CAJ | 학술논문

目的观察不同激光能量对血卟啉单甲醚介导的光动力疗法(HMME-PDT)杀灭离体牙侧支根管内粪肠球菌的效果.方法选取人单根管离体前牙80颗,常规根管预备后建立粪肠球菌感染人工模拟侧支根管模型.实验随机分为8组:A组为阴性对照组,以生理盐水冲洗根管；B组为阳性对照组,以5.25％ NaClO冲洗根管；其余6组为HMME-PDT处理组,各组以40μg/ml血卟啉单甲醚(HMME)为光敏剂,避光孵育5 min后用不同激光功率的532 nm半导体激光在根管内上下提拉螺旋照射120 s,按照激光功率的不同,分为C组(50 mW)、D组(60 mW)、E组(70 mW)、F组(80 mW)、G组(90 mW)、H组(100 mW).各组实验牙标本(每个离体牙近中面侧支根管作为实验前标本,远中面侧支根管作为对应的实验后标本)处理前与处理后即刻用20#K锉取侧支根管内碎屑,然后将碎屑转至含5 ml TPY液体培养基的试管中,10倍递增连续稀释后厌氧培养24 h,菌落计数.结果不同激光功率PDT组和生理盐水冲洗组相比,杀菌率的差异有统计学意义(P＜0.05)；和5.25％ NaClO冲洗组相比,D组、E组、F组、G组、H组杀菌率均明显增高(P＜0.05),而C组与5.25％ NaClO冲洗组杀菌率之间的差异无统计学意义(P＞0.05)；不同激光功率的各PDT组的杀菌率随激光功率的增加而增高,其中F组、G组、H组与C组、D组、E组相比,杀菌率显著提高(P＜0.05),而F组、G组、H组3组间杀菌率的差异无统计学意义(P＞0.05).结论在本实验条件下,HMME-PDT对人工侧支根管内粪肠球菌的最佳杀菌功率参数为80 mW.
목적 관찰불동격광능량대혈계람단갑미개도적광동력요법(HMME-PDT)살멸리체아측지근관내분장구균적효과.방법 선취인단근관리체전아80과,상규근관예비후건립분장구균감염인공모의측지근관모형.실험수궤분위8조:A조위음성대조조,이생리염수충세근관；B조위양성대조조,이5.25％ NaClO충세근관；기여6조위HMME-PDT처리조,각조이40μg/ml혈계람단갑미(HMME)위광민제,피광부육5 min후용불동격광공솔적532 nm반도체격광재근관내상하제랍라선조사120 s,안조격광공솔적불동,분위C조(50 mW)、D조(60 mW)、E조(70 mW)、F조(80 mW)、G조(90 mW)、H조(100 mW).각조실험아표본(매개리체아근중면측지근관작위실험전표본,원중면측지근관작위대응적실험후표본)처리전여처리후즉각용20#K촤취측지근관내쇄설,연후장쇄설전지함5 ml TPY액체배양기적시관중,10배체증련속희석후염양배양24 h,균락계수.결과 불동격광공솔PDT조화생리염수충세조상비,살균솔적차이유통계학의의(P＜0.05)；화5.25％ NaClO충세조상비,D조、E조、F조、G조、H조살균솔균명현증고(P＜0.05),이C조여5.25％ NaClO충세조살균솔지간적차이무통계학의의(P＞0.05)；불동격광공솔적각PDT조적살균솔수격광공솔적증가이증고,기중F조、G조、H조여C조、D조、E조상비,살균솔현저제고(P＜0.05),이F조、G조、H조3조간살균솔적차이무통계학의의(P＞0.05).결론 재본실험조건하,HMME-PDT대인공측지근관내분장구균적최가살균공솔삼수위80 mW.
Objective The purpose of this study was to assess the antibacterial effects of hematoporphyrin monomethylether-photodynamic therapy (HMME-PDT) on Enterococcus faecalis within infected simulated lateral canals in vitro with different energy.Methods Simulated lateral canals were prepared on extracted teeth.The specimens were infected with Enterococcus faecalis and then were randomly divided into eight groups.Group A was considered as negative control,its specimens were irrigated with physiological saline.Group B was the positive control,they were irrigated with 5.25％ NaClO.Other groups were incubated with HMME at concentration of 40 μg/ml for 5 min,followed by exposure to light at 532 nm for 120 s with different powers in a spiral pattern.Groups were named C-H,in corresponding with the power 50,60,70,80,90,100 mW.Microbial samples (the dentin chips from simulated lateral canals) were taken before and after the treatments.The survival fractions in each simulated lateral canal was calculated by counting colony-forming units(CFUs).Results 1.The HMME-PDT-treated groups resulted in a significant reduction in the number of E.faecalis in simulated lateral canals compared with the negative controls(P＜0.05).2.The antibacterial effects of group D、E、F、G、H were higher than the NaCl0-irrigated group(P＜0.05).3.The difference of antibacterial effects between the F、G、H groups was in significant(P＞0.05).Conclusion HMME-PDT had significant inhibitive efficacy on Enterococcus faecalis within infected simulated lateral canals and the efficacy was power-depended.It can play the best effect with the power of 80 mW.