4つの能動的補助灌流法による根管系の洗浄と消毒

Cleaning and disinfection of the root canal system provided by four active supplementary irrigation methods.

抄録

このin vitro試験では、EndoActivator（EA）、Easy Clean（EC）、受動的超音波灌流（PUI）、XP-Endo Finisherによる細菌減少を評価した。下顎第一大臼歯の8～4本の中根に器具を装着し、Enterococcus faecalisを接種し、4群に分けた（n. 20）。主管および象牙細管における細菌の減少は、それぞれMTTアッセイおよび共焦点レーザー走査型顕微鏡（CLSM）を用いたLive/Dead BackLight法により、50, 100, 150µmの深さで測定した（各群n. 10）。統計解析は有意水準95％（P<0.05）で行った。統計学的に有意な差は、主管腔におけるXPFとECの間で確認されただけであった。主根管の象牙細管では、深さ100µmと150µmにおいて、前者ではXPFとECの間に（P=0.027）、後者ではXPFとECの間に（P=0.011）、XPFとPUIの間に（P=0.021）、それぞれ有意な統計的差が認められた。峡部からの象牙細管では、100µmの深さにおいて、XPFとEC（P=0.038）およびECとEA（P=0.029）の間に統計学的に有意な差が生じた。深さ150μmでは、XPFとPUI（P=0.025）およびXPFとEC（P=0.036）を比較した場合にのみ、これらの差が有意であった。どの潅注法も根管内を完全に消毒することはできなかったが、細菌減少指数はXPFを使用した方が概して良好であった。

This in vitro study evaluated the bacterial reduction provided by the EndoActivator (EA), Easy Clean (EC), passive ultrasonic irrigation (PUI), and XP-Endo Finisher. Eight-four mesial roots of mandibular first molars were instrumented, inoculated with Enterococcus faecalis, and divided into four groups (n. 20). Bacterial reduction in the main canals and dentinal tubules were respectively determined by MTT assays and Live/Dead BackLight technique through confocal laser scanning microscopy (CLSM) at 50, 100, and 150 µm in-depth (n. 10 per group). Statistical analyses were conducted following a significance level of 95% (P < 0.05). A significant statistical difference was just identified between XPF and EC in the main canals. In the dentinal tubules from the main root canals, at 100 and 150 µm in-depths, significant statistical differences were only observed between XPF and EC (P = 0.027) for the former and between XPF and EC (P = 0.011) and XPF and PUI (P = 0.021) for the latter. In the dentinal tubules from the isthmus, at 100 µm in-depth, statistically relevant differences did occur between XPF and EC (P = 0.038) and EC and EA (P = 0.029). At 150 µm in-depth, these differences were only significant by comparing XPF and PUI (P = 0.025) and XPF and EC (P = 0.036). Although no irrigation method could thoroughly disinfect the RCS, bacterial reduction indexes were generally better after using XPF.