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牙本质玷污层应保留还是去除?(文献综述)

[Should the dentin smear layer be preserved or eliminated? (Review of the literature)].

作者信息

Wauters T, Wauters J

出版信息

Rev Belge Med Dent (1984). 2000;55(2):93-103.

Abstract

The smear layer is a direct consequence of instrumentation of the root canal wall. Hand instrumentation as well as ultrasonic instrumentation produce a smear layer on the canal wall. This smear layer is composed of dentine, remnants of pulp tissue and odontoblastic processes and bacteria in an infected canal. Removal of the smear layer is accomplished by the irrigation of root canals with EDTA (17%) followed by NaOCl (5.25%). Permeability of the dentine is increased by the removal of smear layer. In this way the bacteria within the infected tubuli can be more easily destroyed by an intracanal dressing. Whether the removal of smear layer decreases the apical leakage is uncertain. To establish the clinical consequences from removal or preservation of the smear layer, further research is needed.

摘要

玷污层是根管壁预备的直接产物。手动器械预备以及超声器械预备都会在根管壁上产生玷污层。该玷污层由牙本质、牙髓组织残余物、成牙本质细胞突起以及感染根管中的细菌组成。通过用17%的乙二胺四乙酸(EDTA)随后用5.25%的次氯酸钠(NaOCl)冲洗根管来去除玷污层。去除玷污层可增加牙本质的通透性。这样一来,感染小管内的细菌就能更容易地被根管内封药破坏。去除玷污层是否会减少根尖渗漏尚不确定。为了确定去除或保留玷污层的临床后果,还需要进一步研究。

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