Er:YAG激光根管荡洗技术对根管充填后根尖微渗漏的影响

Effect of Er:YAG laser-activated root canal irrigation on apical microleakage after root canal treatment

目的:观察不同根管冲洗方法对根管治疗后根尖微渗漏产生的影响。方法:收集老年牙周炎患者拔除的60颗单根前磨牙进行根管治疗,根据荡洗技术的不同随机分为5组,A组:常规注射器头冲洗,B组:超声荡洗;C组:0.2w激光荡洗;D组:0.3w激光荡洗;E组:0.35w激光荡洗。在根管预备过程中使用3%次氯酸钠溶液、17%EDTA溶液作为冲洗液;每一组最后均用无菌生理盐水冲洗30s,干燥根管,根管充填后蓝色流体树脂暂封1周。离体牙脱钙透明化后进行染料渗透实验,观察根尖区微渗漏情况。结果:根管充填完成后7天,手动冲洗组、超声组、0.2W激光组和0.35W激光组的微渗漏长度长于0.3W激光组,差异有统计学意义(P<0.05);手动冲洗组和超声组微渗漏长度长于0.35W激光组,差异有统计学意义(P<0.05)。结论:根管治疗过程中,使用3%次氯酸钠溶液、17%EDTA溶液为冲洗液,激光荡洗效果优于手动荡洗、超声荡洗,其中0.3W Er:YAG激光进行根管荡洗后微渗漏最少。

Objective:To observe the effect of different root canal irrigation methods on the apical microleakage after root canal treatment.Methods:Collect 60 single-root premolars extracted from elderly patients with periodontitis,randomly divided into 5 groups according to the irrigation technique.Group A:conventional syringe root canal irrigation;Group B:ultrasonic root canal irrigation;Group C:0.2w Er:YAG laser-activated root canal irrigation;Group D:0.3w Er:YAG laser-activated root canal irrigation;Group E:0.35w Er:YAG laser-activated root canal irrigation.Root canal preparation was performed using 3%sodium hypochlorite solution and 17%EDTA as flushing solution.Finally,each group was irrigated with sterile normal saline for 30s,the root canal was dried.After filling,the root canal was temporarily sealed with blue fluid resin for 1 week.Dye permeation test was performed to observe the microleakage in apical area after decalcification.Results:7 days after the completion of root canal filling,the microleakage length of manual irrigation group,ultrasonic group,laser 0.2W group and laser 0.35W group was longer than that of laser 0.3W group,the difference was statistically significant(P<0.05).The microleakage length of manual washing group and ultrasonic group was longer than that of laser 0.35W group,and the difference was statistically significant(P<0.05).Conclusion:Using 3%sodium hypochlorite solution and 17%EDTA solution as the washing solution,the effect of Er:YAG laser-activated irrigation is better than that of hand shaking washing and ultrasonic cleaning,and 0.3W Er:YAG laser is the smallest microleakage after root canal cleaning.