Kim Sahng G
Division of Endodontics, Columbia University College of Dental Medicine, 630 W. 168th St. PH7Stem #128, New York, NY 10032, USA.
Dent J (Basel). 2016 Mar 10;4(1):4. doi: 10.3390/dj4010004.
The regeneration of the pulp-dentin complex has been a great challenge to both scientists and clinicians. Previous work has shown that the presence of prior infection may influence the characteristics of tissues formed in the root canal space after regenerative endodontic treatment. The formation of ectopic tissues such as periodontal ligament, bone, and cementum has been observed in the root canal space of immature necrotic teeth with apical periodontitis, while the regeneration of dentin and pulp has been identified in previously non-infected teeth. The current regenerative endodontic therapy utilizes disinfection protocols, which heavily rely on chemical irrigation using conventional disinfectants. From a microbiological point of view, the current protocols may not allow a sufficiently clean root canal microenvironment, which is critical for dentin and pulp regeneration. In this article, the significance of root canal disinfection in regenerating the pulp-dentin complex, the limitations of the current regenerative endodontic disinfection protocols, and advanced disinfection techniques designed to reduce the microorganisms and biofilms in chronic infection are discussed.
牙髓-牙本质复合体的再生一直是科学家和临床医生面临的巨大挑战。先前的研究表明，先前感染的存在可能会影响再生性牙髓治疗后根管空间中形成的组织的特征。在患有根尖周炎的未成熟坏死牙齿的根管空间中，已观察到异位组织如牙周膜、骨和牙骨质的形成，而在先前未感染的牙齿中已鉴定出牙本质和牙髓的再生。当前的再生性牙髓治疗采用消毒方案，该方案严重依赖于使用传统消毒剂的化学冲洗。从微生物学的角度来看，当前的方案可能无法提供足够清洁的根管微环境，而这对于牙本质和牙髓的再生至关重要。在本文中，讨论了根管消毒在牙髓-牙本质复合体再生中的意义、当前再生性牙髓消毒方案的局限性以及旨在减少慢性感染中微生物和生物膜的先进消毒技术。
