根管甲硝唑药尖的实验研究和临床应用

The experimental study and clinical application of metronidazole spike for root canal

目的：为适应不同粗细根管的需要，制备粗、中、细３种抗厌氧菌的甲硝唑药尖。方法：选用甲硝唑、无毒可吸收的高分子多聚物羟丙基甲基纤维素和明胶等，经化学、物理方法交网和固化而成。结果：表明它对牙髓根尖周病的重要致病菌有明显抑菌作用。３Ｈ标记的甲硝唑药尖的体外释放测定证实它能在根管内４８ｈ以上持续释放有效甲硝唑。临床上直接插入感染根管治疗急、慢性根尖周炎８０例，２ｄ～４ｄ能自行吸收，经１次～２次治疗，症状显著改善。结论：该剂型有效安全，不影响正常菌群，未见毒副反应，为合理科学应用抗菌药物开拓新途径。

Aim: In order to adapt the different size of root canal, three kinds of metronidazole (Met) spikes (thick, medial and thin) were made for the treatment of root canal anaerobe infections. Methods: The Met spike for root canal was designed and developed using Met and resoluble polymeric hydroxypropyl methy cellulose and gelatin by the physical-chemical processes of network and solidification etc. Results: Laboratory research indicated that it could inhibit most oral anaerobes associated infectious root canal. Accumulate release radioisotop 3H of Met spike in vitro indicated that Met was constantly released with effective concentration more than 48h. It had treated 80 cases of acute and chronic pulpitis and periapicalitis and resulted in dramatic clinical improvement after inserting Met spike into the root canal one or two times without altering normal flora. Conclusions: This drug can be absorbed after administered for 2d～4d. No harmful side effects counted. It opens a wild way for the purpose of reasonable and scientifical application of antibiotics.