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使用不同浓度次氯酸钠作为初始冲洗液时,对自调式锉的根管牙本质侵蚀和玷污层去除能力的评估。

Evaluation of radicular dentin erosion and smear layer removal capacity of Self-Adjusting File using different concentrations of sodium hypochlorite as an initial irrigant.

作者信息

Kaya Sadullah, Yiğit-Özer Senem, Adigüzel Özkan

机构信息

Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Oct;112(4):524-30. doi: 10.1016/j.tripleo.2011.02.039. Epub 2011 Jun 12.

Abstract

OBJECTIVE

The aim of this study was to evaluate Self-Adjusting File (SAF) in the removal of smear layer and impact on the dentin surface using sodium hypochlorite (NaOCl) as an initial irrigation solution at 3 different concentrations combined with 1% EDTA. In addition, the erosive effect of this dual irrigation regime was examined.

STUDY DESIGN

Root canal preparations were performed in 30 teeth using the SAF with a continuous irrigation device (Vatea) in a closed system in which the apical foramen was sealed. The vibration mode was on for 5 minutes during the preparation. Three different concentrations of NaOCl (1.3%, 2.6%, and 5.25%) and 1% EDTA were used for continuous irrigation. The final flush was also performed using NaOCl with the vibration mode on. The roots were split longitudinally and subjected to scanning electron microscopy (SEM). The presence of the smear layer was scored using a 5-point scoring system, and the erosive capacity of the irrigants were scored using a 3-point scoring system.

RESULTS

The results showed no significant difference in smear layer removal among different concentrations of NaOCl and among the regions. Clean dentin surfaces were observed in 80%, 70%, and 70% with a score of 1 or 2 of the apical thirds using 1.3%, 2.6%, and 5.25% NaOCl, respectively. The 1.3% and 2.6% NaOCl solutions showed similar erosion patterns on the root canal walls (P > .05); however, 5.25% NaOCl caused severe erosion (P < .05).

CONCLUSIONS

When using the SAF with continuous irrigation and vibration, lower concentrations of NaOCl and EDTA can be recommended for efficient clinical removal of the smear layer even in the apical thirds and to avoid excessive erosion of root dentin.

摘要

目的

本研究旨在评估自调式锉(SAF)在使用3种不同浓度的次氯酸钠(NaOCl)作为初始冲洗液并联合1%乙二胺四乙酸(EDTA)时,对玷污层的去除效果及其对牙本质表面的影响。此外,还研究了这种双重冲洗方案的侵蚀作用。

研究设计

在30颗牙齿上使用SAF和连续冲洗装置(Vatea)在封闭系统中进行根管预备,该系统中根尖孔被封闭。预备过程中振动模式开启5分钟。使用3种不同浓度的NaOCl(1.3%、2.6%和5.25%)和1% EDTA进行连续冲洗。最后冲洗时振动模式也开启,同样使用NaOCl。将牙根纵向劈开,进行扫描电子显微镜(SEM)检查。使用5分制评分系统对玷污层的存在情况进行评分,使用3分制评分系统对冲洗液的侵蚀能力进行评分。

结果

结果显示,不同浓度的NaOCl之间以及不同区域之间在玷污层去除方面无显著差异。使用1.3%、2.6%和5.25% NaOCl时,根尖三分之一处分别有80%、70%和70%的牙本质表面清洁,评分为1或2分。1.3%和2.6%的NaOCl溶液在根管壁上显示出相似的侵蚀模式(P >.05);然而,5.25%的NaOCl导致严重侵蚀(P <.05)。

结论

当使用SAF进行连续冲洗和振动时,推荐使用较低浓度的NaOCl和EDTA,以便在临床上有效去除玷污层,即使在根尖三分之一处,同时避免牙根牙本质过度侵蚀。

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