【作者】 张苗苗； 陈峰； 李颂；

【Author】 Miaomiao Zhang;Feng Chen;Song Li;Stomatologic Hospital &College,Key Laboratory of Oral Diseases Research of Anhui Province,Anhui Medical University;

【机构】 安徽医科大学附属口腔医院； 安徽省口腔疾病研究重点实验室；

【摘要】 研究背景和目的:大囊样根尖周病变(Large Periapical Cyst-Like Lesions)的非手术治疗预后受到根管内、外感染控制的影响。目前对于囊腔内存在的微生物、根外生物膜等根外感染尚未有治疗策略。本研究在保守治疗大囊样根尖周病变的基础上辅助根外冲洗,研究冲洗前后囊液内微生物量的变化,评估根外冲洗对囊液内微生物量的影响。研究方法:研究纳入根尖周透射直径大于10mm、根管内抽吸有囊性液体渗出的大囊样根尖周病变11例。根管内感染初步控制后,无菌注射器伸入根尖孔外采集囊液样品(Q),随后氯己定溶液及生理盐水交替根外冲洗,抽尽残留的冲洗液后,同样的方法采集冲洗后(H)囊液样品,并记录采集囊液的颜色。以后每次复诊重复上述采样方式直至无明显渗出。采集的囊液样品采用16SrRNA基因实时定量聚合酶链反应(qPCR)对总微生物进行定量。统计分析比较冲洗前后微生物量的变化以及就诊期间不同囊液颜色间微生物量的差异。研究结果:对比24组冲洗前后囊液微生物量的变化,79.2%的样本冲洗后微生物量降低,且P<0.0001,差异有统计学意义。将采集的囊液按颜色分为7类,不同颜色组间两两比较,21组中有19组,P<0.05,差异有统计学意义。结论:根外冲洗可以降低大囊样根尖周病变囊液内微生物量,提示根外冲洗可以作为非手术治疗大囊样根尖周病变的辅助治疗方法。囊液的颜色不同微生物量可能不同,提示囊液的颜色可以作为一个感染控制指标,为临床治疗提供参考。更多还原

【Abstract】 Background and Objectives:The non-surgical treatment prognosis of large periapical cyst-like lesions is influenced by the control of infection both inside and outside the root canal.Currently,there are no treatment strategies for microbial presence within the cyst cavity or extraradicular biofilm.This study aims to investigate the effect of adjunctive external irrigation on the microbial load within the cyst fluid through evaluating the changes in microbial quantity before and after irrigation.Methods:Eleven cases of large periapical cyst-like lesions with diameter greater than10mm and cystic fluid extrusion were included in this study.After initial control of intracanal infection,sterile syringes were used to collect cyst fluid samples(Q) from the apical foramen.Subsequently,external irrigation was performed using chlorhexidine gluconate solution and saline alternately.After aspirating the residual irrigation fluid,the same method was applied to collect post-irrigation samples(H) of the cyst fluid,and the color of the collected fluid was recorded.The same sampling procedure was repeated during each follow-up visit until no apparent fluid exudation occurred.Quantification of total microorganisms in the collected cyst fluid samples was performed using quantitative polymerase chain reaction(qPCR) targeting the 16S ribosomal RNA gene.Statistical analysis was conducted to compare changes in microbial quantity before and after irrigation,as well as differences in microbial quantity among different colors of cyst fluid.Results:Among the 24 paired samples comparing pre-and post-irrigation cyst fluid microbial quantities,79.2% showed a decrease in microbial load after irrigation,and the difference was statistically significant(P<0.0001).The collected cyst fluid was classified into 7 categories based on color.Pairwise comparisons were made between different color groups,and 19 of 21 pairs showed a P<0.05,indicating statistically significant differences.Conclusion:External irrigation can effectively reduce the microbial load within cyst fluid of large periapical cyst-like lesions,suggesting that it can serve as an adjunctive treatment method for non-surgical management of such lesions.Different colors of cyst fluid may indicate varying microbial loads,highlighting the potential of cyst fluid color as an indicator for infection control.These findings provide valuable insights for the clinical management of such lesions.更多还原