半导体激光对根管内粪肠球菌杀菌效果的体外实验研究

doi:10.13591/j.cnki.kqyx.2025.02.001

摘要/Abstract

摘要：

目的探究半导体激光在不同照射模式、照射时间、功率、照射天数下对根管内粪肠球菌的杀菌效果、根管壁外表面温度、牙本质小管形态的影响,寻找合适的临床操作参数及手法。方法选取根尖发育完成的单根管恒牙牙根,按照射方式不同分为持续照射组和间断照射组,两组分别采用功率1.5、2.0、3.0 W照射10、20、30 s,连续照射3 d方式操作。各组样本在第1天照射过程中进行根管外壁温度测量,每日照射完成后进行粪肠球菌菌落计数,3 d照射完毕后于扫描电镜下观察根管内壁牙本质小管形态,计算牙本质小管开放率及开口直径。结果 ①两种模式下均呈现随功率增大、时间延长,杀菌率增加,根管壁外表面温度升高,牙本质小管由开放逐渐熔融,开口直径逐渐缩小、开放率逐渐降低趋势,直至完全熔融封闭状态。此外,同一参数下持续照射组相比间断照射组上述趋势更明显。②杀菌率存在饱和点,两种模式下照射到第2天时,2.0 W-30 s、3.0 W-20 s、3.0 W-30 s间杀菌率无明显差异(P>0.05)。③持续照射下1.5 W-30 s、2.0 W-20 s、3.0 W-10 s及间断照射下2.0 W-30 s达到根管壁外表面温度安全范围阈值(10 ℃)。结论半导体激光持续照射根管1.5 W-30 s或间断照射2.0 W-30 s连续2 d可达到较好的杀菌效果且对牙根及周围组织无损伤,同时能起到较好的封闭牙本质小管的作用。

关键词: 粪肠球菌, 半导体激光, 根管治疗, 温度, 牙本质小管

Abstract:

Objective To investigate the effects of diode laser on the bactericidal effect of Enterococcus faecalis in root canal, the external surface temperature of root canal outer wall and the morphology of dentin tubules under different irradiation modes, power, time and days, and to find the appropriate clinical operation parameters and techniques. Methods The single tube permanent tooth roots with completed root tip development were selected and divided into continuous mode group and chopped mode group according to the irradiation method. The two groups were irradiated for 10, 20 and 30 s with power of 1.5, 2.0 and 3.0 W respectively, and were continuously irradiated for 3 d. The temperature of the outer wall of the root canal was measured in each group during the first day of irradiation, and the colonies of Enterococcus faecalis were counted after daily irradiation. After 3 days of irradiation, the dentin tubule morphology of the inner wall of the root canal was observed under scanning electron microscopy, and the opening rate and opening diameter of the dentin tubule were calculated. Results ①With the increase of power and the extension of time, the bactericidal rate increased; the external surface temperature of root canal wall increased, and the dentin tubules gradually melted from opening; the opening diameter gradually shrank, and the opening rate gradually decreased, until they were completely fused and closed. In addition, the above trend was more obvious in the continuous mode group than in the chopped mode group under the same parameter. ②There was a preservation point of bactericidal rate, and there was no significant difference between 2.0 W-30 s, 3.0 W-20 s and 3.0 W-30 s under two modes on the second day of irradiation (P>0.05). ③The safe temperature limit of the outer surface of the root canal wall (10 ℃) was reached at 1.5 W-30 s, 2.0 W-20 s, 3.0 W-10 s under continuous mode and 2.0 W-30 s under chopped mode. Conclusion Diode laser continuous irradiation of root canal 1.5 W-30 s or chopped irradiation of 2.0 W-30 s for 2 consecutive days can achieve excellent bactericidal effect and no damage to the root and surrounding tissues, and can play a better role in dentin tubule closure.

Key words: Enterococcus faecalis, diode laser, root canal therapy, temperature, dentin tubules

中图分类号:

R780.2

车舜, 郭威. 半导体激光对根管内粪肠球菌杀菌效果的体外实验研究[J]. 口腔医学, 2025, 45(2): 81-88.

CHE Shun, GUO Wei. Antibacterial efficacy of diode laser on Enterococcus faecalis in root canal: An in vitro study[J]. Stomatology, 2025, 45(2): 81-88.

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时间	持续照射组			间断照射组			对照组
时间	1.5 W	2.0 W	3.0 W	1.5 W	2.0 W	3.0 W	对照组
10 s	90.41±2.48^b	82.30±1.65^c	48.46±1.63^e	90.66±2.42^②	82.55±1.72^③	73.45±1.15^④	99.31±0.24^a①
20 s	75.51±2.28^d	42.75±1.74^f	-	80.41±1.61^③	72.79±2.75^④	-
30 s	32.12±2.27^g	-	-	70.24±1.97^④	37.29±1.74^⑤	-

时间	持续照射组			间断照射组			对照组
时间	1.5 W	2.0 W	3.0 W	1.5 W	2.0 W	3.0 W	对照组
10 s	1.73±0.21^b	1.61±0.17^b	0.98±0.22^d	1.77±0.20^②	1.62±0.22^②	1.19±0.13^③	2.09±0.28^a①
20 s	1.41±0.55^c	0.93±0.13^d	-	1.59±0.23^②	1.17±0.41^③	-
30 s	0.69±0.14^e	-	-	1.14±0.21^③	0.81±0.17^④	-