Nd:YAP激光配合不同冲洗液对根管粪肠球菌消除作用的体外研究

Antimicrobial effect of Nd:YAP laser combined with different root canal irrigants on Enterococcus faecalis

目的通过观察Nd:YAP激光分别与3%H2O2、3%NaClO溶液和2%CHX溶液3种临床常用的根管冲洗剂联合使用时,对根管内粪肠球菌的杀灭效果,为临床寻找更有效、更理想的根管消毒方法提供参考。方法选取48颗成人单根管离体前磨牙,建立粪肠球菌感染根管模型,随机将其均分为6组并做不同处理。A组为生理盐水冲洗组,B组为3%NaClO溶液冲洗组(阳性对照组),C组为Nd:YAP激光+3%NaClO溶液处理组,D组为Nd:YAP激光+2%CHX溶液处理组,E组为Nd:YAP激光+3%H2O2溶液处理组,F组为Nd:YAP激光+NS处理组。激光使用参数均为5 Hz,280 mJ,5 s。选用纸尖法取样,稀释培养48 h后,计算每个样本菌落形成单位(CFU)值。使用SAS 8.02统计软件对结果进行统计学分析。结果B、C、D、E、F组的CFU值均显著低于A组(P<0.05),表明该5组的杀菌效果优于A组,其中C、D组的杀菌效果最为显著。阳性对照组(B组)结果显著低于E、F组(P<0.05),表明B组杀菌效果优于E、F组。而E、F组的CFU值之间的差异则无统计学意义(P>0.05)。结论Nd:YAP激光在5 Hz,280 mJ的参数设定下对粪肠球菌具有显著的清除作用,明显优于单纯使用生理盐水冲洗;Nd:YAP/NaClO组和Nd:YAP/CHX组对粪肠球菌生物膜具有最为有效的清除作用。

Objective The aim of this study was to explore the elimination effect against E.faecalis in root canals by Nd:YAP laser combined with three kinds of commonly used root canal irrigation agents of 3%H2O2,3%NaClO solution and 2%CHX solution,providing a reference for dentists to choose more effective and ideal root canal disinfection methods.Methods Forty-eight extracted human premolars with single root canal were selected.After cleaning and autoclaving,to establish E.faecalis infection models,root canals were contaminated by E.faecalis and incubated for four weeks.Then the models were randomly and averagely divided into six groups and treated as below:specimens in group A were treated with saline irrigation,specimens in group B were treated with 3%NaClO irrigation(as positive control),specimens in group C were treated with Nd:YAP laser+3%NaClO solution,specimens in group D were treated with Nd:YAP laser+2%CHX solution,specimens in group E were treated with Nd:YAP laser+3%H2O2,specimens in group F were treated with Nd:YAP laser+NS(laser parameters:5 Hz,280 mJ,5 s).The bacterial samples from root canals were collected by paper points.The bacterial suspensions were serial diluted and plated on tryptic soy agar plates to enumerate the CFUs after forty-eight hours incubation at 37℃in an aerobic conditions.The results were analyzed by SAS 8.02.Results The CFUs of the group B,C,D,E,F were significantly lower than those of group A(P<0.05),indicating that the bactericidal effect of the five groups was better than that of group A.The results of positive control group(B group)were significantly lower than those of E and F groups(P<0.05),but there was no significant difference between E and F groups(P>0.05).Conclusions The groups treated with Nd:YAP laser(laser parameters:5 Hz,280 mJ,5 s)showed greater effect of elimination against Enterococcus faecalis biofilm compared with the group treated only with saline irrigation.Nd:YAP plus NaClO group and Nd:YAP plus CHX group had the most effective scavenging effect on Enterococcus faecalis biofilm.