中药桂皮醛对感染根管消毒作用的研究

目的 探讨桂皮醛对感染根管的消毒作用。方法 通过体内抑菌试验,将５０例牙髓病、根尖周病随机分为二组,桂皮醛消毒根管组,甲醛甲酚合剂（ＦＣ）常规对照组,观察临床疗效,并从中随机各选１０例,观察根管消毒前后细菌总数（需氧菌,厌氧菌）的变化。结果 临床效果经统计学处理,两组药物消毒根管,差异无显著性（Ｐ〉０．０５）,两组药物消毒根管后细菌（厌氧菌,需氧菌）总数变化,经统计学处理,封药后细菌总数（ＯＤ值）明显少于封药前。结论 桂皮醛体内抑菌作用下ＦＣ相似,可用做感染根管的消毒。     

蜂胶酊对感染根管消毒作用的临床实验研究

用甲醛甲酚作对照,对蜂胶酊作为根管消毒药物作了临床和临床实验研究。７２例病牙封药前后细菌培养结果表明,甲醛甲酚对根管消毒作用强,但开放用药以蜂胶酊为佳。蜂胶酊在根管封药中有较好的消毒作用。可以作为根管消毒药物。     

两种根管冲洗液对狗牙根管内细菌抗菌作用的实验研究

目的观察2%洗必泰溶液和3%双氧水2种根管冲洗液对狗牙根管内粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌的影响,为临床根管治疗提供参考。方法选择成年健康杂种狗3只,共有24个实验牙,48个实验牙根。于狗牙根管内接种粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌。对狗牙完成根管治疗。于治疗后12个月拍摄根尖X线片,并记录牙齿和根尖周组织的临床表现。将患牙随机分为3组,每组7颗患牙,去除根管内充填物并进行根管预备,实验一组用2%洗必泰溶液冲洗根管,实验二组用3%双氧水冲洗根管,对照组用0.9%NaC l溶液冲洗根管。分别在根管预备前及根管预备冲洗后对根管内细菌取样,培养,鉴定并记录细菌菌落数量,测定根管内细菌变化情况。结果根管预备冲洗后3组根管内的细菌量均较根管预备前显著下降（P〈0.05）。2%洗必泰溶液和3%双氧水2种根管冲洗液的杀菌效果明显好于0.9%NaC l溶液（P〈0.05）,2%洗必泰溶液明显好于3%双氧水（P〈0.05）。结论2%洗必泰溶液是有效的根管冲洗药物,可明显减少狗牙根管内粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌的数量,但不能完全清除根管内的细菌。     

慢性根尖周炎应用氢氧化钙根管内封药的临床疗效观察

目的:观察慢性根尖周炎患牙用氢氧化钙根管内封药的临床疗效。方法:选择100例慢性根尖周病变患者随机分为实验组和对照组各50例;观察组用氢氧化钙做根管内封药;对照组用甲醛甲酚做根管内封药,观察术后1周的临床及X线片表现,并分析评定临床疗效。结果:术后1周有效率比较,观察组为96%,对照组为86%;两组间疗效差异具有统计学意义。结论:氢氧化钙是较理想的根管内消毒剂。     

不同赋形剂调制氢氧化钙对粪肠球菌消毒效果影响的体外评价

目的通过应用离体牙根管模型进行根管消毒模拟试验,就应用不同赋形剂调制的氢氧化钙糊剂对根管的消毒作用进行评价。方法选取因正畸拔除的单根管下颌第一前磨牙并进行根管预备,自釉牙骨质界处将离体牙截去牙冠,在距截冠处5 mm去除根尖,仅留5 mm长牙根,筛选获得经制备的模拟根管120个,随机分为4个试验组和2个对照组(空白对照组和阳性对照组),每组各20颗牙齿。将4个试验组及阳性对照组共100个根管建立粪肠球菌根管感染模型,4个试验组根管内分别放置使用生理盐水、甘油、葡萄糖酸氯己定、樟脑苯酚等4种赋形剂调制的氢氧化钙糊剂,阳性对照组20个感染根管中仅放置生理盐水,而空白对照组20个根管不接种细菌,仅置入无菌生理盐水。所有标本牙置5%CO2,95%N2,37℃环境下培养,每组分别于第3、7天取10个根管使用G钻均匀磨取根管内层牙本质粉末,置BHI液体培养基中培养72 h后,测定并分析各根管中残留细菌量。结果使用氢氧化钙糊剂消毒3 d时,4个试验组根管中残留细菌量均较阳性对照组有明显减少(P<0.01),葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组;使用氢氧化钙糊剂7 d时,试验各组均有消毒效果,但生理盐水-氢氧化钙组牙本质小管中有少量均残留细菌,葡萄糖酸氯己定组、樟脑苯酚组的消毒效果差异无统计学意义。结论在离体牙根管消毒实验中,使用4种赋形剂调制的氢氧化钙糊剂均能有效抑制粪肠球菌生长,葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组。     

高频电对感染根管消毒作用的初步实验研究

目的:初步验证高频电对感染根管是否具有较理想的消毒作用,并且与氢氧化钙药尖的消毒作用进行初步比较分析。方法:本实验制作10只家兔40颗门齿的感染根管动物模型,其中20颗用高频电消毒为实验组。20颗用氢氧化钙药尖消毒为对照组,消毒前后分别作需氧菌和厌氧菌培养并比较其消毒效果。结果:消毒前实验组和对照组各20个根管的需氧及厌氧菌培养全部阳性。实验组消毒后需氧菌3个阳性根管、厌氧菌2个阳性根管,消毒前后对需氧和厌氧菌杀灭作用的差异均具有极显著性(P<0.005)。对照组消毒后需氧菌13个阳性根管消毒作用的差异有显著性(P<0.05)。对照组消毒后厌氧菌11个阳性根管消毒作用的差异有极显著性(P<0.005)。实验组和对照组分别对需氧和厌氧2个菌种之间消毒作用的差异均无显著性(P>0.05)。实验组和对照组对需氧菌的消毒作用和对厌氧菌的消毒作用的组间差异均具有极显著性(P<0.005)。结论:高频电对感染根管内容物的消毒作用优于氢氧化钙药尖,具有临床应用的可行性。值得进一步研究。     

超声波对感染根管消毒作用的实验研究

目的:通过与氢氧化钙药尖消毒作用的比较,验证超声波对感染根管的消毒作用并判断其消毒作用的临床应用价值。方法:10只3月龄的小型健康实验家兔随机分成二组后,制备成感染根管动物模型。对模型进行术前细菌培养后,分别做超声根管内消毒和氢氧化钙药尖消毒,术后细菌培养。结果:超声波和氢氧化钙对需氧菌和厌氧菌的杀灭作用无菌种之间的差别;但杀菌效果存在显著差异。实验发现超声波消毒的特点是:第一,无抗菌谱的差异。第二,无热效应,根管壁表面升温不明显。第三,作用无方向性,对任何角度方向上的有机物均能使其失活。第四,越是细小根管作用越强。这些正是根管消毒所要求的特殊条件。结论:1)超声波对感染根管的消毒作用明显优于氢氧化钙药尖。2)超声波对感染根管的消毒作用无抗菌谱的差异。3)超声波对感染根管具有较可靠的消毒作用,作为一种根管消毒手段值得进一步研究。     

四种液体不同作用时间对根管壁的影响

目的：观察乙二胺四乙酸盐（Ethylene diamine tetraacetic acid,EDTA）、氯亚明（Chloramine）、丁克除（Desocclus01）和酚克除（Re-sosolv）等4种化学预备液根管内封药时对根管壁的影响。方法：选择因正畸拔除的健康前磨牙65颗,实验组60颗和对照组5颗。实验组随机分为A、B、C、D4组。每组15颗,各组又随机分为10d组、20d组和30d组,每组5颗。常规开髓、拔髓、干燥根管后丙烯酸树脂封闭根尖孔。根管内封药,磷酸锌暂封,4℃生理盐水中储存,对照组不做任何处理,相同条件下储存。丙烯酸树脂包埋,硬组织切片机切片,扫描电镜观察。结果：通过扫描电镜观察,在本实验周期内与对照组相比较,EDTA封药10天、20天和30天组,根管壁均有不同程度的脱矿,尤其是30d组。氯亚明和丁克除封药10天、20天和30天组,根管壁均有不同程度的脱矿,尤其是30d组,但脱矿部位主要位于根管壁内层,根管壁中外层脱矿较轻。酚克除封药3个时间组,根管壁均无脱矿。结论：EDTA根管内封药20天以内相对安全,不会造成根管壁的重度脱矿。氯亚明和丁克除根管内封药30天以内均不会造成根管壁的重度脱矿。酚克除对根管壁无影响。     

次氯酸钠和洗必泰作为牙根管消毒冲洗液对根管内的感染物质的影响

摘要 目的：探究次氯酸钠和洗必泰作为牙根管消毒冲洗液的对根管内感染物质的影响。方法：选取76例接受根管治疗的患者根据随机数字表法分为观察组和对照组2组,其中对照组患者采用次氯酸钠治疗,观察组患者则采用次氯酸钠和洗必泰联合治疗。对比分析两组患者根管内细菌菌落计数、根管内感染物质、治疗效果、远期有效率和不良反应发生率。结果：根管消毒冲洗后观察组根管内细菌菌落计数和根管内感染物质显著低于对照组,差异具有统计学意义（P<0.05）;观察组患者治疗总有效率和不良反应的发生率分别为100.00%和13.16%,对照组患者治疗总有效率和不良反应的发生率分别为88.00%和65.79%,差异具有统计学意义（P<0.05）。另外,观察组患者第3个月、第6个月和1年后的治疗有效率均大于对照组。结论：次氯酸钠和洗必泰作为牙根管消毒冲洗液能够有效的减少根管内的感染物质的数量,提高治疗有效率,降低不良反应的发生率,值得临床推广使用。     

SYBR GREEN实时荧光定量分析牙龈卟啉单胞菌在初次感染和再感染根管内的定植

目的采用SYBR GREEN实时荧光定量PCR分析和比较牙龈卟啉单胞菌(Porphyromonas gingivalis,P.gingivalis)在初次治疗和再治疗感染根管中的定植情况。方法选择2013年9月至2014年10月于首都医科大学附属北京口腔医院牙体牙髓科就诊的慢性根尖周炎患者的120颗单根管患牙为研究对象,按初次治疗和再治疗分为2组,每组60人。采用SYBR GREEN实时荧光定量PCR(real-time fluorescence quantitative polymerase chain reaction,RTFQ-PCR)比较P.gingivalis在两种感染根管内的检出率和DNA表达水平。结果 RTFQ-PCR结果发现P.gingivalis在初次治疗的感染根管内检出率为45.0%,再治疗感染根管的检出率为41.7%,两者间差异无统计学意义(P=0.713);P.gingivalis在初次治疗的感染根管内的DNA相对表达量(0.197±0.380)和再感染根管内相对表达量(0.449±0.150)比较差异无统计学意义(P=0.301)。结论 P.gingivalis与两种感染根管关系均密切,提示其在初次感染和再感染根尖周炎的发病过程中都发挥致病作用。     

油溶纳米蜂胶液联合两种根充糊剂对感染根管常见菌的体外抑菌性研究

目的探讨蜂胶类根充糊剂对感染根管常见菌的体外抑菌作用。方法选择感染根管的6种常见菌为实验菌种,琼脂扩散法观察蜂胶类根充糊剂的抗微生物作用;建立体外根管粪肠球菌感染模型,评价蜂胶类根充糊剂在离体牙根管内的抗粪肠球菌作用。结果蜂胶类根充糊剂对实验的各种细菌均具有抑菌作用,除油溶纳米蜂胶氢氧化钙甘油糊剂对粪肠球菌和具核梭杆菌的抑菌作用小于对照组外,其他实验组与对照组相比均增强了(P0.05或P0.01)或并未减弱(P0.05)原始糊剂的抑菌效果,糊剂中水溶蜂胶加入后短期内的抑菌作用优于油溶纳米蜂胶。结论蜂胶类根充糊剂对感染根管常见菌具有良好的抑菌效果,将其用作根管充填的材料具有一定的应用前景。     

Microflora profiling of infected root canal before and after treatment using culture-independent methods

This study aimed to profile the microflora in infected root canals before and after root canal treatment using culture-independent methods. Six infected root canals in single-rooted teeth with periapical lesions from five subjects were included. Quantification of total bacteria was performed by real-time PCR with primers targeting 16S rRNA genes. PCR products with universal 16S rRNA gene primers were cloned and partially sequenced, and bacterial identification at the species level was performed by comparative analysis with the GenBank database. The concentration of extracted DNA before treatment was higher than that after root canal treatment, although the difference was not statistically significant. Sequence analysis revealed that oral bacteria such as Fusobacterium, Streptococcus, Olsenella, and Pseudoramibacter detected in cases before root canal treatment disappeared after treatment. These results suggest that the root canal microflora are distinct before and after root canal treatment, and that treatment changes the microflora in both quantity and quality.     

2种不同器械扩锉后根管壁的细菌学研究

目的通过对临床病例的研究,比较减速镍钛机扩和普通不锈钢K型锉清洁根管的能力。方法选取临床需要根管治疗的患牙60例,随机分为2组,经开髓拨髓后分别用镍钛减速机扩和不锈钢K型及H型锉进行根管预备,预备完成后用灭菌棉捻擦拭管壁,作微生物检查。结果2组方法扩锉后对根管内微生物的变化做统计学分析,差异有显著性(P<0.05)。结论镍钛减速机扩对根管的清洁能力高于普通不锈钢扩锉,值得临床的推广。     

Ability of root canal antiseptics used in dental practice to induce chromosome aberrations in human dental pulp cells

Root canal antiseptics are topically applied to root canals within the pulpless teeth to treat the root canal and periapical infections. Because the antiseptics that are applied to root canals can penetrate through dentin or leak out through an apical foramen into the periodontium and distribute by the systemic circulation, it is important to study the safety of these antiseptics. In the present study, we examined the ability to induce chromosome aberrations in human dental pulp cells of five root canal antiseptics, namely, carbol camphor (CC), camphorated p-monochlorophenol (CMCP), formocresol (FC), calcium hydroxide, and iodoform which are most commonly used in dental practice. Statistically significant increases in the levels of chromosome aberrations were induced by CC, FC, or iodoform in a concentration-dependent manner. Conversely, CMCP and calcium hydroxide failed to induce chromosome aberrations in the absence or presence of exogenous metabolic activation. The percentages of cells with polyploid or endoreduplication were enhanced by FC or iodoform. Our results indicate that the root canal antiseptics that exhibited a positive response are potentially genotoxic to human cells.     

Microbiological study and scanning electron microscopic analysis of root canal wall dentin following pumped Diodium Nd:YAG laser irradiation

The capability of Nd:YAG laser in sterilizing root canals and the alterations of dentinal walls induced by laser treatment were investigated. Thirty root canals were infected by P. aeruginosa ATCC 27853 and thirty canals by A. naeslundii CH-12. Within each infection, 4 groups were selected on the basis of the treatment. Among them, 2 test groups (TGs) were treated by Nd:YAG laser at 15 Hz for 15 s, using 2 different settings: 1 Watt/70 Joule and 1.5 Watt/100 Joule, respectively (n = 10 each). The other 2 groups, used as controls (CGs), were: untreated (positive control, n = 5) and sterilized by 5.25% NaClO group (negative control, n = 5). Observations under scanning electron microscope (SEM) and quantitative bacterial counts were performed. These analyses were performed once per group after infections and treatments. Laser treatments significantly reduced the number of both bacteria. SEM investigation showed melting and crystallization of canal dentin over 1.5 W/100 J. Laser irradiation has a bactericidal effect but it does not completely sterilize the root canal as NaClO 5.25% solution does if the goal of treatment is also to avoid alterations of dentinal walls.     

Bactericidal action of carbon dioxide laser radiation in experimental dental root canals

The ability of a carbon dioxide laser to sterilize the root canal of human teeth has been investigated. Three oral bacteria, Streptococcus sanguis, Streptococcus mutans, and Actinomyces viscosus, and three other bacteria, Bacillus cereus, Staphylococcus aureus, and Pseudomonas aeruginosa were used as experimental organisms. Exposure of cells on glass slides to laser radiation showed there was little difference in the exposure required to kill these six organisms. Complete recovery of bacteria from the root canal was initially a problem and was only achieved when bacterial manipulations and removal were carried out in rapid succession, within 5 min of inoculation. However, the geometry of the instrumented canal and the laser alignment were major factors in achieving consistent cell death of oral bacteria in the root canals. Using sets of 10 teeth, four repeated exposures of 10 W for 1 s was found to sterilize 4 or more of the teeth.