抗菌光动力疗法应用于乳前牙治疗对髓腔内微生物的影响

Effect of antibacterial photodynamic therapy on microorganisms in pulp cavities of deciduous anterior teeth

目的 旨在评估常规牙髓治疗后抗菌光动力疗法(a-PDT)对乳前牙髓腔内微生物的影响。方法 选择2020年12月就诊于郑州大学附属医院口腔科儿童的62颗牙髓坏死的乳前牙,随机分为常规根管治疗组(A组)和常规根管治疗联合a-PDT治疗组(B组),每组各31颗。a-PDT使用浓度为0.005%的亚甲蓝作为光敏剂,用无菌纸制锥形管在根管内部涂抹3 min,用激光在根管入口处直接照射40 s(波长:660 nm,能量密度:4 J/cm^(2),功率:100 mW)。使用锥形管采集两组患者根管内的微生物样本(两组均在治疗前和治疗后立即采集)进行培养。治疗后1个月和3个月进行临床随访,包括瘘管和牙齿活动度等。结果 与治疗前比较,A组治疗后细菌载量减少了93%,B组减少了99%,差异无统计学意义(P>0.05);治疗后1个月和3个月,两组康复情况比较差异无统计学意义(P>0.05)。结论 常规治疗联合a-PDT可有效杀灭乳牙内微生物。

Objective To evaluate the effect of antibacterial photodynamic therapy(a-PDT) on microbes in deciduous anterior teeth after conventional endodontic treatment. Methods Sixty-two pulpal necrotic deciduous anterior teeth from children in our hospital in December, 2020 were selected and randomly divided into conventional root canal therapy group(group A, 31 teeth) or conventional root canal therapy combined with a-PDT group(group B, 31 teeth). With 0.005%methylene blue as the photosensitizer of a-PDT, the root canal was coated with a sterile paper cone tube for 3 minutes and then directly irradiated by laser at the root canal entrance for 40 s(wave length: 660 nm, energy density: 4 J/cm^(2), Power:100 mW). The microbial samples in root canals of the two groups were collected using cone tube before treatment and immediately after treatment for culturing. Clinical follow-up was conducted 1 and 3 months after treatment, including fistula and tooth mobility. Results The bacterial load decreased by 93% in group A and 99% in group B after treatment compared to before treatment(P>0.05). There was no significant difference in rehabilitation between the two groups at 1 month and 3 months after treatment(P>0.05). Conclusion Conventional treatment combined with a-PDT can effectively kill bacteria in deciduous teeth.