不同冲洗液的抗菌性和玷污层清除效果的相关性研究

发布时间：2018-05-03 05:32

本文选题：粪肠球菌 + 次氯酸钠　；参考：《天津医科大学》2014年硕士论文

【摘要】：目的比较和分析QMix. MTAD、西曲溴铵(CTR)、氯已定(CHX). EDTA.蒸馏水6种根管冲洗液的根管玷污层清除效果,及其抗菌性和残余抗菌性,以及不同冲洗液的抗菌性、残余抗菌性与根管玷污层清除效果的相关性。对象和方法以170颗无龋离体单根前牙为研究对象,制作标准模型后,高温高压灭菌,建立粪肠球菌感染模型,随机抽取30颗用以检测灭菌及感染模型建立情况,以Crown-Down法对剩余140颗已建立感染模型的离体牙进行根管预备后,分别用QMix、MTAD、CTR、CHX、EDTA.蒸馏水6种冲洗液对预备完成后的根管进行终末冲洗,并设立对照组(不进行任何终末冲洗)。终末冲洗完成后,将每组样本随机分为两个亚组(n=70),其中一个亚组在扫描电镜下检测根管的根上1/3,根中1/3,根尖1/3根管玷污层的清除情况；另外一个亚组分别在终末冲洗结束后,分别于第0,1,2,3....14天进行取样、培养、观察、记录,用来检测冲洗液在根上1/3,根中1/3,根尖1/3的抗菌性及残余抗菌性；并分析6种冲洗液的抗菌性和残余抗菌性与根管玷污层清除效果是否具有相关性。采用单因素方差分析对6种根管冲洗液的玷污层清除效果进行评价；采用卡方检验对6种根管冲洗液的抗菌性及残余抗菌性进行评价。所有分析均使用SPSS17.0统计软件。结果根管玷污层清除效果显示：QMix、MTAD. EDTA3种冲洗液根管玷污层的清除效果分别与对照组比较,差异均具有统计学意义(P0.05)；6种根管冲洗液组间两两比较,除QMix和MTAD之间比较无统计学差异(P0.05),以及CTR、CHX、蒸馏水、对照组之间比较无统计学差异(P0.05)外,其余各组间比较差异均具有统计学意义(P0.05)。玷污层清除得分最低(玷污层清除效果最好)为EDTA,其次为QMix/MTAD,得分最高(玷污层清除效果最差)为CTR/CHX/蒸馏水／对照组。同一冲洗液根上1/3、根中1/3和根尖1/3比较：各组均在根上1/3玷污层得分最低,根尖1/3玷污层得分最高,差异均具有统计学意义(P0.05)。抗菌性显示：QMix、MTAD、CTR、CHX与对照组比较,差异均有统计学意义(P0.002),其余各组间两两比较差异均无统计学意义(P0.002)。残余抗菌性显示：在第1、2、3天,EDTA组、蒸馏水组、对照组分别与QMix组、MTAD组、CTR组、CHX组两两比较,差异均有统计学意义(P0.002),其余各组间两两比较均无统计学差异(P0.002)；在第4-11天,各组间两两比较差异均无统计学意义(P0.002)。 6种根管冲洗液的抗菌性及残余抗菌性与根管玷污层清除效果之间的相关性：无相关关系。结论 QMix、MTAD、EDTA能够有效清除玷污层,但均不能完全清除玷污层。EDTA玷污层清除效果最佳,QMix、MTAD次之,CTR、CHX、蒸馏水不具有清除玷污层的作用。 QMix、MTAD、CTR、CHX均有一定的抗菌性,但均不能彻底杀灭粪肠球菌,作为终末冲洗液其抗菌效果相似。 QMix、MTAD、CTR、CHX均有一定的残余抗菌性,但持续时间长短不一,残余抗菌性持续时间由长到短的顺序为：MTAD CTR QMix CHX。不同冲洗液抗菌性、残余抗菌性与玷污层清除效果之间无相关性。综合分析6种冲洗液的根管玷污层清除效果、抗菌性和残余抗菌性3个特性： EDTA玷污层清除效果最佳,但是抗菌性差； MTAD兼具玷污层清除效果和抗菌性、残余抗菌性的双重效果； QMix玷污层清除效果好,并具有一定的抗菌性和残余抗菌性； CTR和CHX无玷污层清除的作用,但是具有一定的抗菌性和残余抗菌性；蒸馏水不具有以上3种特性。
[Abstract]:objective
Comparison and analysis of the effect of QMix. MTAD, CTR, CHX and EDTA. distilled water on the removal of the root canal smear layer, and its antibacterial and residual antibacterial properties, as well as the antibacterial property of different flushing fluids, the correlation between the residual antibacterial property and the scavenging effect of the root canal smear layer.
Objects and methods
After making standard model of 170 caries free single anterior teeth, a model of Enterococcus faecalis infection was established by high temperature and high pressure, 30 were randomly selected to detect the establishment of sterilization and infection model. After the root canal preparation of the remaining 140 established infected teeth with Crown-Down, QMix, MTAD, CTR, CHX, ED were used respectively. 6 kinds of TA. distilled water were used to rinse the final root canal and set up a control group (without any final flushing). After finishing the end flushing, each group was randomly divided into two subgroups (n=70). One of the subgroups detected the scavenging of the root 1/3, the root 1/3 and the 1/3 root canal of the root canal in the root canal under the scanning electron microscope. The other subgroups were sampled, cultured, observed and recorded at the end of the final flushing, respectively at 0,1,2,3....14 days, respectively, to detect the antibacterial and residual antibacterial properties of the flushing fluid on the root 1/3, the root 1/3, the root tip 1/3, and the analysis of the antibacterial and residual antibacterial properties of the 6 kinds of rinses and the removal of the root canal smear layer. A single factor analysis of variance was used to evaluate the scavenging effect of 6 kinds of root canal flushing fluid, and a chi square test was used to evaluate the antibacterial and residual antibacterial properties of the 6 root canal flushing fluids. All analysis used the SPSS17.0 software.
Result
The scavenging effect of root canal smear layer showed that the scavenging effect of root canal smear layer of QMix, MTAD. EDTA3 irrigation solution was compared with the control group, the difference was statistically significant (P0.05), and there was no statistical difference between the 6 root canal flushing fluid groups, except QMix and MTAD (P0.05), and CTR, CHX, distilled water, and the control group were no more than the control group. The difference of statistical difference (P0.05) was statistically significant (P0.05). The lowest score of smear layer clearance (the best removal effect of smear layer) was EDTA, followed by QMix/MTAD. The highest score (the worst effect of smear layer clearance) was CTR/CHX/ distilled water / control group. The same rinse root 1/3, 1/3 in root and root apex 1/3 were compared. Each group had the lowest score on 1/3 smear layer, and the highest score of apical 1/3 smear layer, and the difference was statistically significant (P0.05).
The results showed that the differences of QMix, MTAD, CTR and CHX were statistically significant (P0.002) compared with the control group (P0.002), and there was no significant difference between the 22 other groups (P0.002).
The residual antimicrobial activity showed that in 1,2,3 days, group EDTA, distilled water group and control group were compared with QMix group, MTAD group, CTR group and CHX group respectively, the difference was statistically significant (P0.002), the other groups were not statistically significant (P0.002) in the 22 groups (P0.002), and there was no statistical difference between each group on day 4-11 (P0.002).
There was no correlation between the antibacterial activity and residual antibacterial activity of 6 root canal irrigation fluids and root canal smear clearance.
conclusion
QMix, MTAD, EDTA can effectively remove the smear layer, but all can not completely remove the smear layer.EDTA smear layer scavenging effect best, QMix, MTAD times, CTR, CHX, distilled water does not have the effect of cleaning the tarnished layer.
QMix, MTAD, CTR and CHX have some antibacterial properties, but they can not kill the Enterococcus faecalis completely. The antibacterial effect is similar to that of the terminal rinse liquid.
QMix, MTAD, CTR and CHX have some residual antibacterial properties, but the duration varies from time to time. The duration of residual antibacterial activity from long to short is MTAD CTR QMix CHX..
There was no correlation between the antibacterial properties of different irrigants, the residual antibacterial property and the smear removal effect.
The characteristics of root canal smear clearance, antibacterial properties and residual antimicrobial properties of the 6 flushing fluids were analyzed in 3 aspects.
EDTA smear layer has the best clearance effect, but its antibacterial property is poor.
MTAD has dual effects of smear removal and antibacterial properties, and residual antibacterial properties.
QMix smear layer has good cleaning effect, and has certain antibacterial and residual antibacterial properties.
CTR and CHX have no scavenging effect, but they have certain antibacterial and residual antibacterial properties.
Distilled water does not have the above 3 characteristics.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.05

【参考文献】