国际口腔医学杂志 ›› 2022, Vol. 49 ›› Issue (5): 569-577.doi: 10.7518/gjkq.2022077
Li Zhuanzhuan1(),Gegen Tana1,2(
)
摘要:
牙髓血运重建术是正式应用于临床的牙髓再生疗法,避免了传统的机械预备,通过彻底有效的根管冲洗和根管消毒,为干细胞创造有利的附着和增殖条件,最终实现牙髓—牙本质复合体再生,使得牙根继续发育成熟。因此根管冲洗和根管消毒对牙髓血运重建术的成功至关重要,但在不同的研究报道中根管冲洗消毒药物的使用差异性较大。本文就牙髓血运重建术中根管冲洗消毒药物的作用机制、作用效果、浓度选择、局限性及解决方案等方面作一综述,以期为年轻恒牙牙髓不可逆性损伤在临床上选择最佳治疗方案提供一定的参考价值。
中图分类号:
1 | 梁宇红, 岳林. 根管治疗技术之根管的化学预备和消毒[J]. 中华口腔医学杂志, 2019, 13(11): 788-792. |
Liang YH, Yue L. Chemical preparation and disinfection of root canal in root canal therapy[J]. Chin J Stomatol, 2019, 13(11): 788-792. | |
2 | Zeng Q, Nguyen S, Zhang HM, et al. Release of growth factors into root canal by irrigations in regenerative endodontics[J]. J Endod, 2016, 42(12): 1760-1766. |
3 | 黄丽东, 宫玮玉, 董艳梅. 根管冲洗的研究进展[J]. 国际口腔医学杂志, 2018, 45(4): 465-472. |
Huang LD, Gong WY, Dong YM. Research pro-gress on root canal irrigation[J]. Int J Stomatol, 2018, 45(4): 465-472. | |
4 | Asgary S, Fazlyab M, Nosrat A. Regenerative en-dodontic treatment versus apical plug in immature teeth: three-year follow-up[J]. J Clin Pediatr Dent, 2016, 40(5): 356-360. |
5 | 高玫惠. 配合超声冲洗进行一次性根管治疗的临床病例报告[D]. 大连: 大连医科大学, 2018. |
Gao MH. Clinical report of single-visit root canal treatment combined with ultrasonic irrigation[D]. Dalian: Dalian Medical University, 2018. | |
6 | Căpută PE, Retsas A, Kuijk L, et al. Ultrasonic irri-gant activation during root canal treatment: a syste-matic review[J]. J Endod, 2019, 45(1): 31-44. |
7 | Bolfoni MR, Ferla Mdos S, Sposito Oda S, et al. Effect of a surfactant on the antimicrobial activity of sodium hypochlorite solutions[J]. Braz Dent J, 2014, 25(5): 416-419. |
8 | 刘贤, 姚云枫, 许辛夷. Nd: YAP激光在牙髓血运重建中的应用效果评价[J]. 上海口腔医学, 2017, 26(6): 628-632. |
Liu X, Yao YF, Xu XY. Application of Nd: YAP laser in dental pulp revascularization[J]. Shanghai J Stomatol, 2017, 26(6): 628-632. | |
9 | Trevino EG, Patwardhan AN, Henry MA, et al. Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips[J]. J Endod, 2011, 37(8): 1109-1115. |
10 | Goncalves LF, Fernandes AP, Cosme-Silva L, et al. Effect of EDTA on TGF- β1 released from the dentin matrix and its influence on dental pulp stem cell migration[J]. Brazilian Oral Res, 2016, 30(1): 131-133. |
11 | dos Reis-Prado AH, Abreu LG, Fagundes RR, et al. Influence of ethylenediaminetetraacetic acid on regenerative endodontics: a systematic review[J]. Int Endod J, 2022, 55(6): 579-612. |
12 | Widbiller M, Eidt A, Hiller KA, et al. Ultrasonic activation of irrigants increases growth factor release from human dentine[J]. Clin Oral Investig, 2017, 21(3): 879-888. |
13 | 赵琦, 尹艳娇, 张志纯. SEM观察Qmix、MTAD与EDTA去除根管玷污层效果的体外对比研究[J]. 实用口腔医学杂志, 2018, 34(6): 834-837. |
Zhao Q, Yin YJ, Zhang ZC. The effects of root canal smear layer removal of Qmix, MTAD and EDTA observed under scanning electron microscope: an in vitro study[J]. J Pract Stomatol, 2018, 34(6): 834-837. | |
14 | Maniglia-Ferreira C, de Almeida-Gomes F, Pinto MMN, et al. In vitro evaluation of the antimicrobial effects of different intracanal medications in necro-tic immature teeth[J]. Eur Acad Paediatr Dent, 2016, 17(4): 251-255. |
15 | Saghiri MA, Asatourian A, Garcia-Godoy F, et al. Effect of biomaterials on angiogenesis during vital pulp therapy[J]. Dent Mater J, 2016, 35(5): 701-709. |
16 | Pınar SE, Ayhan E, Emel UÖ. The effect of intracanal medication variations on microhardness of simulated immature root dentin[J]. Aust Endod J J Aust, 2021, 47(3): 616-623. |
17 | Morago A, Ruiz-Linares M, Ferrer-Luque CM, et al. Dentine tubule disinfection by different irrigation protocols[J]. Microsc Res Tech, 2019, 82(5): 558-563. |
18 | 余擎. 根管内感染的控制策略[J]. 中华口腔医学杂志, 2018(6): 381-385. |
Yu Q. Scavenging strategy for root canal infection[J]. Chin J Stomatol, 2018(6): 381-385. | |
19 | Rico-Romano C, Zubizarreta-Macho Á, Baquero-Artigao MR, et al. An analysis in vivo of intracanal bacterial load before and after chemo-mechanical preparation: a comparative analysis of two irrigants and two activation techniques[J]. J Clin Exp Dent, 2016, 8(1): e9-e13. |
20 | Zandi H, Rodrigues RCV, Kristoffersen AK, et al. Antibacterial effectiveness of 2 root canal irrigants in root-filled teeth with infection: a randomized cli-nical trial[J]. J Endod, 2016, 42(9): 1307-1313. |
21 | Rôças IN, Provenzano JC, Neves MAS, et al. Disinfecting effects of rotary instrumentation with either 2.5% sodium hypochlorite or 2% chlorhexidine as the main irrigant: a randomized clinical study[J]. J Endod, 2016, 42(6): 943-947. |
22 | 刘斌, 梁景平. 牙髓再生的临床应用与未来[J]. 中华口腔医学杂志, 2020, 55(1): 50-55. |
Liu B, Liang JP. Regenerative endodontics: clinical application status and future perspective[J]. Chin J Stomatol, 2020, 55(1): 50-55. | |
23 | Liu Y, Guo LL, Li YQ, et al. In vitro comparison of antimicrobial effectiveness of QMix and other final irrigants in human root canals[J]. Sci Rep, 2015, 5(1): 17823. |
24 | 王雨霏, 汪媛婧, 曾禹豪, 等. 复合根管冲洗剂的研究进展[J]. 牙体牙髓牙周病学杂志, 2018, 28(8): 479-485. |
Wang YF, Wang YJ, Zeng YH, et al. Research pro-gress on multicomponent root canal irrigants[J]. Chin J Conserv Dent, 2018, 28(8): 479-485. | |
25 | Arslan H, Uygun AD, Keskin A, et al. Evaluation of orange-brown precipitate formed in root canals after irrigation with chlorhexidine and QMix and spectroscopic analysis of precipitates produced by a mixture of chlorhexidine/NaClO and QMix/NaClO[J]. Int Endod J, 2015, 48(12): 1199-1203. |
26 | Aspesi M, Kopper PMP, de Carvalho Deluca MC, et al. Cytotoxic, migration, and angiogenic effects of intracanal irrigants on cells involved in revascula-rization of immature teeth[J]. Arch Oral Biol, 2021, 121: 104980. |
27 | Vouzara T, Koulaouzidou E, Ziouti F, et al. Combined and independent cytotoxicity of sodium hypochlorite, ethylenediaminetetraacetic acid and chlor- hexidine[J]. Int Endod J, 2016, 49(8): 764-773. |
28 | 于金华. 临床牙髓再生的现状与挑战[J]. 口腔医学, 2018, 38(8): 673-680. |
Yu JH. Current status and challenge of clinical pulp regeneration[J]. Stomatology, 2018, 38(8): 673-680. | |
29 | Galler KM, D’Souza RN, Federlin M, et al. Dentin conditioning codetermines cell fate in regenerative endodontics[J]. J Endod, 2011, 37(11): 1536-1541. |
30 | Kim SG. Infection and pulp regeneration[J]. Dent J (Basel), 2016, 4(1): 4. |
31 | Alfadda S, Alquria T, Karaismailoglu E, et al. Antibacterial effect and bioactivity of innovative and currently used intracanal medicaments in regenerative endodontics[J]. J Endod, 2021, 47(8): 1294-1300. |
32 | 邱德春, 卫峥, 张倩, 等. 三联抗生素与氢氧化钙在牙髓血运重建中根管消毒效果的回顾性分析[J]. 实用口腔医学杂志, 2021, 37(4): 513-516. |
Qiu DC, Wei Z, Zhang Q, et al. Retrospective analysis of the effectiveness of triple antibiotic paste and calcium hydroxide on root canal disinfection in dental pulp revascularization[J]. J Pract Stomatol, 2021, 37(4): 513-516. | |
33 | Araújo PRDS, Silva LB, Neto APDS, et al. Pulp revascularization: a literature review[J]. Open Dent J, 2017, 10: 48-56. |
34 | 邱思慧, 汪俊. Ca(OH)2和Hoshino制剂对猪牙乳头细胞增殖的影响[J]. 上海口腔医学, 2015, 24(4): 419-422. |
Qiu SH, Wang J. Effects of calcium hydroxide and Hoshino's paste on the proliferation of porcine dental papilla cells[J]. Shanghai J Stomatol, 2015, 24(4): 419-422. | |
35 | 刘琳, 刘珊. 氢氧化钙髓腔封药在年轻恒牙牙髓感染治疗中的临床效果[J]. 实用口腔医学杂志, 2018, 34(2): 269-273. |
Liu L, Liu S. The effects of calcium hydroxide in the treatment of immature permanent tooth pulp infection[J]. J Pract Stomatol, 2018, 34(2): 269-273. | |
36 | 雷金霞, 吕碧波, 张亚婷. iROOT BP Plus在年轻恒牙活髓切断术中的临床疗效[J]. 临床口腔医学杂志, 2019, 35(7): 409-411. |
Lei JX, Lü BB, Zhang YT. The clinical effectiveness of iROOT BP Plus in immature permanent tooth pulpotomimes[J]. J Clin Stomatol, 2019, 35(7): 409-411. | |
37 | 周磊, 王佳, 臧艳君. Er, Cr: YSGG水激光用于根管治疗约诊间疼痛的疗效观察[J]. 上海口腔医学, 2019, 28(2): 184-186. |
Zhou L, Wang J, Zang YJ. Clinical observation of using Er, Cr: YSGG water laser to control endondontic interappointment pain[J]. Shanghai J Stomatol, 2019, 28(2): 184-186. | |
38 | Song MJ, Cao YP, Shin SJ, et al. Revascularization-associated intracanal calcification: assessment of pre-valence and contributing factors[J]. J Endod, 2017, 43(12): 2025-2033. |
39 | McIntyre PW, Wu JL, Kolte R, et al. The antimicrobial properties, cytotoxicity, and differentiation potential of double antibiotic intracanal medicaments loaded into hydrogel system[J]. Clin Oral Investig, 2019, 23(3): 1051-1059. |
40 | Sousa MGDC, Xavier PD, Cantuária APDC, et al. Antimicrobial and immunomodulatory in vitro profile of double antibiotic paste[J]. Int Endod J, 2021, 54(10): 1850-1860. |
41 | Anat D, Chawin U, Tadkamol K, et al. Optimal antimicrobial concentration of mixed antibiotic pastes in eliminating Enterococcus faecalis from root dentin[J]. Aust Endod J, 2020, 47(2): 273-280. |
42 | Silva LB, Jimenez RC, Blomberg N, et al. General guidelines for biomedical software development[J]. F1000Res, 2017, 6: 273. |
43 | Zancan RF, Vivan RR, Milanda Lopes MR, et al. Antimicrobial activity and physicochemical properties of calcium hydroxide pastes used as intracanal medication[J]. J Endod, 2016, 42(12): 1822-1828. |
44 | Sadek RW, Moussa SM, El Backly RM, et al. Eva-luation of the efficacy of three antimicrobial agents used for regenerative endodontics: an in vitro study[J]. Microb Drug Resist, 2019, 25(5): 761-771. |
45 | Devaraj S, Jagannathan N, Neelakantan P. Antibiofilm efficacy of photoactivated curcumin, triple and double antibiotic paste, 2% chlorhexidine and cal-cium hydroxide against Enterococcus fecalis in vitro [J]. Sci Rep, 2016, 6: 24797. |
46 | Yilmaz S, Dumani A, Yoldas O. The effect of anti-biotic pastes on microhardness of dentin[J]. Dent Traumatol, 2016, 32(1): 27-31. |
47 | Saoud TMA, Ricucci D, Lin LM, et al. Regeneration and repair in endodontics-a special issue of the regenerative endodontics-a new era in clinical endo-dontics[J]. Dent J (Basel), 2016, 4(1): 3. |
48 | Pankajakshan D, Albuquerque MTP, Evans JD, et al. Triple antibiotic polymer nanofibers for intracanal drug delivery: effects on dual species biofilm and cell function[J]. J Endod, 2016, 42(10): 1490-1495. |
49 | Alghilan MA, Windsor LJ, Palasuk J, et al. Attachment and proliferation of dental pulp stem cells on dentine treated with different regenerative endodontic protocols[J]. Int Endod J, 2017, 50(7): 667-675. |
50 | Montero-Miralles P, Martín-González J, Alonso-Ezpeleta O, et al. Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review[J]. Int Endod J, 2018, 51(9): 981-988. |
51 | Ray HL, Marcelino J, Braga R, et al. Long-term follow up of revascularization using platelet-rich fibrin[J]. Dent Traumatol, 2016, 32(1): 80-84. |
52 | Maniglia-Ferreira C, de Almeida Gomes F, Vitoriano MDM. Intentional replantation of an avulsed immature permanent incisor: a case report[J]. J Endod, 2017, 43(8): 1383-1386. |
53 | Sabrah AHA, Al-Asmar AA, Alsoleihat F, et al. The discoloration effect of diluted minocycline contai-ning triple antibiotic gel used in revascularization[J]. J Dent Sci, 2020, 15(2): 181-185. |
54 | Zancan RF, Calefi PHS, Borges MMB, et al. Antimicrobial activity of intracanal medications against both Enterococcus faecalis and Candida albicans biofilm[J]. Microsc Res Tech, 2019, 82(5): 494-500. |
55 | Zancan RF, Cavenago BC, Oda DF, et al. Antimicrobial activity and physicochemical properties of antibiotic pastes used in regenerative endodontics[J]. Braz Dent J, 2019, 30(6): 536-541. |
56 | Jacobs JC, Troxel A, Ehrlich Y, et al. Antibacterial effects of antimicrobials used in regenerative en-dodontics against biofilm bacteria obtained from mature and immature teeth with necrotic pulps[J]. J Endod, 2017, 43(4): 575-579. |
57 | Tagelsir A, Yassen GH, Gomez GF, et al. Effect of antimicrobials used in regenerative endodontic procedures on 3-week-old Enterococcus faecalis biofilm[J]. J Endod, 2016, 42(2): 258-262. |
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