不同浓度次氯酸钠处理对牙本质粘接的影响及异抗坏血酸钠的恢复作用  

Effects of different concentrations of sodium hypochlorite on dentine adhesion and the recovery application of sodium erythorbate

作　　者：张碧晗 杨东辉[4] 朱喜蕾 周亚琴 朱沁怡 方厂云[1,2,3] ZHANG Bihan;YANG Donghui;ZHU Xilei;ZHOU Yaqin;ZHU Qinyi;FANG Changyun(Department of Prosthodontics,Center of Stomatology,Xiangya Hospital,Central South University,Changsha 410008;Research Center of Oral and Maxillofacial Tumor,Xiangya Hospital,Central South University,Changsha 410008;Institute of Cancer and Precancerous Lesions,Central South University,Changsha 410008;College of Light Industry,Liaoning University,Shenyang 110036,China)

机构地区：[1]中南大学湘雅医院口腔医学中心牙体牙髓科,长沙410008 [2]中南大学湘雅医院口腔颌面部肿瘤研究中心,长沙410008 [3]中南大学口腔癌前病变研究所,长沙410008 [4]辽宁大学轻型产业学院,沈阳110036

出　　处：《中南大学学报（医学版）》2022年第2期226-237,共12页Journal of Central South University ：Medical Science

摘　　要：目的:根管治疗术是治疗牙髓和根尖周炎症最有效且常见的方法,在根管预备的过程中,化学冲洗起到关键作用。次氯酸钠(sodium hypochlorite,NaOCl)是目前临床广泛应用的根管冲洗液,然而它可能会在发挥杀菌、溶解功能的同时,影响根管治疗后牙本质与修复材料间的粘接强度,导致治疗效果不佳。因此,为保证良好的根管治疗效果,探究NaOCl对牙本质与修复材料间粘接的影响至关重要。本研究旨在探讨不同浓度的NaOCl处理对复合树脂与牙本质间粘接的影响,以及异抗坏血酸钠(sodium erythorbate,ERY)的作用,为根管治疗后牙本质的粘接提供临床指导。方法:选取新鲜拔除的18~33岁青年的第三磨牙70颗,在水冷却下用慢速锯切割获得牙本质试件。实验分为10组,每组14个牙本质试件。其中5组分别为去离子水(deionized water,DW)组、0.5%NaOCl组、1%NaOCl组、2.5%NaOCl组和5.25%NaOCl组,分别用对应液体浸泡20 min,每5 min更换1次液体;剩余5组按照上述相同方法处理后,用DW冲洗1 min,10%ERY溶液浸泡5 min。每组从14个牙本质试件中取4个,在扫描电镜(scanning electron microscope,SEM)下观察,计算牙本质小管的开口数目并测量直径;每组剩余的10个牙本质试件,经自酸蚀粘接系统粘接及复合树脂固化后制备成粘接试件,用慢速锯切割后,每组获得横截面积约1 mm×1 mm大小的20个条状试件,其中10个条状试件于SEM下观察,分别从树脂突形成、树脂突长度、混合层形成3个方面评估粘接层形态;剩余10个进行微拉伸实验和断裂破坏类型分析。结果:0.5%NaOCl、1%NaOCl、2.5%NaOCl、5.25%NaOCl组随着NaOCl浓度的升高,牙本质小管开口数目和直径均逐渐增加(均P<0.05)。DW、0.5%NaOCl、1%NaOCl、2.5%NaOCl、5.25%NaOCl组使用10%ERY后,牙本质小管开口数目和直径没有显著增加(均P>0.05)。在SEM下,DW、0.5%NaOCl、1%NaOCl及2.5%NaOCl组随着NaOCl浓度的增高,树脂突形成评�Objective: Root canal therapy is the most effective and common method for pulpitis and periapical periodontitis. During the root canal preparation, chemical irrigation plays a key role. However, sodium hypochlorite(NaOCl), the widely used irrigation fluid, may impact the bonding strength between dentin and restorative material meanwhile sterilization and dissolving. Therefore, it’s important to explore the influence of NaOCl on the adhesion between dentin and restoration materials to ensure clinical efficacy. This study aims to explore the effect of NaOCl on dentine adhesion and evaluate the effect of dentine adhesion induced by sodium erythorbate(ERY), and to provide clinical guidance on dentin bonding after root canal therapy.Methods: Seventy freshly complete extracted human third molars aged 18-33 years old,without caries and restorations were selected. A diamond saw was used under running water to achieve dentine fragments which were divided into 10 groups with 14 fragments in each group: 2 control [deionized water(DW)±10% ERY] and 8 experimental groups(0.5%,1%, 2.5%, and 5.25% NaOCl±10% ERY). The dentine specimens in the control group(treated with DW) and the experimental groups(treated with 0.5% NaOCl, 1% NaOCl,2.5% NaOCl, and 5.25% NaOCl) were immersed for 20 min using corresponding solutions which were renewed every 5 min. The other 5 groups were immersed in 10% ERY for5 min after an initial washing with DW for 1 min. Then, we selected 4 dentine fragments from all 14 fragments in each group and the numbers and diameters of opening dentinal tubules were observed under scanning electron microscope(SEM). The other 10 dentine fragments from each group were used to make adhesive samples by using self-etch adhesive wand composite resin. All the above adhesive samples were sectioned perpendicular to the bonded interface into 20 slabs with a cross-sectional area of 1 mm×1 mm using a diamond saw under the cooling water, and then the morphology of 10 slabs in each group’s bonding interface was observed from

关 键 词：牙本质粘接 次氯酸钠 异抗坏血酸钠 扫描电镜 微拉伸实验 

分 类 号：R783.1[医药卫生—口腔医学]