根管冲洗剂对树脂类封闭剂与牙本质粘接强度的影响

Effect of root canal irrigants on the bond strength between resin sealants and dentin

根管充填时,使用具有粘接性的树脂类封闭剂与牙本质形成的牢固粘接不仅能减少根尖微渗漏,增强牙齿的抗折性,还能抵抗桩道预备的机械破坏,从而提高根管治疗的成功率。但在根管治疗过程中,冲洗剂的使用可能会改变牙本质的组织结构、牙本质的润湿性,进而影响树脂类封闭剂与牙本质的粘接强度。本文就近年来国内外学者对传统根管冲洗剂及几种新型冲洗剂对树脂类封闭剂与牙本质粘接强度的影响作一综述,结果表明:传统根管冲洗剂NaClO作为最终冲洗剂降低了树脂类封闭剂与牙本质的粘接强度;EDTA会影响根部牙本质的生物力学特性,清除效率低,会影响树脂类封闭剂与牙本质的粘接强度;EDTA与NaClO联合使用并作为最终冲洗剂可提高粘接强度;氯己定亦可增加封闭剂与牙本质的粘接强度,可作为最终冲洗剂;新型冲洗剂MTAD对树脂类封闭剂与牙本质粘接强度产生负面影响;QMix和马来酸去除玷污层效率和牙本质粘接强度与EDTA相同或更高,可代替EDTA作为最终冲洗剂。

When the root canal is filled, the use of the adhesive resin-based sealant to form a strong bond with the dentin reduces microleakage of the apex, enhances the bending resistance of the tooth, and resists the mechanical damage of the pile preparation, thus improving the success rate of root canal treatment. However, during root canal treatment, the use of a rinsing agent may change the tissue structure of the dentin and the wettability of the dentin, thereby affecting the bonding strength between the resin sealing agent and the dentin. In this paper, the effects of a traditional root canal irrigant and several new rinsing agents on the bonding strength of resin sealant and dentin are reviewed. The results show that the traditional root canal rinsing agent NaClO is reduced as the final rinsing agent. The bonding strength of resin sealant to dentin;EDTA affects the biomechanical properties of root dentin, and the removal efficiency is low, which will affect the bond strength between the resin sealant and dentin. EDTA combined with NaClO as a final rinsing agent can improve the bonding strength. Chlorhexidine can also increase the bonding strength between the blocking agent and dentin and can be used as the final rinsing agent. The new rinsing agent MTAD has a negative impact on the resin sealing agent and dentin bond strength. QMix and maleic acid remove smear efficiency with dentin bond strengths greater than or equal to EDTA and can replace EDTA as the final rinse.