Luo Yi, Liu Runze, Liu Pei, Duan Mengting, Fan Wei, Fan Bing
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237# Luoyu Road, Wuhan, 430079, People's Republic of China.
Clin Oral Investig. 2025 Sep 25;29(10):471. doi: 10.1007/s00784-025-06557-1.
To evaluate the effects of penetration enhancers on the physicochemical properties, dentinal tubule penetration, tissue dissolution, and antimicrobial efficacy of root canal irrigants.
Azone, Triton X-100, or iso-octyl polyoxyethylene ether (JFC-E) (0.1%-5%) were individually added to sodium hypochlorite (NaOCl) or chlorhexidine (CHX) to assess the influence of penetration enhancers. Surface tension, contact angle, viscosity and free available chlorine (FAC) were measured. Dentinal penetration of NaOCl was assessed via discolored area and depth under stereomicroscopy. Soft tissue dissolution was evaluated by changes in bovine pulp tissue weight and volume. The inhibition of protease activity was examined by monitoring matrix metalloproteinase (MMP) gelatinolytic activity via in situ zymography in radicular dentin. Confocal laser scanning microscope (CLSM) was used to analyze multispecies biofilms clearance and bacterial viability.
0.5% Azone significantly enhanced NaOCl penetration into dentinal tubules (p < 0.05) while maintaining chlorine stability over 90 days. Although tissue dissolution was not significantly improved (p > 0.05), azone-supplemented NaOCl provided deeper infiltration and greater collagen disruption. In situ zymography revealed lower gelatinolytic activity in dentin treated with azone-supplemented NaOCl or CHX (p < 0.05). In biofilm models, azone-supplemented irrigants showed superior bactericidal effects and biofilm reduction compared to irrigants alone (p < 0.05).
Penetration enhancers, particularly azone, effectively enhance the dentinal tubule penetration and antimicrobial performance of endodontic irrigants without negatively affecting their chemical stability.
The irrigants supplemented with penetration enhancers may improve disinfection of complex root canal anatomies, contributing to more predictable endodontic outcomes.
评估渗透促进剂对根管冲洗剂的物理化学性质、牙本质小管渗透、组织溶解及抗菌效果的影响。
将氮酮、曲拉通X-100或异辛基聚氧乙烯醚（JFC-E）（0.1%-5%）分别添加到次氯酸钠（NaOCl）或氯己定（CHX）中，以评估渗透促进剂的影响。测量表面张力、接触角、粘度和游离有效氯（FAC）。通过立体显微镜下的变色区域和深度评估NaOCl的牙本质渗透。通过牛牙髓组织重量和体积的变化评估软组织溶解。通过在根尖牙本质中进行原位酶谱分析监测基质金属蛋白酶（MMP）的明胶分解活性，来检测蛋白酶活性的抑制情况。使用共聚焦激光扫描显微镜（CLSM）分析多种生物膜清除情况和细菌活力。
0.5%氮酮显著增强了NaOCl向牙本质小管的渗透（p<0.05），同时在90天内保持氯的稳定性。虽然组织溶解没有显著改善（p>0.05），但添加氮酮的NaOCl提供了更深的浸润和更大的胶原破坏。原位酶谱分析显示，用添加氮酮的NaOCl或CHX处理的牙本质中明胶分解活性较低（p<0.05）。在生物膜模型中，与单独的冲洗剂相比，添加氮酮的冲洗剂显示出更好的杀菌效果和生物膜减少效果（p<0.05）。
渗透促进剂，尤其是氮酮，可有效增强根管冲洗剂的牙本质小管渗透和抗菌性能，而不会对其化学稳定性产生负面影响。
添加渗透促进剂的冲洗剂可能会改善复杂根管解剖结构的消毒效果，有助于获得更可预测的根管治疗结果。
