低侵襲根管治療におけるEnterococcus faecalis除去のための3種類の根管内消毒法の比較検討

[Comparison of three root canal disinfection methods for removal of Enterococcus faecalis under minimally invasive root canal treatment].

抄録

目的:

低侵襲根管治療と従来の根管治療で異なる根管消毒方法を比較することにより、低侵襲根管治療に基づく効率的かつ簡便な根管消毒方法を得る。

PURPOSE: To obtain an efficient and simple root canal disinfection method based on minimally invasive root canal treatment by comparing different root canal disinfection methods between minimally invasive root canal treatment and conventional root canal treatment.

方法:

上顎第一大臼歯の抜歯歯66本を実験群（コンピューターガイドによる精密低侵襲根管治療）と対照群（従来の根管治療）にランダムに分けた。各群は、次亜塩素酸ナトリウム＋EDTA根管洗浄、次亜塩素酸ナトリウム＋EDTA＋超音波、次亜塩素酸ナトリウム＋EDTA＋Er：YAGレーザーの3つのサブグループにランダムに分類された。根管消毒後、ペーパーチップ法で試料を採取し培養し、各試料のコロニー形成単位（CFU）値を算出した。その後、象牙質デブリを調製し、F3ファイルを用いて回収した。希釈して培養した後、CFU値を算出した。統計解析は、SPSS 26.0ソフトウェアパッケージで行った。

METHODS: Sixty-six extracted maxillary first molars were randomly divided into experimental group (computer-guided precision minimally invasive root canal treatment) and control group (conventional root canal treatment). All teeth were prepared to ProTaper universal F2, and Enterococcus faecalis infection models were established.Each group was randomly divided into three subgroups, sodium hypochlorite+EDTA root canal irrigation, sodium hypochlorite+EDTA+ultrasonic and sodium hypochlorite +EDTA +Er: YAG laser. After root canal disinfection,the samples were collected by paper tip method and cultured, and colony forming units (CFU) values of each sample were calculated. Then dentin debris was prepared and collected with F3 file. After being diluted and cultured, the CFU value was calculated. Statistical analysis was performed by SPSS 26.0 software package.

結果:

実験群と対照群の根管内壁細菌量を比較した結果，C群とB群の殺菌効果はA群に比べ有意に優れていたが（P＜0.05），B群とC群の間には有意差はなかった（P＞0.05）．実験群では、B1群、C1群、A1群の間に有意差があった（P＜0.05）。B1群、C1群の結果はA1群より低いが、B1群とC1群の間に有意差はなかった(P＞0.05)。対照群では、B2群、C2群、A2群の間に有意差があった（P＜0.05）。B2群、C2群はA2群より低い結果となったが、B2群とC2群の間には有意差はなかった(P＞0.05)。象牙質破片中の細菌量を実験群と対照群で比較したところ、C群の効果が最も高く、次いでB群、A群であり、3群間に有意差があった(P＜0.05).

RESULTS: Comparison of the amount of bacterial inner wall of root canal between the experimental group and the control group showed that the germicidal efficacy of group C and group B were significantly better than that of group A (P＜0.05), but there was no significant difference between group B and group C(P＞0.05). In the experimental group, there was significant difference between group B1, C1 and A1 (P＜0.05). The results of group B1 and C1 were lower than that of group A1, but there was no significant difference between group B1 and group C1(P＞0.05). In the control group, there were significant differences between group B2, C2 and A2 (P＜0.05). The results of group B2 and C2 were lower than that of group A2, but there was no significant difference between group B2 and C2(P＞0.05). Comparison of the amount of bacteria in dentin debris between the experimental group and the control group showed that the effect of group C was the best, followed by group B, and group A, and there were significant differences between three groups(P＜0.05).

結論:

Er:YAGレーザーまたは超音波アシストコンピューターガイド精密低侵襲根管治療の消毒効果は従来の根管治療と同様であり、Er:YAGレーザーは超音波よりも歯根管内の細菌除去に優れており、低侵襲根管治療により適している。

CONCLUSIONS: The disinfection effect of Er:YAG laser or ultrasound assisted computer-guided precision minimally invasive root canal treatment is similar to conventional root canal treatment, and Er:YAG laser is better than ultrasound in removing bacteria from dentinal tubules, which is more suitable for minimally invasive root canal treatment.