Neves Mônica A S, Provenzano José C, Fonseca Simone C L, Rodrigues Renata C V, Gonçalves Lucio S, Siqueira José F, Rôças Isabela N
Department of Endodontics, School of Dentistry, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil.
Department of Endodontics, School of Dentistry, UNIG - Universidade Iguaçu, Nova Iguaçu, RJ, Brazil.
Braz Dent J. 2020 Sep-Oct;31(5):493-498. doi: 10.1590/0103-6440202003245.
This clinical study reports on the antibacterial effects and outcome of endodontic treatment using either a single-file or a multifile system, associated with calcium hydroxide interappointment medication. The root canals of single-rooted teeth with apical periodontitis were treated by using either Reciproc or BioRaCe instrument systems, 2.5% NaOCl irrigation, and calcium hydroxide medication. Bacteriological samples taken before preparation and immediately before obturation were evaluated for total bacterial counts by quantitative real-time polymerase chain reaction (qPCR). Patients were followed up and the treatment outcome was assessed by clinical and radiographic criteria. Decreasing lesions were classified as success in a lenient criterion or failure in a rigid one. Bacteria were detected in all initial samples (47 cases) and were significantly reduced after treatment in both groups (p<0.001). In the Reciproc and BioRaCe groups, 7/25 (28%) and 11/22 (50%) root canals yielded negative qPCR results before obturation, respectively (p>0.05). Quantitative bacterial reduction was similar between groups (p>0.05). The success rate in the BioRaCe group was 95.5% and 77% in the loose and rigid criterion, respectively. In the Reciproc group, corresponding figures were 88% and 76%. Differences in outcome were not significant (p>0.05). No diseased case showed negative qPCR results for bacteria. A difference of >1 Log10 counts was observed between healed and diseased cases. Root canal treatments of teeth with apical periodontitis using a single-file or a multifile system for preparation, associated with NaOCl irrigation and calcium hydroxide interappointment medication, showed similar antibacterial effectiveness and success rate.
本临床研究报告了使用单根管器械或多根管器械系统进行根管治疗，并联合使用氢氧化钙进行诊间封药的抗菌效果及治疗结果。对患有根尖周炎的单根牙根管，采用Reciproc或BioRaCe器械系统、2.5%次氯酸钠冲洗及氢氧化钙封药进行治疗。在根管预备前及即将充填前采集细菌学样本，通过定量实时聚合酶链反应（qPCR）评估细菌总数。对患者进行随访，并根据临床和影像学标准评估治疗结果。病变减轻在宽松标准下分类为成功，在严格标准下分类为失败。所有初始样本（47例）均检测到细菌，两组治疗后细菌数量均显著减少（p<0.001）。在Reciproc组和BioRaCe组中，分别有7/25（28%）和11/22（50%）的根管在充填前qPCR结果为阴性（p>0.05）。两组间细菌数量的减少量相似（p>0.05）。BioRaCe组在宽松和严格标准下的成功率分别为95.5%和77%。Reciproc组的相应数字分别为88%和76%。治疗结果的差异不显著（p>0.05）。没有患病病例的细菌qPCR结果为阴性。愈合病例和患病病例之间观察到>1 Log10数量的差异。使用单根管器械或多根管器械系统进行根管预备，联合次氯酸钠冲洗及氢氧化钙诊间封药治疗根尖周炎患牙，显示出相似的抗菌效果和成功率。
