半导体激光与5.25%NaClO、17%EDTA联合应用对侧支根管内粪肠球菌的清除效果评价

doi:10.19439/j.sjos.2026.02.003

摘要/Abstract

摘要： 目的:探讨半导体激光联合5.25%NaClO、17%金属螯合乙二胺四乙酸（ethylenediaminetetraacetic acid, EDTA）对侧支根管内粪肠球菌（Enterococcus faecalis,E.faecalis）的清除效果。方法:收集2023年1月—2023年12月宁德师范学院附属宁德市医院口腔科门诊拔除的新鲜单根恒牙82颗,用超声器械及牙周刮治器去净牙石和牙周膜,消毒后建立E.faecalis感染侧支根管模型。应用扫描电镜（scanning electron microscopy,SEM）观察E.faecalis感染侧支根管模型是否建立成功。成功制备80个E.faecalis感染侧支根管模型,随机分为A、B、C、D四组,每组20个。A组采用半导体激光处理,B组采用17%EDTA+5.25%NaClO溶液处理,C组采用17%EDTA+5.25%NaClO+半导体激光处理,D组仅用0.9%NaCl溶液处理。对比各组处理前后菌落数差异,计算杀菌率,SEM下观察各组处理后变化情况。结果:接种培养4周后,离体牙根管壁上形成完整的E.faecalis生物膜,紧密贴附并渗透至牙本质小管,成功构建E.faecalis感染模型。处理后,四组菌落数均较处理前显著减少（P<0.05）;其中,C组菌落数最少,杀菌率最高,D组反之,差异具有统计学意义（P<0.05）。A组与B组菌落数、细菌减少量及杀菌率相比无显著差异（P>0.05）。处理后,A、B组根管壁有玷污层与稀疏E.faecalis,牙本质小管开放但粗糙,部分小管口封闭。C组小管口完全暴露,壁面光洁无杂质,小管口熔融且直径减小。D组E.faecalis线性链状分布,根管壁被玷污层覆盖,小管口难见。结论:半导体激光协同5.25%NaClO与17%EDTA对E.faecalis感染侧支根管有良好的杀菌效果,可作为传统根管消毒的补充。

关键词: 侧支根管, 粪肠球菌, 半导体激光, 次氯酸钠, 金属螯合乙二胺四乙酸

Abstract: PURPOSE: To investigate the scavenging effect of diode laser combined with 5.25% sodium hypochlorite (NaClO) and 17% metal chelated ethylenediaminetetraacetic acid (EDTA) on Enterococcus faecalis (E.faecalis) in the root canal. METHODS: From January 2023 to December 2023, totally 82 single permanent teeth were freshly extracted from the outpatient clinic of the Department of Stomatology of Ningde Hospital affiliated to Ningde Normal University, and the tartar and periodontal ligament were removed with ultrasound instruments and periodontal curettage, and the root canal model with E.faecalis infection was established after disinfection. Scanning electron microscopy (SEM) was used to observe whether the root canal model of E.faecalis infected lateral branch was successfully established. A total of 80 E.faecalis-infected lateral root canal models were successfully prepared and randomly divided into 4 groups with 20 in each group. Group A was treated with diode laser, group B was treated with 17% EDTA+5.25% NaClO solution, group C was treated with 17% EDTA+5.25% NaClO+ diode laser, and group D was treated with 0.9% NaCl solution. The difference in the number of colonies between the groups before and after treatment was compared, the sterilization rate was calculated, and the treatment situation of each group was observed under SEM. Results: After 4 weeks of inoculation, a complete E.faecalis biofilm was formed on the root canal wall of isolated teeth, which closely adhered to and penetrated into the dentinal tubule, and the E.faecalis infection model was successfully constructed. After treatment, the number of colonies in the 4 groups was significantly lower than that before treatment(P<0.05). Group C had the lowest number of colonies and the highest bactericidal rate after treatment, while group D had the opposite effect, and the difference was statistically significant (P<0.05). There was no significant difference in the number of colonies, bacterial reduction and sterilization rate between group A and group B (P>0.05). After treatment, the root canal walls of group A and B had smear layers and sparse E.faecalis. The dentin tubules were open but rough, and the openings of some tubules were closed. In group C, the small tube openings were completely exposed, the wall surface was smooth and free of impurities, the small tube openings were molten and the diameter decreased. In group D, E. faecalis was linearly and chainly distributed. The root canal walls were covered by the smear layer, and the small canal openings were difficult to be seen. CONCLUSIONS: Semiconductor laser in combination with 5.25% NaClO and 17% EDTA have a good bactericidal effect on the lateral root canals on the infected side of E. faecalis and can be used as a supplement to traditional root canal disinfection.

Key words: Lateral root canal, Enterococcus faecalis, Diode laser, Sodium hypochlorite, Metal-chelated ethylenediaminetetraacetic acid

中图分类号:

R781.34

陈淋瑜, 钟文, 刘朝进, 焦雪峰. 半导体激光与5.25%NaClO、17%EDTA联合应用对侧支根管内粪肠球菌的清除效果评价[J]. 上海口腔医学, 2026, 35(2): 129-135.

Chen Linyu, Zhong Wen, Liu Chaojin, Jiao Xuefeng. Experimental study on antibacterial effect of semiconductor laser combined with 5.25%NaClO and 17%EDTA on lateral root canals infected by Enterococcus faecalis[J]. Shanghai Journal of Stomatology, 2026, 35(2): 129-135.

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