超声下不同根管冲洗剂组合对感染根管内粪肠球菌杀灭效果的研究

Antimicrobial effect of different root canal irrigant combinations on infected root canals under passive ultrasonic irrigation

目的：比较超声作用下不同根管冲洗剂组合对根管内粪肠球菌的杀灭效果。方法：取粪肠球菌感染根管模型样本90个,随机分为6组（n=15）,其中5个样本用于基线对照,10个样本分别按相应分组处理,A组：25 g/L次氯酸钠液液＋20 g/L洗必泰液;B组：25 g/L次氯酸钠液＋30 m L/L过氧化氢液;C组：10 g/L次氯酸钠液＋20 g/L洗必泰液;D组：10 g/L次氯酸钠液＋30 m L/L过氧化氢液;E组：52.5 g/L次氯酸钠液阳性对照;F组：生理盐水阴性对照。处理前后从样本的根管壁表面采样,并钻取不同深度牙本质进行细菌培养和计数。结果：A、B、C、D、E组根管壁表面及不同深度牙本质的细菌清除率均显著高于F组（P〈0.05）;对各层牙本质的细菌清除率,A组高于B、C、D组（P〈0.05）,与E组相比,除200～300μm深度处明显降低（P〈0.05）外,其他各层与E组相当（P〉0.05）;C组对不同深度牙本质层的细菌清除率均在90%以上,低于A、E组,高于其他各组（P〈0.05）;B、D组在各不同深度牙本质层的细菌清除率基本相当（P〉0.05）,低于其他各实验组和E组（P〈0.05）。结论：超声辅助下用25 g/L次氯酸钠液联合20 g/L洗必泰液冲洗根管,能有效杀灭根管内的粪肠球菌。

AIM： To compare the antimicrobial effect of different root canal irrigant combinations under passive ultrasonic irrigation in root canals. METHODS ： 90 human root canals contaminated with Enterococcus faecalis were randomly divided into 4 experimental groups （ group A： 25 g/L NaClO/20 g/L CHX, group B ： 25 g/L NaClO 30 mL/L H2O2, group C： 10 g/L NaClO 20 g/L CHX, group D： 10 g/L NaClO/30 mL/L H2O2） and 2 two control groups （ group E ： 52.5 g/L NaClO, group F ： 0.9% normal saline, n = 10, 5 were used as base line control）. Before and after treatment bacterial content on the surface of root canal walls and at 100, 200, 300 μm in depth inside the dentinal tubules was measured and analyzed by means of one-way analysis of variance. RESULTS ： On the surface and at different depths of dentine, the bactericidal efficiency of groups of A, B, C, D and E were significantly greater than that of group F （P 〈 0.05）. At all depths, the bacterial reduction of group A was more than that of group B, C and D （P 〈 0.05 ）, similar to that of group E （ P 〉 0.05 ） except at depth of 200 - 300um, the bactericidal efficiency of group A was lower than that of group E （P 〈 0.05）. Moreover, the bactericidal efficiency of group C was lower than that of group A （P 〈0.05）, but higher higher than 90% and than that of group B and D（P 〈0.05）. The bactericidal efficiency of group B and D was similar （ P 〉 0. 05 ）. CONCLUSION： The combination of 25 g/L NaC10 and 20 g/L CHX can be considered to be the ideal irrigant of root canal disinfection.