Savitha A, SriRekha A, Vijay R, Champa C, Jaykumar T
Department of Conservative Dentistry and Endodontics, The Oxford Dental College and Hospital, Bommanahalli, Hosur Road, Bangalore 560068, India.
Saudi Dent J. 2019 Jul;31(3):360-366. doi: 10.1016/j.sdentj.2019.03.003. Epub 2019 Mar 11.
To evaluate the in vivo antibacterial efficacy of 2% chlorhexidine gel (CHX), 2% chitosan (CS) gel and their combination as an intracanal medicament against Enterococcus faecalis during endodontic retreatment procedure, with the use of qPCR.
A total of 45 single rooted permanent teeth were selected from 28 systemically healthy patients (mean age of 43 years). After complete disinfection and access opening as well as gutta-percha (GP) removal, the first microbiological pretreatment sample (S1) was collected. After completion of instrumentation, a post-instrumentation sample (S2) was taken and the teeth were randomly divided into three experimental groups: 2% CHX gel; 2% CS gel; 2% CHX with CS; Fuji IX glass ionomer cement was used to seal the access; after 7 days, the post medication sample (S3) was collected and E. faecalis was quantified using qPCR.
Maximum reduction in bacterial mean CFU (×10) counts was observed between S1 and S2; S2 and S3; S1 and S3 in 2% CHX with chitosan group compared to other groups. Percentage reduction in CFU (×10) counts at different time intervals (S1-S2; S2-S3; S1-S3) was maximum for the 2% CHX with the chitosan group. Comparison of the mean CFU (×10) count within the 2% CHX gel group and the 2% CHX with chitosan group at different time intervals (S1,S2,S3) was found to be highly significant (P = 0.001); whereas in group II, it was significant (P = 0.002).
2% CHX with chitosan group showed the highest microbial reduction against E. faecalis during retreatment of failed endodontic cases.
运用定量聚合酶链反应（qPCR）评估2%洗必泰凝胶（CHX）、2%壳聚糖（CS）凝胶及其组合作为根管内药物在根管再治疗过程中对粪肠球菌的体内抗菌效果。
从28名全身健康的患者（平均年龄43岁）中选取45颗单根恒牙。在完成彻底消毒、开髓以及去除牙胶尖（GP）后，采集首个微生物预处理样本（S1）。完成根管预备后，采集预备后样本（S2），并将牙齿随机分为三个实验组：2% CHX凝胶组；2% CS凝胶组；2% CHX与CS组合组；用富士IX玻璃离子水门汀封闭髓腔；7天后，采集用药后样本（S3），并使用qPCR对粪肠球菌进行定量分析。
与其他组相比，2% CHX与壳聚糖组合组在S1与S2、S2与S3、S1与S3之间观察到细菌平均菌落形成单位（CFU，×10）计数的最大降幅。在不同时间间隔（S1 - S2；S2 - S3；S1 - S3），2% CHX与壳聚糖组合组的CFU（×10）计数降幅百分比最大。在不同时间间隔（S1、S2、S3），2% CHX凝胶组与2% CHX与壳聚糖组合组的平均CFU（×10）计数比较差异具有高度显著性（P = 0.001）；而在第二组中差异具有显著性（P = 0.002）。
在根管治疗失败再治疗过程中，2% CHX与壳聚糖组合组对粪肠球菌的微生物减少效果最为显著。
