3种辅助冲洗方法对离体牙弯曲根管内壁的清洁效果

doi:10.7518/hxkq.2023.2023062

华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (5): 554-562.doi: 10.7518/hxkq.2023.2023062

3种辅助冲洗方法对离体牙弯曲根管内壁的清洁效果

温超颖¹^,²(), 左雯鑫³, 罗文¹^,², 何飞²()

^1.暨南大学口腔医学院口腔医学系，广州 510632
^2.深圳市人民医院（暨南大学第二临床医学院，南方科技大学第一附属医院）口腔科，深圳 518020
^3.香港大学深圳医院口腔医学部，深圳 518053

收稿日期:2023-02-25 修回日期:2023-05-26 出版日期:2023-10-01 发布日期:2023-10-08
通讯作者: 何飞 E-mail:1838615987@qq.com;hefeixqkq@aliyun.com
作者简介:温超颖，医师，学士，E-mail：1838615987@qq.com
基金资助:
深圳市自然科学基金(JCYJ20180228164611173)

Effectiveness of three auxiliary irrigation methods for cleaning the internal walls of root canals of curved isolated teeth

Wen Chaoying¹^,²(), Zuo Wenxin³, Luo Wen¹^,², He Fei²()

^1.School of Stomatology, Jinan University, Guangzhou 510632, China
^2.Dept. of Stomatology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, China
^3.Dept. of Stomatology, The University of Hong Kong Shenzhen Hospital, Shenzhen 518053, China

Received:2023-02-25 Revised:2023-05-26 Online:2023-10-01 Published:2023-10-08
Contact: He Fei E-mail:1838615987@qq.com;hefeixqkq@aliyun.com
Supported by:
The Science and Technology Project of Shenzhen Municipality(JCYJ20180228164611173)

摘要/Abstract

摘要：

目的比较超声、声波和激光3种辅助冲洗方法对弯曲根管内壁的清洁效果。方法 92颗具有弯曲度为20°~40°独立根管的磨牙，标准化预备至04 25#，龙胆紫溶液染色72 h。52个样本随机分为4组（n=13）：注射器组（对照组）、超声组、声波组及激光组，分别进行终末冲洗。每组10个样本垂直于牙长轴分为弯曲上段、弯曲段及根尖段，体视显微镜及Image J软件测量各部位冲洗液渗入牙本质的深度。每组剩余3个样本沿牙体长轴劈开，扫描电子显微镜检测玷污层情况。SPSS 26.0软件进行统计学分析，筛选促渗透作用最佳的冲洗方法。40个样本使用筛选出的方法进行终末冲洗，根据冲洗时间随机分为4组（n=10）：10、20、30、40 s，检测冲洗液渗入深度。结果弯曲上段，各实验组与对照组冲洗液渗入的平均深度无显著差异（P>0.05）。玷污层评分，激光组显著低于对照组和声波组（P<0.01）。弯曲段，超声组冲洗液渗入平均深度明显大于对照组（P<0.05）；各实验组玷污层评分均低于对照组（P<0.05）。根尖段，超声组和激光组冲洗液渗入平均深度均大于对照组（P<0.05）。玷污层评分，激光组显著低于其他组（P<0.05）。根尖段，冲洗液渗入深度随超声冲洗时间延长而增加。结论弯曲根管内超声和激光辅助方法能很好地促冲洗液渗入牙本质小管，尤其是根尖段。弯曲根管中激光辅助冲洗能有效去除玷污层。

关键词: 渗透, 玷污层, 被动超声, EDDY, 激光, 弯曲根管

Abstract:

Objective This study aimed to compare the effectiveness of ultrasound and acoustic and laser cleaning of curved root canals. Methods A total of 92 molars with independent root canals with a curvature of 20°-40° were prepared and standardized at 04 25# and stained with gentian violet solution for 72 h. Among them, 52 were randomly divi-ded into four groups for final rinsing (n=13): NI group, PUI group, EDDY group, and PIPS group. Ten samples in each group were cut horizontally along the long axis perpendicular to the root and divided into curved upper, curved, and apical segments. Images were taken with a stereomicroscope and Image J measurements were taken to calculate the depth of rinse penetration. The remaining three samples from each group were split along the long axis of the dentin, photographed by scanning electron microscope to record the dentin tubule exposure and staining layer, and scored for staining layer by double-blind method. SPSS 26.0 software was used to perform statistical analysis and select the best flushing method. An extra 40 samples were randomly divided into four groups for detection of flushing fluid penetration depth (n=10): 10, 20, 30, and 40 s. Results In the upper part, the mean depth of infiltration was not significantly different between the experimental and control groups (P>0.05). The PIPS group had a significantly lower smear layer score than the control group and the EDDY group (P<0.01). In the curved segment, the mean depth of infiltration was significantly greater in the PUI group than in the control group (P<0.05); the tarnish layer score was lower in each experimental group than in the control group. At the top, the mean depth of infiltration was greater in the PUI and PIPS groups than in the control group (P<0.05), and the smear layer score was lower in the PIPS group than in the other groups (P<0.05). After the time was changed, the depth of infiltration of PUI increased only in the apical segment as the flushing time increased. Conclusion The PUI and PIPS methods facilitate the penetration of irrigation solution into the dentin canal in curved root canals, especially in the apical segment. The PIPS technique is effective in removing the smear layer in curved root canals.

Key words: permeability, smear layer, passive ultrasound, EDDY, laser, curved root canal

中图分类号:

R 781.05

温超颖, 左雯鑫, 罗文, 何飞. 3种辅助冲洗方法对离体牙弯曲根管内壁的清洁效果[J]. 华西口腔医学杂志, 2023, 41(5): 554-562.

Wen Chaoying, Zuo Wenxin, Luo Wen, He Fei. Effectiveness of three auxiliary irrigation methods for cleaning the internal walls of root canals of curved isolated teeth[J]. West China Journal of Stomatology, 2023, 41(5): 554-562.

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分组	弯曲上段	弯曲段	根尖段
NI组	188.49±52.09	155.99±43.02	21.59±6.29
PUI组	250.39±25.30	234.14±50.51*	40.11±9.54****
EDDY组	226.31±58.62	205.95±71.42	31.47±8.92
PIPS组	217.96±63.15	192.44±56.83	31.84±4.27*

分组	弯曲上段	弯曲段	根尖段
10 s组	213.42±71.81	210.24±31.97	0（0，0）*^#
20 s组	263.06±73.33	211.58±13.71	31.46（0，56.83）
30 s组	252.91±76.30	235.54±21.63	34.29（0，55.50）
40 s组	230.62±79.17	224.77±18.38	78.19（42.62，146.68）*^#△

分组	弯曲上段	弯曲段	根尖段
NI组	3（2，5）	4（3，4）	4（4，4）
PUI组	3（2，3）	2（2，3）**	4（3，4）^###
EDDY组	3（3，3）^###	2（2，3）*	4（4，4）^####
PIPS组	2（1，2）**	2（2，2）****	2（2，2）****

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3种辅助冲洗方法对离体牙弯曲根管内壁的清洁效果

Effectiveness of three auxiliary irrigation methods for cleaning the internal walls of root canals of curved isolated teeth

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