根管封闭剂抗菌修饰的研究进展  

Research progress on antimicrobial materials modified root canal sealers

作　　者：马金溢 李博磊 程磊[1] MA Jinyi;LI Bolei;CHENG Lei(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Department of Conserva-tive Dentistry and Endodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病防治全国重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院牙体牙髓病科,四川成都610041

出　　处：《口腔疾病防治》2025年第3期237-243,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(82301058);四川省自然科学基金项目(24NSFSC3519)。

摘　　要：牙髓根尖周病是主要由细菌及其代谢产物引起的常见感染性疾病,通过根管治疗术去除根管内感染物质是目前最常用的治疗方法,然而根管内微生物的持续存在对根管治疗的成功率有着不利影响。现有观点认为,根管封闭剂能封闭核心充填材料无法充填的部分区域,通过其抗菌性对微生物产生抑制作用,降低再感染风险,提升根管治疗成功率。多种策略通过机械锁结或化学结合等各异的机制对根管封闭剂进行抗菌修饰,包括抗生素修饰、季铵化合物修饰、纳米颗粒修饰等,以求增强其抗菌性能。总体而言,抗菌修饰策略日益增多,在改良封闭剂抗菌性方面的效果毋庸置疑。季铵化合物和纳米颗粒修饰后的根管封闭剂在抗生物膜活性方面显示出一定优势,具备潜在的临床前景。然而,修饰后的材料是否具有长期抗菌效果,以及其在体内是否能发挥与体外相似的作用和其生物相容性等问题,还亟待解决。在未来,如何制备具有多维度理想性能的根管封闭剂还需要更长远而深入的探索。Endodontic and periapical lesions are prevalent infectious diseases primarily caused by bacteria and their metabolic byproducts.The most widely used treatment method today is root canal therapy,which aims to remove infec-tious substances from the root canal.Root canal sealers can fill areas that core filling materials cannot reach,effectively reducing the risk of reinfection through their antimicrobial properties thus improving the success rate of root canal treat-ment.Various strategies have been employed to enhance the antimicrobial efficacy of root canal sealers through different mechanisms such as mechanical interlocking or chemical bonding.These strategies include antibiotic modification,qua-ternary ammonium compounds modification,nanoparticle modification,and others.Overall,antimicrobial modification strategies are increasingly diverse,and their effectiveness in enhancing the antimicrobial properties of sealers is beyond doubt.Root canal sealers modified with quaternary ammonium compounds and nanoparticles have shown certain advan-tages in antibiofilm activity and have potential clinical prospects.However,whether these modified materials have long-term antimicrobial effects,whether they can perform similarly in vivo as they do in vitro,and their biocompatibility are issues that still need to be addressed.In the future,the preparation of root canal sealers with ideal multidimensional properties will require further long-term and in-depth exploration.

关 键 词：根管封闭剂 抗菌 抗生素 季铵化合物 甲基丙烯酸十二烷基二甲铵 甲基丙烯酸十六烷基二甲铵 纳米颗粒 壳聚糖纳米颗粒 银纳米颗粒 氧化锌纳米颗粒 

分 类 号：R78[医药卫生—口腔医学]