Tekinarslan Dide, Er Kürşat, Eğin Mine, Dinçer Tuba, Kiliç Ali Osman
Department of Endodontics, Faculty of Dentistry, Antalya Bilim University, Antalya, Turkey.
Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Türkiye.
Microsc Res Tech. 2025 Sep;88(9):2586-2593. doi: 10.1002/jemt.24877. Epub 2025 Apr 23.
This study evaluated the bacterial disinfection efficacy of three different irrigation solutions and their combined usage in dentin tubules contaminated with mixed biofilms. A total of 60 single-rooted mandibular premolars were prepared with ProTaper Next X4, sterilized, and then inoculated with mixed biofilm for 7 days. After biofilm formation, the teeth were randomly divided into six groups (n = 10) based on the irrigation solution used: Group 1: sodium hypochlorite (NaOCl), Group 2: chlorhexidine gluconate (CHX), Group 3: polyhexamethylene biguanide (PHMB), Group 4: NaOCl + CHX, Group 5: NaOCl + PHMB, Group 6: distilled water (control group). The teeth were sectioned at the coronal, middle, and apical thirds and stained with LIVE/DEAD BackLight and examined under a confocal laser scanning microscope (CLSM) to determine the depth of dead bacterial penetration into the dentinal tubules. Additionally, one tooth from each group was subjected to bacterial viable counting before and after irrigation. The CLSM analysis revealed that the greatest penetration of dead bacteria occurred in the coronal third, followed by the apical and middle third (p < 0.05). Combined solutions demonstrated significantly higher disinfection efficacy compared with PHMB alone (p < 0.001). Viable count analysis revealed that Group 4 and Group 5 exhibited the greatest reduction in bacterial proliferation, respectively. The combined use of solutions was found to be more effective than the sole use of solutions. Therefore, it is recommended to combine irrigation solutions during final irrigation in clinical settings.
本研究评估了三种不同冲洗液及其联合使用对被混合生物膜污染的牙本质小管的细菌消毒效果。总共60颗单根下颌前磨牙用ProTaper Next X4进行预备、消毒，然后接种混合生物膜7天。生物膜形成后，根据所用冲洗液将牙齿随机分为六组（n = 10）：第1组：次氯酸钠（NaOCl），第2组：葡萄糖酸氯己定（CHX），第3组：聚六亚甲基双胍（PHMB），第4组：NaOCl + CHX，第5组：NaOCl + PHMB，第6组：蒸馏水（对照组）。在牙冠、牙根中部和根尖三分之一处将牙齿切片，用LIVE/DEAD BackLight染色，并在共聚焦激光扫描显微镜（CLSM）下检查，以确定死细菌渗入牙本质小管的深度。此外，每组取一颗牙齿在冲洗前后进行细菌活菌计数。CLSM分析显示，死细菌的最大渗入发生在牙冠三分之一处，其次是根尖和牙根中部三分之一处（p < 0.05）。与单独使用PHMB相比，联合溶液显示出显著更高的消毒效果（p < 0.001）。活菌计数分析显示，第4组和第5组分别表现出最大程度的细菌增殖减少。发现溶液联合使用比单独使用更有效。因此，建议在临床环境中的最终冲洗过程中联合使用冲洗液。
