Department of Pedodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey.
Department of Medical Microbiology, Atatürk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey.
Clin Oral Investig. 2019 Oct;23(10):3789-3799. doi: 10.1007/s00784-019-02808-0. Epub 2019 Feb 13.
The aim of this randomized, three-arm parallel, single-blinded clinical trial was to evaluate the clinical and microbiological effectiveness of the ozone application in two-visit indirect pulp therapy.
One hundred five lower first molar teeth with deep caries lesion were included and randomly assigned three groups to apply the two-visit indirect pulp therapy. Treatment procedure was applied without any disinfectant (control), with 60-s 2% chlorhexidine digluconate (CHX) or 60-s ozone application. In four different stages (after initial excavation, ozone/CHX application before the temporary restoration, 4 months later immediately after removing temporary restoration, and final excavation), dentin humidity, consistency, and color properties were recorded to evaluate the clinical characteristics of the tissue, and standard dentin samples were collected for the microbiological analysis of mutans streptococci, lactobacilli, and the total number of colony-forming units. The data were analyzed by using Mann-Whitney U test for multiple comparisons.
The remaining dentin became harder, drier, and darker after 4 months in all groups. However, CHX and ozone application were statistically better than the control group (p < 0.05). There was a gradual decrease in the total number of microorganisms in all groups. While cavity disinfectant applications were improved the antibacterial efficacy (control, 79.11%; CHX, 98.39%; ozone, 93.33%), CHX application exhibited a greater significant reduction than both groups (p = 0.000).
The two-visit indirect pulp therapy yielded successful results for all study groups. However, CHX would be conveniently preferable due to improving the treatment success.
The two-visit indirect pulp therapy applied with cavity disinfectant is a proper alternative treatment procedure in deep carious lesions, instead of conventional technique.
本随机、三臂平行、单盲临床试验的目的是评估臭氧应用于两次就诊间接牙髓治疗的临床和微生物学效果。
将 105 颗下颌第一磨牙深龋纳入研究，并随机分为三组应用两次就诊间接牙髓治疗。治疗程序在不使用任何消毒剂的情况下进行（对照组）、应用 60 秒 2%葡萄糖酸氯己定（CHX）或 60 秒臭氧。在四个不同阶段（初次开髓后、临时修复前臭氧/CHX 应用、4 个月后临时修复去除后即刻、最终开髓），记录牙本质湿度、一致性和颜色特性，以评估组织的临床特征，并采集标准牙本质样本进行变形链球菌、乳杆菌和总菌落形成单位的微生物分析。采用 Mann-Whitney U 检验进行多组比较。
所有组在 4 个月后剩余牙本质变得更硬、更干燥、更暗。然而，CHX 和臭氧应用明显优于对照组（p<0.05）。所有组的微生物总数逐渐减少。虽然腔室消毒剂的应用改善了抗菌效果（对照组为 79.11%；CHX 为 98.39%；臭氧为 93.33%），但 CHX 应用的效果明显优于其他两组（p=0.000）。
两次就诊间接牙髓治疗对所有研究组均取得了成功结果。然而，CHX 可能更为方便，因为它提高了治疗成功率。
在深龋病变中，应用腔室消毒剂的两次就诊间接牙髓治疗是一种替代传统技术的合适治疗方法。
