Bryce Graeme, O'Donnell Darren, Ready Derren, Ng Yuan-Ling, Pratten Jonathan, Gulabivala Kishor
Division of Restorative Dental Sciences (Unit of Endodontology), London, United Kingdom.
J Endod. 2009 Sep;35(9):1243-8. doi: 10.1016/j.joen.2009.05.034.
Clinical/microbiological studies have consistently revealed the persistence of some bacteria after conventional root canal debridement. Although this was originally attributed to the complexity of the root canal anatomy and the difficulty of delivering antibacterial agents effectively, it has emerged that the biofilm encasement of bacterial cells may confer a further mechanism of resistance. The purpose of this study was to investigate the relative disruption and bactericidal effects of root canal irrigants on single- and dual-species biofilms of root canal isolates.
Biofilms of Streptococcus sanguinis, Enterococcus faecalis, Fusobacterium nucleatum, and Porphyromonas gingivalis were grown on nitrocellulose membranes for 72 hours and immersed in NaOCl, EDTA, chlorhexidine, and iodine for 1, 5, or 10 minutes. The number of viable and nonviable bacteria disrupted from the biofilm and those remaining adherent were determined by using a viability stain in conjunction with fluorescence microscopy.
Gram-negative obligate anaerobe species were more susceptible to cell removal than gram-positive facultative anaerobes. The majority of cells were disrupted after the first minute of exposure; however, the extent varied according to the agent and species. The most effective agent at disrupting biofilms was NaOCl. Iodine was generally effective at bacterial killing but not disruption.
Biofilm disruption and cell viability were influenced by the species, their coassociation in dual-species biofilms, the test agent, and the duration of exposure. The effectiveness of NaOCl as an endodontic irrigant was reinforced.
临床/微生物学研究一直表明,传统根管清创术后仍有一些细菌持续存在。尽管这最初归因于根管解剖结构的复杂性以及有效输送抗菌剂的困难,但现已发现细菌细胞的生物膜包裹可能赋予了另一种耐药机制。本研究的目的是调查根管冲洗剂对根管分离株单菌种和双菌种生物膜的相对破坏和杀菌作用。
将血链球菌、粪肠球菌、具核梭杆菌和牙龈卟啉单胞菌的生物膜在硝酸纤维素膜上培养72小时,然后浸入次氯酸钠、乙二胺四乙酸、氯己定和碘中1、5或10分钟。通过使用活力染色结合荧光显微镜来确定从生物膜中破坏的活菌和死菌数量以及那些仍附着的细菌数量。
革兰氏阴性专性厌氧菌比革兰氏阳性兼性厌氧菌更容易被去除细胞。大多数细胞在暴露的第一分钟后就被破坏;然而,破坏程度因试剂和菌种而异。破坏生物膜最有效的试剂是次氯酸钠。碘通常在杀菌方面有效,但在破坏生物膜方面无效。
生物膜破坏和细胞活力受菌种、它们在双菌种生物膜中的共存情况、测试试剂以及暴露持续时间的影响。次氯酸钠作为牙髓冲洗剂的有效性得到了加强。