2%洗必泰凝胶、双抗生素糊剂和壳聚糖-洗必泰纳米粒子作为根管内药物对儿童第一恒磨牙中粪肠球菌和白色念珠菌的直接和残留抗菌作用：一项体外研究。
Direct and residual antimicrobial effect of 2% chlorhexidine gel, double antibiotic paste and chitosan- chlorhexidine nanoparticles as intracanal medicaments against Enterococcus faecalis and Candida albicans in primary molars: an in-vitro study.
机构信息
Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University Cairo, Organization of African Unity St.-Abbasia-Cairo, 11566, Cairo, Egypt.
出版信息
BMC Oral Health. 2023 Aug 4;23(1):296. doi: 10.1186/s12903-023-02862-x.
BACKGROUND
Thorough disinfection of root canals in primary molars may be complicated by the complex root canal morphology. This in-vitro study aimed to compare direct and residual antimicrobial effect of 2% chlorhexidine (CHX) gel, 500 mg/ml double antibiotic paste (DAP) and chitosan-chlorhexidine nanoparticles (CS-CHX NPs) as intracanal medicaments against Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) in primary molars.
METHODS
Mesial roots of 63 mandibular second primary molars were infected with E. faecalis and C. albicans. Teeth were divided into 9 groups: Ia: (CS-CHX NPs), IIa: (CHX), IIIa: (DAP), IVa: chitosan nanoparticles (CSNPs) in which medicaments were placed for 3 days, groups Ib: (CS-CHX NPs), IIb: CHX, IIIb: (DAP), IVb: (CSNPs) in which medicaments were placed for 7 days, and Group V (control): teeth were infected, irrigated with saline, and sampled 3- and 7-days post-infection. Microbiological samples were obtained after infection, 3, and 7 days after medicament placement and 7 days after medicament removal for both time points. One-way ANOVA, Tukey's post hoc test and paired t-test were used at p < 0.05.
RESULTS
CS-CHX NPs had the highest anticandidal effect which was comparable to CHX and significantly higher than other medicaments (p < 0.001) at both time points. CS-CHX NPs had the highest effect against E. faecalis which was comparable to DAP and significantly higher than other medicaments (p < 0.001) at 3 days. All medicaments showed similar effect against E. faecalis after 7 days. The 7-days placement significantly increased the antimicrobial effect against both micro-organisms in all groups, except CS-CHX NPs which showed an insignificant increase. CS-CHX NPs showed the highest residual effect against both micro-organisms that increased with 7-days placement.
CONCLUSION
CSNPs and CHX combination showed a synergistic effect against both micro-organisms. CS-CHX NPs displayed a higher effect at a shorter period compared to other medicaments, yet its residual effect was higher with 7-days placement.
背景
儿童磨牙的根管形态复杂，彻底消毒可能较为困难。本体外研究旨在比较 2%洗必泰（CHX）凝胶、500mg/ml 双抗生素糊剂（DAP）和壳聚糖-洗必泰纳米粒（CS-CHX NPs）作为根管内药物对粪肠球菌（E. faecalis）和白色念珠菌（C. albicans）的直接和残留抗菌效果。
方法
63 颗下颌第二乳磨牙的近中根感染粪肠球菌和白色念珠菌。牙齿分为 9 组：Ia：（CS-CHX NPs），IIa：（CHX），IIIa：（DAP），IVa：壳聚糖纳米粒（CSNPs），其中药物放置 3 天，组 Ib：（CS-CHX NPs），IIb：CHX，IIIb：（DAP），IVb：（CSNPs），其中药物放置 7 天，组 V（对照）：牙齿感染，用生理盐水冲洗，感染后 3 天和 7 天取样。微生物样本在感染后、药物放置后 3 天和 7 天以及两个时间点药物去除后获得。p<0.05 时采用单因素方差分析、Tukey 事后检验和配对 t 检验。
结果
CS-CHX NPs 对白色念珠菌的抗真菌效果最高，与 CHX 相当，明显高于其他药物（p<0.001），在两个时间点均如此。CS-CHX NPs 对粪肠球菌的作用最高，与 DAP 相当，明显高于其他药物（p<0.001），在 3 天时如此。所有药物在 7 天时对粪肠球菌的作用相似。7 天放置时间显著提高了所有组中两种微生物的抗菌效果，除 CS-CHX NPs 外，无显著差异。CS-CHX NPs 对两种微生物的残留效果最高，且随着 7 天放置时间的增加而增加。
结论
CSNPs 和 CHX 联合对两种微生物有协同作用。CS-CHX NPs 与其他药物相比，在较短的时间内表现出更高的效果，但 7 天放置后的残留效果更高。
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