氢氧化钙氯己定混合液对根管治疗失败病例进行根管消毒的效果研究

目的:探讨氢氧化钙氯己定混合液对根管治疗失败病例进行根管消毒的效果.方法:门诊选择105例单根管根管治疗失败的病例,进行根管内重新封药,实验组(氢氧化钙和2%氯己定混合液组)和两对照组(氢氧化钙组和2%氯己定组)各35例.就诊3次,每次收集根管内细菌标本进行培养;随访1年,了解术后疗效.结果:感染根管的初始样本分析,实验组和两对照组均有5颗牙齿感染了粪肠球菌.经过两次封药,最初感染粪肠球菌的所有牙齿,混合组得到了理想消毒.而氢氧化钙对照组,5颗牙齿中有3颗牙齿得到良好消毒,2%氯己定组有4颗牙齿得到良好消毒.第2次就诊,混合组的粪肠球菌感染率明显小于两对照组(P<0.05).随访1年,实验组失败数均小于两对照组,但二者无统计学差别(P>0.05).结论:2%氯己定与氢氧化钙混合药对控制粪肠球菌感染有一定疗效,在根管治疗失败病例的再治疗领域,具有进一步研究价值.

Effectiveness of a mixture of calcium hydroxide and chlorhexidine digluconate

Objective:To evaluate the effectiveness of a mixture of calcium hydroxide and chlorhexidine digluconate for root canal disinfection. Methods: The 105 subjects for this study were selected from the patients of out-patient clinic. The canal was packed with either 2% chlorhexidine and Ca(OH)_2 slurry(35 samples) or aqueous Ca(OH)_2 slurry(35 samples) or 2% chlorhexidine(35 samples).The bacterium samples of root canals were obtained in every visit for 3 visits. Every sample in each group harbored enterococcus faecalis was cultured.Then every subject was followed up for one year to get the message about treatment state. Results: After two intracanal disinfection, 5 teeth where enterococcus faecalis were found at the initial sampling were successfully disinfected when Ca(OH)_2 was mixed with 2% chlorhexidine. Only 3 of the 5 teeth with initial content of enterococcus faecalis were successfully disinfected in Ca(OH)_2 group and 4 of 5 teeth with initial content of enterococcus faecalis were successfully disinfected in 2% chlorhexidine group. The infection rate of enterococcus faecalis in mixture medicine group was lower than in other two groups in the second visit and there were statistical differences (P<0.05).The failure number in mixture group was less than in other two goups in one-year follow-up,but there was no statistical difference(P>0.05). Conclusion: A mixture of 2% chlorhexidine and Ca(OH )_2 slurry has effective disinfection for enterococcus faecalis in failure cases of root canal therapy and is worth of further study.