超声和Er:YAG激光冲洗活化技术对人感染根管牙本质的渗透效果  

The penetration effect of ultrasound and Er:YAG laser irrigation activation techniques on dentine of infected human root canals

作　　者：任月月 许慧慧 李午丽[1] 张苗苗 陈峰 李颂[1] REN Yueyue;XU Huihui;LI Wuli;ZHANG Miaomiao;CHEN Feng;LI Song(College&Hospital of Stomatology,Anhui Medical University,Key Laboratory of Oral Diseases Research of Anhui Province,He-fei 230032,China)

机构地区：[1]安徽医科大学口腔医学院·安徽医科大学附属口腔医院牙体牙髓科,安徽省口腔疾病研究重点实验室,安徽合肥230032

出　　处：《口腔疾病防治》2023年第8期573-579,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：安徽省高校自然科学研究项目(KJ2020A0164)。

摘　　要：目的体外评估超声和Er:YAG激光冲洗活化技术对次氯酸钠溶液在人感染根管牙本质中渗透的影响,为临床感染根管的治疗提供参考。方法收集36例感染根管,根据冲洗技术随机分组:常规注射器冲洗(conventional syringe irrigation,CSI)组12例、被动超声冲洗(passive ultrasonic irrigation,PUI)组12例、Er:YAG激光光子诱导光声流技术(Er:YAG laser and photon-induced photoacoustic streaming,PIPS)组12例;收集36例清洁根管,根据冲洗技术随机分组:CSI组12例、PUI组12例、PIPS组12例。纳入根管均为后牙的直根管,所有根管经标准化牙根长度后进行机械预备、相应动力冲洗流程,随后使用2%亚甲蓝溶液根管内染色,观察冲洗剂渗透区域。使用EXAKT硬组织切磨系统取根管冠、根中、根尖1/3处100~150μm的横向硬组织切片,采用光学显微镜观察并测量数据(最大渗透深度、平均渗透深度、渗透百分比)以评估染料渗透效果。结果3种冲洗技术下,在根管的全长,感染根管中的最大渗透深度、平均渗透深度、渗透百分比均显著小于清洁根管,差异均有统计学意义(P<0.05)。在感染根管的冠方、根中以及根尖,PIPS组分别在渗透百分比、平均渗透深度以及最大渗透深度上大于CSI组(P<0.05);PUI组和CSI组的最大渗透深度、平均渗透深度和渗透百分比的差异无统计学意义(P>0.05);PIPS组和PUI组的最大渗透深度、平均渗透深度和渗透百分比的差异无统计学意义(P>0.05)。结论感染根管的牙本质渗透性弱于清洁根管;Er:YAG激光冲洗活化技术可显著改善次氯酸钠溶液对感染牙本质的渗透效果,而被动超声冲洗并未显著改善渗透效果。Objective This ex vivo study evaluated the effect of ultrasound and Er:YAG laser irrigation activation techniques on the penetration of sodium hypochlorite solution into infected human root canal dentin,providing a refer⁃ence for clinical infection control of infected root canals.Methods Thirty⁃six cases of infected root canals were col⁃lected and randomly divided into three groups according to the irrigation technique:12 cases in the conventional sy⁃ringe irrigation(CSI)group,12 cases in the passive ultrasonic irrigation(PUI)group,12 cases in the Er:YAG laser and photon⁃induced photoacoustic streaming(PIPS)group and 36 cases of clean root canals(12 cases in the CSI group,12 cases in the PUI group,12 cases in the PIPS group).All of the selected root canals were straight root canals of posteri⁃or teeth.After standardizing the root length,all canals were subjected to instrumentation and dynamic irrigation.2%methylene blue solution was used to visualize the penetration of the irrigant.EXAKT cutting and grinding equipment was used to take transverse sections of 100⁃150μm at the coronal,middle and apical thirds of the root canals.The da⁃ta(maximum penetration depth,average penetration depth,and penetration percentage)were observed under a light mi⁃croscope to evaluate the effect of dye penetration.Results With the three irrigation techniques,the maximum penetra⁃tion depth,average penetration depth and penetration percentage of the infected root canals were significantly lower than those of clean root canals in the full length of the root canal(P<0.05).The penetration percentage,average pene⁃tration depth and maximum penetration depth of the PIPS group were significantly higher than those of the CSI group in the coronal,middle and apical thirds of the infected root canal,respectively(P<0.05).There was no significant dif⁃ference in the maximum penetration depth,average penetration depth or penetration percentage between the PUI and CSI groups(P>0.05).There was also no significant difference in t

关 键 词：感染根管 牙本质 ER:YAG激光 被动超声冲洗 常规注射器冲洗 次氯酸钠 根管冲洗 渗透 

分 类 号：R78[医药卫生—口腔医学]