微创开髓下3种根管消毒方法对粪肠球菌清除效果比较  

Comparison of three root canal disinfection methods for removal of Enterococcus faecalis under minimally invasive root canal treatment

作　　者：单晓阳 孙莉青 王月月 杨楠[1,2] 孙慧斌[1,4] SHAN Xiao-yang;SUN Li-qing;WANG Yue-yue;YANG Nan;SUN Hui-bin(Department of Stomatology,Affiliated Hospital of Qingdao University.Qingdao 266003;School of Stomatology of Qingdao University.Qingdao 266003;Department of Stomatology,Qingdao Women and Children's Hospital.Qingdao 266000;Dental Digital Medicine&3D Printing Engineering Laboratory of Qingdao University.Qingdao 266003,Shandong Province,China)

机构地区：[1]青岛大学附属医院口腔科,山东青岛266003 [2]青岛大学口腔医学院,山东青岛266003 [3]青岛市妇女儿童医院口腔科,山东青岛266000 [4]青岛大学口腔数字医学与3D打印工程实验室,山东青岛266003

出　　处：《上海口腔医学》2022年第1期17-23,共7页Shanghai Journal of Stomatology

基　　金：全国医学专业学位研究生教育指导委员会研究课题(B1-YX20180302-03);山东省研究生导师指导能力提升计划(SDYY18071)

摘　　要：目的:比较微创和常规开髓下的不同根管消毒方法,获得一种基于微创开髓的高效简便的根管消毒方法。方法:将66颗离体上颌第一磨牙随机分为实验组(计算机辅助引导下开髓)和对照组(常规开髓),均预备至ProTaper Universal F2,建立粪肠球菌感染模型。每组再随机分为NaClO+EDTA冲洗(A)、NaClO+EDTA+超声荡洗(B)、NaClO+EDTA+Er:YAG激光(C)3个亚组,进行根管消毒后取样培养,计算每个样本菌落形成单位(colony-forming units,CFU)值。以F3锉预备并收集牙本质碎屑,稀释培养后,计算CFU值。采用SPSS 26.0软件包对数据进行统计学分析。结果:根管内壁表面实验组和对照组CFU结果显示,C组和B组的杀菌效果显著优于A组(P<0.05),但C组和B组无显著差异(P>0.05)。实验组内比较,B1、C1组与A1组之间有显著差异(P<0.05),B1、C1组结果均低于A1组,但B1、C1之间无显著差异(P>0.05)。对照组组内比较,B2、C2组与A2组之间有显著差异(P<0.05),B2、C2组结果均低于A2组,但B2、C2之间无显著差异(P>0.05)。实验组和对照组牙本质碎屑细菌量的比较结果显示,C组效果最佳,B组次之,A组最差,各组两两之间均有显著差异(P<0.05)。结论:计算机引导下微创根管治疗,在Er:YAG激光或超声辅助下,可获得与常规根管治疗相仿的消毒效果,且Er:YAG激光对牙本质小管的细菌清除效果优于超声,更适用于微创根管治疗。PURPOSE:To obtain an efficient and simple root canal disinfection method based on minimally invasive root canal treatment by comparing different root canal disinfection methods between minimally invasive root canal treatment and conventional root canal treatment.METHODS:Sixty-six extracted maxillary first molars were randomly divided into experimental group(computer-guided precision minimally invasive root canal treatment)and control group(conventional root canal treatment).All teeth were prepared to ProTaper universal F2,and Enterococcus faecalis infection models were established.Each group was randomly divided into three subgroups,sodium hypochlorite+EDTA root canal irrigation,sodium hypochlorite+EDTA+ultrasonic and sodium hypochlorite+EDTA+Er:YAG laser.After root canal disinfection,the samples were collected by paper tip method and cultured,and colony forming units(CFU)values of each sample were calculated.Then dentin debris was prepared and collected with F3 file.After being diluted and cultured,the CFU value was calculated.Statistical analysis was performed by SPSS 26.0 software package.RESULTS:Comparison of the amount of bacterial inner wall of root canal between the experimental group and the control group showed that the germicidal efficacy of group C and group B were significantly better than that of group A(P<0.05),but there was no significant difference between group B and group C(P>0.05).In the experimental group,there was significant difference between group B1,C1 and A1(P<0.05).The results of group B1 and C1 were lower than that of group A1,but there was no significant difference between group B1 and group C1(P>0.05).In the control group,there were significant differences between group B2,C2 and A2(P<0.05).The results of group B2 and C2 were lower than that of group A2,but there was no significant difference between group B2 and C2(P>0.05).Comparison of the amount of bacteria in dentin debris between the experimental group and the control group showed that the effect of group C was the best,followed

关 键 词：微创根管治疗 根管消毒 粪肠球菌 ER:YAG激光 超声荡洗 

分 类 号：R781.05[医药卫生—口腔医学]