Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
J Endod. 2012 Feb;38(2):204-8. doi: 10.1016/j.joen.2011.10.024. Epub 2011 Dec 6.
The objectives of this study were to evaluate and compare the time-dependent chemical and ultramorphologic effects of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) in young and old dentin.
Sixty-four teeth scheduled for extraction were collected from young (<30 years) and old (>60 years) patients. In 48 teeth, the dentin was reduced to a powder state and treated with EDTA or EDTA + NaOCl for 1 and 10 minutes, respectively. X-ray diffraction analysis was used to determine the changes in the composition of dentin through dissolution of hydroxyapatite (HAp). In the remaining teeth (n = 16), the root canals were prepared, bisected, and subjected to the same time-dependent treatment regimens. The changes in the number and area of dentinal tubules were calculated by image analysis. The data were analyzed statistically by paired t test and one-way analysis of variance, followed by Tukey honestly significant difference test at P = .05.
In both young and old dentin, EDTA significantly decreased the HAp intensity at 1 and 10 minutes, whereas EDTA + NaOCl only decreased that of old dentin at 10 minutes. Pair-wise comparisons revealed that in old dentin, the reduction in HAp intensity after treatment with EDTA and EDTA + NaOCl was significantly greater at 10 minutes than at 1 minute, whereas in young dentin, a significant decrease was only observed in the EDTA/10-minute subgroup. Compared with their 1-minute counterparts, 10-minute treatment with EDTA + NaOCl significantly increased the tubular diameter and tubular area of old dentin. In young dentin, the tubular area and diameter values were not affected by treatment time (P > .05).
In young root dentin, 10-minute treatment with EDTA + NaOCl does not significantly alter the chemical and ultramorphologic structure and thus appears to be unnecessary. In old dentin, extended treatment time with EDTA + NaOCl should be avoided owing to excessive demineralization and erosion. In both types of dentin, EDTA was not effective in complete removal of the smear layer.
本研究旨在评估和比较乙二胺四乙酸(EDTA)和次氯酸钠(NaOCl)在年轻和老年牙本质中随时间变化的化学和超微结构效应。
从年轻(<30 岁)和老年(>60 岁)患者中收集 64 颗拟拔除的牙齿。在 48 颗牙齿中,将牙本质研磨成粉末状态,分别用 EDTA 或 EDTA+NaOCl 处理 1 分钟和 10 分钟。X 射线衍射分析用于通过羟磷灰石(HAp)的溶解来确定牙本质成分的变化。在其余 16 颗牙齿(n=16)中,根管预备后,将其等分并进行相同的随时间变化的处理方案。通过图像分析计算牙本质小管数量和面积的变化。采用配对 t 检验和单因素方差分析对数据进行统计学分析,然后在 P=0.05 时采用 Tukey Honestly Significant Difference 检验进行多重比较。
在年轻和老年牙本质中,EDTA 在 1 分钟和 10 分钟时均显著降低 HAp 强度,而 EDTA+NaOCl 仅在 10 分钟时降低老年牙本质的 HAp 强度。两两比较显示,在老年牙本质中,EDTA 和 EDTA+NaOCl 处理 10 分钟后 HAp 强度的降低明显大于 1 分钟,而在年轻牙本质中,仅在 EDTA/10 分钟亚组中观察到显著降低。与 1 分钟组相比,EDTA+NaOCl 处理 10 分钟显著增加了老年牙本质的管腔直径和管腔面积。在年轻牙本质中,处理时间对管腔面积和直径值没有影响(P>0.05)。
在年轻的根牙本质中,10 分钟 EDTA+NaOCl 处理不会显著改变化学和超微结构,因此似乎没有必要。在老年牙本质中,应避免延长 EDTA+NaOCl 的处理时间,因为这会导致过度脱矿和侵蚀。在这两种牙本质中,EDTA 都不能有效地完全去除玷污层。