Division of Endodontics, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, Canada.
J Endod. 2010 Jan;36(1):100-4. doi: 10.1016/j.joen.2009.09.018.
Irrigation of the root canal with antibacterial solutions is considered an essential part of root canal treatment in endodontics. The purpose of this study was to investigate whether mechanical agitation (ultrasonic or sonic) improves the effectiveness of chlorhexidine against biofilm bacteria in vitro.
Collagen-coated hydroxyapatite (CHA) disks were exposed to dispersed subgingival plaque for 3 weeks at 37 degrees C. The multispecies biofilms established were subjected for 1 and 3 minutes to CHX-Plus (Vista Dental Products, Racine, WI) and 2% chlorhexidine (CHX), with or without mechanical agitation. After treatment, the amount of dead bacteria in biofilms was analyzed by viability staining and confocal laser scanning microscopy (CLSM). The morphology of biofilms, with or without mechanical agitation, was also examined by CLSM.
The structure of the biofilm did not show any obvious change when the solutions surrounding the biofilm were exposed to continuous ultrasonic or sonic agitation. The combined use of mechanical agitation and chlorhexidine had a more pronounced antimicrobial effect against the biofilms than either one alone. Sonic activation (EndoActivator; Advanced Endodontics, Santa Barbara, CA) showed the highest levels of bactericidal activity with CHX-Plus after both exposure times. The proportion of killed bacteria also depended on the type of irrigant (p < 0.001) and the time of exposure (p < 0.001).
The low-intensity ultrasonic or sonic agitation that does not disrupt biofilm or disperse the biofilm bacteria improves the action of disinfectants against biofilm bacteria.
在牙髓学中，根管冲洗被认为是根管治疗的重要组成部分。本研究旨在探讨机械搅拌（超声或声流）是否能提高洗必泰对体外生物膜细菌的效果。
胶原涂层羟基磷灰石（CHA）盘在 37 度下暴露于分散的龈下菌斑中 3 周。建立的多菌种生物膜在 CHX-Plus（Vista Dental Products，Racine，WI）和 2%洗必泰（CHX）中分别进行 1 分钟和 3 分钟的处理，有或没有机械搅拌。处理后，通过活菌染色和共聚焦激光扫描显微镜（CLSM）分析生物膜中死菌的数量。还用 CLSM 检查有无机械搅拌时生物膜的形态。
当生物膜周围的溶液暴露于连续的超声或声流时，生物膜的结构没有明显变化。机械搅拌与洗必泰联合使用对生物膜的抗菌效果比单独使用任何一种都更明显。在两种暴露时间后，与 CHX-Plus 联合使用时，声流激活（EndoActivator；Advanced Endodontics，Santa Barbara，CA）显示出最高的杀菌活性。被杀灭的细菌比例也取决于冲洗剂的类型（p<0.001）和暴露时间（p<0.001）。
不会破坏生物膜或分散生物膜细菌的低强度超声或声流可增强消毒剂对生物膜细菌的作用。
