JP3463985B2 - Dental tooth surface treatment agent - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention is applied to root canal treatment, periodontal disease treatment and restorative treatment in the field of dentistry, and is a cutting waste generated on a dentin cutting surface when mechanically shaving the tooth structure. , A dental tooth surface treatment agent for dissolving and removing a so-called smear layer.

[0002]

2. Description of the Related Art In dental treatment, a treatment for mechanically cutting an infected tooth substance, so-called caries or pulp, to remove an infection source is carried out.

[0003] In the repair treatment in which the infected tooth substance is removed by cutting and filled with an artificial material such as metal, ceramic or resin, when the infection reaches the pulp, the source of infection in the root canal or root canal ivory After cutting and expanding the quality, root canal disinfection and root canal filling, as well as periodontal disease treatment that grinds the tooth surface to remove tartar adhered to the root surface, ivory It is known that cutting and polishing a textured surface forms cutting debris called a smear layer on the dentin surface. (The Quintessence, Volume 15, 44)
6-448, 1996) Needs root canal treatment. The root canal of the tooth is filled with tissue pieces, necrotic pieces, bacteria and toxins produced there, and decay products, and root canal wall dentin also causes inflammation. Contaminated with sexual irritants, these sources of infection need to be eliminated. The purpose of this root canal treatment is to sterilize the root canal and prevent reinfection of the tissues around the apex of the root.
It is roughly divided into three processes of root canal filling. Above all, root canal enlargement is an important surgical method for achieving successful root canal treatment. And
After enlarging the root canal, the source of infection is eliminated by mechanically cleaning and expanding the root canal using a small device such as a file or reamer.

Particularly in the case of an infected root canal, bacteria remain in the smear layer or bacteria invade the dentinal tubules immediately below the smear layer. Therefore, if the smear layer is not completely removed, This may impede the penetration of the next germicidal cleaning solution or root canal disinfectant, making it impossible to sterilize the inside of the root canal, which may adversely affect the prognosis after root canal treatment.

By the way, the idea that "the smear layer should be removed" is prevailing in any of the above treatments, and various drugs and methods have been studied so far. For example, ultrasonic cleaning with sterilized water and cleaning with an aqueous solution of sodium hypochlorite are carried out, but the smear layer cannot be completely removed by this cleaning. In addition, acidic phosphoric acid, citric acid, phenolsulfonic acid, polyacrylic acid, etc. have also been used. In this case, although the smear layer can be completely removed, irritation to the tissue when it overflows outside the apical foramen There is concern about sex. In addition, a high concentration of organic acid may be used, but this may be a disadvantageous factor because it causes crystal deposition in the root canal.

Therefore, as the smear layer removing agent, a 15 to 17 wt% aqueous solution of ethylenediamine-4acetic acid (hereinafter referred to as EDTA) adjusted to neutral (pH 7.3) is currently most widely used. . This EDTA is advantageous because it reacts with the calcium ions of the cut dentin to form a soluble calcium chelate.

However, the smear layer removing agent using EDTA also has a therapeutic problem. For example, some commercially available products are gels or pastes containing urea peroxide and neutral EDTA, but this has poor penetrability and diffusion, and removes the smear layer near the narrowed apex. This is a problem that the thickener component remains on the root canal wall after cleaning, which is not possible.

Regarding the form of the root canal, the central part of the root is wide and the root apex is narrow, and a large amount of dentin cutting powder remains in the root apex after mechanically expanding the root canal. Therefore, a sufficient amount of the drug solution does not reach the apex and the smear layer may be incompletely removed. Neutral EDTA reduces the chelating ability, that is, the smear layer removing ability, by reacting with calcium ions of cutting dentin. Therefore, in clinical operation,
Attempts have been made to pump small instruments in a root canal filled with a large amount of drug solution and to maintain the effect by exchanging drug solution, refluxing and stirring. However, the removal of the smear layer was incomplete with an aqueous solution of EDTA having a low concentration of 15 to 17% by weight or less, which has been conventionally considered effective.

[0009]

The problem to be solved by the present invention is to obtain a sufficient smear layer removing effect by applying a small amount without exchanging a chemical solution and without physically refluxing or stirring. The present invention provides a dental surface treatment agent for dental use.

[0010]

The dental tooth surface treating agent of the present invention is characterized in that it contains a chelating agent consisting of an aminocarboxylic acid and the pH value of its aqueous solution is 8.5 or more.

Aminocarboxylic acids include ethylenediamine-4acetic acid (EDTA) and hydroxyethylimino-
Diacetic acid (HIDA), dihydroxyethylglycine (D
HEG), nitrilo-3-acetic acid (NTA), hydroxyethylethylenediamine-3acetic acid (HEDTA), diethylenediamine-5-acetic acid (DTPA), triethylenetetramine-6-acetic acid (TTHA) selected from one or more. Can be used.

The concentration of the aminocarboxylic acid in the aqueous solution is 1 in view of the ability to remove the smear layer and the prevention of recrystallization in the aqueous solution.
~ 30% by weight can be applied, but in actual use 3 ~
Even a low concentration of 10% by weight is sufficiently effective. If aiming at cost reduction, 3 to 5% by weight is a preferable concentration.

The tooth surface treating agent of the present invention is preferably in the form of an aqueous solution from the viewpoint of its permeability into the smear layer, but it may be used in the form of gel.

The pH of the aqueous solution of aminocarboxylic acid
The value must be 8.5 or more from the viewpoint of the smear layer removing ability.

As the alkalizing agent used for adjusting the pH value to 8.5 or more, any salt can be used as long as it is a water-soluble salt formed by reacting with an aminocarboxylic acid, for example, sodium hydroxide and potassium hydroxide. , Lithium hydroxide and the like, and alkali metal hydroxides. Of course, all the alkali solutions such as alkali metal oxides and carbonates are included.

Even if an alkali metal salt of aminocarboxylic acid such as EDTA-2 sodium is used as a starting material, the same effect can be obtained if the pH is adjusted to 8.5 or more.

[0017]

BEST MODE FOR CARRYING OUT THE INVENTION As an embodiment of the dental tooth surface treatment agent of the present invention, an example applied to root canal treatment will be described. After enlarging the root canal opening, the root canal cleaned and expanded with a file and a reamer is filled with the drug solution of the present invention using a syringe with an injection needle. After leaving for 2 minutes, wash with water or 6
After alternate cleaning with 10% sodium hypochlorite and 3% hydrogen peroxide solution, the inside of the root canal is dried with a paper point, and a series of surgical procedures such as root canal disinfection are performed. When the ultrasonic cleaning device is used together when applying the chemical liquid of the present invention, the treatment time of the chemical liquid is shortened, and the smear layer can be completely removed to the vicinity of the apex in about 1 minute.

[0018]

EXAMPLE 1 Disodium EDTA was dissolved in purified water, 5N-sodium hydroxide aqueous solution was added while carefully measuring the pH value with a pH meter, and each pH was adjusted as shown in Table 1. A 3% EDTA solution with adjusted values was prepared.

[0019]

[Table 1] The root canal length was measured after confirming that the K file of No. 15 reached the apical foramen in advance by expanding the medullary cavity of a human extracted tooth that had not been treated with a root canal and was stored in water. Then 1m from the root canal length
The shortened length was set as the working length, and root canal enlargement was performed by a full-circle filing method using a K file from No. 15 to No. 60 in a physiological saline bath. After completion of root canal expansion, alternate washing with 5% sodium hypochlorite and 3% hydrogen peroxide solution was performed, and each EDTA solution shown in Table 1 was fed into the root canal with an endontic syringe.
It was left to act for 2 minutes. After that, the inside of the root canal was dried with a cotton plug, a scoring line was placed in the mesio-distal direction using a disc, and the test tooth was divided by a chisel and mallet to expose the root canal wall surface.

The sample was vapor-deposited with platinum, and the state of smear layer removal on the root canal surface at the root canal, root canal, and root apex was observed by a scanning electron microscope.

Table 2 shows the state of smear layer removal by the treatment solutions having the pH values shown in Table 1. 3% EDTA with pH 9.0 or above
With the solution, the smear layer was removed in all of the root canal, the central part of the root canal, and the apex of the root, and good results were obtained.

On the other hand, 3% ED having a pH of 8.0 or less
In the TA solution, the smear layer was removed at the root canal and the central part of the root canal, but the apical smear layer could not be removed at all. In addition, as a comparative example, when only physiological saline and alternate cleaning (sodium hypochlorite + hydrogen peroxide solution) were used, the smear layer was not removed at all observation points, and dentinal tubules could not be confirmed and smear layers were not observed. It was covered.

As a result, the pH values are 8.0 and 9.0.
It can be seen that there is a critical value that completely removes the smear layer between.

[0024]

[Table 2] Example 2 The same test as in Example 1 was carried out by adjusting the pH value of each 17% EDTA solution in the same manner as in Example 1 and shortening the treatment time to 1 minute.

Table 3 shows the test results. Under the treatment condition of 1 minute, when the pH value was 7.3, the root apex smear layer was not removed, and the removability was improved by increasing the pH value. At pH 8.5, although a part of the smear layer remained, it was confirmed that the smear layer was removed. At pH 9.5, good removability was confirmed for all aminocarboxylic acids except EDTA. This gives a pH value of 8.5.
From the above, it can be seen that there is a critical value for completely removing the smear layer.

[0026]

[Table 3]

[0027]

The dental tooth surface treating agent for removing the dentin smear layer of the present invention is a p-type aqueous solution of aminocarboxylic acid.
By changing the H value to 8.5 or more, even at the apex where a large amount of dentin cutting powder remains, a large amount of chemical liquid, pump movement by small instruments, exchange of chemical liquid, reflux and stirring are unnecessary. The smear layer can be removed in a relatively short time without performing any work.

Many cases actually encountered in clinical practice are complicated, and the dental tooth surface treatment agent of the present invention is expected to be a tooth surface treatment agent capable of removing the smear layer more reliably. Suitable for

─────────────────────────────────────────────────── --- Continuation of the front page (56) References JP-A-1-279815 (JP, A) JP-A-1-90108 (JP, A) JP-A-1-45308 (JP, A) JP-A-6- 122608 (JP, A) JP-A 1-230510 (JP, A) JP-A 1-230509 (JP, A) JP-A 60-2245 (JP, A) JP-A 6-107514 (JP, A) JP-A-61-183203 (JP, A) Special table 10-511638 (JP, A) Special table 10-505859 (JP, A) Special table 9-512565 (JP, A) (58) Fields investigated (Int.Cl. ⁷ , DB name) A61K 6/00-6/10

Claims (2)

(57) [Claims] 1. A dental tooth surface treating agent for removing a smear layer after cutting a dentin surface, wherein the dental tooth surface treating agent contains a chelating agent composed of an aminocarboxylic acid and has a pH value. Is 8.5 or more, a dental tooth surface treatment agent. 2. The aminocarboxylic acid is ethylenediamine-
Tetraacetic acid, hydroxyethylimino-2acetic acid, nitrilo-
Triacetic acid, hydroxyethylethylenediamine-3acetic acid,
The dental tooth surface treating agent according to claim 1, which is one or two or more selected from the group consisting of diethylenediamine-5-acetic acid and triethylenetetramine-6-acetic acid.