利用扫描电子显微镜分析声波辅助根管荡洗作用时间对玷污层清理效果的影响  

The effect of sonic activated device used for different time on intracanal smear layer removal:An SEM analysis

作　　者：肖敏[1] 刘瑾 范晓敏[1] 吴昊泽 王珏钰 王可境 李娜[1] 蒋文凯[1] 梅笑寒 XIAO Min;LIU Jin;FAN Xiaomin;WU Haoze;WANG Jueyu;WANG Kejing;LI Na;JIANG Wenkai;MEI Xiaohan(State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Key Laboratory of Stomatology,Department of Operative Dentistry&Endodontics,School of Stomatology,Fourth Military Medical University,Xi'an 710032,China)

机构地区：[1]军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室,第四军医大学口腔医学院牙体牙髓病科,陕西西安710032 [2]黄山市人民医院口腔科,安徽黄山245000

出　　处：《口腔医学》2023年第1期46-51,共6页Stomatology

基　　金：国家自然科学基金面上项目(82270973);陕西省自然科学基础研究计划-面上项目(2021JM-235);陕西省重点研发计划(2021SF-032)。

摘　　要：目的通过扫描电子显微镜(SEM)观察不同作用时间下根管壁玷污层的清除情况,以明确临床中使用声波辅助设备荡洗根管的最佳时间。方法选择单直根管的人离体前牙56颗,常规机械预备后根据冲洗剂不同分为2个实验组:生理盐水组和EDTA组,每组均辅助使用声波驱动的VDW荡洗工作尖完成根管荡洗。生理盐水组根据荡洗时间分为3个亚组:5 s组,30 s组,50 s组;EDTA组根据荡洗时间分为6个亚组:5 s组,10 s组,20 s组,30 s组,40 s组,50 s组。对照组不进行根管冲洗及荡洗。SEM观察根管壁冠、中、根三段的玷污层情况。结果生理盐水组荡洗30 s后冠方1/3与对照组及5 s组相比差异有统计学意义(P<0.05),根中下段无差异(P>0.05);50 s后根尖区玷污层评分与其余各组评分相比差异有统计学意义(P<0.05)。EDTA组荡洗5或10 s后,根管中上段玷污层评分与对照组相比差异有统计学意义(P<0.05),根尖区无意义(P>0.05);20 s~40 s组根尖区与前两组相比差异有统计学意义(P<0.05);50 s组根尖区与其余各组相比均存在明显差异(P<0.05)。对比两个实验组间荡洗50 s后的玷污层清洁效果,根管全段均表现出明显统计学差异(P<0.05)。结论EDTA辅助使用声波荡洗50 s玷污层清洁效果最佳。Objective To observe the clearance of smear layer on the root canal wall in different action time by scanning electron microscope(SEM),and to determine the optimal amount of time using sonically activated irrigation to wash root canal in clinic.Methods Fifty-six ex vivo human anterior teeth with single straight root canal were selected.After routine mechanical preparation,they were divided into two experimental groups according to different irrigating agents:saline group and EDTA group.Each group was assisted by VDW sonic activation EDDY.The saline group was divided into three subgroups according to the irrigating time:5 s,30 s and 50 s;EDTA group was divided into six subgroups according to the irrigating time:5 s,10 s,20 s,30 s,40 s and 50 s.The control group did not undergo root canal irrigation.After irrigation,the root was cut longitudinally.The smear layer of crown,middle and apical of root canal wall was observed by SEM.Results After irrigating for 30 seconds,there was a significant difference between the normal saline group and the control group and the 5 second group(P<0.05),and there was no difference in the middle and apical part(P>0.05).After 50 seconds,there was a significant difference in the score of the smear layer between the apical area and the other groups(P<0.05).After irrigating for 5 seconds or 10 seconds in EDTA group,there was a significant difference between the scores of the crown and middle area of the root canal and the control group(P<0.05),and there was no significant difference in the apical area(P>0.05).There was a significant difference between the 20-40 second group and the first two groups(P<0.05).There was a significant difference between the 50 second group and the other groups(P<0.05).Comparing the cleaning effect on the smear layer after 50 seconds of irrigating between the two experimental groups,the whole root canal showed significant statistical difference(P<0.05).Conclusion The EDTA-assisted sonic activated device used for 50 seconds has the best cleaning effect.

关 键 词：根管冲洗 声波荡洗 玷污层 EDTA 扫描电子显微镜 

分 类 号：R781.05[医药卫生—口腔医学]