- 期刊
現今使用牙根表面處理之爭議性
Current Controversy in Root Conditioning
摘要
受到牙周病所影響的牙根表面常存在有大量的細菌與內毒素。這些污染源是相當不利於牙周組織的修復與再生的過程。根據文獻報告，只利用結石刮除與牙根整平（Sc/RP）的機械性方式，是很難有效的將牙根表面之內毒素完全去除。因此利用化學藥劑來處理牙根表面，被證實可以獲得更佳的生物相容性。這些藥劑包括了phosphoric acid, citric acid, tetracycline-HC1, ethylenediaminetetraacetic acid (EDTA)等等。在過去的20年來，一系列的活體外（in vitro）與動物之相關實驗，證實了牙根表面處理（root conditioning）過後的牙根表面具有許多的優點，並且可以增進新附著形成（new attachment formation）。然而在人體上的臨床實驗，有無施行牙根調理對於術後結果似乎是沒有多大影響。究竟這問題出在哪？活體外／動物實驗與實際臨床不同環境下，牙根表面處理效果為何有如此之差異性？臨床上牙根表面處理究竟需不需要採用？這些問題，也期待更進一步的研究來解開這使用上的爭議性。
並列摘要
Root surfaces of periodontally affected teeth ale usually contaminated by bacterium and their endotoxin, and these contaminations jeopardize the outcome of periodontal repair/ regeneration. According to the literature reports, mechanical instrumentation by the scaling and root planing alone can't completely eliminate the bacterial endotoxin from the root surface. Therefore, it has been proposed to chemically condition the contaminated root surface that can improve the root compatibility. A number of agents have been used conjunction with de-mineralization/ new attachment procedures, including phosphoric acid, citric acid, tetracycline-HCI, EDTA etc. Within the past 20 years, many series of in vitro and animal studies usirg the chemically root conditioning have suggested its potential usefulness. However, it seems that there was no statistically significant improvement of clinical treatment outcome in conjunction with chemically root conditioning procedures. Thus, future studies are still needed to shed more light about the differences in the root conditioning procedures used between in vitro/ animal and clinical situations to get the better clinical outcome.