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新型 HEDP 溶液冲洗根管后与传统次氯酸钠联合 EDTA 冲洗根管后根管壁的清洁度和侵蚀:扫描电镜研究。

Cleanliness and erosion of root canal walls after irrigation with a new HEDP-based solution vs. traditional sodium hypochlorite followed by EDTA. A scanning electron microscope study.

机构信息

Department of Endodontology School of Dental Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.

Department of Preventive Dentistry, Periodontology and Cariology, University of Goettingen, Goettingen, Germany.

出版信息

Clin Oral Investig. 2020 Oct;24(10):3699-3706. doi: 10.1007/s00784-020-03249-w. Epub 2020 May 16.

Abstract

OBJECTIVES

To compare the cleanliness and erosion of root canal walls after the use of a new HEDP (1-hydroxyethane-1,1-diphosphonic acid) -based irrigant with that achieved by irrigation with sodium hypochlorite followed by EDTA.

MATERIALS AND METHODS

Forty recently extracted single-rooted teeth were prepared with ProTaper Next files to size X3, using either HEDP-containing 3% sodium hypochlorite, throughout the procedure (n = 20), or 3% sodium hypochlorite followed by a final rinse with 17% EDTA (n = 20), which were both applied with a syringe and needle. Ten additional teeth were prepared and irrigated with saline and served as negative controls. The teeth were split longitudinally and subjected to SEM evaluation for the presence of a smear layer, debris, and erosion of the root canal wall. The Pearson chi-square test was used to compare the results, and the level of significance was set at p < 0.05.

RESULTS

In both groups, there were more cases with a smear layer in the apical third of the root canal than in the coronal third, but the groups did not differ from each other significantly (p = 0.545). The root canal walls in both groups were almost free of debris, showing no difference between the groups (p = 0.342). Moderate erosion of the root dentine was found in 10-26% of the cases in both groups, but severe erosion was detected in only one case in each of the groups, which did not differ significantly from each other (p = 0.606).

CONCLUSION

Within the limitations of the present study, the HEDP-based irrigation solution did not differ from 3% sodium hypochlorite followed by EDTA in terms of cleanliness or the incidence of erosion of the canal wall.

CLINICAL RELEVANCE

When used with syringe and needle irrigation, the new HEDP-based irrigant is convenient and safe but should not be expected to result in cleaner canal walls than 3% sodium hypochlorite followed by 17% EDTA.

摘要

目的

比较新型 HEDP(1-羟基亚乙基二膦酸)基冲洗液与次氯酸钠冲洗后再用 EDTA 冲洗对根管壁清洁度和侵蚀的影响。

材料与方法

40 颗最近拔出的单根牙用 ProTaper Next 锉至 X3 号,分别用含 HEDP 的 3%次氯酸钠(n=20)或 3%次氯酸钠冲洗后再用 17% EDTA 终末冲洗(n=20),均采用注射器和针头进行冲洗。另外 10 颗牙用生理盐水冲洗作为阴性对照。牙体纵向劈开后进行 SEM 评估,观察有无玷污层、碎屑和根管壁侵蚀。采用 Pearson χ²检验进行结果比较,显著性水平设为 p<0.05。

结果

两组根管根尖 3 区均较冠 3 区有更多的玷污层病例,但组间差异无统计学意义(p=0.545)。两组根管壁均几乎无碎屑,组间差异无统计学意义(p=0.342)。两组各有 10%-26%的病例出现中度牙本质侵蚀,但严重侵蚀的病例各只有 1 例,组间差异无统计学意义(p=0.606)。

结论

在本研究的限制范围内,新型 HEDP 基冲洗液与 3%次氯酸钠冲洗后再用 EDTA 相比,在清洁度或根管壁侵蚀发生率方面无差异。

临床意义

使用注射器和针头冲洗时,新型 HEDP 基冲洗液方便且安全,但不应期望其清洁根管壁的效果优于 3%次氯酸钠冲洗后再用 17% EDTA。

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