不同赋形剂调制氢氧化钙对粪肠球菌消毒效果影响的体外评价  

An in vitro study on effects of different calcium hydroxide pastes against Enterococcus faecalis in root canal

作　　者：肖茂德 黄雅静[3] 李月恒[3] 黄锐[3] 周智[3] 

机构地区：[1]重庆市九龙坡区第三人民医院,重庆400080 [2]重庆市九龙坡区第一中医院,重庆400080 [3]重庆医科大学口腔医学院牙体牙髓科,重庆401147

出　　处：《中国微生态学杂志》2011年第11期997-1000,共4页Chinese Journal of Microecology

基　　金：重庆市卫生局科研课题资助(20080488)

摘　　要：目的通过应用离体牙根管模型进行根管消毒模拟试验,就应用不同赋形剂调制的氢氧化钙糊剂对根管的消毒作用进行评价。方法选取因正畸拔除的单根管下颌第一前磨牙并进行根管预备,自釉牙骨质界处将离体牙截去牙冠,在距截冠处5 mm去除根尖,仅留5 mm长牙根,筛选获得经制备的模拟根管120个,随机分为4个试验组和2个对照组(空白对照组和阳性对照组),每组各20颗牙齿。将4个试验组及阳性对照组共100个根管建立粪肠球菌根管感染模型,4个试验组根管内分别放置使用生理盐水、甘油、葡萄糖酸氯己定、樟脑苯酚等4种赋形剂调制的氢氧化钙糊剂,阳性对照组20个感染根管中仅放置生理盐水,而空白对照组20个根管不接种细菌,仅置入无菌生理盐水。所有标本牙置5%CO2,95%N2,37℃环境下培养,每组分别于第3、7天取10个根管使用G钻均匀磨取根管内层牙本质粉末,置BHI液体培养基中培养72 h后,测定并分析各根管中残留细菌量。结果使用氢氧化钙糊剂消毒3 d时,4个试验组根管中残留细菌量均较阳性对照组有明显减少(P<0.01),葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组;使用氢氧化钙糊剂7 d时,试验各组均有消毒效果,但生理盐水-氢氧化钙组牙本质小管中有少量均残留细菌,葡萄糖酸氯己定组、樟脑苯酚组的消毒效果差异无统计学意义。结论在离体牙根管消毒实验中,使用4种赋形剂调制的氢氧化钙糊剂均能有效抑制粪肠球菌生长,葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组。Objective To evaluate the antimicrobial efficacy of different calcium hydroxide pastes mixed with dif- ferent vehicles against Enterococcusfaecalis in vitro, and provide reference for clinical application. Method Extracted human single-rooted mandibular first premolar were collected. After canal preparation, the crowns and roots were removed, and a total of 120 specimens were selected. After sterilization, the root canals were divided randomly into four experiment groups （physiologlcal saline, camphorated phenol, glycerin, ehlorhexidine gluconate respectively） and two control groups, each group having 20 specimens. Then the specimens were contaminated with Enterococcus faecalis, except the negative control group. The teeth were treated with different intracanal medicament as below： group 1 with Saline （ negative con- trol） ; group 2 with calcium hydroxide paste plus sterile physiological saline; group 3 with calcium hydroxide paste plus camphorated phenol; group 4 with calcium hydroxide paste plus glycerin; group 5 with calcium hydroxide paste plus 2% chlorhexidine gluconate; group 6 with physiological saline without intracanal medication （positive control） ; Then the canals were incubated at 37 ℃（5% CO2,95% N2）. After 3 and 7 days, dentin chips were collected and incubated in BHI for 72 hours to observe the growth of the microorganisms by a spectrophotometer. The data were submitted to the analysis of variance （ANOVA, P = 0.05）. Result All the medicaments were effective for eliminating the baeteria when the pastes were placed for 3 and 7 days. The groups of calcium hydroxide manipulated with glycerin, camphorated phenol or chlorhexidine gluconate showed better antimierobial activity than Ca（OH） 2 manipulated with physiological saline. Ca（OH） 2 pastes with camphorated phenol or chlorhexidme gluconate were more effective for eliminating bacteria than the paste with glycerin after 7 days＇ root canal disinfection. Conclusion Calcium hydroxide with Camphorated phenol or chlorhexidine

关 键 词：氢氧化钙 粪肠球菌 根管消毒 葡萄糖酸氯己定 

分 类 号：R378.12[医药卫生—病原生物学]