根管壁无生物膜时牙本质小管消毒的定量评估：一项研究

Quantitative Assessment of Dentinal Tubule Disinfection in Absence of Biofilm on Root Canal Walls: An Study.

作者信息

Byakova Svetlana Fedorovna, Dezhurko-Korol Viktoria Andreevna, Novozhilova Nina Evgenievna, Makeeva Irina Mikhailovna, Lukashev Alexandr Nikolaevich, Akhmadishina Ludmila Vasilievna, Semenov Alexandr Mikhailovich, Moisenovich Mikhail Mikhailovich, Arkhipova Anastasiya Yurievna, Ponirovsky Evgenii Nikolaevich

机构信息

Department of Therapeutic Dentistry, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, Mojaiskii val str, Moscow, Russia.

E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), M. Pirogovskaya str., Moscow, Russia.

出版信息

Iran Endod J. 2020 Summer;15(3):155-165. doi: 10.22037/iej.v15i3.27453.

DOI:10.22037/iej.v15i3.27453

PMID:36703803

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9709850/

Abstract

INTRODUCTION

This study aimed at assessing the quantitative effect of calcium hydroxide, 2% chlorhexidine gel, and 1.5% chlorhexidine linked to xanthan gel specifically against intratubular bacteria.

METHODS AND MATERIALS

Fifty-two semi-cylindrical bovine dentin specimens were infected with by centrifugation with subsequent 7-days incubation. The surface of specimens was disinfected with 3% HO. Scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM) and the count of bacterial colony-forming units (CFU/mg) were used to assess dentin infection. A total of 40 specimens were incubated for 2 weeks with one of the intracanal medication applied (10 samples for each group): 1) calcium hydroxide, 2) 2% chlorhexidine gel, 3) 1.5% chlorhexidine linked to xanthan gel and 4) sterile saline. Final passive ultrasonic irrigation with 3% sodium hypochlorite was performed in half of the total specimens. The effect of intracanal medications and irrigation against intratubular bacteria was assessed by bacterial culturing of dentin shavings. Two-Way ANOVA model was applied followed by post-hoc Tukey's test for multiple pair-wise comparisons of mean CFU/mg values.

RESULTS

SEM, CLSM, and bacterial culturing confirmed the absence of the surface biofilm on the root canal wall and showed vital intratubular bacteria at the depth up to 700 m. Two-week application of 1.5% chlorhexidine with xanthan gel and 2% chlorhexidine gel significantly decreased intratubular bacterial counts compared with saline (=0.0003 and =0.0005, respectively). Subsequent passive ultrasonic irrigation with 3% sodium hypochlorite significantly reduced the number of intratubular bacteria in all groups except for the group with 1.5% chlorhexidine-xanthan gel (=0.0054).

CONCLUSION

This modified model study showed ultrasonically activated irrigation with sodium hypochlorite had greater effect on intratubular bacteria counts compared with 2-week application of intracanal medications.

摘要

引言

本研究旨在评估氢氧化钙、2%氯己定凝胶和1.5%氯己定与黄原胶联用对根管内细菌的定量影响。

方法与材料

52个半圆柱形牛牙本质标本通过离心感染，随后培养7天。标本表面用3%过氧化氢消毒。采用扫描电子显微镜（SEM）、共聚焦激光扫描显微镜（CLSM）和细菌菌落形成单位计数（CFU/mg）评估牙本质感染情况。40个标本分别用以下一种根管内药物处理2周（每组10个样本）：1）氢氧化钙，2）2%氯己定凝胶，3）1.5%氯己定与黄原胶联用，4）无菌生理盐水。一半标本最后用3%次氯酸钠进行被动超声冲洗。通过对牙本质碎屑进行细菌培养评估根管内药物和冲洗对根管内细菌的影响。采用双向方差分析模型，随后进行事后Tukey检验以对平均CFU/mg值进行多组两两比较。

结果

SEM、CLSM和细菌培养证实根管壁表面无生物膜，且在深度达700μm处存在存活的根管内细菌。与生理盐水相比，1.5%氯己定与黄原胶联用以及2%氯己定凝胶处理2周显著降低了根管内细菌数量（分别为P = 0.0003和P = 0.0005）。随后用3%次氯酸钠进行被动超声冲洗，除1.5%氯己定 - 黄原胶组外，所有组的根管内细菌数量均显著减少（P = 0.0054）。