Haapasalo Markus, Qian Wei, Portenier Isabelle, Waltimo Tuomas
Division of Endodontics, Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
J Endod. 2007 Aug;33(8):917-25. doi: 10.1016/j.joen.2007.04.008. Epub 2007 Jun 22.
Successful treatment of apical periodontitis is dependent on the elimination of the infective microflora from the necrotic root canal system. Antimicrobial irrigating solutions and other locally used disinfecting agents and medicaments have a key role in the eradication of the microbes. While most if not all presently used disinfecting agents rapidly kill even the resistant microbes when tested in vitro in a test tube, the effectiveness of the same agents is clearly weaker in the in vivo conditions. Recent studies have given valuable information about the interaction of endodontic disinfecting agents with dentin and other compounds present in the necrotic root canal. As a result of such interactions the antimicrobial effectiveness of several of our key disinfectants may be weakened, or even eliminated under certain circumstances. Different disinfectants show different sensitivity to the action by the various potential inactivators, such as dentin, serum proteins, hydroxyapatite, collagen derived from different sources, and microbial biomass. This review is a summary of our present knowledge of the mostly negative interactions between endodontic disinfecting agents and the various compounds present in the root canal environment.
根尖周炎的成功治疗取决于从坏死根管系统中清除感染性微生物群。抗菌冲洗液以及其他局部使用的消毒剂和药物在根除微生物方面起着关键作用。虽然目前使用的大多数（如果不是全部）消毒剂在试管中进行体外测试时能迅速杀死甚至耐药的微生物，但在体内条件下，相同消毒剂的效果明显较弱。最近的研究提供了有关牙髓消毒剂与坏死根管中存在的牙本质及其他化合物相互作用的宝贵信息。由于这种相互作用，我们的几种关键消毒剂的抗菌效果可能会减弱，甚至在某些情况下会被消除。不同的消毒剂对各种潜在灭活剂（如牙本质、血清蛋白、羟基磷灰石、不同来源的胶原蛋白和微生物生物质）的作用表现出不同的敏感性。本综述总结了我们目前对牙髓消毒剂与根管环境中各种化合物之间大多为负面相互作用的认识。
