冲洗液对标准牙根根管内粪肠球菌和白念珠菌混合感染的抗微生物作用比较  

Effects of irrigants on mixed biofilm of Enterococcus faecalis and Candida albicans in standard root canal models

作　　者：吕盈 徐瑞 张琴琴 史般若 吴翘楚 魏昕[1] LYU Ying;XU Rui;ZHANG Qinqin;SHI Banruo;WU Qiaochu;WEI Xin(Jiangsu Key Laboratory of Oral Diseases,Department of Conservative Dentistry and Endodontics Affiliated Hospital of Stomatology Nanjing Medical University Nanjing 20029,China)

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室,南京医科大学附属口腔医院牙体牙髓科,江苏南京210029

出　　处：《口腔医学》2023年第5期434-438,445,共6页Stomatology

基　　金：国家自然科学基金(81970945);江苏省科教能力提升工程——江苏省研究型医院(YJXYYJSDW4),江苏省医学创新中心(CXZX202227)。

摘　　要：目的 评估2.5%次氯酸钠(NaClO)、2%氯己定(CHX)溶液作为冲洗液对标准牙根模型根管内粪肠球菌和白念珠菌混合感染的抗微生物效果。方法 在标准牙根模型内接种粪肠球菌和白念珠菌,混合感染根管28 d;ProTaper NEXT镍钛器械预备,用2.5%NaClO、2%CHX溶液分别冲洗,生理盐水作为空白对照。通过比较每个样本冲洗前后的菌落形成单位(CFU)值和激光共聚焦扫描显微镜(CLSM)下观察冲洗液在牙本质小管内的渗透深度,比较不同冲洗液对标准牙根牙本质小管内混合微生物的抑制作用。结果 2.5%NaClO和2%CHX溶液对混合感染根管内粪肠球菌和白念珠菌的清除率均高于生理盐水(P<0.05)。CLSM显示2.5%NaClO对于根上、根中、根尖部牙本质小管内混合感染微生物的抑制作用明显优于2%CHX。结论 2.5%NaClO对于混合感染根管的抗微生物作用较2%CHX更好,可以在临床中用于粪肠球菌和白念珠菌混合感染的冲洗。Objective To evaluate the antimicrobial effects of different irrigants on the mixed infection of Enterococcus faecalis and Candida albicans in standard root canal models. Methods The mixed biofilm of Enterococcus faecalis and Candida albicans was inoculated into the standard root canal and cultured for 28 days. Canals were washed with 2.5% NaClO or 2% CHX and prepared with ProTaper NEXT, and normal saline was used as a blank control. After chemomechanical preparation, microbial reduction rates were calculated using colony-forming units(CFUs)counting methods;the depths of microbial inhibition in dentinal tubules were examined using a confocal laser scanning electron microscope(CLSM). Results The clearance rates of Enterococcus faecalis and Candida albicans in mixed infection root canals in 2.5% NaClO and 2% CHX groups were higher than those in normal saline group(P<0.05). CLSM observation showed that the inhibition depths of 2.5% NaClO group were significantly higher than those of 2% CHX group(P<0.05), while 2% CHX only inhibited microbes on the superficial dentine. Conclusion 2.5% NaClO exhibits better cleaning effect than 2% CHX on the mixed infection of Enterococcus faecalis and Candida albicans, which can be widely used in clinic.

关 键 词：根管消毒 粪肠球菌 白念珠菌 次氯酸钠 氯己定 

分 类 号：R781.05[医药卫生—口腔医学]