一种溴化自酸蚀黏结剂对龋坏牙本质的抗菌效果——体内研究。

Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.

Medical Department II Gastroenterology, Hepatology, Infectious Diseases, Pneumology, Section Hepatology, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, Germany.

J Dent. 2021 Feb;105:103555. doi: 10.1016/j.jdent.2020.103555. Epub 2020 Dec 17.

OBJECTIVES

This in vivo study compared the antibacterial effect of a self-etch adhesive with and without the brominated monomer 12-methacryloyloxydodecyl-pyridinium bromide (MDPB) on carious dentin after selective caries removal.

METHODS

10 patients showing deep primary carious lesions at two posterior teeth without pulpal symptoms were included. At visit I, carious tissue was selectively removed and carious dentin was sampled with a sterile roundbur (Komet No. 18). One cavity was restored with composite (SDR, Ceram X; DENTSPLY DeTrey) using an MDPB-containing self-etch adhesive (Clearfil Protect Bond, Kuraray Noritake; PB). The other restoration served as a control (Clearfil SE Bond II, Kuraray Noritake; SE). At visit II after 8 weeks, carious dentin was sampled again. Bacterial growth in carious dentin was differentiated using microbial cultivation. Bacterial DNA from intact cells and cell-free DNA were quantified using 16S rRNA gene-based real-time PCR and the microbial community composition was analyzed by amplicon deep-sequencing. Wilcoxon test was applied for statistical analysis.

RESULTS

Both treatments showed a decrease of intact bacterial cells in carious dentin at visit II compared to visit I (PB: visit I: 1.110, visit II: 1.710 (p = 0.03); SE: visit I: 1.110, visit II = 2.410 (p = 0.002)). No statistically significant reduction of cell-free bacterial DNA was detected (PB: visit I: 6.110, visit II: 1.610 (p = 0.08); SE: visit I: 5.310, visit II: 2.910 (p = 0.10)). The decrease of intact cell-derived (p = 0.371) and cell-free DNA (p = 0.455) did not differ significantly between PB and SE. Lactobacillus was most abundant within the microbial community at both visits. Alpha-diversity was not affected by treatment and samples showed high intra- and interindividual diversity.

CONCLUSION AND CLINICAL SIGNIFICANCE

Both self-etch adhesives have an antibacterial effect due to a decrease of bacterial DNA after selective caries removal. However, the results do not reveal any additional antibacterial effect by MDPB. The study is registered with the German Clinical Trials Register (DRKS00011532).

目的

本体内研究比较了含有和不含有溴代单体 12-甲丙烯酰氧基十二基吡啶溴化物（MDPB）的自酸蚀黏结剂在选择性去龋后对龋坏牙本质的抗菌效果。

方法

纳入 10 名患有两颗后牙深龋且无牙髓症状的患者。在第 1 次就诊时，使用无菌圆钻（Komet No.18）选择性去除龋坏组织并采集龋坏牙本质样本。一个窝洞用含有 MDPB 的自酸蚀黏结剂（Clearfil Protect Bond， Kuraray Noritake；PB）进行复合树脂修复（SDR， Ceram X；DENTSPLY DeTrey）。另一个作为对照（Clearfil SE Bond II， Kuraray Noritake；SE）。8 周后第 2 次就诊时，再次采集龋坏牙本质样本。使用微生物培养法区分龋坏牙本质中的细菌生长情况。使用基于 16S rRNA 基因的实时 PCR 定量检测完整细胞和无细胞 DNA 中的细菌 DNA，并通过扩增子深度测序分析微生物群落组成。应用 Wilcoxon 检验进行统计学分析。

结果

与第 1 次就诊相比，两种治疗方法在第 2 次就诊时均使龋坏牙本质中的完整细菌细胞数量减少（PB：第 1 次就诊：1.110，第 2 次就诊：1.710（p=0.03）；SE：第 1 次就诊：1.110，第 2 次就诊：2.410（p=0.002））。未检测到无细胞细菌 DNA的统计学显著减少（PB：第 1 次就诊：6.110，第 2 次就诊：1.610（p=0.08）；SE：第 1 次就诊：5.310，第 2 次就诊：2.910（p=0.10））。PB 和 SE 之间完整细胞衍生物（p=0.371）和无细胞 DNA（p=0.455）的减少无显著差异。在两次就诊时，乳杆菌都是微生物群落中最丰富的细菌。处理对α多样性没有影响，样本显示出高度的个体内和个体间多样性。