van der Sluis L W M, Versluis M, Wu M K, Wesselink P R
Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
Int Endod J. 2007 Jun;40(6):415-26. doi: 10.1111/j.1365-2591.2007.01243.x. Epub 2007 Apr 17.
Ultrasonic irrigation of the root canal can be performed with or without simultaneous ultrasonic instrumentation. When canal shaping is not undertaken the term passive ultrasonic irrigation (PUI) can be used to describe the technique. In this paper the relevant literature on PUI is reviewed from a MEDLINE database search. Passive ultrasonic irrigation can be performed with a small file or smooth wire (size 10-20) oscillating freely in the root canal to induce powerful acoustic microstreaming. PUI can be an important supplement for cleaning the root canal system and, compared with traditional syringe irrigation, it removes more organic tissue, planktonic bacteria and dentine debris from the root canal. PUI is more efficient in cleaning canals than ultrasonic irrigation with simultaneous ultrasonic instrumentation. PUI can be effective in curved canals and a smooth wire can be as effective as a cutting K-file. The taper and the diameter of the root canal were found to be important parameters in determining the efficacies of dentine debris removal. Irrigation with sodium hypochlorite is more effective than with water and ultrasonic irrigation is more effective than sonic irrigation in the removal of dentine debris from the root canal. The role of cavitation during PUI remains inconclusive. No detailed information is available on the influence of the irrigation time, the volume of the irrigant, the penetration depth of the instrument and the shape and material properties of the instrument. The influence of irrigation frequency and intensity on the streaming pattern as well as the complicated interaction of acoustic streaming with the adherent biofilm needs to be clarified to reveal the underlying physical mechanisms of PUI.
根管超声冲洗可以在超声预备的同时进行，也可以单独进行。当不进行根管塑形时，可使用“被动超声冲洗（PUI）”一词来描述该技术。本文通过检索MEDLINE数据库，对PUI的相关文献进行综述。被动超声冲洗可使用小号锉或光滑镍钛丝（10-20号）在根管内自由振荡，以引发强烈的声微流效应。PUI可作为清洁根管系统至关重要的辅助手段，与传统冲洗针冲洗相比，它能从根管中清除更多的有机组织、浮游细菌和牙本质碎屑。与超声预备同时进行的超声冲洗相比，PUI在清洁根管方面更有效。PUI在弯曲根管中也能发挥作用，光滑镍钛丝的效果与K型锉相当。根管的锥度和直径是决定牙本质碎屑清除效果的重要参数。次氯酸钠冲洗比水冲洗更有效，超声冲洗比声波冲洗在清除根管内牙本质碎屑方面更有效。PUI过程中，空化作用的角色尚无定论。关于冲洗时间、冲洗液体积、器械的穿透深度以及器械的形状和材料特性的影响，目前尚无详细信息。冲洗频率和强度对微流模式的影响以及声微流与附着生物膜的复杂相互作用，需要进一步阐明，以揭示PUI潜在的物理机制。
