预热次氯酸钠溶液冲洗根管对根管内粪肠球菌杀灭效果的临床研究

In vivo intracanal irrigation antimicrobial effect of pre-heated sodium hypochlorite on Enterococcus faecalis

目的:观察预热的次氯酸钠(NaClO)溶液冲洗根管对根管内粪肠球菌(Enterococcus faecalis,E.faecalis的杀灭效果。方法:分别观察30℃1%的NaClO溶液、30℃5%的NaClO溶液、55℃的1%的NaClO溶液和55℃5%的NaClO溶液对粪肠球菌标准株ATCC29212的体外杀菌能力。同时60颗临床诊断为慢性根尖周炎的下颌前磨牙随机分成4组,ProTaper镍钛器械预备根管的同时,分别采用30℃1%的NaClO溶液、30℃5%的NaClO溶液、55℃的1%的NaClO溶液和55℃5%的NaClO溶液冲洗根管。无菌纸捻即刻取菌,培养根管内细菌。实时荧光定量PCR检测粪肠球菌数量。结果:虽然55℃的1%和5%的次氯酸钠溶液在体外均有较强的杀灭培养的粪肠球菌标准株的能力,但是临床用55℃的1%和5%的次氯酸钠溶液冲洗根管后,粪肠球菌的检出量无差别(P>0. 05)。结论:预热的次氯酸钠溶液冲洗根管,不能减少粪肠球菌的检出量。预热的次氯酸钠溶液冲洗根管对根管治疗疗效的影响尚待进一步研究。

Objective: To observe the intracanal antimicrobial effect of pre-heated NaClO solutions as irrigation on Enterococcus faecalis( E.faecalis).Methods: Killing efficacy of 1% NaClO solutions and 5% NaClO solutions against 48-h incubations of E.faecalis ATCC29212 was compared at 30℃ and 55℃. Sixty mandibular premolars with clinical diagnosis of chronic apical periodontitis were randomly divided into four groups.The root canal were prepared using ProTaper nickel-titanium instruments,at the same time,30℃ 1% NaClO solutions,30℃ 5% NaClO solutions,55℃ 1% NaClO solutions and 55℃5% NaClO solutions were used respectively as irrigation in each groups.The sterile paper points were immediately dipped into the canals to obtain bacteria,then cultured.Real-time PCR was used to detect the number of E.faecalis.Results: Although the1% NaClO solutions and 5% NaClO solutions at 55℃ have a strong ability to kill E.faecalis ATCC29212 in vitro,there was no difference in the amount of the detected E.faecalis in the root canal in vivo( P>0. 05) after irrigation using 1% or 5% NaCl O solutions at 55℃.Conclusion: Irrigation the root canal with the pre-warmed NaClO solutions does not reduce the amount of E.faecalis.The effect of pre-heated NaClO solutions on root canal treatment has yet to be further studied.