超音波とナノバブルを用いた薬剤導入による新しい根管内無菌化法の開発  [in Japanese] A Novel Method for Disinfection of Root Canal System by Enhanced Delivery of Medicaments using Ultrasound with Nanobubbles  [in Japanese]

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Author(s)

    • 江場 久哲 EBA Hisanori
    • 国立長寿医療研究センター歯科口腔先進医療開発センター再生歯科医療研究部:愛知学院大学歯学部歯内治療学講座 Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology Research Institute:Department of Endodontics, School of Dentistry, Aichi-Gakuin University
    • 庵原 耕一郎 IOHARA Koichiro
    • 国立長寿医療研究センター歯科口腔先進医療開発センター再生歯科医療研究部 Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology Research Institute
    • 堀場 直樹 HORIBA Naoki
    • 愛知学院大学歯学部歯内治療学講座 Department of Endodontics, School of Dentistry, Aichi-Gakuin University
    • 中村 洋 NAKAMURA Hiroshi
    • 愛知学院大学歯学部歯内治療学講座 Department of Endodontics, School of Dentistry, Aichi-Gakuin University
    • 中島 美砂子 NAKASHIMA Misako
    • 国立長寿医療研究センター歯科口腔先進医療開発センター再生歯科医療研究部:愛知学院大学歯学部歯内治療学講座 Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology Research Institute:Department of Endodontics, School of Dentistry, Aichi-Gakuin University

Abstract

感染根管治療における無菌化は,治療の成否に大きく関与する.しかしながら,根管は閉塞・狭窄,湾曲,側枝・副根管の存在などにより,しばしば根管拡大・清掃が困難で貼薬剤が到達できず,完全無菌化が困難となり治療期間の延長を余儀なくされる.さらに根管拡大形成による歯質の損失は,歯の破折・抜歯の要因となり,予後に大きな影響を及ぼす.そこで本研究では,短時間で根管内を完全に無菌化する方法の開発を目的として,ナノバブルと超音波を併用することにより,根管内の薬剤を象牙細管深くまで浸透させるための最適な導入条件を検討した.粒径0.2〜0.3μmのピークを示すナノバブルを用いた場合,濃度5%は10%に比べて,また超音波の電圧30Vは31Vに比べて,イヌ抜去歯の象牙細管深部への薬剤導入が有意に多量に認められた.また,イヌ抜去歯の象牙細管内にgreen fluorescent protein (GFP)で標識されたEnteyococcus faecalisを感染させ,72時間後に処置を行い,さらに48時間培養後に150μmの厚みの切片を作製し,共焦点レーザー顕微鏡にて無菌化を検討した.その結果,薬剤アンピシリンを根管内に注入して5%ナノバブルと超音波電圧30Vを120秒間適用することにより,薬剤のみやナノバブルと超音波のみに比べて有意にGFP蛍光の減少がみられた.以上のことから,ナノバブルと超音波を併用することで,象牙細管内に薬剤を深く浸透させ,根管内を短時間に無菌化できる可能性が示唆された.

The main goal of root canal treatment is to disinfect the root canal. Proper cleansing of the root canal space is considered essential for success in endodontics. The disinfection of the root canal is performed by mechanical enlargement and chemical irrigants. Then an intracanal medicament is applied in the root canal. However, it is very difficult to completely eliminate bacteria from the root canal system, including those regions where access is difficult, such as canal irregularities, bifurcation, isthmus, fin, and the like. Excess enlargement of the root canal causes root fracture and may necessitate future tooth extraction and has a great influence on a prognosis. Thus, this study was performed to develop a novel method for complete disinfection of the root canal system. Optimal conditions for ultrasound and nanobubbles were examined to deliver medicaments deeper to the dentinal tubules of root canals. Nanobubbles of 0.2-0.3 μm in diameter and with a final concentration of 5% were superior to those of 10 %, and a ultrasound voltage 30 V was superior compared with 31 V to deliver medicaments. The root canals of extracted dog's teeth were infected by GFP-labeled Enterococcus faecalis in the dentinal tubules for 72 hours, and then ultrasound treatment was performed. Disinfection was examined in sections, 150 μm in thickness, after 48 hours-cultivation by confocal laser microscopy. As a result, a significant reduction of GFP fluorescence was seen by application of medicaments into the root canal with ampicillin together with 5% nanobubbles and ultrasound at a voltage of 30 V for 120 seconds compared with medication alone or in conjunction with nanobubbles and ultrasound. These results suggested that medicaments could be delivered deeply in the dental tubules using nanobubbles together with ultrasound leading to disinfection of the intracanal space in a short time.

Journal

  • The Japanese Journal of Conservative Dentistry

    The Japanese Journal of Conservative Dentistry 54(6), 432-441, 2011

    The Japanese Society of Conservative Dentistry

References:  35

Codes

  • NII Article ID (NAID)
    110009419172
  • NII NACSIS-CAT ID (NCID)
    AN00191201
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    0387-2343
  • Data Source
    CJP  NII-ELS  J-STAGE 
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