根管超声冲洗系统的抗菌效果：一项体外研究。

Antibacterial efficacy of an endodontic sonic-powered irrigation system: An in vitro study.

机构信息

Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

The Dental College of Georgia, Augusta University, Augusta, GA, USA.

出版信息

J Dent. 2018 Aug;75:105-112. doi: 10.1016/j.jdent.2018.06.003. Epub 2018 Jun 13.

DOI:10.1016/j.jdent.2018.06.003

PMID:29908290

Abstract

OBJECTIVE

To evaluate the efficacy of EDDY, a new sonic-powered irrigation system, in reducing intracanal bacteria load.

METHODS

Thirty-eight instrumented, autoclaved single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days. Two teeth were used as negative control without bacterial contamination. For the bacteria-inoculated teeth, 6 were used as positive control without irrigation. The remaining 30 teeth were randomly divided into 2 groups (N = 15), using 3% NaOCl as irrigant: (A) 30-gauge syringe needle irrigation (SNI), (B) EDDY (VDW, Munich, Germany). Twelve teeth per group and 4 teeth in the positive control were evaluated for bacterial reduction using MTT assay. The remaining teeth were split for BacLight LIVE/DEAD staining to examine the percentages of live/dead bacteria present in the dentinal tubules from different canal locations (coronal, mid-root and apical portions of the canal space) using confocal laser scanning microscopy (CLSM).

RESULTS

MTT assay indicated that both SNI and EDDY significantly reduced overall intracanal bacterial load compared with the positive control, with no significant difference between the two techniques. CLSM indicated that EDDY had better intratubular bacterial killing efficacy than SNI in the coronal and mid-root portions of the canal space only but not in the apical portion. In all canal locations (coronal, mid-root apical), both systems failed to eliminate bacteria that proliferated deep within the dentinal tubules.

CONCLUSION

With the use of 3% NaOCl, sonic-powered irrigant activation with EDDY tips did not provide additional advantage over SNI in killing Enterococcus faecalis from deep intraradicular dentin.

CLINICAL SIGNIFICANCE

Both the sonic-powered root canal irrigant activation system and syringe needle irrigation can reduce intracanal bacteria load but are incapable of completely killing all bacteria that resided deep within the dentinal tubules of root canals infected with Enterococcus faecalis.

摘要

目的

评估新型声波动力冲洗系统 EDDY 降低根管内细菌负荷的疗效。

方法

将 38 颗已根管预备、高压蒸汽灭菌的单根人上颌前磨牙用粪肠球菌（ATCC-29212）接种 21 天。其中 2 颗作为无细菌污染的阴性对照。对于接种细菌的牙齿，6 颗作为不冲洗的阳性对照。其余 30 颗牙齿随机分为 2 组（每组 15 颗），使用 3%次氯酸钠作为冲洗液：（A）30 号根管冲洗针（SNI）冲洗，（B）EDDY（VDW，慕尼黑，德国）冲洗。每组 12 颗牙和阳性对照的 4 颗牙采用 MTT 检测评估细菌减少量。其余牙齿用于 BacLight LIVE/DEAD 染色，通过共聚焦激光扫描显微镜（CLSM）检查不同根管位置（根管冠部、中部和根尖部）牙本质小管内活菌/死菌的比例。

结果

MTT 检测表明，SNI 和 EDDY 均显著降低了整体根管内细菌负荷，与阳性对照相比，差异有统计学意义，但两种技术之间无显著差异。CLSM 表明，EDDY 在根管冠部和中部仅在根管空间内具有比 SNI 更好的根管内杀菌效果，但在根尖部则没有。在所有根管位置（根管冠部、中部、根尖部），两种系统都未能消除在牙本质小管深部增殖的细菌。