目的 比较根管治疗一次法和两次法清除慢性根尖周炎患牙根管内细菌的能力.方法 慢性根尖周炎患者100例共100个牙,随机分为一次法组和两次法组,分别在根管预备前、预备后(封药后)取样做细菌培养,对比两组根管预备前后菌落数的变化.取根管预备后(封药后)的样本,提取细菌DNA, PCR扩增,测序,确定细菌的种属进行比较.结果 比较一次法组根备后和二次法组封药后菌量,差异无统计学意义(P>0.05).两组根管内的口腔链球菌、嗜酸乳杆菌、粪肠球菌、内氏放线菌、厌氧消化链球菌、中间普雷沃菌的检出差异无统计学意义(P>0.05),但两次法组的具核梭杆菌和牙龈卟啉单胞菌检出率高于一次法组,差异有统计学意义(P<0.05).结论 根管治疗两次法并不能明显降低感染根管内细菌的数量和种类,与一次法的疗效不存在明显差异.%Objective To compare the ability of single-visit RCT and 2-visit RCT to remove bacteria in infected root canal. Methods There were 100 patients with chronic periapical periodontitis who were randomly divided into single-visit group and 2-visit group. Bacteria culture was taken before and after the root canal preparation(or after disinfection).The change of colony number before and af-ter the preparation of two groups was compared. The sample after preparation(or after disinfection)was taken,DNA was extracted from bacteria,PCR was amplified,and the sequence was detected to identify bacterial species. Results Comparing the amount of bacteria of single-visit group(after preparation)with 2-visit group(after disinfection), the difference was not statistically significant. There was no significant difference between the two groups in Streptococcus oralis,Lactobacillus acidophilus,Enterococcus faecalis,Actinomyces naeslundii,Peptostreptococcus anaerobius,and Prevotella intermedia(P>0.05). However, the detection rates of the Fusobacterium nucleatum and Porphyromonas gingivalis in 2-visit groups were higher than those in single-visit group,and the difference was statistical-ly significant(P<0.05). Conclusion 2-visit RCT cannot reduce the number and species of bacteria significantly. There is no signifi-cant difference between two methods.
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