冲洗液对超声根管预备抗菌效果的影响

目的研究生理盐水、EDTA、次氯酸钠、口泰与超声波联合应用杀灭感染根管内厌氧菌的效果。方法将100例慢性根尖周炎患者共100颗患牙随机分为常规组、生理盐水组、EDTA组、次氯酸钠组、口泰组5组,每组各20颗患牙,常规组用常规法手持器械根管预备并分别用3%双氧水和生理盐水常规针筒式冲洗根管,后四组均用超声法进行根管预备并分别以生理盐水、EDTA、次氯酸钠、口泰作为超声冲洗液,根管预备前后分别取样进行厌氧培养。结果次氯酸钠组和口泰组其厌氧菌减少程度均显著大于生理盐水组(P<0.01),明显大于EDTA组(P<0.05);生理盐水组和EDTA组之间其厌氧菌的减少程度无显著性差异(P>0.05);次氯酸钠组和口泰组之间其厌氧菌减少程度无显著性差异(P>0.05)。结论口泰与超声波联合应用可有效杀灭感染根管内厌氧菌,其抗菌效果与次氯酸钠相近似。     

超声和冲洗液联合应用在根管预备中的抗菌效果

目的:研究生理盐水、次氯酸钠、口泰与超声波联合应用杀灭感染根管内厌氧菌的效果。方法:将120例慢性根尖周炎患者共120颗患牙随机分为6组,每组各20颗患牙,A、B、C组均用超声法进行根管预备并分别以生理盐水、次氯酸钠、口泰作为超声冲洗液,A1、B1、C1组均用常规法手持器械根管预备并分别用生理盐水、次氯酸钠、口泰常规针筒式根管冲洗,根管预备前后分别取样进行厌氧培养。结果:A组厌氧菌减少程度明显大于A1组(P<0.01),B组厌氧菌减少程度明显大于B1组(P<0.01),C组厌氧菌减少程度明显大于C1组(P<0.01);B和C组的厌氧菌减少程度均明显大于A组(P<0.01);B和C组的厌氧菌减少程度无显著性差异(P>0.05).结论:超声波在根管灭菌方面有独特的优势,口泰与超声波联合应用可有效杀灭感染根管内厌氧菌,其抗菌效果与次氯酸钠相近似,是一种较理想的根管超声冲洗液。     

口泰用于根管超声冲洗抗菌效果的研究

目的 :研究口泰与超声波联合应用杀灭感染根管内厌氧菌的效果。方法 :将 6 0例慢性根尖周炎患者共 6 0颗患牙随机分为 3组 ,每组各 2 0颗患牙 ,第 1组常规法手持器械根管预备及常规针筒式根管冲洗 ,第 2、3组均用超声法进行根管预备并分别以生理盐水、口泰作为超声冲洗液 ,根管预备前后分别取样进行厌氧培养。结果 :第 2组厌氧菌减少程度明显大于第 1组 (P <0 .0 5 ) ;第 3组厌氧菌减少程度明显大于第 2组 (P <0 .0 1) ,显著大于第 1组(P <0 .0 0 1)。结论 :超声波在根管杀菌方面有独特的优势 ,口泰可有效杀灭感染根管内厌氧菌 ,是一种较理想的根管超声冲洗液     

酸性氧化电位水根管冲洗的抗菌效果

目的：研究酸性氧化电位水超声冲洗杀灭感染根管内厌氧菌的效果及其作为根管超声冲洗液的可行性。方法：将90例慢性根尖周炎患者共90颗患牙随机分为3组,每组各30颗患牙,第1组手持器械结合机用根管锉进行根管预备,常规针管式双氧水与生理盐水交替冲洗,第2、第3组同第一组进行根管预备,分别以生理盐水、酸性氧化电位水作为冲洗液进行根管超声冲洗,根管预备前后分别根管内取样进行厌氧菌培养。结果：第2组厌氧菌减少程度明显大于第1组（P〈0．05）;第3组厌氧菌减少程度大于第2组（P〈0．01）、显著大于第1组（P〈0．001）。结论：超声波在根管预备方面有一定的优势,酸性氧化电位水配合超声冲洗能有效杀灭感染根管内的厌氧菌,是一种理想的根管超声冲洗消毒液。     

口康含漱液用于超声根管预备抗菌效果的研究

目的探讨口康与超声联合应用杀灭感染根管内厌氧菌的效果。方法将60例慢性根尖周炎患者共60个患牙随机分为3组,每组各20个患牙,A组常规法手持器械根管预备和常规针筒式根管冲洗,B、C组均用超声法进行根管预备并分别以生理盐水、口康作为超声冲洗液,根管预备前后分别取样进行厌氧培养。结果B组厌氧菌减少程度明显大于A组(P<0.05);C组厌氧菌减少程度明显大于B组(P<0.01),显著大于A组(P<0.001)。结论超声在根管杀菌方面有独特的优势,口康可有效杀灭感染根管内厌氧菌,是一种较理想的根管超声冲洗液。     

中药制剂用于超声根管预备的初步研究

目的评价中药制剂洁尔阴与超声波联合应用杀灭感染根管内厌氧菌的效果。方法将临床诊断为慢性根尖周炎的60例患者的60颗患牙随机分为3组（每组20颗牙）,第1组为传统手持器械对照组,第2组为超声生理盐水对照组,第3组为超声洁尔阴实验组。根管清理前后分别取样进行厌氧培养。结果传统手持器械组与超声生理盐水组之间差异有显著性（P<0.05）;超声洁尔阴组与超声生理盐水组之间差异有极显著性（P<0.01）。结论超声波在根管杀菌方面有独特的优势,中药洁尔阴可有效地杀灭感染根管内的厌氧菌,是符合生物学原则、较理想的超声根管冲洗液。     

17％EDTA与1％NaOCl组合用于根管超声冲洗抗菌效果的临床研究

目的研究17％EDTA＋1％NaOCl与超声波联合应用杀灭感染根管内厌氧菌的效果。方法将100例慢性根尖周炎患者共100颗患牙随机分为A组（2．5％NaOCl）、B组（1％NaOCl）、C组（17％EDTA＋1％NaOCl）、D组（17％EDTA）、E组（生理盐水）5组,每组各20颗患牙,采用手持器械预备根管后,分别采用2．5％NaOCl、1％NaOCl、17％EDTA＋1％NaOCl、17％EDTA、生理盐水超声法冲洗根管,根管预备前后分别取样进行厌氧培养。结果根管预备前后,五组根管内厌氧菌减少程度之间有显著性差异（P〈0．01）,其中C组（17％EDTA＋1％NaOCl组）厌氧茵的减少程度明显大于B组（1％NaOCl组）（P〈0．05）,显著大于D组（17％EDTA组）和E组（生理盐水组）（P〈0．01）,与A组（2．5％NaOCl组）之间无显著性差异（P〉0．05）。结论17％EDTA＋1％NaOCl与超声波联合应用可有效杀灭根管内的厌氧菌,其抗菌效果优于单独使用的1％NaOCl,与单独使用的2．5％NaOCl效果相近,是一种有效的根管冲洗液组合。     

两种根管预备法与聚维酮碘冲洗液进行根管预备的效果

目的 :探讨根管超声波预备和常规预备配合聚维酮碘冲洗液的灭菌效果及临床疗效。方法 :将 2 0 0 1- 0 7— 2 0 0 3- 0 2间门诊就诊的 2 10例患者 2 5 9个患牙随机分为 4组 :常规预备加普通冲洗液组 (A组 )、超声波预备加普通冲洗液组 (B组 )、常规预备加聚维酮碘冲洗液组 (C组 )、超声波预备加聚维酮碘冲洗液组 (D组 )。统计 4组患者根管预备时间 ,对比各组临床疗效 ,并进行方差分析。 4组患牙在根管预备前及预备后进行根管内厌氧菌培养 ,并对结果进行统计学分析。结果 :A、B、C、D 4组封药后临床反应无差异 ,在根管预备时间上 ,A、C组长于B、D组 (P <0 .0 5 )。 4组根管预备前厌氧菌培养阳性株数明显多于根管预备后 (P <0 .0 1) ,而 4组之间厌氧菌培养结果统计分析表明 ,A组与B、C、D组间有统计学差异 (P <0 .0 5 ) ,B、C、D 3组间没有统计学差异。结论 :常规根管预备与超声波根管预备配合不同冲洗液在临床疗效方面无差异 ,单纯常规根管预备配合普通冲洗液在灭菌效果方面要弱于其他配合 ,表明超声波预备根管和聚维酮碘冲洗液都具有很好的灭菌效果 ,二者联合应用有一定的临床前景。     

金栀含漱液用于感染根管冲洗消毒的细菌学观察

目的:观察金栀含漱液对感染根管冲洗消毒的抗菌效果。方法:选择27例患者的感染根管患牙30颗,随机分为实验组和对照组,每组15颗。实验组采用金栀2倍稀释液冲洗根管,浓缩液作为根管消毒药物。对照组采用氯亚明冲洗根管,氢氧化钙药尖消毒根管。根管预备冲洗前、预备冲洗后、封药后分别取细菌样本进行厌氧培养、分离和鉴定,计算并采用重复测量的方差分析比较2组细菌检出率、CFU随时间的变化趋势。结果:实验组专性厌氧菌的检出率由73.3%下降到预备冲洗后的46.7%和封药后的13.3%,对照组厌氧菌的检出率由73.3%下降到预备冲洗后的20.0%和封药后的26.7%,2组细菌检出率无统计学差异(P=0.9721)。实验组专性厌氧菌CFU由1462.9下降为预备冲洗后的27.9和封药后的15.7,对照组厌氧菌CFU由1402.8下降到预备冲洗后的14.0和封药后的45.1,2组细菌检出量无统计学差异(P=0.688)。结论:金栀含漱液对感染根管内厌氧菌有良好的抗菌效果。     

替硝唑液治疗有瘘型根尖周炎疗效观察

目的观察替硝唑液治疗有瘘型根尖周炎的临床疗效。方法常规法预备根管后用注射器抽取替硝唑液作通畅冲洗,设对照组用过氧化氢液冲洗。结果实验组106颗患牙一次冲洗后成功102颗,4颗患牙治疗失败;对照组100颗患牙成功89颗,失败11颗,两组差异有显著性(P<0.05)。结论替硝唑液对感染根管内厌氧菌有较强杀灭作用,作为瘘道及根管冲洗剂是临床用药的一个较好选择。     

Comparative study of the configuration and the cleanliness level of root canals prepared with the aid of sodium hypochlorite and bis-dequalinium-acetate solutions

Bis-dequalinium acetate (BDA), a quaternary ammonium compound, was introduced as a bactericidal and chemotherapeutic agent for endodontic use. This study was undertaken to compare the efficacy of this compound to 5.25% sodium hypochlorite in the cleansing and shaping of root canals. One hundred twenty freshly extracted teeth were divided into three groups. Each group was treated with the aid of the test material; saline solution was used as a control. After completion of the endodontic preparation, a silicone imprint of the canals was performed and the teeth were decalcified. The imprints were examined three-dimensionally to determine the amount of debris and canal configuration due to defective preparation and anatomic variation. No significant difference could be observed between the tested materials with respect to cleanliness and the shape of the canals. At the apical third, however, the BDA-treated canals showed more favorable results with respect to cleanliness. On the basis of the present and previous findings, it was concluded that BDA might be a favorable replacement for sodium hypochlorite as an irrigation solution.     

Bacteriologic status of the root canal after sonic, ultrasonic and hand instrumentation

Abstract The purpose of this study was to assess the bacteriologic status of the root canal after sonic, ultrasonic and hand instrumentation. Root canal infection was induced in 50 single-rooted teeth in young dogs by removing the pulp and filling the canals with dental plaque. After 7 clays the root canals were instrumented under aseptic conditions with conventional hand instruments, a sonic vibratory device or an ultrasonic device. Sterile saline or 2.5% sodium hypochlorite was used as irrigating solution. Following instrumentation a sterile paper point was sealed into the root canals. After 7 d the root canals were reopened under aseptic conditions and the paper points were incubated for the demonstration of bacteria, using pre-reduced thioglycolate culture medium and anaerobic chambers. The results obtained with the different instrumentation techniques and irrigating solutions were compared by means of the Chi-square test. The results indicated that the sonic and ultrasonic devices were not more effective in the elimination of bacteria from the root canal than conventional hand instrumentation. Irrigation with sodium hypochlorite appeared to be more effective than saline in producing bacteria-free root canals; however, this difference was not statistically significant. Thus, it appeared that more than one appointment and the supporting action of an antibacterial medicament between appointments would be necessary to achieve bacteria-free root canals in infected teeth in a predictable manner.     

四种浓度次氯酸钠根管消毒效果的评价

目的 探讨4种浓度次氯酸钠对感染根管的消毒作用.方法 将100例慢性根尖周炎患者随机分为5组,分别使用0.25%、0.50%、1.00%、2.00%的次氯酸钠和生理盐水作为根管冲洗剂,根管预备前后,分离、培养根管内厌氧菌,观察并记录细菌形态及菌落数.结果 4种浓度次氯酸钠对感染根管均有消毒作用,生理盐水的根管消毒作用差.结论 在橡皮障未能普及的情况下,作为根管冲洗剂的次氯酸钠合适浓度为1.00%.     

Evaluation of the effectiveness of sodium hypochlorite used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal, in vitro

The effectiveness of 4.0% sodium hypochlorite (NaOCl) used with three irrigation methods in the elimination of Enterococcus faecalis from the root canal was tested in vitro . Root canals contaminated with E. faecalis were treated as follows: (i) irrigation with 2 mL of NaOCl solution and agitation with hand files; (ii) irrigation with 2 mL of NaOCl solution and ultrasonic agitation; (iii) irrigation with NaOCl alternated with hydrogen peroxide. Contaminated canals irrigated with sterile saline solution served as the control. Paper points used to sample bacteria from the root canals were transferred to tubes containing 5 mL of brain heart infusion (BHI) broth. Tubes were incubated and the appearance of broth turbidity was indicative of bacteria remaining in the root canal. There were no statistically significant differences between the experimental groups. However, NaOCl applied by the three methods tested, was significantly more effective than the saline solution (control group) in disinfecting the root canal.     

机用ProTaper根管预备附加不同超声冲洗液对根管显微硬度的影响

]目的：探讨机用镍钛ProTaper根管预备附加不同超声冲洗液对根管壁牙本质显微硬度的影响。方法收集60颗离体单根管上颌前牙,随机分为6组,A组为对照组,B组应用机用镍钛ProTaper根管预备至F3,C组预备后附加3%过氧化氢溶液超声冲洗1 min,D组预备后附加口泰漱口液超声冲洗1 min,E组预备后附加17%EDTA溶液超声冲洗1 min,F组预备后附加蒸馏水超声冲洗1 min。将每个牙根平均横截为根上、根中和根尖 3 段,再纵向劈开,用显微硬度仪分别测量各组根管壁显微硬度。采用SPSS 17.0软件包对数据进行统计学分析。结果A组根管各处的显微硬度分别为（52.66±1.64）HV、（52.08±1.53）HV和（51.47±2.53）HV,差异无显著性（P>0.05）,其他各组的根尖1/3显微硬度均低于根颈和根中1/3,差异显著（P<0.05）。在根颈1/3和根中1/3,E组显微硬度分别为（44.65±1.33）HV和（42.55±1.12）HV,与其他各组相比,差异显著（P<0.05）。在根尖1/3,E组显微硬度为（37.82±1.60）HV,下降最为显著,其次为C组,显微硬度为（44.14±1.73）HV。B组、D和F组之间相比,无显著性差异（P>0.05）。结论机用镍钛ProTaper根管预备至F3可使根尖1/3显微硬度下降。17%EDTA溶液超声冲洗1 min可使根管各部显微硬度下降, 3%过氧化氢可使根尖1/3显微硬度下降,口泰漱口液和蒸馏水对根管各部牙本质显微硬度值无明显影响。     

Preliminary in vitro evaluation of Carisolv as a root canal irrigant

AIM: To test the null hypothesis that Carisolv is no better than PBS in removing organic debris from uninstrumented root canals. METHODOLOGY: The pulps of two uniform groups of 36 immature, sheep mandibular incisors were grossly removed with barbed broaches immediately prior to the study. Roots in group 1 were irrigated with phosphate buffered saline (PBS), strong sodium hypochlorite (4.5%) or Carisolv without ultrasonic agitation, whilst in group 2 the same irrigants were activated with ultrasound. Canal walls were exposed to irrigants for 10, 20 or 30 min at 37 degree C. In group 2, ultrasound was applied for 30 s at 2, 5 and 7 min within each 10 min incubation period. After washing irrigants free and immersion in fixative, all teeth were split longitudinally, critical point dried and sputter coated for SEM analysis. SEM photomicrographs were recorded of representative areas in the coronal, middle and apical canal thirds and debris scored by a single assessor against a five-point scale. Intraobserver reliability was assessed by Cohens kappa scores and debris scores analysed by the non-parametric Kruskal-Wallis test at P < 0.05. RESULTS: Sodium hypochlorite was significantly better than Carisolv and PBS in cleaning root canals (P < 0.0001), whether or not ultrasound was applied. Carisolv was shown to clean canals better than PBS, again whether or not ultrasound was applied (P = 0.01). Both incubation time and ultrasound enhanced the action of Carisolv (P < 0.001) whilst the activity of PBS was not significantly improved by exposure time or the application of ultrasound. Kappa scores of 0.90-0.95 indicated excellent consistency in debris scoring. CONCLUSIONS: Within the limitations of this preliminary study (i). Carisolv cleaned root canals better than PBS and shows promise as an adjunct to root canal preparation; (ii). the action of Carisolv was enhanced by incubation times beyond 20 min whether or not ultrasound was applied; (iii). sodium hypochlorite solution remains the gold standard endodontic irrigant, provided that it is used with care and is contained in the canal system.     

不同器械及预备方法对单根管内感染物清除效果的比较

目的:比较分析不同器械及方法机械预备后对单根管内细菌感染物的清除效果及其影响因素.方法:选择45 个慢性根尖周炎的单根管患牙,随机分为3 组,每组15 个患牙,A组:手用不锈钢锉、步退法预备根管;B组:HERO 642镍钛锉、标准冠下法预备根管;C组:Mtwo镍钛锉、改良冠向下法预备根管.各组预备过程中用无菌生理盐水冲洗,分别于预备前、预备后根管内取样、接种、培养,检测根管内细菌种类及数量的变化.结果: 3 组器械及方法机械预备后均可使根管内的细菌种类及数量明显减少(P<0.01),其中手用不锈钢根管锉、步退法及Mtwo旋转镍钛锉、改良冠向下法预备后根管内细菌的减少量均大于HERO 642旋转镍钛锉、标准冠下法,且差异有显著性(P<0.05),手用不锈钢根管锉、步退法预备后根管内细菌的减少量大于Mtwo旋转镍钛锉、改良冠向下法,但差异无显著性(P>0.05).结论:机械预备可以大大减少根管内细菌量,但不能达到完全无菌,旋转镍钛器械、标准冠下法在提高根管内感染清除能力并无明显优势,机械预备应配合化学预备以提高根管治疗的成功率.     

Histological study of the effect of some irrigating solutions on bacterial endotoxin in dogs

The aim of this study was to evaluate, histopathologically, the effectiveness of mechanical preparation of root canals using different irrigating solutions in dog teeth filled with LPS after pulpectomy. A total of 120 root canals of 6 mongrel dogs were filled with a solution of LPS after pulpectomy. The irrigating solutions used were saline, 1, 2.5, and 5% sodium hypochlorite, and 2% chlorhexidine. No irrigation was used in the control group. The animals were sacrificed after 60 days and the teeth were fixed and demineralized. Subsequently, serial 6-microm sections were stained with hematoxylin and eosin and Mallory's trichrome for histopathological analysis and Brown-Brenn for verification of bacterial contamination. Analysis showed that the inflammatory infiltrate was statistically less intense in the groups in which the root canals were irrigated with 5% sodium hypochlorite and 2% chlorhexidine. However, none of the irrigating solutions completely inactivated the harmful effects of LPS. Mechanical preparation associated with different irrigating solutions did not completely inactivate LPS.