The effectiveness of increased apical enlargement in reducing intracanal bacteria
The effectiveness of increased apical enlargement in reducing intracanal bacteria
复制标题
DOI：
10.1097/00004770-200211000-00008
复制
发表时间：
2002-11-01
影响因子：
4.2
通讯作者：
Trope, M
中科院分区：
文献类型：
--
作者：
Card, SJ;Sigurdsson, A;Trope, M
有人认为，根管的根尖部分没有充分消毒的典型仪器方案。本研究的目的是确定是否仪器的尺寸比通常使用的更大，将更有效地消除可培养的细菌从canal.Forty根尖牙周炎的临床和放射学证据的患者从牙髓诊所招募。选择下颌尖牙（n = 2）、双尖牙（n = 11）和磨牙（近中牙根）（n = 27）进行研究。在入路时和两次连续器械插入后进行细菌采样。第一种器械使用1% NaOCl和0.04锥度ProFile（R）旋转锉。尖牙和双尖牙根管的器械尺寸为#8，磨牙根管的器械尺寸为#7。第二个器械使用LightSpeed（R）锉和1% NaOCl冲洗，以进一步扩大根尖三分之一。通常情况下，磨牙的器械尺寸为60，尖牙/双尖牙根管的尺寸为80。我们的研究结果表明，100%的尖牙/双尖牙根管和81.5%的磨牙根管在第一次器械尺寸后被清除了细菌。第二次手术后，磨牙结果改善至89%。在59.3%的磨牙近中根管中，93%的根管在第一次内固定后无菌，使用Wilcoxon秩和检验，发现初始样本与第一次和第二次内固定后的样本之间存在统计学显著性差异（p < 0.0001）。遵循两种器械方案的样本之间的差异不显著（p = 0.0617）。它的结论是简单的根管系统（没有多个管通信）可能会呈现无菌时，利用这种类型的准备。
It has been suggested that the apical portion of a root canal is not adequately disinfected by typical instrumentation regimens. The purpose of this study was to determine whether instrumentation to sizes larger than typically used would more effectively remove culturable bacteria from the canal.Forty patients with clinical and radiographic evidence of apical periodontitis were recruited from the endodontic clinic. Mandibular cuspids (n = 2), bicuspids (n = 11), and molars (mesial roots) (n = 27) were selected for the study. Bacterial sampling was performed upon access and after each of two consecutive instrumentations. The first instrumentation utilized 1% NaOCl and 0.04 taper ProFile(R) rotary files. The cuspid and bicuspid canals were instrumented to a #8 size and the molar canals to a #7 size. The second instrumentation utilized LightSpeed(R) files and 1% NaOCl irrigation for further enlargement of the apical third. Typically, molars were instrumented to size 60 and cuspid/bicuspid canals to size 80.Our findings show that 100% of the cuspid/bicuspid canals and 81.5% of the molar canals were rendered bacteria-free after the first instrumentation sizes. The molar results improved to 89% after the second instrumentation. Of the (59.3%) molar mesial canals without a clinically detectable communication, 93% were rendered bacteria-free with the first instrumentation.Using a Wilcoxon rank sum test, statistically significant differences (p < 0.0001) were found between the initial sample and the samples after the first and second instrumentations. The differences between the samples that followed the two instrumentation regimens were not significant (p = 0.0617). It is concluded that simple root canal systems (without multiple canal communications) may be rendered bacteria-free when preparation of this type is utilized.