摘要
粪肠球菌近年来被证实与牙髓根尖周病的关系十分密切,是造成根管持续性或继发性感染和根管治疗失败的重要菌群之一。传统的根管消毒药物如次氯酸钠、氯己定、氢氧化钙等由于药物使用的浓度限制和根管系统自身的复杂性等,不能完全清除根管内的粪肠球菌,如何有效对抗根管内粪肠球菌的感染成为当前牙髓根尖周病治疗的重要研究方向之一。近年来,针对粪肠球菌的耐药性和致病性,出现了一些新型的消毒方法和抗菌剂,如激光、光动力疗法、超声荡洗和臭氧等,它们与传统根管冲洗药物联用能明显增强原传统药物对根管内粪肠球菌的清除能力。此外,二氧化氯、纳米氧化镁、超氧化水和N-乙酰半胱氨酸等新型消毒方式的出现,均证明对根管内粪肠球菌具有独特的杀伤作用。以上新型消毒方式的研究目前大多处于体外实验阶段,其对正常组织的刺激和损伤尚缺乏相关临床数据的支撑,有待于进一步的研究。
Enterococcus faecalis has been confirmed to be closely related to dental pulp and periapical disease in recent years.Enterococcus faecalis is one of the important bacteria causing persistent or secondary root canal infection and root canal treatment failure.Traditional root canal disinfection drugs such as sodium hypochlorite,chlorhexidine and calcium hydroxide can not completely remove Enterococcus faecalis in the root canal because of the concentration limitation of the drug and the complexity of the root canal system.Therefore,how to effectively resist the Enterococcus faecalis infection in the root canal has become one of the important research directions in the treatment of periodontal pulp periapical disease.In recent years,some new antimicrobial agents and disinfection methods have emerged due to the drug resistance and pathogenicity of Enterococcus faecalis,such as laser,photodynamic,ultrasonic irrigation and ozone therapy.Their combination with traditional root canal irrigation drugs can significantly enhance the ability of traditional drugs to remove Enterococcus faecalis in the root canal.In addition,the emergence of new disinfection methods such as chlorine dioxide,nano-magnesia,superoxidized water and N-acetylcysteine have been shown to have a unique killing effect on Enterococcus faecalis in root canals.At present,most of the new disinfection methods described above are in the in vitro experimental stage,and their stimulation and damage to normal tissue still lack relevant clinical data support;thus,these outcomes need to be further studied.
作者
周敏
许来俊
ZHOU Min;XU Laijun(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Department of Conservative Dentistry and Endodontics,West China Hospital of Stomatology,Sich-uan University,Chengdu 610041,China)
出处
《口腔疾病防治》
2020年第9期607-612,共6页
Journal of Prevention and Treatment for Stomatological Diseases
基金
四川省科学技术厅重点项目(2017SZ0030)。
关键词
根管治疗
感染根管
粪肠球菌
根管消毒
次氯酸钠
氯己定
光动力疗法
激光
臭氧
二氧化氯
纳米氧化镁
超氧化水
root canal therapy
infected root canal
Enterococcus faecalis
root canal disinfection
sodium hy-pochlorite
chlorhexidine
photodynamic therapy
laser
ozone
chlorine dioxide
nanometer magnesium oxide
super-oxidized water
