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几种冲洗剂联合使用对牙本质表面特性、氯己定吸附及微生物对牙本质黏附的影响。

Effect of the combination of several irrigants on dentine surface properties, adsorption of chlorhexidine and adhesion of microorganisms to dentine.

作者信息

Tartari T, Wichnieski C, Bachmann L, Jafelicci M, Silva R M, Letra A, van der Hoeven R, Duarte M A H, Bramante C M

机构信息

Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.

Department of Endodontics, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil.

出版信息

Int Endod J. 2018 Dec;51(12):1420-1433. doi: 10.1111/iej.12960. Epub 2018 Jun 29.

Abstract

AIM

To investigate the effects of combinations of several irrigants on the roughness and wettability of dentine, adhesion of Enterococcus faecalis and Candida albicans and adsorption of chlorhexidine (CHX) to the dentine.

METHODOLOGY

Bovine dentine samples were prepared and their surface roughness standardized. The samples were distributed in groups (n = 10) and subjected to one of the following irrigation protocols: G1 - saline solution; G2 - sodium hypochlorite (NaOCl); G3 - NaOCl + ethylenediaminetetraacetic acid (EDTA); G4 - NaOCl + peracetic acid (PAA); G5 - NaOCl + 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP); G6 - NaOCl + EDTA + CHX; G7 - NaOCl + PAA + CHX; G8 - NaOCl + HEDP + CHX; and G9 - mixture of NaOCl + HEDP. After treatments, roughness and wettability were measured. In order to evaluate the adhesion of microorganisms to dentine, new dentine samples were prepared and after 2 h of contact with the microorganisms, were analysed using a confocal laser scanning microscope and the number of microorganisms adhering to the surfaces were determined. Absorption spectra were collected by attenuated total reflectance of Fourier-transform infrared spectroscopy before and after immersion of other dentine samples in each solution of G6, G7 and G8 and in a solution of 2% CHX at various time intervals. The areas of the band associated with CHX with the peak at 1492 cm were calculated between 1479 and 1500 cm of the spectral range. The data obtained in all experiments were subjected to one-way ANOVA (α < 0.05). The values of the CHX band were also subjected to one-way repeated measures ANOVA (α < 0.05).

RESULTS

Saline solution, NaOCl, HEDP and CHX did not alter the roughness of the dentine (P > 0.05), whilst EDTA and PAA did (P < 0.05). Dentine surface wettability increased after the use of all irrigants compared to saline solution (P < 0.05), with HEDP causing the greatest increases (P < 0.05). The adhesion of E. faecalis was favoured on surfaces treated with only saline solution and NaOCl, and on samples that had decalcifying agents as the final irrigant (P < 0.05). The adhesion of C. albicans was highest on surfaces treated with only saline solution and on surfaces that had NaOCl used as the last irrigant (P < 0.05). The use of CHX as a final irrigant reduced the adhesion of both microorganisms. The roughness and wettability did not influence the adhesion of the microorganisms tested. The adsorption of CHX to the dentine was significant after 1 min of immersion of the mineralized samples in the irrigant (P < 0.05), and the use of chelating agents prior to CHX potentiated this adsorption.

CONCLUSIONS

The irrigation solutions had a variable effect on the properties of dentine, on the adhesion of E. faecalis and C. albicans and the adsorption of CHX to the dentine surface.

摘要

目的

研究几种冲洗剂组合对牙本质粗糙度、润湿性、粪肠球菌和白色念珠菌黏附以及洗必泰(CHX)在牙本质上吸附的影响。

方法

制备牛牙本质样本并使其表面粗糙度标准化。将样本分组(n = 10),并进行以下冲洗方案之一:G1 - 生理盐水;G2 - 次氯酸钠(NaOCl);G3 - NaOCl + 乙二胺四乙酸(EDTA);G4 - NaOCl + 过氧乙酸(PAA);G5 - NaOCl + 1-羟基亚乙基-1,1-二膦酸(HEDP);G6 - NaOCl + EDTA + CHX;G7 - NaOCl + PAA + CHX;G8 - NaOCl + HEDP + CHX;以及G9 - NaOCl + HEDP混合物。处理后,测量粗糙度和润湿性。为评估微生物对牙本质的黏附,制备新的牙本质样本,在与微生物接触2小时后,使用共聚焦激光扫描显微镜进行分析,并确定黏附在表面的微生物数量。在G6、G7和G8的每种溶液以及不同时间间隔的2% CHX溶液中浸泡其他牙本质样本前后,通过傅里叶变换红外光谱的衰减全反射收集吸收光谱。在光谱范围1479至1500 cm处计算与CHX相关的峰位于1492 cm处的谱带面积。所有实验获得的数据进行单因素方差分析(α < 0.05)。CHX谱带的值也进行单因素重复测量方差分析(α < 0.05)。

结果

生理盐水、NaOCl、HEDP和CHX未改变牙本质粗糙度(P > 0.05),而EDTA和PAA改变了粗糙度(P < 0.05)。与生理盐水相比,使用所有冲洗剂后牙本质表面润湿性均增加(P < 0.05),其中HEDP导致的增加最大(P < 0.05)。仅用生理盐水和NaOCl处理的表面以及以脱钙剂作为最终冲洗剂的样本上,粪肠球菌的黏附更有利(P < 0.05)。仅用生理盐水处理的表面以及以NaOCl作为最后冲洗剂的表面上,白色念珠菌的黏附最高(P < 0.05)。使用CHX作为最终冲洗剂可降低两种微生物的黏附。粗糙度和润湿性不影响所测试微生物的黏附。矿化样本在冲洗剂中浸泡1分钟后,CHX在牙本质上的吸附显著(P < 0.05),并且在CHX之前使用螯合剂可增强这种吸附。

结论

冲洗溶液对牙本质特性、粪肠球菌和白色念珠菌的黏附以及CHX在牙本质表面的吸附有不同影响。

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