Rathakrishnan Mensudar, Sukumaran Vridhachalam Ganapathy, Subbiya Arunajatesan
Professor, Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospitals , Chennai, India .
Professor and Head of Department, Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospitals , Chennai, India .
J Clin Diagn Res. 2016 Apr;10(4):ZC104-6. doi: 10.7860/JCDR/2016/17200.7685. Epub 2016 Apr 1.
The goal of endodontic therapy is to completely eliminate the microorganisms and the smear layer from the root canal in order to provide a good seal of the root filling materials.
The aim of this study was to find a viable alternative irrigant, which is easily available with less erosion and clinically acceptable smear layer removal by comparing the efficacy of EDTA and commercially available super-oxidized water, named Oxum, as a final rinse on smear layer removal and erosion in relation to coronal, middle and apical thirds of radicular dentin using Scanning Electron Microscope (SEM) analysis.
Freshly extracted 30 human lower second premolar teeth with straight roots and type I canal anatomy were selected. The root canals were cleaned and shaped using Universal Protaper Rotary System. Irrigation was performed with 1 ml of 2.5% of NaOCl solution after each instrument change. The final irrigation (5 ml) sequence was as follows: Group I- 17% EDTA, Group II - OXUM, and Group III - 0.9% saline (control) for one minute. Then, the root canals were finally irrigated with 5ml of distilled water to remove any precipitate. The roots were then gently split into two halves using a chisel and subjected to SEM analysis.
The SEM photomicrographs were evaluated by two independent examiners and Mann Whitney results showed that there was no statistically significant difference between the two examiners. Non-parametric statistical analysis of all experimental groups showed significant difference between coronal, middle and apical third for smear layer removal with p-value<0.05. For erosion, in group II (oxum) showed statistically significant difference between coronal, middle and apical third and it showed significantly less dentine erosion when compared to EDTA.
Within the limitations of the present study, Oxum the commercially available super-oxidized water proved to be equally effective in smear layer removal with less erosion when compared to EDTA.
牙髓治疗的目标是彻底清除根管内的微生物和玷污层，以便为根管充填材料提供良好的封闭。
本研究的目的是寻找一种可行的替代冲洗剂，通过比较乙二胺四乙酸（EDTA）和市售的超氧化水（名为Oxum）作为最终冲洗剂对玷污层去除效果及侵蚀作用，利用扫描电子显微镜（SEM）分析其在牙根牙本质冠部、中部和根尖三分之一处的情况，找到一种易于获得、侵蚀性较小且临床上可接受的玷污层去除方法。
选取30颗新鲜拔除的人下颌第二前磨牙，牙根直且根管解剖结构为I型。使用通用Protaper旋转系统对根管进行清理和塑形。每次更换器械后用1毫升2.5%的次氯酸钠溶液冲洗。最终冲洗（5毫升）顺序如下：第一组用17%的EDTA，第二组用Oxum，第三组用0.9%的生理盐水（对照组），冲洗1分钟。然后，用5毫升蒸馏水对根管进行最终冲洗以去除任何沉淀物。接着用凿子将牙根轻轻劈成两半并进行SEM分析。
SEM显微照片由两名独立检查者进行评估，曼-惠特尼结果显示两名检查者之间无统计学显著差异。对所有实验组的非参数统计分析表明，在玷污层去除方面，冠部、中部和根尖三分之一之间存在显著差异，p值<0.05。对于侵蚀，第二组（Oxum）在冠部、中部和根尖三分之一之间显示出统计学显著差异，并且与EDTA相比，其牙本质侵蚀明显更少。
在本研究的局限性内，市售的超氧化水Oxum在去除玷污层方面与EDTA同样有效，且侵蚀性更小。
