Aydin Cumhur, Tunca Yasar Meric, Senses Zeynep, Baysallar Mehmet, Kayaoglu Guven, Ørstavik Dag
Department of Endodontics and Conservative Treatment, Gülhane Military Medical Academy, Center for Dental Sciences, Ankara, Turkey.
Acta Odontol Scand. 2007 Jun;65(3):167-70. doi: 10.1080/00016350701206626.
This study aimed to test the hypothesis that aggressive dentin removal through greater-tapered instrumentation reduces the intracanal bacteria more effectively than conservative dimension instrumentation.
Twenty extracted human lower premolar teeth were used. After extirpation of the pulps, the teeth were autoclaved and immersed in a broth inoculated with Enterococcus faecalis and incubated for 7 days to allow infection of the dentinal tubules. The teeth were divided into 2 experimental groups, each comprising 10 teeth. The teeth were instrumented either with ProTaper or with Hero Shaper nickel-titanium rotary instrumentation techniques. It was calculated that ProTaper theoretically has the potential to remove at least twice the dentin volume compared with Hero Shaper. The apical preparation was standardized to file size 30. Saline solution was used for irrigation. Bacteriological samples were taken before and after instrumentation and plated onto tryptic soy agar, and the reduction in numbers was calculated.
Both instrumentation techniques significantly reduced the number of bacteria in the root canal (p<0.05). Reduction in absolute bacterial numbers was up to 98%. There was no statistically significant difference between the two techniques.
Preparation with an instrumentation technique removing substantial amounts of dentin did not reduce the intracanal bacteria more effectively than a more conservative instrumentation technique.
本研究旨在验证以下假设:与保守尺寸的根管预备器械相比,使用大锥度器械进行激进的牙本质去除能更有效地减少根管内细菌。
使用20颗拔除的人下颌前磨牙。牙髓摘除后,对牙齿进行高压灭菌,然后浸入接种粪肠球菌的肉汤中,孵育7天以使牙本质小管感染。将牙齿分为2个实验组,每组10颗牙齿。分别使用ProTaper或Hero Shaper镍钛旋转器械技术对牙齿进行根管预备。经计算,理论上ProTaper去除的牙本质体积是Hero Shaper的至少两倍。根尖预备标准化为30号锉。使用生理盐水进行冲洗。在根管预备前后采集细菌学样本,接种于胰蛋白胨大豆琼脂培养基上,并计算细菌数量的减少情况。
两种根管预备技术均显著减少了根管内细菌数量(p<0.05)。细菌绝对数量减少高达98%。两种技术之间无统计学显著差异。
与更保守的根管预备技术相比,使用能去除大量牙本质的器械进行预备并不能更有效地减少根管内细菌。