Tong Jiaru, Liu Liu, Du Jing, Gao Yuan, Song Dongzhe, Huang Dingming
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
J Dent Sci. 2023 Jan;18(1):157-164. doi: 10.1016/j.jds.2022.06.019. Epub 2022 Jul 8.
BACKGROUND/PURPOSE: The efficiency of root canal irrigation has an important impact on the prognosis of root canal treatment. Photon-induced photoacoustic streaming (PIPS) and shock wave enhanced emission photoacoustic streaming (SWEEPS) are the special modality of Er: YAG laser, whether can they improve the efficiency of root canal irrigation remains to be studied.
Fifty human teeth with curved root canals were collected and stored in the thymol solution until used in the study. After traditional endodontic cavities preparation, root canals were prepared to size #35 with a 0.04 taper. The final irrigating techniques were as follows: (I) manual dynamic activation (MDA), (II) ultrasonically activated irrigation (UAI), (III) sonically activated irrigation (SAI), (IV) PIPS, and (V) SWEEPS. Fifty teeth were randomly divided into five groups mentioned above. After root canal preparation, the roots were cleaved longitudinally. The dentine surfaces were photographed from the coronal, middle, and apical third of the root by scanning electron microscopy operated at a low vacuum. Two examiners separately graded each image according to the remained smear layer situations.
PIPS and SWEEPS groups showed fewer smear layers remaining than the others in the middle and the apical third ( 0.05) of the root canal. In contrast, in the coronal third, five groups showed no significant difference ( > 0.05).
PIPS and SWEEPS showed superior smear layer clearing efficiency than traditional irrigating techniques in curved root canals.
背景/目的：根管冲洗的效率对根管治疗的预后有重要影响。光子诱导光声流（PIPS）和冲击波增强发射光声流（SWEEPS）是铒激光的特殊模式，它们是否能提高根管冲洗效率仍有待研究。
收集50颗有弯曲根管的人牙，保存在百里酚溶液中直至用于本研究。在进行传统的牙髓腔预备后，将根管预备至#35号，锥度为0.04。最终的冲洗技术如下：（I）手动动态激活（MDA），（II）超声激活冲洗（UAI），（III）声波激活冲洗（SAI），（IV）PIPS，以及（V）SWEEPS。将50颗牙齿随机分为上述五组。根管预备后，将牙根纵向劈开。通过在低真空下操作的扫描电子显微镜从牙根的冠部、中部和根尖三分之一处拍摄牙本质表面照片。两名检查者根据残留的玷污层情况分别对每张图像进行分级。
在根管中部和根尖三分之一处，PIPS组和SWEEPS组残留的玷污层比其他组少（P<0.05）。相比之下，在冠部三分之一处，五组之间无显著差异（P>0.05）。
在弯曲根管中，PIPS和SWEEPS显示出比传统冲洗技术更优异的玷污层清除效率。
