J Endod. 2011 Jun;37(6):836-8. doi: 10.1016/j.joen.2011.03.001. Epub 2011 Apr 13.
During apicoectomy and retrograde cavity preparation, a smear layer, which contains microorganisms and necrotic pulpal tissues, is formed on the dentinal surfaces cut by the instruments. Bacteria can survive and proliferate inside or below the smear layer. The purpose of this study was to evaluate in vitro two different procedures for the removal of the smear layer in retrocavities prepared with ultrasonic retrotips.
Twenty-eight single-rooted teeth were cleaned, shaped, and obturated with gutta-percha and sealer. The apical 3 mm of each root were cut with a carbide bur, and retrograde cavities were prepared with ProUltra ultrasonic retrotips (Maillefer Dentsply, Baillagues, Switzerland) at a depth of 3 mm. Teeth in group A were treated with a gel of 35% orthophosphoric acid for 15 seconds, and teeth in group B were treated with a gel of 24% EDTA at a neutral pH for 2 minutes. The samples were prepared for scanning electron microscopic observation and scored for the presence of the smear layer on the retrocavity walls.
Eighty percent of the teeth in group A showed an optimal degree of cleanliness of the walls, with dentinal tubules completely open. The majority of analyzed samples coming from group B showed dentinal tubules covered with the smear layer.
The analysis of the samples showed that orthophosphoric acid is more effective than EDTA in removing surgical smear layer even with less time of action.
在根尖切除术和逆行腔预备过程中,器械切割牙本质表面会形成含有微生物和坏死牙髓组织的玷污层。细菌可以在玷污层内部或下方存活和繁殖。本研究的目的是体外评估两种不同的程序,用于去除超声逆铣针预备的逆行腔中的玷污层。
28 颗单根牙用牙胶和密封剂进行清洁、成形和填充。用碳化钨钻头切除每个牙根的根尖 3mm,用 ProUltra 超声逆铣针(Maillefer Dentsply,Baillagues,瑞士)在深度为 3mm 处预备逆行腔。A 组用 35%磷酸凝胶处理 15 秒,B 组用中性 pH 值的 24% EDTA 凝胶处理 2 分钟。对样本进行扫描电子显微镜观察,并对逆行腔壁上玷污层的存在进行评分。
A 组 80%的牙齿显示出壁面最佳的清洁度,牙本质小管完全开放。B 组的大多数分析样本显示牙本质小管被玷污层覆盖。
样本分析表明,即使作用时间较短,磷酸也比 EDTA 更有效地去除手术玷污层。