本文選題：糞腸球菌 + 次氯酸鈉��； 參考：《天津醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 比較和分析QMix. MTAD、西曲溴銨(CTR)、氯已定(CHX). EDTA.蒸餾水6種根管沖洗液的根管玷污層清除效果,及其抗菌性和殘余抗菌性,以及不同沖洗液的抗菌性、殘余抗菌性與根管玷污層清除效果的相關(guān)性。 對象和方法 以170顆無齲離體單根前牙為研究對象,制作標(biāo)準(zhǔn)模型后,高溫高壓滅菌,建立糞腸球菌感染模型,隨機(jī)抽取30顆用以檢測滅菌及感染模型建立情況,以Crown-Down法對剩余140顆已建立感染模型的離體牙進(jìn)行根管預(yù)備后,分別用QMix、MTAD、CTR、CHX、EDTA.蒸餾水6種沖洗液對預(yù)備完成后的根管進(jìn)行終末沖洗,并設(shè)立對照組(不進(jìn)行任何終末沖洗)。終末沖洗完成后,將每組樣本隨機(jī)分為兩個亞組(n=70),其中一個亞組在掃描電鏡下檢測根管的根上1/3,根中1/3,根尖1/3根管玷污層的清除情況；另外一個亞組分別在終末沖洗結(jié)束后,分別于第0,1,2,3....14天進(jìn)行取樣、培養(yǎng)、觀察、記錄,用來檢測沖洗液在根上1/3,根中1/3,根尖1/3的抗菌性及殘余抗菌性；并分析6種沖洗液的抗菌性和殘余抗菌性與根管玷污層清除效果是否具有相關(guān)性。采用單因素方差分析對6種根管沖洗液的玷污層清除效果進(jìn)行評價；采用卡方檢驗對6種根管沖洗液的抗菌性及殘余抗菌性進(jìn)行評價。所有分析均使用SPSS17.0統(tǒng)計軟件。 結(jié)果 根管玷污層清除效果顯示：QMix、MTAD. EDTA3種沖洗液根管玷污層的清除效果分別與對照組比較,差異均具有統(tǒng)計學(xué)意義(P0.05)；6種根管沖洗液組間兩兩比較,除QMix和MTAD之間比較無統(tǒng)計學(xué)差異(P0.05),以及CTR、CHX、蒸餾水、對照組之間比較無統(tǒng)計學(xué)差異(P0.05)外,其余各組間比較差異均具有統(tǒng)計學(xué)意義(P0.05)。玷污層清除得分最低(玷污層清除效果最好)為EDTA,其次為QMix/MTAD,得分最高(玷污層清除效果最差)為CTR/CHX/蒸餾水／對照組。同一沖洗液根上1/3、根中1/3和根尖1/3比較：各組均在根上1/3玷污層得分最低,根尖1/3玷污層得分最高,差異均具有統(tǒng)計學(xué)意義(P0.05)。 抗菌性顯示：QMix、MTAD、CTR、CHX與對照組比較,差異均有統(tǒng)計學(xué)意義(P0.002),其余各組間兩兩比較差異均無統(tǒng)計學(xué)意義(P0.002)。 殘余抗菌性顯示：在第1、2、3天,EDTA組、蒸餾水組、對照組分別與QMix組、MTAD組、CTR組、CHX組兩兩比較,差異均有統(tǒng)計學(xué)意義(P0.002),其余各組間兩兩比較均無統(tǒng)計學(xué)差異(P0.002)；在第4-11天,各組間兩兩比較差異均無統(tǒng)計學(xué)意義(P0.002)。 6種根管沖洗液的抗菌性及殘余抗菌性與根管玷污層清除效果之間的相關(guān)性：無相關(guān)關(guān)系。 結(jié)論 QMix、MTAD、EDTA能夠有效清除玷污層,但均不能完全清除玷污層。EDTA玷污層清除效果最佳,QMix、MTAD次之,CTR、CHX、蒸餾水不具有清除玷污層的作用。 QMix、MTAD、CTR、CHX均有一定的抗菌性,但均不能徹底殺滅糞腸球菌,作為終末沖洗液其抗菌效果相似。 QMix、MTAD、CTR、CHX均有一定的殘余抗菌性,但持續(xù)時間長短不一,殘余抗菌性持續(xù)時間由長到短的順序為：MTAD CTR QMix CHX。 不同沖洗液抗菌性、殘余抗菌性與玷污層清除效果之間無相關(guān)性。 綜合分析6種沖洗液的根管玷污層清除效果、抗菌性和殘余抗菌性3個特性： EDTA玷污層清除效果最佳,但是抗菌性差； MTAD兼具玷污層清除效果和抗菌性、殘余抗菌性的雙重效果； QMix玷污層清除效果好,并具有一定的抗菌性和殘余抗菌性； CTR和CHX無玷污層清除的作用,但是具有一定的抗菌性和殘余抗菌性； 蒸餾水不具有以上3種特性。
[Abstract]:objective
Comparison and analysis of the effect of QMix. MTAD, CTR, CHX and EDTA. distilled water on the removal of the root canal smear layer, and its antibacterial and residual antibacterial properties, as well as the antibacterial property of different flushing fluids, the correlation between the residual antibacterial property and the scavenging effect of the root canal smear layer.
Objects and methods
After making standard model of 170 caries free single anterior teeth, a model of Enterococcus faecalis infection was established by high temperature and high pressure, 30 were randomly selected to detect the establishment of sterilization and infection model. After the root canal preparation of the remaining 140 established infected teeth with Crown-Down, QMix, MTAD, CTR, CHX, ED were used respectively. 6 kinds of TA. distilled water were used to rinse the final root canal and set up a control group (without any final flushing). After finishing the end flushing, each group was randomly divided into two subgroups (n=70). One of the subgroups detected the scavenging of the root 1/3, the root 1/3 and the 1/3 root canal of the root canal in the root canal under the scanning electron microscope. The other subgroups were sampled, cultured, observed and recorded at the end of the final flushing, respectively at 0,1,2,3....14 days, respectively, to detect the antibacterial and residual antibacterial properties of the flushing fluid on the root 1/3, the root 1/3, the root tip 1/3, and the analysis of the antibacterial and residual antibacterial properties of the 6 kinds of rinses and the removal of the root canal smear layer. A single factor analysis of variance was used to evaluate the scavenging effect of 6 kinds of root canal flushing fluid, and a chi square test was used to evaluate the antibacterial and residual antibacterial properties of the 6 root canal flushing fluids. All analysis used the SPSS17.0 software.
Result
The scavenging effect of root canal smear layer showed that the scavenging effect of root canal smear layer of QMix, MTAD. EDTA3 irrigation solution was compared with the control group, the difference was statistically significant (P0.05), and there was no statistical difference between the 6 root canal flushing fluid groups, except QMix and MTAD (P0.05), and CTR, CHX, distilled water, and the control group were no more than the control group. The difference of statistical difference (P0.05) was statistically significant (P0.05). The lowest score of smear layer clearance (the best removal effect of smear layer) was EDTA, followed by QMix/MTAD. The highest score (the worst effect of smear layer clearance) was CTR/CHX/ distilled water / control group. The same rinse root 1/3, 1/3 in root and root apex 1/3 were compared. Each group had the lowest score on 1/3 smear layer, and the highest score of apical 1/3 smear layer, and the difference was statistically significant (P0.05).
The results showed that the differences of QMix, MTAD, CTR and CHX were statistically significant (P0.002) compared with the control group (P0.002), and there was no significant difference between the 22 other groups (P0.002).
The residual antimicrobial activity showed that in 1,2,3 days, group EDTA, distilled water group and control group were compared with QMix group, MTAD group, CTR group and CHX group respectively, the difference was statistically significant (P0.002), the other groups were not statistically significant (P0.002) in the 22 groups (P0.002), and there was no statistical difference between each group on day 4-11 (P0.002).
There was no correlation between the antibacterial activity and residual antibacterial activity of 6 root canal irrigation fluids and root canal smear clearance.
conclusion
QMix, MTAD, EDTA can effectively remove the smear layer, but all can not completely remove the smear layer.EDTA smear layer scavenging effect best, QMix, MTAD times, CTR, CHX, distilled water does not have the effect of cleaning the tarnished layer.
QMix, MTAD, CTR and CHX have some antibacterial properties, but they can not kill the Enterococcus faecalis completely. The antibacterial effect is similar to that of the terminal rinse liquid.
QMix, MTAD, CTR and CHX have some residual antibacterial properties, but the duration varies from time to time. The duration of residual antibacterial activity from long to short is MTAD CTR QMix CHX..
There was no correlation between the antibacterial properties of different irrigants, the residual antibacterial property and the smear removal effect.
The characteristics of root canal smear clearance, antibacterial properties and residual antimicrobial properties of the 6 flushing fluids were analyzed in 3 aspects.
EDTA smear layer has the best clearance effect, but its antibacterial property is poor.
MTAD has dual effects of smear removal and antibacterial properties, and residual antibacterial properties.
QMix smear layer has good cleaning effect, and has certain antibacterial and residual antibacterial properties.
CTR and CHX have no scavenging effect, but they have certain antibacterial and residual antibacterial properties.
Distilled water does not have the above 3 characteristics.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.05

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本文編號：1837210