【作者】 梁宇红； 陈智滨； 王嘉德；

【机构】 北京大学口腔医学院；

【摘要】 目的:比较超声波与声波根管冲洗应用于感染根管的清理效果,筛选符合临床操作实际的冲洗方法。方法:拔除双尖牙90颗分为6组(n=15),牙根沿根管纵剖后,根尖部根管壁上制作沟槽模拟不规则区,填入牙本质泥,分组进行不同条件的超声波和声波冲洗,冲洗前后评价沟槽牙本质屑祛除百分率,筛选出冲洗效果好和临床实用的两种方法:超声冲洗1分钟+5.25%次氯酸钠冲洗(间隔30秒2ml)、超声波冲洗3分钟+5.25%次氯酸钠冲洗(每隔1分钟2ml)。临床病例选择慢性根尖周炎患者(n=30),随机分为2组:根管预备后采用不同方法冲洗,观察根管细菌菌落数变化、诊间疼痛发生率及侧枝充盈情况,术后一年疗效分析。结果:离体牙实验冲洗前后残屑清除率比较:超声波组(1、2、3组)与声波组(4、5、6组)之间差异有统计学意义。超声波组间无明显差异,其中冲洗时间短的1分钟超声冲洗与冲洗效果最好的3分钟超声冲洗方法进入临床实验。临床病例冲洗前后根管细菌培养结果、EIAE的发生率、侧枝根管充填率、1年有效率没有显著性差异(P>0.05)。结论:超声波冲洗效果优于声波冲洗效果,推荐临床应用。1和3分钟超声冲洗结合间断次氯酸钠冲洗方法可获得满意的根管清洁效果。更多还原

【Abstract】 Objective:The purpose of this study was to compare the cleaning efficacy of passive ultrasonic irrigation with that of passive sonic irrigation after instrumentation in infected canals.Methods Root canal instrumentation were prepared in 90 extracted premolars.Each root was split longitudinally,forming two halves.A groove was cut in the apical canal wall in each half and the groove was filled dentin debris.All canals were divided 6 groups using different parameter of passive ultrasonical irrigation or passive sonic itrrigation(n=15).Before and after irrigation,images of the grooves were captured and scored.The differences in debris scores between the experimental groups were analysed.Two effective ultrasonic irrigation method were selected for clinical trial.60 teeth with apical periodontitis were randomly divided into 2 groups after instrumentation.Group 1:the canal was flushed for 1 minute with 5.25%NaclO.Group 2:the canal was flushed for 3 minute with 5.25%NaclO.Postoperative pain,bacterial sample count,lateral canal obturation,and one-year successful cases were evaluated.Results Ultrasonic passive irrigation produced significantly cleaner canals than that of sonic.The debris scores evaluation showed:passive ultrasonic irrigation for 1 minute to 3 minutes was effective in removing dentin debris.In clinical trial,the postoperative pain,bacterial sample count,lateral canal obturation accidence,and one-year successful rates were not significantly different among two groups(P>0.05).Conclusions Passive Ultrasonic passive irrigation produced significantly cleaner canals than passive sonic irrigation.Passive ultrasonic irrigation for 1 minute to 3 minutes was effective in infected canals.更多还原