根管治疗后疾病中粪肠球菌的致病性和检测及清除

Pathogenicity, detection, and elimination of Enterococcus faecalis in post-treatment endodontic disease

粪肠球菌是根管治疗后疾病最常见的细菌，在再感染根管内的检出率为24％～77％。粪肠球菌的致病性与其形成的生物膜高度相关，而其耐药性也与其致病性密不可分，是引发根管内慢性感染的关键。粪肠球菌的检测以细菌培养和聚合酶链反应（PCR）为主，而PCR用于检测感染根管内粪肠球菌较细菌培养更为敏感。根管治疗后疾病中粪肠球菌的清除方法多种多样，结果各不相同。有研究显示抑菌率，质量分数2％的氯己定为100％，10％的盐酸氯丙嗪为88．8％，4％的利多卡因凝胶为76．4％和5％的盐酸阿米洛利为71．4％；有研究则显示，混合物．四环素．异构体．酸．去污剂、QMiX和次氯酸钠皆较2％氯己定更有效。还有研究显示，铒：钇．铝石榴石激光对粪肠球菌生物膜有清除作用。

Enterococcus faecalis（E.faecalis） is the most commonly detected bacteria in post-treatment endodontic disease, with a detection rate that ranges from 24% to 77% in reinfected root canal. The pathogenicity of E.faecalis is highly correlated with the formation of biofilms and presents a complex relationship to drug resistance. This association is the key factor in chronic infections in the root canal. Primary methods, including bacterial culture and PCR, are used to detect Efaecalis. PCR is more sensitive to Efaecalis in the infected root canals than bacterial culture. Methods on removal of Efaecalis in post-treatment endodontic disease vary and provide different results, particularly inhibition rate. The use of 2% chlorhexidine gel results in 100% inhibition of bacterial growth compared with using 10% chlorpromazine（88.8%）, 4% lignocaine ge1（76.4%）, and 5% amiloride hydrochloride（71.4%）. Moreover, mixture-tetracycline-isomer-acid-detergent, QMiX, and NaC10 are more effective than 2% chlorhexidine. In addition, erbium： yttrium-aluminum-garnet laser can eliminate Efaecalis biofilm. This article reviewed different correlation studies regarding pathogenicity, detection, and elimination of Efaecalis in post-treatment endodontic disease.