Huang Yun, Xu Rui, Lv Ying, Shen Jiadi, Wei Xin
Department of Endodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.
State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing Medical University, Nanjing, China.
Aust Endod J. 2025 Aug;51(2):336-348. doi: 10.1111/aej.12947. Epub 2025 May 3.
Conservative access cavity (ConsAC) has been increasingly advocated to preserve tooth structure, but its effect on disinfection efficacy against complex biofilms remains unclear. This study evaluated the effectiveness of different irrigants combined with Ni-Ti instruments on mixed biofilms of Enterococcus faecalis and Candida albicans in maxillary premolars with ConsAC or traditional access cavity (TradAC). A total of 208 extracted intact premolars were divided into ConsAC and TradAC groups. Root canals were infected with mixed biofilms and treated with 2.5% NaOCl, 2% CHX or 1% farnesol, followed by preparation using ProTaper Gold (PTG) or XP-endo Shaper (XPS). Efficacy was assessed using CFU counting, SEM, and CLSM. PTG was more effective than XPS under the same conditions. NaOCl showed superior antimicrobial activity compared with CHX and farnesol. TradAC achieved better microbial reduction than ConsAC. This study provides evidence-based insights into the disinfection performance of different irrigation-instrument combinations under varying access designs.
保守入路窝洞（ConsAC）越来越多地被提倡用于保留牙体组织，但其对复杂生物膜消毒效果仍不清楚。本研究评估了不同冲洗剂联合镍钛器械对上颌前磨牙采用ConsAC或传统入路窝洞（TradAC）时粪肠球菌和白色念珠菌混合生物膜的消毒效果。总共208颗完整拔除的前磨牙被分为ConsAC组和TradAC组。根管感染混合生物膜后，用2.5%次氯酸钠、2%氯己定或1%法尼醇处理，随后使用ProTaper Gold（PTG）或XP-endo Shaper（XPS）进行预备。使用菌落形成单位计数、扫描电子显微镜和共聚焦激光扫描显微镜评估效果。在相同条件下，PTG比XPS更有效。与氯己定和法尼醇相比，次氯酸钠显示出更强的抗菌活性。TradAC比ConsAC实现了更好的微生物减少。本研究为不同入路设计下不同冲洗-器械组合的消毒性能提供了基于证据的见解。
