Yared Ghassan, Ramli Ghada Asmar
Private Practice, Lebanese University, Beirut, Lebanon.
Department of Orthodontics, Lebanese University, Beirut, Lebanon.
J Conserv Dent. 2020 Jan-Feb;23(1):10-14. doi: 10.4103/JCD.JCD_306_20. Epub 2020 Oct 10.
Oval-shaped canals represent a challenge in endodontics. Infected tissue may remain in their recesses. This concern may be more critical with minimally instrumentation techniques.
The present study evaluated the disinfection ability in oval-shaped canals of a noninstrumentation technique using ultrasonic agitation and intracanal heating of sodium hypochlorite (NaOCl) compared to rotary canal preparation and ultrasonic agitation with and without heating of NaOCl.
Sixty extracted mandibular incisors were included. The teeth had pulp necrosis and apical periodontitis and oval-shaped canals. They were divided into three groups depending on the treatment protocol: (1) IHAN: intracanal heating and ultrasonic agitation of NaOCl only, (2) R-IHAN: Rotary preparation followed by IHAN, and (3) R-passive ultrasonic agitation (PUA): Rotary preparation and ultrasonic agitation of NaOCl.
Root canal samples were taken before (S1) and after (S2) the endodontic procedures were completed and cultured anaerobically.
Wilcoxon tests were performed to compare colony-forming units (CFUs) before and after the endodontic procedures for the three groups. The percentage of variation of CFUs was compared among the three groups using Kruskal-Wallis tests, followed by Mann-Whitney U-tests.
All S1 samples were positive. All S2 samples showed bacterial growth in R-PUA compared to 17 in R-IHAN. None of the S2 samples in IHAN were positive. Bacteria reduction was significant in each group ( < 0.001). The percentage of bacteria reduction was highest for IHAN and lowest for R-PUA ( < 0.001).
Intracanal heating and ultrasonic agitation of NaOCl without instrumentation completely eliminated bacteria from infected oval-shaped canals.
椭圆形根管给牙髓病治疗带来了挑战。感染组织可能残留在其隐窝内。对于微创治疗技术而言,这一问题可能更为关键。
本研究评估了一种非器械操作技术在椭圆形根管中的消毒能力,该技术使用超声波震荡和次氯酸钠(NaOCl)根管内加热,并与旋转根管预备以及有无NaOCl加热的超声波震荡进行比较。
纳入60颗拔除的下颌切牙。这些牙齿患有牙髓坏死和根尖周炎且根管呈椭圆形。根据治疗方案将它们分为三组:(1)IHAN组:仅进行NaOCl根管内加热和超声波震荡;(2)R - IHAN组:先进行旋转预备,然后进行IHAN;(3)R - 被动超声波震荡(PUA)组:旋转预备并进行NaOCl的超声波震荡。
在牙髓治疗程序完成前(S1)和完成后(S2)采集根管样本,并进行厌氧培养。
采用Wilcoxon检验比较三组牙髓治疗前后的菌落形成单位(CFU)。使用Kruskal - Wallis检验比较三组CFU的变化百分比,随后进行Mann - Whitney U检验。
所有S1样本均为阳性。与R - IHAN组的17个样本相比,R - PUA组所有S2样本均显示有细菌生长。IHAN组的S2样本均无阳性。每组细菌减少均有统计学意义(<0.001)。细菌减少百分比在IHAN组最高,在R - PUA组最低(<0.001)。
不进行器械操作,NaOCl根管内加热和超声波震荡可完全清除感染椭圆形根管内的细菌。