不同冲洗方案对慢性根尖周炎根管微生物的影响

The effects of different irrigating solutions to root canal microorganism on chronic periapical periodontitis

目的:评价不同的冲洗方案对慢性根尖周炎根管冲洗效果的影响。方法:选取45例慢性根尖周炎患者,根据根管预备时采用的不同冲洗方案,随机分为3组,分别为NaClO+MTAD组、NaClO+EDTA组、H2O2+NaCl组。各组分别于根管预备前及根管预备后取样,于厌氧条件下培养48h后进行菌落计数,比较根管预备前后各组间菌落数差异;取根管预备前的细菌制成悬液,行各组冲洗液的抑菌环实验,比较各组抑菌环的直径;评价并比较各组根管治疗前及根管治疗6个月后根尖周指数、PAI指数。结果:45例患牙在分别经过NaClO+MTAD、NaClO+EDTA、H2O2+NaCl的冲洗后,菌落数均低于根管预备前(P<0. 05),NaClO+MTAD组、NaClO+EDTA组的细菌减少率均高于H2O2+NaCl组(P<0. 05),NaClO+MTAD组与NaClO+EDTA组间细菌减少率无差异(P>0. 05);抑菌环实验结果,NaClO+MTAD组的抑菌环直径最大,NaClO+EDTA次之,H2O2+NaCl最小,三者间存在统计学差异(P<0. 05);6个月后复查,3组的根尖周指数、PAI指数均较治疗前降低,差异有统计学意义(P<0. 05)。各组根管治疗后的根尖周指数及PAI指数,NaClO+MTAD组与NaClO+EDTA组间无统计学差异(P>0. 05),均低于H2O2+NaCl组,差异有统计学意义(P<0. 05)。结论:NaClO+MTAD与NaClO+EDTA的抗菌效果均优于传统的H2O2+NaCl联合冲洗方案,但前两者间无明显差异。

Objective:To evaluate the irrigation effects of different irrigating solutions on chronic periapical periodontitis.Methods:45 patients with chronic periapical periodontitis were irrigated by NaClO+MTAD(NaClO+MTAD group),NaClO+EDTA(NaClO+EDTA group),H2O2+NaCl(H2O2+NaCl group)respectively.Bacterial was taken before and after the canal preparation,and cultured 48 h under anaerobic conditions.The CFU were compared among three groups.Bacterial abtained from root canal before canal preparation were made into suspension.The bacteriostasis loop experiment were carried out.The diameters of bacteriostasis loop were compared among three groups.The CPI and PAI evaluation were carried out 6 months later.Results:The CFU of 3 groups after canal preparation were less than that before canal preparation(P<0.05).Bacterial reduction rate of NaClO+MTAD group and NaClO+EDTA group were higher than that of H2O2+NaCl group(P<0.05),and there was no difference between the former two groups(P>0.05).The diameters of bacteriostasis loop of NaClO+MTAD group were highest in three groups,and that of H2O2+NaCl group were lowest in three groups,there was significant difference in three groups(P<0.05).The CPI and PAI of 3 groups after canal preparation 6 months were less than that before canal preparation(P<0.05).CPI and PAI of NaClO+MTAD group and NaClO+EDTA group were lower than that of H2O2+NaCl group(P<0.05),and there was no difference between the former two groups after canal preparation6 months(P>0.05).Con clusion:The antibacterial effect of NaClO+MTAD and NaClO+EDTA were better than that of H2O2+NaCl,and there was no difference between NaClO+MTAD and NaClO+EDTA in the antibacterial effect.