PDF(Pubmed)
Abstract：
Photon-initiated photoacoustic streaming (PIPS) with an Er: YAG laser has been introduced in root canal treatment to improve irrigation and facilitate the removal of bacteria in the root canal system. This study aimed to compare the antibacterial effectiveness of two different root canal irrigation techniques, conventional needle irrigation (CNI) and PIPS, using 1% sodium hypochlorite (NaOCl), in the treatment of teeth with apical periodontitis. Sixty patients with a total of sixty teeth affected by apical periodontitis were included in this study. The teeth underwent root canal therapy, and after mechanical instrumentation, they were randomly assigned to two groups (n = 30) based on the final irrigation protocol: CNI or PIPS with 1% NaOCl. Bacterial suspensions in the root canals were evaluated using Adenosine 5\'-triphosphate (ATP) assay kit after mechanical instrumentation and after final irrigation. Then, a follow-up was conducted after 7 days. The results revealed that final irrigation significantly reduced ATP values in both the CNI and PIPS groups (P < 0.001). The ATP values after final irrigation was greater in the CNI group compared to the PIPS group (P < 0.001). After a 7-day follow-up, percussion tenderness and fistula were significantly resolved in both groups (P < 0.05). A multivariate linear regression model was used to identify the factors that influence post irrigation ATP values. The analysis demonstrated that pre-operative percussion tenderness (P = 0.006), the presence of a fistula (P < 0.001) and the method used in the final irrigation (P < 0.001) had a significant impact on the ATP value after final irrigation. These results indicate that employing PIPS with 1% NaOCl as the final irrigation protocol exhibited superior antibacterial effectiveness and has the potential to enhance clinical outcomes in the treatment of teeth afflicted with apical periodontitis.
摘要：
在根管治疗中引入了带有Er：YAG激光的光子引发的光声流（PIPS），以改善灌溉并促进根管系统中细菌的去除。本研究旨在比较两种不同根管冲洗技术的抗菌效果。常规针头冲洗（CNI）和PIPS，使用1%次氯酸钠(NaOCl)，在治疗根尖周炎的牙齿。本研究包括60例受根尖周炎影响的患者，共60颗牙齿。牙齿接受了根管治疗，在机械仪表之后，根据最终的灌溉方案，将他们随机分为两组（n=30）：CNI或含1％NaOCl的PIPS。在机械仪器和最终冲洗后，使用5'-三磷酸腺苷（ATP）测定试剂盒评估根管中的细菌悬浮液。然后，7天后进行随访.结果表明，最终灌溉显着降低了CNI和PIPS组的ATP值（P<0.001）。与PIPS组相比，CNI组最终冲洗后的ATP值更高（P<0.001）。经过7天的随访，两组患者搏动压痛和瘘均有明显缓解(P<0.05)。使用多元线性回归模型来确定影响灌溉后ATP值的因素。分析表明术前搏动压痛（P=0.006），瘘管的存在(P<0.001)和最终冲洗中使用的方法(P<0.001)对最终冲洗后的ATP值有显著影响.这些结果表明，采用含1％NaOCl的PIPS作为最终冲洗方案表现出优异的抗菌效果，并具有增强治疗根尖周炎牙齿的临床效果的潜力。
