Zehnder Matthias
Department of Preventive Dentistry, Periodontology, and Cariology, Division of Endodontology, University of Zürich Center for Dental Medicine, Switzerland.
J Endod. 2006 May;32(5):389-98. doi: 10.1016/j.joen.2005.09.014.
Local wound debridement in the diseased pulp space is the main step in root canal treatment to prevent the tooth from being a source of infection. In this review article, the specifics of the pulpal microenvironment and the resulting requirements for irrigating solutions are spelled out. Sodium hypochlorite solutions are recommended as the main irrigants. This is because of their broad antimicrobial spectrum as well as their unique capacity to dissolve necrotic tissue remnants. Chemical and toxicological concerns related to their use are discussed, including different approaches to enhance local efficacy without increasing the caustic potential. In addition, chelating solutions are recommended as adjunct irrigants to prevent the formation of a smear layer and/or remove it before filling the root canal system. Based on the actions and interactions of currently available solutions, a clinical irrigating regimen is proposed. Furthermore, some technical aspects of irrigating the root canal system are discussed, and recent trends are critically inspected.
在病变牙髓腔进行局部伤口清创是根管治疗中防止牙齿成为感染源的主要步骤。在这篇综述文章中,阐述了牙髓微环境的具体情况以及对冲洗液的相应要求。推荐使用次氯酸钠溶液作为主要冲洗剂。这是因为它们具有广泛的抗菌谱以及溶解坏死组织残余物的独特能力。讨论了与它们使用相关的化学和毒理学问题,包括在不增加腐蚀性的情况下提高局部疗效的不同方法。此外,推荐使用螯合溶液作为辅助冲洗剂,以防止在填充根管系统之前形成玷污层和/或去除玷污层。基于目前可用溶液的作用和相互作用,提出了一种临床冲洗方案。此外,还讨论了根管系统冲洗的一些技术方面,并对最新趋势进行了批判性审视。