不同根管冲洗方式对根管充填后管壁粘接强度影响研究

目的采用推力实验检测不同冲洗方式对根管封闭剂AH-Plus及iRoot SP与根管壁粘接性能的影响,同时比较两种根管封闭剂的粘接强度。方法收集2013年在中国医科大学附属口腔医院就诊患者拔除的56颗上颌单根管前磨牙。根据根管冲洗方式的不同,将所有样本随机均分为A～D组,每组14颗。A组为次氯酸钠(NaClO)溶液注射冲洗根管,B组为NaClO配伍乙二胺四乙酸(EDTA)溶液注射冲洗根管;C组为NaClO配伍EDTA溶液注射冲洗后辅以超声冲洗根管;D组为NaClO配伍EDTA溶液注射冲洗和超声冲洗根管后,使用氯己定(CHX)溶液再次冲洗根管。根据根管封闭剂的不同,每组又均分成2个亚组,分别使用AH-Plus和iRoot SP根管封闭剂。待根管充填后,采用推力实验比较各组的粘接强度。结果不同根管封闭剂对粘接强度无明显影响(P> 0.05),不同的冲洗方式对粘接强度有影响(P <0.05)。B1、B2组的粘接强度分别高于A1、A2组,差异有统计学意义(均P <0.05);C1、C2组的粘接强度分别高于B1、B2组,差异有统计学意义(均P <0.05);而D1、D2组的粘接强度分别与C1、C2组比较,差异无统计学意义(P> 0.05)。结论采用NaClO配伍EDTA溶液作为根管冲洗液并辅以超声冲洗技术能有效增加根管封闭剂与根管壁的粘接强度,而CHX溶液做为最后一步根管冲洗液对根管封闭剂粘接强度的影响不大。iRoot SP及AH-Plus与根管壁的粘接强度无明显差别,均可作为根管封闭剂应用于临床。

Effect of different irrigation protocols on bond strength of root canal seelers to the wall after root canal filling

Objective　To evaluate the influence of different irrigation protocols on the bond strength of two root canal seales（AH-Plus and iRoot SP） to dentin by using a push-out test design. Compare the bond strength of two sealers at the same time. Methods　Fifty-six maxillary single-root premolars extracted from patients who visited China Medical University Hospital of Stomatology in 2013 were used in this study. According to the irrigation protocol，the samples were randomly divided into four groups（A ~ D）（n = 14）. Group A：injection irrigation with NaClO；Group B：injection irrigation with NaOCl and EDTA；Group C：injection irrigation with NaOCl and EDTA，followed by ultrasonic irrigation；Group D：injection irrigation with NaOCl and EDTA，followed by ultrasonic irrigation，and then injection irrigation with CHX. Depending on the root canal sealer，each group was divided into two subgroups（AH-Plus and iRoot SP）. After the root canal was filled，the tensile strength of each group was compared using a push-out test. Results　Different root canal sealers had no significant effect on the bonding strength（P > 0.05），but different irrigation methods had an effect on the bonding strength（P < 0.05）. The bonding strength of Group B1 and B2 was higher than that of Group A1 and A2 （all P < 0.05）；the bonding strength of Group C1 and C2 was higher than that of Group B1 and B2 （all P < 0.05）；the bonding strength of Group D1 and D2 was not significantly different from that of Group C1 and C2 （P > 0.05）. Conclusion　The use of NaClO in combination with EDTA as root canal irrigation followed by ultrasound irrigation can effectively increase the bond strength between the sealer and the root canal wall. The CHX solution as the last step of the irrigation solution has little effect on the bond strength between the sealer and the root canal wall. There is no significant difference in the bonding strength between iRoot SP and AH-Plus，and they can both be used as a root canal sealer in clinical practice.