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[五种根管冲洗剂在感染根管中的抗菌及残余抗菌活性:一项体外对比研究]

[Antibacterial and residual antimicrobial activities of five final irrigants in infected root canal: an in vitro comparative study].

作者信息

Wu Z, Guo X J, Qiao F, Wu L G

机构信息

Department of Endodontics, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, China.

Department of Stomatology, Cangzhou Central Hospital, Cangzhou Hebei 061014, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2016 Sep;51(9):532-7. doi: 10.3760/cma.j.issn.1002-0098.2016.09.005.

Abstract

OBJECTIVE

To evaluate antibacterial and residual antimicrobial activities of five root canal irrigants including Qmix, MTAD(mixture of a tetracycline isomer, an acid, and a detergent), 0.2% cetrimide(CTR), 2% chlorhexidine(CHX) and 17% ethylene diaminetetraacetic acid(EDTA) and to find the most optimal final irrigants for using in root canal therapy.

METHODS

The standard enterococcus infection models were built up in 100 single rooted incisors with single canal. Totally 30 teeth were selected by using random number tablefor detecting the quality of the bacteria model. Crown-down technique with rotary ProTaper system was used to prepare the root canals. Then the teeth were randomly divided into seven groups of which five groups were irrigated with five different irrigants respectively, one group was irrigated with distilled water(distilled water group) and one group was no-irrigation group. Each tooth was sectioned into three parts: apical 1/3, middle 1/3 and coronal 1/3. After irrigation, specimenswere cultivated from day 0 to day 14. All statistical analyses were performed by means of SPSS 17.0 software. Chi-squared test was used to evaluate antibacterial activities. Generalized estimating equations was used to evaluate residual antimicrobial activities.

RESULTS

All samples rinsed with Qmix, MTAD, CTR, CHX were bacteria-free in 0 day. The samples rinsed with EDTA and distilled water had no bacteria in 7 coronal sections, 6 middle sections and 9 apical sections, respectively. The results of Qmix, MTAD, CTR and CHX groups showed significant difference when compared with that of distilled water, EDTA and control groups(P<0.05). Residual antimicrobial resultsin EDTA, distilled water, no-irrigation groups showed significant differences compared with that of Qmix, MTAD, CTR, CHX groups according to pairwise comparison(P<0.05) on day 1, 2 and 3. There was no significant difference between the other two groups(P>0.05). Antimicrobial properties on the coronal 1/3 and apical 1/3, middle 1/3 and apical 1/3 showed significant difference(P<0.05) while middle 1/3 and coronal 1/3 showed no significant difference(P>0.05).

CONCLUSIONS

Qmix, MTAD, CTR and CHX had an antimicrobial activity, but could not destroy Enterococcus faecalis completely. Antimicrobial activity in coronal 1/3 was better than in apical 1/3. Qmix, MTAD, CTR and CHX had a residual antimicrobial activity with various lasting times. The lasting time of residual antimicrobial activity was as follow: MTAD> CTR>Qmix>CHX. EDTA had no antibacterial and residual antimicrobial activities.

摘要

目的

评估5种根管冲洗剂(Qmix、MTAD(一种四环素异构体、一种酸和一种去污剂的混合物)、0.2%西曲溴铵(CTR)、2%氯己定(CHX)和17%乙二胺四乙酸(EDTA))的抗菌及抗菌后残余活性,以寻找根管治疗中最理想的终末冲洗剂。

方法

在100颗单根单根管的切牙中建立标准肠球菌感染模型。通过随机数字表选取30颗牙齿检测细菌模型质量。采用旋转ProTaper系统的冠向下技术预备根管。然后将牙齿随机分为7组,其中5组分别用5种不同冲洗剂冲洗,1组用蒸馏水冲洗(蒸馏水组),1组不冲洗(不冲洗组)。每颗牙齿分为根尖1/3、根中1/3和冠1/3三部分。冲洗后,从第0天至第14天进行标本培养。所有统计分析均使用SPSS 17.0软件。采用卡方检验评估抗菌活性。采用广义估计方程评估抗菌后残余活性。

结果

用Qmix、MTAD、CTR、CHX冲洗的所有样本在第0天均无菌。用EDTA和蒸馏水冲洗的样本在冠部7个切片、根中部6个切片和根尖部9个切片中分别无菌。Qmix、MTAD、CTR和CHX组的结果与蒸馏水、EDTA和对照组相比有显著差异(P<0.05)。在第1、2和3天,通过两两比较,EDTA、蒸馏水、不冲洗组的抗菌后残余结果与Qmix、MTAD、CTR、CHX组相比有显著差异(P<0.05)。其他两组之间无显著差异(P>0.05)。冠1/3与根尖1/3、根中1/3与根尖1/3的抗菌性能有显著差异(P<0.05),而根中1/3与冠1/3无显著差异(P>0.05)。

结论

Qmix、MTAD、CTR和CHX具有抗菌活性,但不能完全杀灭粪肠球菌。冠1/3的抗菌活性优于根尖1/3。Qmix、MTAD、CTR和CHX具有不同持续时间的抗菌后残余活性。抗菌后残余活性的持续时间如下:MTAD>CTR>Qmix>CHX。EDTA无抗菌及抗菌后残余活性。

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