作者：姜醒，郑瑜谦，吴为良，王海亮 作者单位：福建医科大学 附属口腔医院综合科，福州 350002
【摘要】 目的 比较不同冲洗液联合应用去除根管玷污层的效果。 方法 40颗离体单根管牙截冠后随机分为5组，采用冠向下法进行根管预备，预备中分别以不同根管冲洗液进行根管冲洗。A组：20 g/L醋酸氯已定(CHX)溶液;B组：25 g/L次氯酸钠(NaOCl)溶液;C组：20 g/L CHX溶液+乙二胺四乙酸(EDTA)凝胶;D组：25 g/L NaOCl溶液+EDTA凝胶;E组(对照组)：蒸馏水。然后将牙体沿颊舌向纵劈，扫描电镜观察各组样本在根中1/3玷污层和牙本质碎屑的去除情况，统计学分析比较各组根管清洁的差异。 结果 A、B、C和D组与E组比较差别有统计学意义(P<0.05),B、D组对玷污层的去除和牙本质小管开放程度与A、C组比较，差别有统计学意义(P<0.05)。两两比较得出C组优于A组(P<0.05)，B、D两组差别无统计学意义(P>0.05)。 结论 CHX、NaOCl单独或联合EDTA凝胶均可去除玷污层。NaOCl+EDTA凝胶组的冲洗效果最好，单独使用CHX清洁效果不佳，与EDTA凝胶配合使用去除玷污层的能力有提高。
【关键词】 根管疗法; 根管冲洗剂; 消毒药(剂); 依地酸; 显微镜检查，电子，扫描
Application Modes of Different Root Canal Irrigants
in Removing Smear Layer of Root Canals: A Comparative Study
JIANG Xing, ZHENG Yuqian, WU Weiliang, WANG Hailiang
Department of General Dentistry, The Affiliated Stomatology Hospital,
Fujian Medical University, Fuzhou 350002, China
ABSTRACT: Objective To compare the effects of application modes of different root canal irrigants on removing the smear layer of root canals. Methods 40 human teeth with a single root canal were randomly divided into 5 groups after the amputation of the crowns of these teeth. All of the root canals were irrigated with six different root canal irrigants when the canals were prepared with crowndown technique. The teeth in Group A were irrigated with 20 g/L chlorhexidine acetate solution (CHX), and Group B with 25 g/L sodium hypochlorite solution (NaOCl). In the specimens of Group C the root canals were irrigated with 20 g/L CHX + EDTA gel, and those of Group D with 25 g/L NaOCl+EDTA gel. The control specimens in Group E were irrigated with distilled water. After the teeth were split into two buccallingually, the cleaning effects of all the specimens from the 5 groups on the removal of smear layer in the middle third of the root canal and debris was observed with a scanning electron microscope, and analyzed statistically. Results Compared with Group E, there was significant difference among Group A, B, C and D (P<0.05). Group B and D had significantly less smear layer and more visible open dentinal tubules compared with Group A and C(P<0.05). Paired comparison showed that Group C was superior to Group A (P<0.05). There was no significant difference between Group B and D (P>0.05). Conclusion Either chlorhexidine or NaOCl, used alone or in combination with EDTA gel, can remove smear layer. The group with NaOCl+ EDTA gel has the best cleaning effect. Chlorhexidine solution as a root canal irrigant cannot remove all the smear layer from the rootcanal system. Combined with EDTA gel, however, its performance in the removal of smear layer has obviously improved.
