根管冲洗剂对树脂类封闭剂与牙本质粘接强度的影响
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摘要
根管充填时,使用具有粘接性的树脂类封闭剂与牙本质形成的牢固粘接不仅能减少根尖微渗漏,增强牙齿的抗折性,还能抵抗桩道预备的机械破坏,从而提高根管治疗的成功率。但在根管治疗过程中,冲洗剂的使用可能会改变牙本质的组织结构、牙本质的润湿性,进而影响树脂类封闭剂与牙本质的粘接强度。本文就近年来国内外学者对传统根管冲洗剂及几种新型冲洗剂对树脂类封闭剂与牙本质粘接强度的影响作一综述,结果表明:传统根管冲洗剂NaClO作为最终冲洗剂降低了树脂类封闭剂与牙本质的粘接强度;EDTA会影响根部牙本质的生物力学特性,清除效率低,会影响树脂类封闭剂与牙本质的粘接强度;EDTA与NaClO联合使用并作为最终冲洗剂可提高粘接强度;氯己定亦可增加封闭剂与牙本质的粘接强度,可作为最终冲洗剂;新型冲洗剂MTAD对树脂类封闭剂与牙本质粘接强度产生负面影响;QMix和马来酸去除玷污层效率和牙本质粘接强度与EDTA相同或更高,可代替EDTA作为最终冲洗剂。
When the root canal is filled, the use of the adhesive resin-based sealant to form a strong bond with the dentin reduces microleakage of the apex, enhances the bending resistance of the tooth, and resists the mechanical damage of the pile preparation, thus improving the success rate of root canal treatment. However, during root canal treatment, the use of a rinsing agent may change the tissue structure of the dentin and the wettability of the dentin, thereby affecting the bonding strength between the resin sealing agent and the dentin. In this paper, the effects of a traditional root canal irrigant and several new rinsing agents on the bonding strength of resin sealant and dentin are reviewed. The results show that the traditional root canal rinsing agent NaClO is reduced as the final rinsing agent. The bonding strength of resin sealant to dentin; EDTA affects the biomechanical properties of root dentin, and the removal efficiency is low, which will affect the bond strength between the resin sealant and dentin. EDTA combined with NaClO as a final rinsing agent can improve the bonding strength. Chlorhexidine can also increase the bonding strength between the blocking agent and dentin and can be used as the final rinsing agent. The new rinsing agent MTAD has a negative impact on the resin sealing agent and dentin bond strength. QMix and maleic acid remove smear efficiency with dentin bond strengths greater than or equal to EDTA and can replace EDTA as the final rinse.
When the root canal is filled, the use of the adhesive resin-based sealant to form a strong bond with the dentin reduces microleakage of the apex, enhances the bending resistance of the tooth, and resists the mechanical damage of the pile preparation, thus improving the success rate of root canal treatment. However, during root canal treatment, the use of a rinsing agent may change the tissue structure of the dentin and the wettability of the dentin, thereby affecting the bonding strength between the resin sealing agent and the dentin. In this paper, the effects of a traditional root canal irrigant and several new rinsing agents on the bonding strength of resin sealant and dentin are reviewed. The results show that the traditional root canal rinsing agent NaClO is reduced as the final rinsing agent. The bonding strength of resin sealant to dentin; EDTA affects the biomechanical properties of root dentin, and the removal efficiency is low, which will affect the bond strength between the resin sealant and dentin. EDTA combined with NaClO as a final rinsing agent can improve the bonding strength. Chlorhexidine can also increase the bonding strength between the blocking agent and dentin and can be used as the final rinsing agent. The new rinsing agent MTAD has a negative impact on the resin sealing agent and dentin bond strength. QMix and maleic acid remove smear efficiency with dentin bond strengths greater than or equal to EDTA and can replace EDTA as the final rinse.
引文
[1]Souza MA,Dalla Lana D,Gabrielli EA,et al.Effectiveness of final decontamination protocols against Enterococcus faecalis and its influence on bond strength of filling material to root canal dentin[J].Photodiagnosis Photodyn Ther,2017,17(3):92-97.
[2]Fuzinatto RN,Farina AP,Souza MA,et al.Effects of an endodontic auxiliary chemical substance on the bond strength of two methacrylate-based endodontic sealers to dentin[J].Microsc Res Tech,2017,80(6):627-633.
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[4]Pantoja C,Silva D,Soares A J,et al.Influence of ethanol on dentin roughness,surface free energy,and interaction between AHPlus and root dentin[J].Braz Oral Res,2018,32:e33.
[5]Chen H,Zhao XY,Qiu Y,et al.The tubular penetration depth and adaption of four sealers:a scanning electron microscopic study[J].Biomed Res Int,2017:2946524.
[6]Schaefer E,Bering N,Buerklein S.Selected physicochemical properties of AH Plus,EndoREZ and RealSeal SE root canal sealers[J].Odontology,2015,103(1):61-65.
[7]李志伟,李劼,刘艳,等.不同终末冲洗方案对根管封闭剂与根管壁牙本质润湿性能的影响[J].牙体牙髓牙周病学杂志,2018,28(5):270-275.
[8]Cecchin D,Farina AP,Souza MA,et al.Evaluation of antimicrobial effectiveness and dentine mechanical properties after use of chemical and natural auxiliary irrigants[J].J Dent,2015,43(6):695-702.
[9]Neelakantan P,Sharma S,Shemesh HA.Influence of irrigation sequence on the adhesion of root canal sealers to dentin:a fourier transform infrared spectroscopy and push-out bond strength analysis[J].J Endod,2015,41(7):1108-1111.
[10]Pimentel Corrêa AC,Cecchin D,de Almeida JF,et al.Sodium thiosulfate for recovery of bond strength to dentin treated with sodium hypochlorite.[J].J Endod,2016,42(2):284-288.
[11]Cecchin D,Farina A,Bedranrusso A.The effects of endodontic substances and naturally reducing agents on the bond strength of epoxy resin-based sealer to root dentin[J].J Conserv Dent,2017,20(5):302-306.
[12]Ballal NV,Jain I,Tay FR.Evaluation of the smear layer removal and decalcification effect of QMix,maleic acid and EDTA on root canal dentine[J].J Dent,2016,51:62-68.
[13]Vilanova WV,Carvalho-Junior JR,Alfredo E,et al.Effect of intracanal irrigants on the bond strength of epoxy resin-based and methacrylate resin-based sealers to root canal walls[J].Int Endod J,2012,45(1):42-48.
[14]Uzunoglu E,Turker SA,Karahan S.The Effect of increased temperatures of QMix and EDTA on the push-out bond strength of an epoxy-resin based sealer[J].J Clin Diagn Res,2015,9(7):ZC98-ZC101.
[15]Tartari T,Wichnieski C,Bachmann L,et al.Effect of the combination of several irrigants on dentine surface properties,adsorption of chlorhexidine and adhesion of microorganisms to dentine[J].Int Endod J,2018,51(12):1420-1433.
[16]Vallabhdas AK,Kumar C,Kabbinale P,et al.Evaluation of hybrid layer and bonding interface after water storage with and without the usage of 2%chlorhexidine:a scanning electron microscope study[J].J Contemp Dent Pract,2018,19(1):52-59.
[17]Prado M,Simao RA,Gomes BP.Effect of different irrigation protocols on resin sealer bond strength to dentin[J].J Endod,2013,39(5):689-692.
[18]Gupta S,Mittal R,Singla M,et al.Comparative evaluation of the antimicrobial efficacy of MTAD,oxytetracycline,sodium hypochlorite and chlorhexidine against Enterococcus faecalis:an ex-vivo study[J].Saudi Endodontic J,2013,2(2):70-74.
[19]Yogender K,Jitendra L,Sureka B,et al.Comparative evaluation of demineralization of radicular dentin with 17%ethylenediaminetetraacetic acid,10%citric acid,and MTAD at different time intervals:an in vitro study[J].J Int Soc Prev Community Dent,2016,6(1):44-48.
[20]Charlie KM,Kuttappa MA,George L,et al.A scanning electron microscope evaluation of smear layer removal and antimicrobial action of mixture of tetracycline,acid and detergent,Sodium hypochlorite,ethylenediaminetetraacetic acid,and chlorhexidine gluconate:an in vitro study[J].J Int Soc Prev Community Dent,2018,8(1):62-69.
[21]Ertas H,Sagsen B.Comparison of the effect of MTAD and conventional irrigation agents on apical leakage and Push-Out bond strength of root canal filling[J].Scanning,2015,37(6):393-398.
[22]Ravikumar J,Bhavana V,Thatimatla C,et al.The effect of four different irrigating solutions on the shear bond strength of endodontic sealer to dentin-An In-vitro study[J].J Int Oral Health,2014,6(1):85-88.
[23]Bodrumlu E,Avsar A,Bodrumlu EH,et al.The effects of Calcium hydroxide removal methods on bond strength of epiphany SE with two irrigation protocols[J].Acta Odontol Scand,2013,71(3/4):989-993.
[24]Akman M,Eldeniz AU,Ince S,et al.Push-out bond strength of a new post system after various post space treatments[J].Dent Mater J,2016,35(6):876-880.
[25]Aranda-Garcia AJ,Kuga MC,Vitorino KR,et al.Effect of the root canal final rinse protocols on the debris and smear layer removal and on the push-out strength of an epoxy-based sealer[J].Microsc Res Tech,2013,76(5):533-537.
[26]Ballal NV,Tweeny A,Khechen KA,et al.Wettability of root canal sealers on intraradicular dentine treated with different irrigating solutions[J].J Dent,2013,41(6):556-560.
[27]Ferrer-Luque CM,González-Castillo S,Ruiz-Linares M,et al.Antimicrobial residual effects of irrigation regimens with maleic acid in infected root canals[J].J Biol Res,2015,22(1):1-5.
[28]Ballal NV,Ferrer-Luque CM,Sona M,et al.Evaluation of final irrigation regimens with maleic acid for smear layer removal and wettability of root canal sealer[J].Acta Odontol Scand,2018,76(3):199-203.
[29]Herczegh A,Palcso B,Lohinai Z,et al.Tracking of the degradation process of chlorhexidine digluconate and ethylenediaminetetraacetic acid in the presence of hyper-pure chlorine dioxide in endodontic disinfection[J].J Pharm Biomed Anal,2019,164:360-364.
[30]Kamalasanan RR,Devarasanahalli SV,Rashmi K,et al.Effect of5%chlorine dioxide irrigant on micro push out bond strength of resin sealer to radicular dentin:an in vitro study[J].J Clin Diagn Res,2017,11(5):ZC49-ZC53.
[31]Christensen CE,Mcneal SF,Eleazer P.Effect of lowering the pHof sodium hypochlorite on dissolving tissue in vitro[J].J Endod,2008,34(4):449-452.
[32]Nishikiori R,Nomura Y,Sawajiri M,et al.Influence of chlorine dioxide on cell death and cell cycle of human gingival fibroblasts[J].J Dent,2008,36(12):993-998.
[2]Fuzinatto RN,Farina AP,Souza MA,et al.Effects of an endodontic auxiliary chemical substance on the bond strength of two methacrylate-based endodontic sealers to dentin[J].Microsc Res Tech,2017,80(6):627-633.
[3]Tedesco M,Chain MC,Bortoluzzi EA,et al.Comparison of two observational methods,scanning electron and confocal laser scanning microscopies,in the adhesive interface analysis of endodontic sealers to root dentine[J].Clin Oral Investig,2018,22(6):2353-2361.
[4]Pantoja C,Silva D,Soares A J,et al.Influence of ethanol on dentin roughness,surface free energy,and interaction between AHPlus and root dentin[J].Braz Oral Res,2018,32:e33.
[5]Chen H,Zhao XY,Qiu Y,et al.The tubular penetration depth and adaption of four sealers:a scanning electron microscopic study[J].Biomed Res Int,2017:2946524.
[6]Schaefer E,Bering N,Buerklein S.Selected physicochemical properties of AH Plus,EndoREZ and RealSeal SE root canal sealers[J].Odontology,2015,103(1):61-65.
[7]李志伟,李劼,刘艳,等.不同终末冲洗方案对根管封闭剂与根管壁牙本质润湿性能的影响[J].牙体牙髓牙周病学杂志,2018,28(5):270-275.
[8]Cecchin D,Farina AP,Souza MA,et al.Evaluation of antimicrobial effectiveness and dentine mechanical properties after use of chemical and natural auxiliary irrigants[J].J Dent,2015,43(6):695-702.
[9]Neelakantan P,Sharma S,Shemesh HA.Influence of irrigation sequence on the adhesion of root canal sealers to dentin:a fourier transform infrared spectroscopy and push-out bond strength analysis[J].J Endod,2015,41(7):1108-1111.
[10]Pimentel Corrêa AC,Cecchin D,de Almeida JF,et al.Sodium thiosulfate for recovery of bond strength to dentin treated with sodium hypochlorite.[J].J Endod,2016,42(2):284-288.
[11]Cecchin D,Farina A,Bedranrusso A.The effects of endodontic substances and naturally reducing agents on the bond strength of epoxy resin-based sealer to root dentin[J].J Conserv Dent,2017,20(5):302-306.
[12]Ballal NV,Jain I,Tay FR.Evaluation of the smear layer removal and decalcification effect of QMix,maleic acid and EDTA on root canal dentine[J].J Dent,2016,51:62-68.
[13]Vilanova WV,Carvalho-Junior JR,Alfredo E,et al.Effect of intracanal irrigants on the bond strength of epoxy resin-based and methacrylate resin-based sealers to root canal walls[J].Int Endod J,2012,45(1):42-48.
[14]Uzunoglu E,Turker SA,Karahan S.The Effect of increased temperatures of QMix and EDTA on the push-out bond strength of an epoxy-resin based sealer[J].J Clin Diagn Res,2015,9(7):ZC98-ZC101.
[15]Tartari T,Wichnieski C,Bachmann L,et al.Effect of the combination of several irrigants on dentine surface properties,adsorption of chlorhexidine and adhesion of microorganisms to dentine[J].Int Endod J,2018,51(12):1420-1433.
[16]Vallabhdas AK,Kumar C,Kabbinale P,et al.Evaluation of hybrid layer and bonding interface after water storage with and without the usage of 2%chlorhexidine:a scanning electron microscope study[J].J Contemp Dent Pract,2018,19(1):52-59.
[17]Prado M,Simao RA,Gomes BP.Effect of different irrigation protocols on resin sealer bond strength to dentin[J].J Endod,2013,39(5):689-692.
[18]Gupta S,Mittal R,Singla M,et al.Comparative evaluation of the antimicrobial efficacy of MTAD,oxytetracycline,sodium hypochlorite and chlorhexidine against Enterococcus faecalis:an ex-vivo study[J].Saudi Endodontic J,2013,2(2):70-74.
[19]Yogender K,Jitendra L,Sureka B,et al.Comparative evaluation of demineralization of radicular dentin with 17%ethylenediaminetetraacetic acid,10%citric acid,and MTAD at different time intervals:an in vitro study[J].J Int Soc Prev Community Dent,2016,6(1):44-48.
[20]Charlie KM,Kuttappa MA,George L,et al.A scanning electron microscope evaluation of smear layer removal and antimicrobial action of mixture of tetracycline,acid and detergent,Sodium hypochlorite,ethylenediaminetetraacetic acid,and chlorhexidine gluconate:an in vitro study[J].J Int Soc Prev Community Dent,2018,8(1):62-69.
[21]Ertas H,Sagsen B.Comparison of the effect of MTAD and conventional irrigation agents on apical leakage and Push-Out bond strength of root canal filling[J].Scanning,2015,37(6):393-398.
[22]Ravikumar J,Bhavana V,Thatimatla C,et al.The effect of four different irrigating solutions on the shear bond strength of endodontic sealer to dentin-An In-vitro study[J].J Int Oral Health,2014,6(1):85-88.
[23]Bodrumlu E,Avsar A,Bodrumlu EH,et al.The effects of Calcium hydroxide removal methods on bond strength of epiphany SE with two irrigation protocols[J].Acta Odontol Scand,2013,71(3/4):989-993.
[24]Akman M,Eldeniz AU,Ince S,et al.Push-out bond strength of a new post system after various post space treatments[J].Dent Mater J,2016,35(6):876-880.
[25]Aranda-Garcia AJ,Kuga MC,Vitorino KR,et al.Effect of the root canal final rinse protocols on the debris and smear layer removal and on the push-out strength of an epoxy-based sealer[J].Microsc Res Tech,2013,76(5):533-537.
[26]Ballal NV,Tweeny A,Khechen KA,et al.Wettability of root canal sealers on intraradicular dentine treated with different irrigating solutions[J].J Dent,2013,41(6):556-560.
[27]Ferrer-Luque CM,González-Castillo S,Ruiz-Linares M,et al.Antimicrobial residual effects of irrigation regimens with maleic acid in infected root canals[J].J Biol Res,2015,22(1):1-5.
[28]Ballal NV,Ferrer-Luque CM,Sona M,et al.Evaluation of final irrigation regimens with maleic acid for smear layer removal and wettability of root canal sealer[J].Acta Odontol Scand,2018,76(3):199-203.
[29]Herczegh A,Palcso B,Lohinai Z,et al.Tracking of the degradation process of chlorhexidine digluconate and ethylenediaminetetraacetic acid in the presence of hyper-pure chlorine dioxide in endodontic disinfection[J].J Pharm Biomed Anal,2019,164:360-364.
[30]Kamalasanan RR,Devarasanahalli SV,Rashmi K,et al.Effect of5%chlorine dioxide irrigant on micro push out bond strength of resin sealer to radicular dentin:an in vitro study[J].J Clin Diagn Res,2017,11(5):ZC49-ZC53.
[31]Christensen CE,Mcneal SF,Eleazer P.Effect of lowering the pHof sodium hypochlorite on dissolving tissue in vitro[J].J Endod,2008,34(4):449-452.
[32]Nishikiori R,Nomura Y,Sawajiri M,et al.Influence of chlorine dioxide on cell death and cell cycle of human gingival fibroblasts[J].J Dent,2008,36(12):993-998.