大气压非平衡等离子体在根管消毒中的体外和体内研究：对替代冲洗策略的启示。
In vitro and in vivo research of atmosphere pressure nonequilibrium plasmas on root canal disinfection: implication for alternative strategy for irrigation.
机构信息
Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, China.
State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Clin Oral Investig. 2021 Oct;25(10):5833-5842. doi: 10.1007/s00784-021-03888-7. Epub 2021 Mar 24.
OBJECTIVE
To investigate an intracanal disinfection methodology of APNPs (atmosphere pressure nonequilibrium plasmas) or modified APNPs in root canal treatment and evaluate the antimicrobial efficiency against in vitro infected dentinal tubules and in vivo experimental apical periodontitis.
MATERIALS AND METHODS
Dentine specimens were centrifugated with Enterococcus faecalis to generate 1-day-old and 3-week-old biofilms, and were treated with 2% chlorhexidine (Chx), APNP or modified APNP for 3 and 10 min (n=4). LIVE/DEAD staining was employed to analyze the ratio of deactivated bacteria. Experimental apical periodontitis in beagles was induced. Root canal therapy with APNPs or modified APNPs was performed and the antimicrobial effect was evaluated by histological and radiographical analyses.
RESULTS
APNP deactivated 1-day-old and 3-week-old E. feacalis in dentinal tubules as much as 2% Chx irrigating. Modified APNP significantly deactivated more E. faecalis biofilms in dentinal tubules for 3-min and 10-min treatments, without thermal damage or dentinal destruction being observed. In beagles' apical periodontitis, significantly increased BV/TV and decreased lesion volume of apical bone were found in modified APNP group than 2% Chx irrigation group according to μCT. Fewer inflammatory cells and bacterial residual in dentine were observed in modified APNP-treated apical tissue by histology staining compared with those in the 2% Chx irrigation group.
CONCLUSION
The antimicrobial effect of APNP jet irradiation was comparable to that of 2% Chx irrigation. No structural damage in dentine or tissue necrosis at the periapical region was induced upon treatment. The modified APNP demonstrated an increased antimicrobial efficacy compared with 2% Chx irrigation both in vitro and in vivo.
CLINICAL RELEVANCE
The modified APNPs can be used as an alternative intracanal disinfection strategy.
目的
研究一种针对根管治疗的 APNPs（大气压非平衡等离子体）或改良 APNPs 的管内消毒方法，并评估其对体外感染的牙本质小管和体内实验性根尖周炎的抗菌效率。
材料与方法
将粪肠球菌离心于牙本质标本上以产生 1 天龄和 3 周龄生物膜，并分别用 2%洗必泰（Chx）、APNP 或改良 APNP 处理 3 和 10 分钟（n=4）。采用 LIVE/DEAD 染色分析失活细菌的比例。在比格犬中诱导实验性根尖周炎。采用 APNPs 或改良 APNPs 进行根管治疗，并通过组织学和放射学分析评估其抗菌效果。
结果
APNP 对牙本质小管内的 1 天龄和 3 周龄粪肠球菌的失活效果与 2% Chx 冲洗相当。改良 APNP 对牙本质小管内的粪肠球菌生物膜在 3 分钟和 10 分钟处理时的失活效果显著更强，且未观察到热损伤或牙本质破坏。在比格犬的根尖周炎中，与 2% Chx 冲洗组相比，改良 APNP 组的根尖骨体积比（BV/TV）显著增加，病变体积显著减小。与 2% Chx 冲洗组相比，改良 APNP 处理的根尖组织的组织学染色显示炎症细胞和牙本质内细菌残留较少。
结论
APNP 射流照射的抗菌效果与 2% Chx 冲洗相当。治疗后牙本质或根尖区组织无结构损伤或组织坏死。与 2% Chx 冲洗相比，改良 APNP 在体外和体内均显示出更强的抗菌效果。
临床相关性
改良 APNPs 可作为替代根管内消毒策略。
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