评估用氢氧化钙和氯己定药物处理的根管冠方封闭后再污染所需的时间。

Evaluation of time required for recontamination of coronally sealed canals medicated with calcium hydroxide and chlorhexidine.

作者信息

Gomes B P F A, Sato E, Ferraz C C R, Teixeira F B, Zaia A A, Souza-Filho F J

机构信息

Department of Restorative Dentistry, Endodontic Unit, Dental School of Piracicaba, State University of Campinas, Piracicaba, SP, Brazil.

出版信息

Int Endod J. 2003 Sep;36(9):604-9. doi: 10.1046/j.1365-2591.2003.00694.x.

DOI:10.1046/j.1365-2591.2003.00694.x

PMID:12950574

Abstract

AIM

To determine in vitro the time required for recontamination of coronally sealed canals medicated with either calcium hydroxide (CaOH2), 2% chlorhexidine gel (CG) or with a combination of both.

METHODOLOGY

Eighty intact, caries-free, premolar teeth with straight roots and mature apices were selected for the study. After biomechanical preparation of 75 teeth, they were randomly divided into nine groups according to the intracanal medicament and the coronal seal with 'Intermediate Restorative Material' (IRM) as follows: (i) 10 teeth medicated with CG, coronally unsealed; (ii) 10 teeth medicated with CaOH2, coronally unsealed; (iii) 10 teeth medicated with CaOH2 + CG, coronally unsealed; (iv) 10 teeth medicated with CG + coronal seal; (v) 10 teeth medicated with CaOH2 + coronal seal; (vi) 10 teeth medicated with CG + CaOH2 + coronal seal; (vii) 10 teeth without intracanal medicament and coronally sealed; (viii) 5 teeth without intracanal medicament and coronally unsealed, used as the positive control group (PC); (ix) 5 teeth with intact crowns used as the negative control group (NC). Glass flasks were filled with Brain Heart Infusion broth (BHI), so that only the root apex was in contact with the broth, while the crown was immersed in human saliva + BHI (3:1). The flasks were then incubated at 37 degrees C in an atmosphere of 10% CO2, and microbial growth was checked daily.

RESULTS

All specimens of the PC showed contamination within 1 day of incubation, while the NC showed no evidence of broth turbidity. Recontamination was detected after an average time of 3.7 days in the unsealed canals medicated with CG, 1.8 days in the group medicated with CaOH2 and 2.6 days in the group medicated with CaOH2 + CG. When the crowns were sealed with IRM, recontamination was detected within 13.5 days in the canals medicated with CG, after 17.2 days in the group medicated with CaOH2 and after 11.9 days in the group medicated with CG + CaOH2. The group with no medication, but sealed with IRM, showed recontamination after 8.7 days. There were statistically significant differences between the teeth with or without coronal seal (P<0.05).

CONCLUSION

The coronal seal delayed but did not prevent leakage of microorganisms. There was no difference between the various medicaments.

摘要

目的

在体外确定用氢氧化钙（CaOH₂）、2%氯己定凝胶（CG）或两者联合用药后，根管冠方封闭被再次污染所需的时间。

方法

选取80颗完整、无龋、牙根直且根尖成熟的前磨牙用于本研究。对75颗牙齿进行生物力学预备后，根据根管内用药及用“中间修复材料”（IRM）进行冠方封闭情况将其随机分为9组：（i）10颗牙齿用CG用药，冠方未封闭；（ii）10颗牙齿用CaOH₂用药，冠方未封闭；（iii）10颗牙齿用CaOH₂ + CG用药，冠方未封闭；（iv）10颗牙齿用CG + 冠方封闭；（v）10颗牙齿用CaOH₂ + 冠方封闭；（vi）10颗牙齿用CG + CaOH₂ + 冠方封闭；（vii）10颗牙齿未进行根管内用药但冠方封闭；（viii）5颗牙齿未进行根管内用药且冠方未封闭，用作阳性对照组（PC）；（ix）5颗牙冠完整的牙齿用作阴性对照组（NC）。将玻璃烧瓶中装满脑心浸液肉汤（BHI），使仅根尖与肉汤接触，而牙冠浸于人类唾液 + BHI（3:1）中。然后将烧瓶置于37℃、10%二氧化碳的环境中孵育，每天检查微生物生长情况。

结果

PC组的所有标本在孵育1天内均出现污染，而NC组未出现肉汤浑浊的迹象。在用CG用药的未封闭根管中，平均3.7天后检测到再次污染；在用CaOH₂用药的组中为1.8天；在用CaOH₂ + CG用药的组中为2.6天。当用IRM封闭牙冠时，在用CG用药的根管中13.5天内检测到再次污染，在用CaOH₂用药的组中为17.2天，在用CG + CaOH₂用药的组中为11.9天。未用药但用IRM封闭的组在8.7天后出现再次污染。有或没有冠方封闭的牙齿之间存在统计学显著差异（P<0.05）。