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. 2020 Oct;24(10):3529-3538. doi: 10.1007/s00784-020-03223-6. Epub 2020 Feb 6.
The aim of this randomized, controlled, three-arm parallel-group, double-blinded clinical trial was to investigate the clinical and microbiological effects of the ozone application in stepwise excavation of primary molars.
This study was conducted in in vivo conditions with 105 lower primary molars that had deep caries lesions. The teeth were randomly divided into three groups: (I) control group, conventional stepwise excavation with no disinfectants; (II) CHX (positive control) group, 2% chlorhexidine digluconate; and (III) experimental group, ozone application. Dentine samples were collected at 4 different time points (T0, at the first appointment, after partial removal of carious dentin; T1, at the first appointment, after applying disinfection procedure; T2, at the second appointment - at the end of the 4-month period - immediately after the removal of the temporary restoration; T3, at the second appointment, after the final excavation) for the microbiological analysis of mutans streptococci and lactobacilli and the total number of colony-forming units. Clinical changes including dentin color, humidity, and consistency were recorded. Data were analyzed using the Mann-Whitney U test, Friedman test, and chi-squared test (p = 0.05).
The dentin became harder and drier after 4 months in all the groups. There was a gradual reduction in the total number of microorganisms in all the three groups. Bacterial reduction was greater in the CHX group compared to the ozone group (p = 0.002) and was greater in the ozone group compared to the control group (p = 0.015) after 4 months (control, 78%; CHX, 93%; ozone, 82%).
Stepwise excavation of primary teeth provided successful outcomes in all the groups. Moreover, CHX, due to its practicality and cost-effectiveness, can be effectively used with one- or two-step indirect pulp therapies.
Usage of cavity disinfectants in the stepwise excavation procedure contributes to the reduction of bacterial population in the cavity, which may allow the avoidance of the second step of the indirect pulp therapy for primary teeth.
本随机对照三臂平行组双盲临床试验旨在研究臭氧化应用于乳磨牙逐步挖除术的临床和微生物学效果。
本研究在体内条件下对 105 颗具有深龋损的下颌乳磨牙进行，随机分为三组：（I）对照组，无消毒剂的常规逐步挖除术；（II）CHX（阳性对照组），2%葡萄糖酸氯己定；（III）实验组，臭氧应用。在 4 个不同时间点（T0，第一次就诊时，在部分去除龋坏牙本质后；T1，第一次就诊时，在应用消毒程序后；T2，第二次就诊时-在 4 个月结束时-在临时修复去除后立即；T3，第二次就诊时，在最终挖掘后）采集牙本质样本，用于变形链球菌和乳杆菌以及总菌落形成单位的微生物分析。记录临床变化，包括牙本质颜色、湿度和一致性。使用曼-惠特尼 U 检验、弗里德曼检验和卡方检验（p=0.05）分析数据。
所有组在 4 个月后牙本质变得更硬和干燥。所有三组的微生物总数逐渐减少。CHX 组的细菌减少量大于臭氧组（p=0.002），并且在 4 个月后臭氧组与对照组相比细菌减少量更大（p=0.015）（对照组，78%；CHX，93%；臭氧，82%）。
在所有组中，乳磨牙的逐步挖除术都取得了成功的结果。此外，CHX 由于其实用性和成本效益，可以有效地用于一步或两步间接牙髓治疗。
在逐步挖除过程中使用腔消毒剂有助于减少腔内细菌数量，这可能允许避免对乳磨牙进行第二次间接牙髓治疗。
