J Endod:2种根管冲洗剂对牙髓再治疗效果和1种分子方法检验感染对愈合的影响:1项临床随机试验

2019-07-30 lishiting MedSci原创

这篇研究的目的是为了比较根尖周炎牙齿根管再治疗时使用1%次氯酸钠(NaOCl)或2%氯己定二葡萄糖酸钠(CHX)用作冲洗剂时对临床和放射线影像效果的影响。采用1种分子方法检测残余感染对疗效的影响。

这篇研究的目的是为了比较根尖周炎牙齿根管再治疗时使用1%次氯酸钠(NaOCl)或2%氯己定二葡萄糖酸钠(CHX)用作冲洗剂时对临床和放射线影像效果的影响。采用1种分子方法检测残余感染对疗效的影响。

研究将52颗已行根充并伴有根尖周炎的牙齿按照再治疗过程中使用冲洗剂的不同随机分为2组。在治疗前(S1)和预备后使用NaOCl或CHX进行冲洗(S2)以及氢氧化钙封药后(S3)收集根管内微生物样本,并通过16S ribosomal RNA实时定量聚合酶链式反应(qPCR)对总细菌数进行定量分析。在术后1和4年随访中,通过尖周指标评估尖周状态,并对结果评分,分为愈合(<3)或未愈合(≥3)。

结果显示,在1和4年的随访调查中,分别收集到45颗牙齿(NaOCl, n = 20; CHX, n = 25)和33颗牙齿(NaOCl, n = 16; CHX, n = 17)的数据。术后1年,NaOCl组65%愈合,CHX为64%,2者间无显著性差异(P > .05)。在之后的随访中,相应的结果分别为81%和82% (P > .05)。S3阶段中,qPCR阴性结果的根管愈合率(79%)明显高于qPCR阳性根管(45%, P < .05)。在半数未愈合病例中,平均细菌负荷从S2至S3逐渐增多(P < .05)。所有S3阳性根管内细菌计数<3.12 × 103的病例最终愈合。根管充填根尖水平的增加明显影响治疗效果(P < .05)。

结论:1% NaOCl和2% CHX对疗效的影响没有明显差异。qPCR在充填期间检测到的持续存在的细菌会显著影响疗效。

原始出处:

Zandi H, Petronijevic N, et al. Outcome of Endodontic Retreatment Using 2 Root Canal Irrigants and Influence of Infection on Healing as Determined by a Molecular Method: A Randomized Clinical Trial. J Endod. 2019 Jul 9. pii: S0099-2399(19)30431-5. doi: 10.1016/j.joen.2019.05.021.

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    2020-01-07 jxrzshh
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time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032235, encodeId=fe46103223517, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Jul 30 12:01:00 CST 2019, time=2019-07-30, status=1, ipAttribution=)]
  5. 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time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032235, encodeId=fe46103223517, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Jul 30 12:01:00 CST 2019, time=2019-07-30, status=1, ipAttribution=)]
  6. 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  7. 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time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032235, encodeId=fe46103223517, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Jul 30 12:01:00 CST 2019, time=2019-07-30, status=1, ipAttribution=)]
  8. 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time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032235, encodeId=fe46103223517, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Jul 30 12:01:00 CST 2019, time=2019-07-30, status=1, ipAttribution=)]
  9. 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content=<a href='/topic/show?id=c72462241ff' target=_blank style='color:#2F92EE;'>#根管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62241, encryptionId=c72462241ff, topicName=根管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba5e11492705, createdName=zhaozhouchifen, createdTime=Thu Aug 01 00:01:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564174, encodeId=dfb915641e429, content=<a href='/topic/show?id=c80d30641d1' target=_blank style='color:#2F92EE;'>#再治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30641, encryptionId=c80d30641d1, topicName=再治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fd4415287515, createdName=whmdzju, createdTime=Thu Aug 01 00:01:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032235, encodeId=fe46103223517, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Jul 30 12:01:00 CST 2019, time=2019-07-30, status=1, ipAttribution=)]
    2019-08-01 whmdzju
  10. 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content=<a href='/topic/show?id=c72462241ff' target=_blank style='color:#2F92EE;'>#根管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62241, encryptionId=c72462241ff, topicName=根管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba5e11492705, createdName=zhaozhouchifen, createdTime=Thu Aug 01 00:01:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564174, encodeId=dfb915641e429, content=<a href='/topic/show?id=c80d30641d1' target=_blank style='color:#2F92EE;'>#再治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30641, encryptionId=c80d30641d1, topicName=再治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fd4415287515, createdName=whmdzju, createdTime=Thu Aug 01 00:01:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032235, encodeId=fe46103223517, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Jul 30 12:01:00 CST 2019, time=2019-07-30, status=1, ipAttribution=)]
    2019-07-30 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0