微创开髓下3种根管消毒方法对粪肠球菌清除效果比较

doi:10.19439/j.sjos.2022.01.004

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (1): 17-23.doi: 10.19439/j.sjos.2022.01.004

微创开髓下3种根管消毒方法对粪肠球菌清除效果比较

单晓阳^1,2, 孙莉青^1,3, 王月月^1,2, 杨楠^1,2, 孙慧斌^1,4

1.青岛大学附属医院口腔科,山东青岛 266003;
2.青岛大学口腔医学院,山东青岛 266003;
3.青岛市妇女儿童医院口腔科,山东青岛 266000;
4.青岛大学口腔数字医学与3D打印工程实验室,山东青岛 266003

收稿日期:2021-06-04 修回日期:2021-07-20 出版日期:2022-02-25 发布日期:2022-03-10
通讯作者: 孙慧斌,E-mail:shb353.qindao@163.com
作者简介:单晓阳(1995-),女,硕士,E-mail：952732180@qq.com
基金资助:
全国医学专业学位研究生教育指导委员会研究课题(B1-YX20180302-03); 山东省研究生导师指导能力提升计划(SDY18071)

Comparison of three root canal disinfection methods for removal of Enterococcus faecalis under minimally invasive root canal treatment

SHAN Xiao-yang^1,2, SUN Li-qing^1,3, WANG Yue-yue^1,2, YANG Nan^1,2, SUN Hui-bin^1,4

1. Department of Stomatology, Affiliated Hospital of Qingdao University. Qingdao 266003;
2. School of Stomatology of Qingdao University. Qingdao 266003;
3. Department of Stomatology, Qingdao Women and Children's Hospital. Qingdao 266000;
4. Dental Digital Medicine & 3D Printing Engineering Laboratory of Qingdao University. Qingdao 266003, Shandong Province, China

Received:2021-06-04 Revised:2021-07-20 Online:2022-02-25 Published:2022-03-10

摘要/Abstract

摘要： 目的: 比较微创和常规开髓下的不同根管消毒方法,获得一种基于微创开髓的高效简便的根管消毒方法。方法: 将66颗离体上颌第一磨牙随机分为实验组（计算机辅助引导下开髓）和对照组（常规开髓）,均预备至ProTaper Universal F2,建立粪肠球菌感染模型。每组再随机分为NaClO+EDTA冲洗（A）、NaClO+EDTA+超声荡洗（B）、NaClO+EDTA+Er:YAG激光(C)3个亚组,进行根管消毒后取样培养,计算每个样本菌落形成单位（colony-forming units,CFU）值。以F3锉预备并收集牙本质碎屑,稀释培养后,计算CFU值。采用 SPSS 26.0 软件包对数据进行统计学分析。结果: 根管内壁表面实验组和对照组CFU结果显示,C组和B组的杀菌效果显著优于A组（P<0.05）,但C组和B组无显著差异（P>0.05）。实验组内比较,B1、C1组与A1组之间有显著差异（P<0.05）,B1、C1组结果均低于A1组,但B1、C1之间无显著差异（P>0.05）。对照组组内比较,B2、C2组与A2组之间有显著差异（P<0.05）,B2、C2组结果均低于A2组,但B2、C2之间无显著差异（P>0.05）。实验组和对照组牙本质碎屑细菌量的比较结果显示,C组效果最佳,B组次之,A组最差,各组两两之间均有显著差异（P<0.05）。结论: 计算机引导下微创根管治疗,在Er:YAG激光或超声辅助下,可获得与常规根管治疗相仿的消毒效果,且Er:YAG激光对牙本质小管的细菌清除效果优于超声,更适用于微创根管治疗。

关键词: 微创根管治疗, 根管消毒, 粪肠球菌, Er:YAG激光, 超声荡洗

Abstract: PURPOSE: To obtain an efficient and simple root canal disinfection method based on minimally invasive root canal treatment by comparing different root canal disinfection methods between minimally invasive root canal treatment and conventional root canal treatment. METHODS: Sixty-six extracted maxillary first molars were randomly divided into experimental group (computer-guided precision minimally invasive root canal treatment) and control group (conventional root canal treatment). All teeth were prepared to ProTaper universal F2, and Enterococcus faecalis infection models were established.Each group was randomly divided into three subgroups, sodium hypochlorite+EDTA root canal irrigation, sodium hypochlorite+EDTA+ultrasonic and sodium hypochlorite +EDTA +Er: YAG laser. After root canal disinfection,the samples were collected by paper tip method and cultured, and colony forming units (CFU) values of each sample were calculated. Then dentin debris was prepared and collected with F3 file. After being diluted and cultured, the CFU value was calculated. Statistical analysis was performed by SPSS 26.0 software package. RESULTS: Comparison of the amount of bacterial inner wall of root canal between the experimental group and the control group showed that the germicidal efficacy of group C and group B were significantly better than that of group A (P<0.05), but there was no significant difference between group B and group C(P>0.05). In the experimental group, there was significant difference between group B1, C1 and A1 (P<0.05). The results of group B1 and C1 were lower than that of group A1, but there was no significant difference between group B1 and group C1(P>0.05). In the control group, there were significant differences between group B2, C2 and A2 (P<0.05). The results of group B2 and C2 were lower than that of group A2, but there was no significant difference between group B2 and C2(P>0.05). Comparison of the amount of bacteria in dentin debris between the experimental group and the control group showed that the effect of group C was the best, followed by group B, and group A, and there were significant differences between three groups(P<0.05). CONCLUSIONS: The disinfection effect of Er:YAG laser or ultrasound assisted computer-guided precision minimally invasive root canal treatment is similar to conventional root canal treatment, and Er:YAG laser is better than ultrasound in removing bacteria from dentinal tubules, which is more suitable for minimally invasive root canal treatment.

Key words: Minimally invasive root canal treatment, Root canal disinfection, Enterococcus faecalis, Er:YAG laser, Ultrasonic irrigation

中图分类号:

R781.05

单晓阳, 孙莉青, 王月月, 杨楠, 孙慧斌. 微创开髓下3种根管消毒方法对粪肠球菌清除效果比较[J]. 上海口腔医学, 2022, 31(1): 17-23.

SHAN Xiao-yang, SUN Li-qing, WANG Yue-yue, YANG Nan, SUN Hui-bin. Comparison of three root canal disinfection methods for removal of Enterococcus faecalis under minimally invasive root canal treatment[J]. Shanghai Journal of Stomatology, 2022, 31(1): 17-23.

参考文献

[1] Yahata Y, Masuda Y, Komabayashi T.Comparison of apical centring ability between incisal-shifted access and traditional lingual access for maxillary anterior teeth[J]. Aust Endod J, 2017, 43(3): 123-128.
[2] Allen C, Meyer CA, Yoo E, et al.Stress distribution in a tooth treated through minimally invasive access compared to one treated through traditional access: a finite element analysis study[J]. J Conserv Dent, 2018, 21(5): 505-509.
[3] 李泽雨, 王玲香, 朱学臣, 等. 导板引导下精准微创根管治疗后牙体组织抗折性能的评价[J]. 上海口腔医学, 2020, 29(5): 487-491.
[4] Zandi H, Petronijevic N, Mdala I, et al.Outcome of endodontic retreatment using 2 root canal irrigants and influence of infection on healing as determined by a molecular method: a randomized clinical trial[J]. J Endod, 2019, 45(9): 1089-1098.
[5] Waltimo T, Trope M, Haapasalo M, et al.Clinical efficacy of treatment procedures in endodontic infection control and one year follow-up of periapical healing[J]. J Endod,2005,31(12): 863-866.
[6] Neelakantan P, Khan K, Hei Ng GP, et al.Does the orifice-directed dentin conservation access design debride pulp chamber and mesial root canal systems of mandibular molars similar to a traditional access design?[J]. J Endod, 2018, 44(2): 274-279.
[7] Krishan R, Paqué F, Ossareh A, et al.Impacts of conservative endodontic cavity on root canal instrumentation efficacy and resistance to fracture assessed in incisors, premolars, and molars[J]. J Endod, 2014, 40(8): 1160-1166.
[8] Vieira GCS, Pérez AR, Alves FRF, et al.Impact of contracted endodontic cavities on root canal disinfection and shaping[J]. J Endod, 2020, 46(5): 655-661.
[9] Sundqvist G, Figdor D, Persson S, et al.Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,1998, 85(1): 86-93.
[10] El Karim I, Kennedy J, Hussey D.The antimicrobial effects of root canal irrigation and medication[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 103(4): 560-569.
[11] Moradi Eslami L, Vatanpour M, Aminzadeh N, et al.The comparison of intracanal medicaments, diode laser and photodynamic therapy on removing the biofilm of Enterococcus faecalis and Candida albicans in the root canal system(ex-vivo study)[J]. Photodiagnosis Photodyn Ther, 2019, 26: 157-161.
[12] Keskin C, Demiryürek EÖ, Onuk EE.Pyrosequencing analysis of cryogenically ground samples from primary and secondary/persistent endodontic infections[J]. J Endod, 2017, 43(8): 1309-1316.
[13] Zheng JX, Wu Y, Lin ZW, et al.Characteristics of and virulence factors associated with biofilm formation in clinical Enterococcus faecalis isolates in China[J]. Front Microbiol, 2017, 8: 02338.
[14] Paiva SS, Siqueira JF Jr, Rôças IN, et al.Supplementing the antimicrobial effects of chemomechanical debridement with either passive ultrasonic irrigation or a final rinse with chlorhexidine: a clinical study[J]. J Endod, 2012, 38(9): 1202-1206.
[15] Carver K, Nusstein J, Reader A, et al.In vivo antibacterial efficacy of ultrasound after hand and rotary instrumentation in human mandibular molars[J]. J Endod, 2007, 33(9): 1038-1043.
[16] Mozo S, Llena C, Forner L.Review of ultrasonic irrigation in endodontics: increasing action of irrigating solutions[J]. Med Oral Patol Oral Cir Bucal, 2012, 17(3): e512-e516.
[17] Saghiri MA, Asgar K, Gutmann JL, et al.Effect of laser irradiation on root canal walls after final irrigation with 17% EDTA or BioPure MTAD: X-ray diffraction and SEM analysis[J]. Quintessence Int, 2012, 43(10): e127-e134.
[18] Guidotti R, Merigo E, Fornaini C, et al.Er:YAG 2 940-nm laser fiber in endodontic treatment: a help in removing smear layer[J]. Lasers Med Sci, 2014, 29(1): 69-75.
[19] Olivi G, Divito E, Peters O, et al.Disinfection efficacy of photon-induced photoacoustic streaming on root canals infected with Enterococcus faecalis: an ex vivo study[J]. J Am Dent Assoc, 2014, 145(8): 843-848.
[20] 郭惠杰, 岳林. 粪肠球菌在根管内定植模式的体外研究[J]. 北京大学学报(医学版), 2009, 41(6): 699-701.
[21] Meire MA, Coenye T, Nelis HJ, et al.Evaluation of Nd:YAG and Er:YAG irradiation, antibacterial photodynamic therapy and sodium hypochlorite treatment on Enterococcus faecalis biofilms[J]. Int Endod J, 2012, 45(5): 482-491.
[22] Neelakantan P, Cheng CQ, Mohanraj R, et al.Antibiofilm activity of three irrigation protocols activated by ultrasonic, diode laser or Er:YAG laser in vitro[J]. Int Endod J, 2015, 48(6): 602-610.
[23] Raiss P, Pape G, Jäger S, et al.In vitro measurement of temperature changes during implantation of cemented glenoid components[J]. Acta Orthop, 2010, 81(2): 211-215.
[24] Eriksson AR, Albrektsson T.Temperature threshold levels for heat-induced bone tissue injury: a vital-microscopic study in the rabbit[J]. J Prosthet Dent, 1983, 50(1): 101-107.
[25] Lee BS, Jeng JH, Lin CP, et al.Thermal effect and morphological changes induced by Er:YAG laser with two kinds of fiber tips to enlarge the root canals[J]. Photomed Laser Surg, 2004, 22(3): 191-197.
[26] Watanabe S, Saegusa H, Anjo T, et al.Dentin strain induced by laser irradiation[J]. Aust Endod J, 2010, 36(2): 74-78.
[27] 黄仙波, 杨永进, 李广. 3种根管消毒方法的效果对比[J]. 牙体牙髓牙周病学杂志, 2015, 25(5): 322-325.
[28] Mohammadi Z, Jafarzadeh H, Shalavi S, et al.Recent advances in root canal disinfection: a review[J]. Iran Endod J, 2017, 12(4): 402-406.

微创开髓下3种根管消毒方法对粪肠球菌清除效果比较

Comparison of three root canal disinfection methods for removal of Enterococcus faecalis under minimally invasive root canal treatment

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	张英豪, 赵宁, 赵爱杰, 朱超. Er:YAG激光与涡轮手机去骨拔除下颌低位水平阻生智牙的效果比较[J]. 上海口腔医学, 2023, 32(1): 75-79.
[2]	朱红, 魏萌, 刘攀, 袁璐, 张研楠, 陈剑锋. 不同频率铒激光对氧化锆陶瓷粘接性能的影响[J]. 上海口腔医学, 2022, 31(5): 460-465.
[3]	涂慧娟, 李凌宇, 李医丹, 罗真兰, 俞明. Er:YAG激光联合引导骨再生治疗种植体周围炎伴骨缺损效果评价[J]. 上海口腔医学, 2022, 31(4): 418-422.
[4]	吴昱卓, 周艳, 梅幼敏, 宦泓, 孙敬伟. Er:YAG激光治疗II度根分叉病变牙周炎患者的临床疗效评价[J]. 上海口腔医学, 2020, 29(3): 308-311.
[5]	陆佳萍, 黄正蔚, 钱文昊. 根管负压冲洗对根尖推出物及根管内粪肠球菌的影响[J]. 上海口腔医学, 2019, 28(6): 601-604.
[6]	汪嘉, 赵申, 冉淑君, 孙喆, 梁景平. 不同根管冲洗方式对粪肠球菌生物膜清除效果评价[J]. 上海口腔医学, 2019, 28(3): 246-250.
[7]	毕静, 刘尧, 陈旭. iRoot FM对牙髓卟啉单胞菌抗菌效果评价[J]. 上海口腔医学, 2017, 26(5): 488-491.
[8]	吴凯悦, 许春姣, 池毓坦, 孙晓娟, 王宏峰, 王苗苗. Er:YAG激光治疗慢性牙周炎对龈沟液中Dickkopf-1水平和ALP活性的影响[J]. 上海口腔医学, 2017, 26(3): 285-289.
[9]	陆春慧, 钟群. 应用水激光和超声进行根管消毒的效果评价[J]. 上海口腔医学, 2017, 26(3): 314-316.
[10]	孙楚文, 朱亚琴. 不同根管消毒方法对粪肠球菌清除作用的体外研究[J]. 上海口腔医学, 2017, 26(2): 134-138.
[11]	王昊明, 周梦琪, 洪瑾. Er:YAG激光对犬根尖周组织影响的组织学评价[J]. 上海口腔医学, 2016, 25(6): 657-662.
[12]	周梦琪, 王昊明, 肖家祁, 洪瑾. Er:YAG激光联合次氯酸钠对管间峡区的清理作用[J]. 上海口腔医学, 2016, 25(5): 532-537.
[13]	杨红丽，唐睿，龚瑜，张玉皓. 根管预备及根管消毒期间诊间疼痛的临床观察[J]. 上海口腔医学, 2016, 25(2): 227-230.
[14]	张富华，李矛，韦智君，赵兵. 纳米银颗粒联合氢氧化钙对饥饿期粪肠球菌生物膜的作用[J]. 上海口腔医学, 2016, 25(1): 11-15.
[15]	许雪松，朱亚琴. 根管预备尺寸对Er:YAG激光消毒效果的影响[J]. 上海口腔医学, 2015, 24(6): 645-651.