ENPC组:17%EDTA+3%NaOCl+6.5%PA+CMC/ACP。利用SEM、AFM、纳米压痕仪对样本进行显微结构、机械性能分析。建立单根管机械预备后模型,应用上述冲洗方案后进行根充,利用万能测试仪检测推出粘接强度。在牙本质片上建立粪肠球菌生物膜模型,通过CLSM观察各组冲洗方案对生物膜的清除效果。结果:在应用上述冲洗方案后,SEM可观察到EN组牙本质胶原纤维受损,纳米硬度和弹性模量较NS组下降;ENP组发现交联增粗的胶原纤维相互交织于受损的牙本质表面,弹性模量较EN组得到提高,但纳米硬度略低于NS组;ENPC组不仅发现牙本质表面及交联的胶原纤维上有矿物质沉积,而且其纳米硬度和弹性模量较NS组均明显提高。推出实验表明在应用不同冲洗方案处理后,唯有ENPC组在根尖1/3水平的推出粘接强度值最大。此外,CLSM图像表明ENPC组清除粪肠球菌生物膜能力最强。结论:将PA与CMC/ACP联合应用作为辅助终末冲洗方案,可以修复在机械化学预备后损伤的根管牙本质显微结构,促进脱矿牙本质再矿化,优化其力学性能,提高粘接强度且增强抗菌作用。更多还原

【Abstract】 Objectives:The synergistic effects of procyanidins and CMC/ACP as terminal auxiliary irrigation drugs are studied after root canal chemical preparation.Methods:Human permanent premolars were collected and prepared into dentin slices.The chemical irrigation protocals were as follows:①NS group:0.9% saline(negative control group);②EN group:17% EDTA+3%NaOCl;③ENP group:17%EDTA+3%NaOCl+6.5%PA;④ENPC group:17% EDTA+3% NaOCl+6.5%PA+CMC/ACP.Analyze the effect of different irrigation strategies on the ultrastructure、mechanical properties of root canal dentin、push-out bonding strength and anti-biofilm action.Results:After applying irrigation protocals,SEM images showed that minerals deposited in the dentin matrix over the cross-linked collagen fibers for the ENPC group.The ENPC group obtained the best nano-hardness and elastic modulus.Only ENPC group significantly improved the push-out bonding strength in apical third areas of the root canal.CLSM images demonstrated that the synergistic application of PA+CMC/ACP can significantly improve the removal effect of Enterococcus faecalis biofilm.Conclusions:The combination of PA and CMC/ACP can repair the ultrastructure of root canal dentin damaged after mechano-chemical preparation,enhance its mechanical properties,adhesive strength and antibacterial effect.更多还原