从根管牙本质中去除玷污层和柠檬酸改性氯己定的抗菌效果。
Smear Layer Removal from Root Canal Dentin and Antimicrobial Effect of Citric Acid-modified Chlorhexidine.
机构信息
Department of Restorative Dentistry and Periodontology and Endodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
School of Dentistry, Mae Fah Luang University, Chiang Rai, Thailand.
出版信息
Eur Endod J. 2020 Dec;5(3):257-263. doi: 10.14744/eej.2020.38258.
OBJECTIVE
To study the effectiveness of various concentrations of citric acid (CA) added to 2% chlorhexidine (CHX) on smear layer removal from the root canal wall and antimicrobial efficacy against Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans).
METHODS
Fifty-three single-rooted mandibular premolars were decoronate and the root canals underwent mechanical instrumentation using MTwo rotary files to size 40/0.06. The samples were then randomly divided into 5 groups according to the root canal irrigants to be used: 17% ethylenediaminetetraacetic acid (EDTA), 2% CHX, 1%, 6%, and 10% citric acid-modified 2% chlorhexidine (CAmCHX). Three teeth irrigated with phosphate-buffered saline (PBS) were used as a negative control. The smear layer removal effectiveness was evaluated under scanning electron microscopy (SEM). Images were randomly taken at the apical, middle, and coronal third level. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests. Disc diffusion and direct exposure tests were performed along with three additional control groups consisting of 1%, 6%, and 10% CA groups to assess and compare the antimicrobial efficacy of irrigants against E. faecalis and C. albicans. Statistical analysis was conducted using one-way ANOVA and Dunnett's T3 tests.
RESULTS
Smear layer removal effectiveness in 17% EDTA group and 6% and 10% CAmCHX groups were not significantly different in the coronal and apical third of the root canal (P>0.05), however at the middle third of the root canal, the 10% CAmCHX group had significantly less remaining smear layer than all of the other experimental groups (P<0.05). There was significantly more smear layer remnant in the CHX group (P<0.01). For antimicrobial efficacy, the largest growth inhibition zone against E. faecalis was recorded in the 10% CAmCHX group (P<0.05). For planktonic E. faecalis, 1%, 6%, and 10% CAmCHX demonstrated an insignificant difference in antimicrobial efficacy compared to CHX (P>0.05). CA demonstrated no antifungal effect against C. albicans. Whereas, 6% and 10% CAmCHX resulted in the largest growth inhibition zone. Also, adding CA to CHX resulted in an insignificant difference in antifungal effect against planktonic C. albicans compared to CHX (P>0.05).
CONCLUSION
When CA was added into CHX, the mixed irrigant demonstrated smear layer removal ability. Additionally, its antimicrobial effect remained the same.
目的
研究不同浓度柠檬酸（CA）添加到 2%洗必泰（CHX）对去除根管壁玷污层的效果以及对粪肠球菌（E. faecalis）和白色念珠菌（C. albicans）的抗菌效果。
方法
53 颗下颌前磨牙被截冠，使用 MTwo 旋转锉对根管进行机械预备至 40/0.06 号。然后，根据使用的根管冲洗液将样本随机分为 5 组：17%乙二胺四乙酸（EDTA）、2% CHX、1%、6%和 10%柠檬酸改性 2%洗必泰（CAmCHX）。用磷酸盐缓冲盐水（PBS）冲洗的 3 颗牙齿作为阴性对照。在扫描电子显微镜（SEM）下评估去除玷污层的效果。在根尖、中部和冠部三分之一处随机拍摄图像。使用 Kruskal-Wallis 和 Mann-Whitney U 检验进行统计分析。进行了扩散盘试验和直接暴露试验，并与包括 1%、6%和 10% CA 组在内的另外三个对照组进行比较，以评估和比较冲洗液对粪肠球菌和白色念珠菌的抗菌效果。使用单因素方差分析和 Dunnett's T3 检验进行统计分析。
结果
在根管的冠部和根尖三分之一处，17% EDTA 组、6%和 10% CAmCHX 组的去除玷污层效果无显著差异（P>0.05），然而在根管的中部三分之一处，10% CAmCHX 组的残留玷污层明显少于所有其他实验组（P<0.05）。CHX 组的残留玷污层明显较多（P<0.01）。在抗菌效果方面，对粪肠球菌的最大抑菌环记录在 10% CAmCHX 组（P<0.05）。对于浮游粪肠球菌，1%、6%和 10% CAmCHX 与 CHX 相比，其抗菌效果无显著差异（P>0.05）。CA 对白色念珠菌没有抗真菌作用。然而，6%和 10% CAmCHX 导致最大的抑菌环。此外，将 CA 添加到 CHX 中，对浮游白色念珠菌的抗真菌效果与 CHX 相比无显著差异（P>0.05）。
结论
当 CA 被添加到 CHX 中时，混合冲洗液具有去除玷污层的能力。此外，其抗菌效果保持不变。
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