皆さん、こんにちは。

今回は根管洗浄に関する文献です。

Local wound debridement in the diseased pulp space is the main step in root canal treatment to prevent the tooth from being a source of infection. In this review article, the specifics of the pulpal microenvironment and the resulting requirements for irrigating solutions are spelled out. Sodium hypochlorite solutions are recommended as the main irrigants. This is because of their broad antimicrobial spectrum as well as their unique capacity to dissolve necrotic tissue remnants. Chemical and toxicological concerns related to their use are discussed, including different approaches to enhance local efficacy without increasing the caustic potential. In addition, chelating solutions are recommended as adjunct irrigants to prevent the formation of a smear layer and/or remove it before filling the root canal system. Based on the actions and interactions of currently available solutions, a clinical irrigating regimen is proposed. Furthermore, some technical aspects of irrigating the root canal system are discussed, and recent trends are critically inspected.（略）

Finally, it should be mentioned that the irrigating concepts presented here are aimed at obtaining a clean root canal system that is ideally prepared for the classic filling technique, using guttapercha and a sealer. In the future, other ways to fill root canal systems may evolve and/or be established, such as the use of resinbonded systems (175), bioactive materials (176), or even the attempt to regenerate pulp tissue in necrotic cases (177). Although radical changes in the irrigating concept are not likely to occur, the specific needs for irrigants when such alternative attempts are followed are yet to be delineated.

つまり

根管洗浄剤にもヒポクロやクロルヘキシジンやH2O2など

色々ありますが、現在もまだどれが最適か

討論が続いているということです。

しかし、今後根充にレジンボンディングや歯髄再生療法

など新しい方法が開拓されるに従い

根管洗浄法も進化していくだろうということです。

引用文献

Zehnder M.

Root canal irrigants.

J Endod. 2006 May;32(5):389-98.