临床常用根管冲洗液去除根管玷污层的 研究进展
Research Progress on Removal of Root Canal Smear Layer by Clinical Common Root Canal Irrigants
DOI: 10.12677/acm.2026.1662469, PDF,   
作者: 孙小茜, 毕文娟, 杨鑫旭：华北理工大学口腔医学院，河北 唐山；李崴嵬*：唐山市工人医院口腔科，河北 唐山
关键词: 根管冲洗液；玷污层；EDTA；次氯酸钠；有机酸；Root Canal Irrigants； Smear Layer； EDTA； Sodium Hypochlorite； Organic Acids
摘要: 根管治疗的核心在于彻底清除感染与玷污层，提升根管消毒及充填效果。玷污层为根管机械预备后形成的有机–无机结构复合层，可阻碍消毒药物渗透并影响封闭剂粘接效果。根管冲洗是去除玷污层的关键手段，不同类型冲洗液的作用机制与效果存在明显差异：乙二胺四乙酸(EDTA)、次氯酸钠为临床常用传统根管冲洗液，前者可螯合钙离子，去除无机成分，后者能溶解有机组织，但单一溶液难以实现全面清洁；MTAD、QMiX、SmearClear等复合制剂兼具螯合与抗菌作用，效果稳定且适用性更广；有机酸类冲洗液生物相容性良好，去除根尖1/3区域玷污层优势显著。本文对各类根管冲洗液去除玷污层的效果、特点及临床应用进行综述，为临床合理选择冲洗方案提供参考。
Abstract: The core of root canal therapy lies in thoroughly eliminating infections and smear layers to improve the efficacy of root canal disinfection and obturation. The smear layer is an organic-inorganic composite layer formed after mechanical root canal preparation, which hinders the penetration of disinfectants and impairs the bonding effect of sealers. Root canal irrigation serves as a key method to remove the smear layer, and distinct differences exist in the mechanisms and effects of different irrigants. Ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite are conventional clinically used root canal irrigants. EDTA chelates calcium ions to remove inorganic components, while sodium hypochlorite dissolves organic tissues, yet a single irrigant fails to achieve thorough cleansing. Compound preparations such as MTAD, QMiX and SmearClear possess both chelating and antibacterial properties with stable effects and wide applicability. Organic acid irrigants feature favorable biocompatibility and exert prominent advantages in removing the smear layer in the apical one-third region. This paper reviews the efficacy, characteristics and clinical applications of various root canal irrigants in smear layer removal, aiming to provide references for rational selection of irrigation protocols in clinical practice.
文章引用：孙小茜, 毕文娟, 杨鑫旭, 李崴嵬. 临床常用根管冲洗液去除根管玷污层的 研究进展[J]. 临床医学进展, 2026, 16(6): 2461-2471. https://doi.org/10.12677/acm.2026.1662469

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