高级电化学扩孔锉（EC-Reamer）在根管治疗中的应用。

Advanced Electrochemical Reamer (EC-Reamer) for Root Canal Treatment.

机构信息

Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, USA.

Department of Pediatric Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, USA.

出版信息

Eur Endod J. 2023 Jan;8(1):79-89. doi: 10.14744/eej.2022.86094.

DOI:10.14744/eej.2022.86094

PMID:36748441

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10098461/

Abstract

OBJECTIVE

According to the American Association of Endodontists (AAE), 22 million endodontic procedures have been performed annually. Root canal treatment is needed to prevent infection and restore function when a tooth is severely infected or decayed. This procedure is the only way to preserve the natural tooth and avoid artificial replacement (implant, denture, etc.). The current study aims to develop an electrochemical reamer (EC-Reamer or EC-R) that can help to disinfect the canal system and thus improve the success rate of root canal treatment.

METHODS

The COMSOL Multiphysics software was utilized to simulate the experimental setup and confirm the current flow in the electrolyte. The benchtop experimental approach follows a specific electrochemical protocol, (i) open circuit potential to monitor the electrochemical stabilization and (ii) potentiostatic scan at -9.0 V as the treatment stage. Identification of feasible reference electrode (RE) and insulation material for the exploratory benchtop studies considered platinum (Pt) and gold (Au) wire as the REs and hot melt adhesive (HMA) and liquid tape as the insulation materials. The antimicrobial effects of EC-R were analysed using Enterococcus faecalis (E. faecalis). One-way ANOVA with the Tukey post hoc test and a significance level of P<0.05 is used to compare the groups with an experimental duration of 60 seconds.

RESULTS

The findings showed that magnitude and current fluctuations created by Pt wire are promising when compared to Au wire, while Pt-HMA pair is chosen considering Pt's good electrochemical inertness and HMA's easy handling, availability, and non-hazardous features. The use of potentiostatic duration of 1 s and 3 s resulted in >99.99% E. faecalis reduction. Duration at 5 s and above resulted in a total bacterial kill. Statistical analysis confirmed a significant difference among the groups tested with commercial and custom-built potentiostats.

CONCLUSION

The outcome provided preliminary data for developing an EC-R prototype to enhance the antimicrobial effect during root canal treatment potentially. (EEJ-2022-01-04).

摘要

目的

根据美国牙髓病学协会（AAE）的数据，每年进行的牙髓治疗约为 2200 万例。当牙齿受到严重感染或腐烂时，需要进行根管治疗以防止感染并恢复功能。该手术是保留天然牙齿和避免人工替代（种植体、义齿等）的唯一方法。本研究旨在开发一种电化学扩孔器（EC-Reamer 或 EC-R），以帮助消毒根管系统，从而提高根管治疗的成功率。

方法

使用 COMSOL Multiphysics 软件模拟实验设置并确认电解质中的电流。台式实验方法遵循特定的电化学方案，（i）开路电位监测电化学稳定化，（ii）作为处理阶段在-9.0V 下进行恒电位扫描。在探索性台式研究中，考虑到铂（Pt）和金（Au）丝作为参考电极（RE），热熔胶（HMA）和液体胶带作为绝缘材料，对可行的 RE 和绝缘材料进行了鉴定。使用粪肠球菌（E. faecalis）分析 EC-R 的抗菌效果。使用单因素方差分析和 Tukey 事后检验，在实验持续时间为 60 秒的情况下，对各组进行比较，显著性水平为 P<0.05。

结果

结果表明，与 Au 丝相比，Pt 丝产生的幅度和电流波动更有希望，而考虑到 Pt 的良好电化学惰性和 HMA 的易于处理、可用性和无危害性，选择了 Pt-HMA 对。使用 1s 和 3s 的恒电位持续时间可使粪肠球菌减少>99.99%。持续时间为 5s 及以上可实现完全杀灭细菌。统计学分析证实，使用商用和定制的恒电位仪的各组之间存在显著差异。