DeWald J P
Caruth School of Dental Hygiene, Texas A&M University System-Baylor College of Dentistry, Dallas, USA.
Dent Mater. 1997 Mar;13(2):74-81. doi: 10.1016/s0109-5641(97)80015-2.
Infection control concerns regarding the handling of teeth for research purposes have prompted investigators to evaluate the effects of disinfection/sterilization on extracted teeth. The objectives of this literature review were to assess the reported findings of the effect of disinfection or sterilization on teeth used for in vitro bonding studies and make recommendations on their use.
A search of the literature was performed to obtain background information on infection control guidelines and current findings regarding disinfection or sterilization of extracted teeth. Published articles addressing the effects of different disinfection and sterilizing procedures on the tooth, such as structural changes of dentin and dentin permeability or effect on bond strengths, were examined and compared for agreement or disagreement of findings. The review was organized by the type of disinfection or sterilization method utilized by the investigators. These methods were evaluated in an attempt to address whether disinfection/sterilization of extracted teeth can be recommended or if the procedure simply produces another variable.
Formalin, chemical heat sterilization (Chemiclave), autoclave, ethylene oxide and gamma radiation methods of disinfection/sterilization have been investigated for their effects on extracted teeth. When the effect of formalin storage on dentin bond strengths was examined, investigator results were extremely varied. Autoclave and chemical sterilization were found to produce comparable dentin bond results when compared to controls. Gamma radiation did not produce structural changes in the dentin but it currently has not been investigated for its effect on dentin bond strength. And while ethylene oxide produced similar dentin bond strength results when compared to controls, its use as a sterilant was determined to be ineffective.
Investigators have found formalin storage to be effective for infection control purposes. It cannot, however, be recommended as a storage medium for dentin bonding studies due to the variability in dentin bond strengths resulting from its use. Ethylene oxide is also not recommended due to its inability to effectively sterilize teeth. Chemical heat and autoclave sterilization methods are recommended for preventing cross-contamination during in vitro dentin bonding research. This recommendation is based on current research findings which examined the effect of these sterilization methods on dentin and dentin bond strengths.
出于对研究用牙齿处理过程中感染控制的担忧，研究人员开始评估消毒/灭菌对拔除牙齿的影响。本综述的目的是评估已报道的消毒或灭菌对用于体外粘结研究的牙齿的影响，并对其使用提出建议。
进行文献检索，以获取关于感染控制指南的背景信息以及当前有关拔除牙齿消毒或灭菌的研究结果。查阅已发表的文章，这些文章探讨了不同消毒和灭菌程序对牙齿的影响，如牙本质的结构变化、牙本质渗透性或对粘结强度的影响，并对研究结果的一致性或分歧进行比较。本综述按照研究人员使用的消毒或灭菌方法类型进行组织。对这些方法进行评估，以确定是否可以推荐对拔除牙齿进行消毒/灭菌，或者该程序是否只会产生另一个变量。
已对福尔马林、化学热灭菌（化学高压釜）、高压蒸汽灭菌、环氧乙烷和伽马射线消毒/灭菌方法对拔除牙齿的影响进行了研究。在研究福尔马林储存对牙本质粘结强度的影响时，研究人员的结果差异极大。与对照组相比，发现高压蒸汽灭菌和化学灭菌产生的牙本质粘结结果相当。伽马射线未在牙本质中产生结构变化，但目前尚未研究其对牙本质粘结强度的影响。虽然与对照组相比，环氧乙烷产生的牙本质粘结强度结果相似，但确定其作为消毒剂无效。
研究人员发现福尔马林储存对于感染控制有效。然而，由于其使用导致牙本质粘结强度存在差异，因此不能推荐将其作为牙本质粘结研究的储存介质。由于环氧乙烷无法有效对牙齿进行灭菌，因此也不推荐使用。建议采用化学热灭菌和高压蒸汽灭菌方法，以防止在体外牙本质粘结研究期间发生交叉污染。这一建议基于当前研究结果，这些研究结果考察了这些灭菌方法对牙本质和牙本质粘结强度的影响。
