Vera Jorge, Ochoa-Rivera Jorge, Vazquez-Carcaño Marino, Romero Monica, Arias Ana, Sleiman Philippe
Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Puebla, Mexico.
Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Jalapa, Mexico.
J Endod. 2015 Nov;41(11):1884-7. doi: 10.1016/j.joen.2015.08.009. Epub 2015 Oct 1.
The positive effect of cryotherapy has been widely described in medicine. The aim of the present study was to validate a new methodology to reduce and maintain external root surface temperature for at least 4 minutes.
Twenty extracted single-rooted teeth were instrumented to size 35/.06 and subjected to 2 different irrigation interventions with a repeated-measures design using 5% sodium hypochlorite first (control) and 2.5°C cold saline solution later (experimental). In both, 20 mL of the irrigant solution was delivered for a total time of 5 minutes with a microcannula attached to the EndoVac system (Kerr Endo, Orange County, CA) inserted to the working length. The initial and lowest temperatures were recorded in the apical 4 mm with a digital thermometer for both irrigants. Data were analyzed with the repeated measure analysis of variance (Greenhouse-Geisser correction) and Bonferroni post hoc tests. Differences in maintaining a -10°C temperature reduction over 4 minutes were assessed with the Fisher exact test.
Although significant differences were found between the initial and lowest temperatures in both the control and experimental irrigation procedures (P < .001), the experimental intervention reduced it almost 10 times that of the control. When maintaining a -10°C temperature reduction over 4 minutes, the teeth in the experimental group also sustained significantly better results (P = 3.047 × 10(-10)).
Using cold saline solution as the final irrigant reduced the external root surface temperature more than 10°C and maintained it for 4 minutes, which may be enough to produce a local anti-inflammatory effect in the periradicular tissues.
冷冻疗法的积极作用在医学领域已得到广泛描述。本研究的目的是验证一种新方法,以降低并将牙根外表面温度维持至少4分钟。
选取20颗拔除的单根牙,预备至35/.06号,采用重复测量设计进行两种不同的冲洗干预,先使用5%次氯酸钠(对照),后使用2.5°C冷盐水溶液(实验)。两种情况下,均通过连接到EndoVac系统(Kerr Endo,加利福尼亚州奥兰治县)并插入工作长度的微套管输送20 mL冲洗液,持续5分钟。使用数字温度计记录两种冲洗液在根尖4 mm处的初始温度和最低温度。数据采用重复测量方差分析(Greenhouse-Geisser校正)和Bonferroni事后检验进行分析。采用Fisher精确检验评估在4分钟内维持温度降低10°C的差异。
尽管对照冲洗程序和实验冲洗程序的初始温度和最低温度之间均存在显著差异(P <.001),但实验干预使温度降低幅度几乎是对照的10倍。在4分钟内维持温度降低10°C时,实验组牙齿的效果也显著更好(P = 3.047×10⁻¹⁰)。
使用冷盐水溶液作为最终冲洗液可使牙根外表面温度降低超过10°C并维持4分钟,这可能足以对根尖周组织产生局部抗炎作用。