Er:YAG激光对弯曲根管内粪肠球菌灭菌效果的体外研究

Sterilization Effect of Er:YAG Laser on Enterococcus Faecalis in Curved Root Canals:An in Vitro Study

目的:探究Er:YAG激光PIPS、SWEEPS与传统冲洗方法在多根牙的直根管及弯曲根管内的灭菌效果差异。方法:分别选取直根管和弯曲根管多根牙建立粪肠球菌感染模型。将离体牙随机分为8组,每组15例,做以下处理:A(PIPS+直根管);B(PIPS+弯曲根管);C(SWEEPS+直根管);D(SWEEPS+弯曲根管);E(PUI+直根管);F(PUI+弯曲根管);G(CI+直根管);H(CI+弯曲根管),选取同批次离体牙做空白对照。处理后提取培养细菌,24 h后菌落计数,并进行扫描电镜和激光共聚焦观察。结果:各组灭菌效果:直根管:PIPS/SWEEPS>PUI>CI;弯曲根管组:SWEEPS>PIPS/PUI>CI;SWEEPS组在根管在根尖部能达到更高的灭菌深度及玷污层去除效果。结论:与传统根管冲洗方法相比,Er:YAG激光PIPS、SWEEPS对弯曲根管内细菌及玷污层去除效果显著提高,且SWEEPS优于PIPS。

Objective:To explore the difference in the sterilization effect of Er:YAG laser PIPS,SWEEPS,and traditional irrigation methods in straight root canals and curved root canals of multiple teeth.Methods:The straight root canal and the curved root canal were selected to establish the Enterococcus faecalis infection model.The isolated teeth were randomly divided into 8 groups,15 cases in each group,and the following treatments were performed:A(PIPS+straight root canal);B(PIPS+curved root canal);C(SWEEPS+straight root canal);D(SWEEPS+curved root canal);E(PUI+straight root canal);F(PUI+curved root canal);G(CI+straight root canal);H(CI+curved root canal),the same batch of isolated teeth were selected as a blank control.After treatment,the bacteria were extracted and cultured.After 24 hours,the colonies were counted and observed by scanning electron microscope and laser confocal.Results:Sterilization effect of each group:straight root canal:PIPS/SWEEPS>PUI>CI;curved root canal group:SWEEPS>PIPS/PUI>CI.SWEEPS group can reach a higher sterilization depth in the root canal at the apex and smear removal effect.Conclusion:Compared with traditional root canal irrigation methods,Er:YAG laser PIPS and SWEEPS can significantly improve the removal of bacteria and smear layer in curved root canals,and SWEEPS is better than PIPS.