三种根管冲洗液对根管内可疑致病菌的抑制作用分析

›› 2019, Vol. 39 ›› Issue (1): 25-29.

三种根管冲洗液对根管内可疑致病菌的抑制作用分析

王颖¹,吴连俊²,吴红霞³,赵永旗¹,陈晖⁴,邓淑丽¹

1. 浙江大学医学院附属口腔医院
2. 温州医科大学附属口腔医院
3. 余杭第五人民医院
4. 浙江省口腔医院

收稿日期:2018-06-06 修回日期:2018-08-02 出版日期:2019-01-28 发布日期:2019-01-28
通讯作者: 邓淑丽 E-mail:dengshuli3@163.com
基金资助:
浙江省自然基金;浙江省医药卫生一般研究计划;浙江省中医药管理局一般研究计划

Analysis of inhibitory effects of three endodontic irrigations on the pathogens in root canals

Received:2018-06-06 Revised:2018-08-02 Online:2019-01-28 Published:2019-01-28
Contact: Shu LiDENG E-mail:dengshuli3@163.com

摘要/Abstract

摘要： 目的　比较慢性根尖周炎患牙根管治疗过程中使用三种不同根管冲洗液进行根管预备，分析治疗前后根管内四种可疑致病菌的检出情况，了解不同冲洗液对这些可疑致病菌的抑制作用，为根管预备时冲洗液的选择和应用提供微生物学依据。方法　选取60颗慢性根尖周炎患牙（单根管），根据根管预备时采用不同冲洗液随机分为三组（每组20颗）： NaClO 组（根管冲洗液为2.5％次氯酸钠，sodium hypochlorite）；H2O2 组（根管冲洗液为3％双氧水，hydrogen peroxide）；PVP-I组（根管冲洗液为1％聚维酮碘，Povidone iodine ，怡速欣）。分析根管治疗前后临床指数（Clinical periapical index，CPl）；同时采集根管预备前后患牙根管内感染物，提取细菌基因组DNA，合成针对粪肠球菌（Enterococcus faecalis，E.f）、具核梭杆菌（Fusobacterium nucleatum, F.n）、牙龈卟啉单胞菌（Porphyromonas gingivalis, P.g）和牙髓卟啉单胞菌（Porphyromonas endodontalis,P.e）的16S rDNA基因的特异性引物，运用实时荧光定量PCR（qRT-PCR）技术，比较分析E.f、F.n、P.g及P.e的检出率和检出量。结果　三组治疗前、后E.f、F.n、P.g和P.e的检出率相同，但可疑致病菌的检出量均有下降。其中P.e检出数量下降在三组间无显著差异（P>0.05），而E.f、F.n和P.g检出下降率经统计学检验有差异（P<0.05）；在NaClO组和PVP-I组间E.f、F.n和P.g检出下降率统计学检验无差异（P>0.05），而NaClO组和PVP-I组分别与H2O2组比较，E.f、F.n和P.g检出下降率大，差异有统计学意义（P<0.05）。PVP-I组P.e检出下降率大于H2O2组，差异有统计学意义（P<0.05）。结论　使用三种不同根管冲洗液进行根管预备，能明显的减少感染根管内的E.f、F.n、P.g和P.e的量；用2.5％NaClO和1％PVP-I根管冲洗液对四种可疑致病菌的抑制作用没有明显的差异，但与3％双氧水比较，两者对E.f、P.g和F.n抑制作用更明显；对P.e的抑制作用分析，1%PVP-I比3%H2O2更有效。

关键词: 根管冲洗液, 慢性根尖周炎, 根管内可疑菌, 实时荧光定量聚合酶链反应

Abstract: Abstract：　Objective　 To compare the inhibitory effect of three endodontic irrigating reagents (NaOCl, H2O2, PVP-I) on four kinds of bacteria (E.f, F.n, P.g, P.e) in human root canals after chemo-mechanical preparation. Methods　60 single root teeth with chronic apical periodontitis were randomly divided into three groups. The first group (n=20) was irrigated with 2.5% NaOCl. The second group (n=20) was irrigated with 3% H2O2. The third group (n=20) was irrigated with 1% PVP-I. Clinical periapical indexes was presented by the diameter of image shadows. The symptoms of pain and swelling were documented and measured before and after the root canal treatment. Real-time quantitative-polymerase chain reaction (qRT-PCR) was used to compare the positive rates and quantities of four bacteria (E.f, F.n, P.g and P.e) in different groups. Statistical analysis was performed using the Mann–Whitney test. Results The symptom of pain and swelling was significantly decreased and relieved in all three groups after root canal treatment. The bacteria load was reduced significantly after treatment in three gourps. There was no significant inhibitory effect on P.e in three groups（P >0.05）,whereas the numbers of E.f, F.n and P.g were reduced significantly (P<0.05). The numbers of E.f, F.n and P.g were reduced significantly in both NaClO-group and the (PVP-I)-group comparing to the H2O2-group (P<0.05). The detection rate of P.e in the (PVP-I)-group was lower than the H2O2-group (P<0.05). Conclusions 2.5% NaClO, 1% PVP-I and 3% H2O2 can effectively inhibit the growth of E.f, F.n, P.g and P.e in infectious root canals. There was no significant inhibitory effect on these four bateria between 2.5%NaClO and 1% PVP-I, but both showed inhibitory effect on E.f, F.n and P.g comparing to 3% H2O2. 1% PVP-I showed better inbitory effect on P.e than 3% H2O2.

Key words: Irrigations, Chronic periodontitis, bacteria, Real-time fluorescence quantitative polymerase chain reaction

王颖吴连俊吴红霞赵永旗陈晖邓淑丽. 三种根管冲洗液对根管内可疑致病菌的抑制作用分析[J]. , 2019, 39(1): 25-29.

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