A cleaning protocol for rotary nickel-titanium endodontic instruments
A cleaning protocol for rotary nickel-titanium endodontic instruments
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DOI：
10.1111/j.1834-7819.2004.tb00045.x
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发表时间：
2004-03-01
影响因子：
2.1
通讯作者：
Messer, HH
中科院分区：
文献类型：
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作者：
Parashos, P;Linsuwanont, P;Messer, HH
背景：根管和所有牙科器械灭菌前的清洁是其加工再利用的先决条件。本研究旨在开发一种临床实用的清洁方案，用于消毒前的旋转镍钛（NiTi）根管锉。方法：对六种不同类型的牙锉进行牙齿清洁实验。实验包括机械和化学去除锉根管碎片的三个组成部分：用海绵浸泡氯己定去除粗屑、预浸泡和超声。清洁后，将文件浸入Van Gieson溶液中，并在放大镜下检查染色碎片。还检查了新的未使用文件。结果：从宏观上看，没有可见的碎片，所有的文件在所有的清理序列后都是干净的。显微镜下，新的文件显示染色和未染色的碎片，几个实验性的清洁方案产生的文件没有染色的碎片。将最有效的清理序列的元素组合在一起，形成了一个清理协议，可预测地生成干净的文件。结论：该结果不支持单次使用根管锉的建议，因为不能在两次使用之间清洁锉。在实验条件下，制定的清洁方案使旋转镍钛锉100%不含污迹碎片。该方案包括在浸泡在0.2%氯己定溶液中的洗净海绵中剧烈拍打10下，在酶清洁溶液中预浸泡30分钟，在同一溶液中超声检查15分钟，并用流动的自来水冲洗20秒。该协议可适用于所有牙髓文件。
Background: The cleaning of endodontic and all dental instruments prior to sterilization is a prerequisite for their processing for re-use. This study aimed to develop a clinically practical cleaning protocol for rotary nickel-titanium (NiTi) endodontic files prior to sterilization.Methods: Cleaning experiments were conducted on six different types of files that had been used on human teeth. The experiments involved three components of mechanical and chemical removal of root canal debris from the files: the use of sponges soaked with chlorhexidine to remove gross debris, pre-soaking, and ultrasonication. After cleaning, the files were immersed in Van Gieson's solution and examined under magnification for stained debris. New unused files were also examined.Results: Macroscopically, there were no instances of visible debris and all files appeared clean after all cleaning sequences. Microscopically, new files showed both stained and unstained debris, and several experimental cleaning regimens produced files that were free of stained debris. Combining elements of the most effective cleaning sequences resulted in a cleaning protocol that predictably produced clean files.Conclusions: The results do not support the recommendation for the single use of endodontic files based on inability to clean files between uses. Under experimental conditions the cleaning protocol developed rendered rotary NiTi files 100 per cent free of stained debris. The protocol comprises 10 vigorous strokes in a scouring sponge soaked in 0.2 per cent chlorhexidine solution, a 30 minute pre-soak in an enzymatic cleaning solution, 15 minutes ultrasonication in the same solution, and a 20 second rinse in running tap water. The protocol can be applied to all endodontic files.