5种冲洗剂组合对前牙直根管清洁效果的比较  

Comparison of the effects of 5 irragant combinations on cleaning of anterior straight root canal walls

作　　者：李辰[1] 杜嵘[1] 朱亚琴[1] 

机构地区：[1]上海第二医科大学附属第九人民医院.口腔医学院口腔内科,上海200011

出　　处：《上海口腔医学》2005年第3期293-297,共5页Shanghai Journal of Stomatology

基　　金：上海市科委启明星计划(01QB14025)

摘　　要：目的:比较5种冲洗剂组合对前牙直根管的清洁效果。方法:25颗离体直根管前牙,随机分为5组,不锈钢K锉常规法预备根管,应用5种冲洗剂组合进行冲洗。第1组:根管器械预备期间和预备结束后依次用1%NaOCl和3%H2O2冲洗;第2组:根管器械预备期间用1%NaOCl冲洗,预备结束后用17%EDTA冲洗;第3组:根管器械预备期间和预备结束后依次用1%NaOCl和17%EDTA冲洗;第4组:根管器械预备期间依次用17%EDTA和1%NaOCl冲洗,器械预备结束后用17%EDTA冲洗;第5组:根管器械预备期间依次用17%EDTA、1%TritonX-100(表面活性剂)和1%NaOCl冲洗,器械预备结束后用17%EDTA冲洗。每组冲洗剂剂量和冲洗时间均为22ml和7min。将牙纵劈后进行扫描电镜观察。结果:第1组,根管壁上见典型玷污层结构和大量杂质和残屑。第2组在根管冠、中1/3能部分去除玷污层,根尖1/3残留大量玷污层。第3组虽然能有效去除玷污层,但会引起牙本质小管中度腐蚀。第5组在根管冠、中1/3能部分去除玷污层,但根管壁上黏着大量杂质和残屑,此外还存在重度腐蚀现象。第4组根管清洁效果最好,且对牙本质小管无腐蚀性。结论:在严格控制冲洗时间和顺序的情况下,联合应用17%EDTA和1%NaOCl能有效去除玷污层,且不会腐蚀牙本质小管。PURPOSE:To evaluate the effect of 5 kinds of irrigant combinations on cleaning of anterior straight root canal walls. METHODS: 25 extracted human maxillary anterior teeth, with a single straight root were randomly divided into 5 groups. They were instrumented with K-files and conventional preparation technique. The irrigations were as follow: in group 1,the canals were irrigated with 1% NaOCl and 3% H2O2 in sequence during and after instrumentation.In group 2,the canals were irrigated with 1% NaOCl during instrumentation and after instrumentation being irrigated with 17% EDTA. In group 3,irrigation during and after instrumentation was accomplished using 17% EDTA and 1% NaOCl in sequence. In group 4,irrigation during instrumentation was accomplished using 17% EDTA and 1% NaOCl in sequence, and after instrumentation being irrigated with 17% EDTA.In group 5,the canals were irrigated with 17% EDTA, 1% Triton X-100 and 1% NaOCl in sequence during instrumentation and irrigated with 17% EDTA after instrumentation. The total amount of irrigant was 22ml and the irrigation time was 7 minutes in each root canal. The root was split longitudinally and 3 specimens in each group were evaluated regarding to the smear layer, debris and erosion of dentinal tubules with SEM at the coronal, middle and apical thirds. RESULTS: In group 1, typical amorphous smear layer and abundance of debris were seen on the wall of canals. In group 2, the smear layer was removed partly in coronal and middle thirds, but the apical surface of the canal walls were covered with a typical amorphous smear layer. Although irrigants of group 3 could remove smear layer effectively, it resulted in moderate erosion of dentinal tubules. In group 5, part of the smear layer was removed on the surface of coronal and middle thirds but abundance of debris were present on the surface at the apical levels. Severe erosion was noted on the root canal surfaces in this group. Irrigation of group 4 had the best result: it not only removed smear layer effectively ,but also h

关 键 词：根管冲洗剂 玷污层 次氯酸钠 EDTA 表面活性剂 

分 类 号：R781.05[医药卫生—口腔医学]