下颌第一磨牙管间峡区清理技术的体外研究  

An in vitro study of the debridement of isthmuses in mandibular first molars

作　　者：古丽莎[1] 凌均棨[1] 黄湘雅[1] 韦曦[1] 徐琼[1] 

机构地区：[1]中山大学光华口腔医学院.附属口腔医院.口腔医学研究所,广州510055

出　　处：《中华口腔医学研究杂志（电子版）》2008年第5期29-34,共6页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：卫生部部属(管)医疗机构2007-2009年临床学科重点项目(卫规财函[2007]353号);2005年广州市医药卫生科技重大项目(2005-ZDa-002)

摘　　要：目的探讨通过组织学方法观察和评价次氯酸钠与超声技术和(或)氢氧化钙联合应用对根管及管间峡区内有机碎屑的清理效果,为管间峡区清理技术的建立提供实验依据。方法收集新鲜拔除的下颌第一磨牙45颗,用ProTaper手用锉预备近颊和近舌两根管后,将45例近中根随机分为A、B和C三组,分别采用以下方法完成根管清理:A组5.25%NaOCl超声冲洗1min,B组和C组均先用Ca(OH)2糊剂处理根管24h,再分别通过超声冲洗和常规冲洗技术清理根管,冲洗液均为0.5%NaOCl。标本脱钙包埋后,取距根尖1、1.5、2、2.5、3mm处的切片各1张作为观察片,行HE染色。用图像软件分析根管及管间峡区内有机碎屑的含量,计算根管和管间峡区清洁度并对数据进行统计学分析。结果A组和B组的根管清洁度(根尖1～2.5mm水平)和管间峡区清洁度(根尖1～3mm水平)均优于C组(P<0.05),A、B组间的差异不具有统计学意义。结论Ca(OH)2糊剂和0.5%NaOCl超声冲洗联合应用可获得较理想的根管及管间峡区清理效果,可替代5.25%NaOCl超声冲洗法成为一种安全、有效的根管及管间峡区清理技术。Objective To histologically evaluate the efficacy of sodium hypochlorite （NaOCl） in combination with ultrasonic irrigation and/or calcium hydroxide （Ca（OH）2） in dissolving necrotic tissue and cleaning root canals as well as canal isthmuses in mesial roots of mandibular first molars. Methods 45 freshly extracted human mandibular first molars were randomly assigned to three groups. Each group consisted of 15 mesial roots. They were instrumented by using ProTaper hand files and subsequently subjected to three different irrigation regimens as followed： Group A-a 1 min of ultrasonic irrigation with 5.25% NaOCl, group B-a 1 min of ultrasonic irrigation with 0.5% NaOCl after pretreatment with Ca （OH）2 paste for 24 h, and group C-irrigation with 15ml of 5.25% NaOCl using disposable syringes after pretreatment with Ca（OH）2 paste for 24 h. After histological preparation and staining, 4 μm crosssections from the 1- to 3-mm apical levels were evaluated for percentage of tissue removal. Results Nonparametric analysis revealed that mean percentage of canal and isthmus cleanliness values were significantly higher in group A and B at all levels evaluated, except one （P 〈 0.05）. Conclusion 0.5% NaOCl ultrasonic irrigation in combination with Ca （OH）2 pretreatment can be used safely and effectively in root canal irrigation instead of 5.25% NaOCl.

关 键 词：下颌第一磨牙 管间峡区 有机碎屑 超声冲洗 

分 类 号：R781.05[医药卫生—口腔医学] R780.2[医药卫生—临床医学]