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차아염소산나트륨과 클로르헥시딘의 반응침전물 형성방지를 위한 여러 가지 근관세척 방법의 비교

THE COMPARISON OF DIFFERENT CANAL IRRIGATION METHODS TO PREVENT REACTION PRECIPITATE BETWEEN SODIUM HYPOCHLORITE AND CHLORHEXIDINE

김진우|박세희|조경모|최문선
대한치과보존학회 (Korean Academy Of Conservative Dentistry)|2010.03|Restorative Dentistry and Endodontics|제35권 제2호|pp. 80-87

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참고문헌

키워드

Sodium hypochlorite차아염소산나트륨Canal irrigation클로르헥시딘Chlorhexidine근관세척Precipitate침전물Para-chloroaniline
주제분류치의학

초록

이 실험의 목적은 NaOCl과 CHX의 혼합사용 시, 발생하는 침전물의 형성을 막기 위해 두 용액간의 접촉을 줄일 수 있는 여러 가지 방법을 비교하고, 관찰된 침전물의 원소를 분석하는 것이다. 발거된 50개의 단근치를 사용하였으며 2.5% NaOCl을이용하여 .04 taper ProFile #40까지 근관형성 하였다. 치아는 다음과 같은 근관세척 방법에 따라 4개의 실험군과 1개의 대조군으로 나누었다; 대조군: 2.5% NaOCl, 1군: 2.5% NaOCl + 2% CHX, 2군: 2.5% NaOCl + paper points + 2% CHX, 3군: 2.5% NaOCl + .04/#45 근관확대 + 2% CHX, 4군: 2.5% NaOCl +95% alcohol+ 2% CHX. 근관세척 후 치아를 양분하고 치관부, 중간부, 치근부 세부위로 나누어 전계 방사형 주사 전자현미경을 통하여 잔사 비율, 개방 상아세관 비율, 상아세관 내 물질의 원소분석을 시행하였다. 실험결과, 실험군 사이에 잔사비율과 개방된 상아세관 비율 비교에서 통계학적으로 유의할 만한 차이는 나타나지 않았다. 1 군의 한 시편에서 C의 함유량이 높게 나타났으며 N과 Cl도 함께 검출되어para-chloraniline으로 추정되며, 1 군의 다른 시편과 나머지 실험군에서는 O, P, C, Ca의 순으로 함유량이 높은 것으로 나타나 수산화인회석으로 추정된다. NaOCl 세척 후 바로 CHX 세척을 한 군에서 PCA로 의심되는 물질이 검출된 바, 두 용액의 직접적인 접촉을 피하기 위해 주의가 필요하며, 본 실험에 사용된 여러 근관 세척방법 이용 시 침전물의 형성을 예방할 수 있을 것이다.

Abstract

The purpose of this study was to compare the different canal irrigation methods to prevent the formation of precipitate between sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Extracted 50 human single-rooted teeth were used. The root canals were instrumented using NiTi rotary file (Profile .04/#40) with 2.5% NaOCl and 17% EDTA as irrigants. Teeth were randomly divided into four experimental groups and one control group as follows; Control group: 2.5% NaOCl only, Group 1: 2.5% NaOCl + 2% CHX, Group 2: 2.5% NaOCl + paper points + 2% CHX, Group 3: 2.5% NaOCl + preparation with one large sized-file + 2% CHX, Group 4: 2.5% NaOCl +95% alcohol+ 2% CHX. The teeth were split in bucco-lingual aspect and the specimens were observed using Field Emission Scanning Electron Microscope. The percentages of remaining debris and patent dentinal tubules were determined. Statistical analysis was performed with one-way analysis of variance (ANOVA). Energy Dispersive x-ray Spectroscopy was used for analyzing the occluded materials in dentinal tubule for elementary analysis. There were no significant differences in percentage of remaining debris and patent tubules between all experimental groups at all levels (p > .05). In elementary analysis, the most occluded materials in dentinal tubule were dentin debris. NaOCl/CHX precipitate was detected in one tooth specimen of Group 1. In conclusion, there were no significant precipitate on root canal, but suspected material was detected on Group 1. The irrigation system used in this study could be prevent the precipitate formation. [J Kor Acad Cons Dent 35(2):80-87, 2010]

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