Ramezani Gholamhossein, Savadkouhi Sohrab Tour, Sayahpour Sahar
Department of Pediatric Dentistry, Dental Branch, Islamic Azad University, Tehran, Iran.
Department of Endodontics, Dental Branch, Islamic Azad University, Tehran, Iran.
J Int Soc Prev Community Dent. 2017 Sep-Oct;7(5):247-251. doi: 10.4103/jispcd.JISPCD_198_17. Epub 2017 Sep 18.
Apexification is a challenging treatment in necrotic open apices teeth and bacterial leakage is the main reason for the treatment failure. The aim of this study is to compare the effect of mixing mineral trioxide aggregate (MTA) with chlorhexidine (CHX) on microbial leakage in apexification treatment of simulated immature teeth.
In this experimental study, 44 intact central incisors were selected based on inclusion criteria. The coronal and 2 mm of apical part of the specimens were removed till all root segments were 12 mm long. The apical parts of the teeth were prepared using Profile #40/0.06 (Dentsply Maillefer, Ballaigues, Switzerland) in the apical to coronal direction to simulate open apices. The specimens were separated into experimental groups ( = 40) and control groups ( = 4). Group 1 delivered a 5 mm apical plug by MTA/HO and group 2 delivered an apical plug by MTA/CHX 0.12%. The positive control group had no apical barrier; on the other hand, the negative control group had an apical barrier and two layers of nail varnish on entire root surface. The microbial leakage assessment was done by a dual-chamber apparatus using fresh human saliva after 10-week follow-up. The turbidity of the lower chamber containing the Brain Heart Infusion (BHI) solution was analyzed based on the McFarland (0.5) standard which utilizes spectrophotometry results. Data analyses were done using Chi-square, Kaplan-Meier, and log-rank tests.
MTA/CHX group had lower microbial leakage percentage ( = 0.001) and longer time of leakage ( = 0.002) in compared with MTA/HO group and the difference was statistically meaningful.
Based on the results of this study, MTA/CHX mixture can reduce the amount of bacterial leakage.
根尖诱导成形术是治疗坏死性开放根尖牙齿的一项具有挑战性的治疗方法，细菌渗漏是治疗失败的主要原因。本研究的目的是比较将三氧化矿物凝聚体（MTA）与洗必泰（CHX）混合在模拟未成熟牙齿根尖诱导成形治疗中对微生物渗漏的影响。
在本实验研究中，根据纳入标准选择了44颗完整的中切牙。去除标本的冠部和根尖部分2mm，直到所有牙根段长度为12mm。使用Profile #40/0.06（登士柏迈尔法，瑞士巴莱格）从根尖向冠部方向制备牙齿的根尖部分，以模拟开放根尖。将标本分为实验组（n = 40）和对照组（n = 4）。第1组用MTA/HO形成5mm的根尖充填物，第2组用0.12%的MTA/CHX形成根尖充填物。阳性对照组没有根尖屏障；另一方面，阴性对照组有根尖屏障且在整个牙根表面涂有两层指甲油。在10周随访后，使用新鲜人唾液通过双腔装置进行微生物渗漏评估。根据利用分光光度法结果的麦氏（0.5）标准分析含有脑心浸液（BHI）溶液的下腔的浊度。使用卡方检验、Kaplan-Meier检验和对数秩检验进行数据分析。
与MTA/HO组相比，MTA/CHX组的微生物渗漏百分比更低（P = 0.001），渗漏时间更长（P = 0.002），差异具有统计学意义。
基于本研究结果，MTA/CHX混合物可减少细菌渗漏量。
