超声根管预备联用冲洗液的抗菌效果及术后临床评价

Bactericidal effect of ultrasonic treatment combined with irrigations in root canal preparation and its clinlical evaluation after treatment

目的:比较甲硝唑、洗必泰和生理盐水联合超声技术杀灭感染根管内厌氧菌的效果以及术后反应的临床评价。方法:临床选择慢性根尖周炎患牙400颗,随机分为甲硝唑联合超声技术组、洗必泰联合超声技术组、生理盐水联合超声技术组和对照组,每组各100颗患牙,比较其术后发生根管治疗期间急症(EIE)的情况。并从每组中各随机抽取20颗患牙,对其根管预备前后分别取样进行厌氧培养,评价其抗厌氧菌效果。结果:根管预备后各组均能显著减少厌氧菌数量(P<0.01),且甲硝唑组和洗必泰组效果更佳(P<0.05),但两者间差异没有统计学意义(P>0.05);甲硝唑组和洗必泰组发生EIE的比率明显低于生理盐水组和对照组(P<0.05),但两者之间差异没有统计学意义(P>0.05)。结论:甲硝唑与洗必泰两种超声根管冲洗液均可有效的杀灭根管内细菌,预防根管治疗术后反应,有助于提高根管治疗的成功率。

Objective：To evaluate the bactericidal effect of ultrasonic treatment combined with metronidazole, chlorhexidine and physiological saline in root canal preparation and the clinlical evaluation after treatment. Methods：A totle of 400 chronic periapicalperiodontitis teeth in clinic were selected and then divided them into four groups,metronidazole combined with ultrasonic technique group,chlorhexidine combined with ultrasonic technique group,physiological saline combined with ultrasonic technique group and control group.Each group had 100 teeth.The incidence of endodontic inter-appointment emergencies（EIE） after treatment was compared. Twenty teeth of each group were selected and anaerobic bacteria colony counting before and after root canal preparation were examined. Results：Anaerobic bacteria of each group were significant reduced（P〈0.01 ）,and the effects of metronidazole and cblorhexidine groups were better（P〈0.05 ）, but there was no statistical difference between the two groups（P〉0.05）.The metronidazole and chlorhexidine groups had lower incidence of EIE than the other two groups,but there was no statistical difference between them（P〉0.05 ）. Conclusions： Metronidazole and chlorhexidine were ideal root canal ultrasonic irrigations and they could kill bacteria of root canal and prevent the incidence of postoperative pain,so it can increase success of root canal therapy.