Institute of Microbiology and Infection & Centre for Computational Biology & School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
Institute of Microbiology and Infection & Centre for Computational Biology & School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
J Dent. 2020 Feb;93:103283. doi: 10.1016/j.jdent.2020.103283. Epub 2020 Jan 31.
Chemo-mechanical preparation of the root canal leaves behind viable bacteria which can lead to treatment failure. Materials used inside the root canal should possess antimicrobial properties and also resist disintegration in the presence of biofilm.
Gutta-percha, three root canal sealers (Pulp Canal Sealer, AH Plus and BioRoot RCS) and materials used to make posts (a metal and a resin) were evaluated. Their antimicrobial activity against Enterococcus faecalis in direct contact was assessed by scanning electron microscopy and live-dead staining using confocal microscopy over a period of eight weeks. The materials' structural integrity was assessed by scanning electron microscopy.
The antimicrobial activity of the materials varied. The metal alloy posts as well as BioRoot RCS sealer did not allow any biofilm accumulation; but gutta-percha, Pulp Canal Sealer and resin from fibre-reinforced posts encouraged thick biofilm accumulation. Microstructural changes were observed in AH Plus (washout) and BioRoot (crystal deposition) in contact with biofilm. The Pulp Canal and BioRoot RCS sealers exhibited a modified ion leaching pattern in contact with microbially loaded media.
The microbial challenge affected the material microstructure in some of the materials tested and allowed biofilm accumulation. Although clinical success depends on a number of factors, materials that are structurally sound and exhibit antimicrobial properties are preferable for endodontic therapy and tooth restoration involving entry in the root canal.
根管的化学机械预备会留下存活的细菌，这可能导致治疗失败。根管内使用的材料应具有抗菌性能，并能在生物膜存在的情况下抵抗崩解。
对牙胶、三种根管封闭剂（牙髓封闭剂、AH Plus 和 BioRoot RCS）以及用于制作桩的材料（一种金属和一种树脂）进行了评估。通过扫描电子显微镜和共聚焦显微镜在 8 周的时间内对其与粪肠球菌的直接接触的抗菌活性进行了评估。通过扫描电子显微镜评估了材料的结构完整性。
材料的抗菌活性不同。金属合金桩和 BioRoot RCS 封闭剂不允许任何生物膜积聚；但牙胶、牙髓封闭剂和纤维增强桩的树脂则促进了厚生物膜的积聚。与生物膜接触时，AH Plus（冲洗）和 BioRoot（晶体沉积）观察到微结构变化。牙髓封闭剂和 BioRoot RCS 封闭剂在与微生物负载介质接触时表现出改性的离子浸出模式。
微生物的挑战影响了一些测试材料的微观结构，并允许生物膜的积聚。尽管临床成功取决于许多因素，但对于根管治疗和涉及根管进入的牙齿修复，结构完整且具有抗菌性能的材料更可取。
