不同冲洗剂联合超声荡洗对根管壁清洁效果及牙本质结构影响的体外研究

doi:10.13591/j.cnki.kqyx.2025.03.008

摘要/Abstract

摘要：

目的评价次氯酸钠与Ultra Clean在超声荡洗下对根管的清洁效果及牙本质结构的影响。方法收集129颗单根管离体牙,采用Waveone Gold镍钛锉将根管预备至M#,预备完成后依照冲洗剂的不同,采用随机数字表法分为3组:A组次氯酸钠+生理盐水,B组次氯酸钠+EDTA,C组次氯酸钠+Ultra Clean。使用1%亚甲蓝溶液染色,体视显微镜下观察染液渗透深度及渗透范围;采用数码相机和扫描电镜观察根管内碎屑及玷污层去除情况;通过傅里叶红外光谱仪分析牙本质微观结构变化。结果根管上、中段,C组的渗透深度及范围大于A、B组(P<0.05),C组的碎屑百分数低于A、B组(P<0.05),B、C组玷污层评分低于A组(P<0.05)。根管下段,B、C组在渗透能力、碎屑及玷污层清除评价中均优于A组(P<0.05)。C组的脱矿能力及牙本质胶原纤维暴露大于A组和空白组(P<0.05)。结论次氯酸钠与Ultra Clean搭配超声荡洗被认为具有良好的清洁效果,有较强的脱矿能力但可能会使牙本质胶原纤维暴露稍有增加。

关键词: 根管冲洗, 玷污层, 牙本质

Abstract:

Objective To evaluate the effect of sodium hypochlorite and Ultra Clean on root canal cleaning and dentin structure. Methods A total of 129 single canal isolated teeth were collected and root canal was prepared to M # with Waveone Gold nickel titanium file. After preparation, they were divided into 3 groups by random number table according to irrigant:group A sodium hypochlorite + normal saline, group B sodium hypochlorite +EDTA, and group C sodium hypochlorite +Ultra Clean. The dye was stained with 1% methylene blue solution, and the penetration depth and range of the dye solution were observed under a type microscope. The removal of debris and stain layer in the root canal was observed by digital camera and scanning electron microscope. The change of dentin microstructure was analyzed by Fourier infrared spectrometer. Results In the upper middle part of the root canal, the penetration depth and range of group C were greater than those of groups A and B (P<0.05); the percentage of debris in group C was lower than that of groups A and B (P<0.05), and the stain layer score in groups B and C was lower than that of group A (P<0.05). In the lower root canal segment, groups B and C were superior to group A in the evaluation of permeability, debris and stain removal (P<0.05). The demineralization ability and exposure of dentin collagen fiber in group C were higher than those in group A and blank group (P<0.05). Conclusion Sodium hypochlorite combined with Ultra Clean is considered to have good cleaning effect and strong demineralization ability, but it may slightly increase the exposure of organic matter such as collagen fiber.

Key words: root canal irrigation, smear layer, dentin

中图分类号:

R781.05

帅冰洁, 张昊, 周永庆. 不同冲洗剂联合超声荡洗对根管壁清洁效果及牙本质结构影响的体外研究[J]. 口腔医学, 2025, 45(3): 204-209.

SHUAI Bingjie, ZHANG Hao, ZHOU Yongqing. In vitro study on cleaning effect of different rinsing agents combined with ultrasonic swaging on root canal wall and dentin microstructure[J]. Stomatology, 2025, 45(3): 204-209.

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组别	根上段	根中段	根下段
A	10.45±1.91^c	7.96±1.15^c	4.61±1.20^b
B	12.92±2.05^b	10.94±1.18^b	6.10±0.57^a
C	14.24±1.99^a	12.82±1.02^a	6.76±0.86^a

组别	根上段	根中段	根下段
A	515.27±30.58^c	395.80±42.88^c	163.62±36.07^b
B	617.36±49.84^b	464.89±26.82^b	209.28±16.52^a
C	727.35±51.56^a	516.43±20.45^a	223.01±14.75^a

组别	根上段	根中段	根下段
A	6.34±0.30^a	7.68±0.74^a	12.01±1.86^a
B	5.59±0.41^b	6.21±0.32^b	8.79±0.77^b
C	4.00±0.58^c	5.13±0.20^c	8.59±0.70^b

组别	根上段	根中段	根下段
A	1.56±0.51^a	2.31±0.60^a	2.63±0.89^a
B	0.81±0.75^b	1.44±0.63^b	1.75±0.68^b
C	0.69±0.70^b	0.94±0.77^b	1.69±0.48^b

组别	碳酸盐v₂峰/磷酸盐v₃峰	酰胺Ⅰ峰/磷酸盐v₃峰
空白对照组	0.37±0.02^b	0.38±0.02^b
A	0.35±0.03^b	0.29±0.09^c
B	0.63±0.05^a	0.65±0.05^a
C	0.67±0.04^a	0.68±0.05^a