Bonsor S J, Nichol R, Reid T M S, Pearson G J
The Dental Practice, 21 Rubislaw Terrace, Aberdeen AB10 1XE, and Department of biomaterials in Relation to Dentistry, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK.
Br Dent J. 2006 Jul 22;201(2):101-5; discussion 98; quiz 120. doi: 10.1038/sj.bdj.4813819.
To compare the effect of a combination of 20% citric acid solution and photo-activated disinfection with the use of 20% citric acid and 2.25% sodium hypochlorite solutions on bacterial load on the dentine walls in prepared canals in vivo.
Sixty-four randomly selected cases were evaluated and allocated to one of two groups. In Group 1, after gaining access to the root canal, bacterial load on the canal walls was sampled using endodontic files. A further sample was taken after apex location and initial widening of the canal had been completed and the photo-activated disinfection process carried out. A final sample was taken after completion of the canal preparation using citric acid and sodium hypochlorite solutions. In Group 2, the initial sample was taken as described previously. A second sample was taken after conventional preparation using 20% citric acid and sodium hypochlorite solutions as co-irrigants. A final sample was then taken after a subsequent PAD treatment. All samples were cultured for facultative anaerobic bacteria.
Of the canals treated in Group 1 only two of the 23 canals infected showed culturable bacteria after the use of citric acid and photo-activated disinfection. Of these two canals, one was free of culturable bacteria on completion of conventional treatment but the other still contained culturable bacteria. In Group 2, four canals of the 23 infected initially, remained contaminated after conventional treatment. After subsequent photo-activated disinfection three of these four canals were free of culturable bacteria.
Results indicate that the use of a chelating agent acting as a cleaner and disrupter of the biofilm and photo-activated disinfection to kill bacteria is an effective alternative to the use of hypochlorite as a root canal cleaning system.
比较20%柠檬酸溶液与光活化消毒联合使用，以及使用20%柠檬酸和2.25%次氯酸钠溶液对体内预备根管牙本质壁细菌载量的影响。
随机选取64例病例进行评估，并分为两组。在第1组中，进入根管后，使用根管锉对根管壁的细菌载量进行取样。在完成根尖定位、根管初步扩锉并进行光活化消毒后，再取一次样。使用柠檬酸和次氯酸钠溶液完成根管预备后，取最后一次样。在第2组中，初始样本的采集方法与之前描述的相同。使用20%柠檬酸和次氯酸钠溶液作为联合冲洗液进行常规预备后，取第二次样。随后进行光活化消毒处理后，取最后一次样。所有样本均培养兼性厌氧菌。
在第1组治疗的根管中，23个感染根管中只有2个在使用柠檬酸和光活化消毒后培养出可培养细菌。在这两个根管中，一个在完成常规治疗后没有可培养细菌，但另一个仍含有可培养细菌。在第2组中，最初感染的23个根管中有4个在常规治疗后仍被污染。在随后的光活化消毒后，这4个根管中有3个没有可培养细菌。
结果表明，使用螯合剂作为生物膜的清洁剂和破坏剂，并结合光活化消毒来杀灭细菌，是一种有效的替代方法，可替代使用次氯酸钠作为根管清洁系统。
