JP7446099B2 - 歯の根管内および根管象牙細管内の感染治療用組成物 - Google Patents
歯の根管内および根管象牙細管内の感染治療用組成物 Download PDFInfo
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- JP7446099B2 JP7446099B2 JP2019221658A JP2019221658A JP7446099B2 JP 7446099 B2 JP7446099 B2 JP 7446099B2 JP 2019221658 A JP2019221658 A JP 2019221658A JP 2019221658 A JP2019221658 A JP 2019221658A JP 7446099 B2 JP7446099 B2 JP 7446099B2
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Description
抗菌剤と、ナノバブルとを含有しており、前記ナノバブルは、その表面がプラスに帯電したプラスナノバブルであることを特徴とする、歯の根管内および根管象牙細管内の感染治療用組成物。
組成物中に含有される表面がプラスに帯電したプラスナノバブルにより水の表面張力が小さくなり、水の浸透性が高くなる。プラスナノバブル水の浸透性が抗菌剤の抗菌作用と相乗的に作用することによって、歯の根管部の深部まで抗菌剤を行き渡らせることができ、歯および口腔内の感染を制御することができる。また、表面がプラスに帯電したプラスナノバブルを用いることにより抗菌効果に優れた歯の根管内および根管象牙細管内の感染治療用組成物となる。
スミヤー層を除去するための口腔内付着物の除去促進剤では、単にスミヤー層を除去するのみならず象牙質強度を保持する必要がある。なお、スミヤー層は、その一部が象牙細管内まで入り込み、この象牙細管内まで入り込んだスミヤー層はスミヤープラグ又はスミヤー栓と呼ばれることがある。
プラーク、バイオフィルム又は舌苔を除去するための口腔内付着物の除去促進剤では、ナノバブルを含有するゲルであるナノバブルゲルを適用する。ナノバブルゲルの粘度は、特に限定されるものではないが、例えば450Mpa・s以下である。ナノバブルゲルの粘度が高すぎると流動性が低下するため利便性が低下するおそれがあるからである。
1歳齢のイヌに全身麻酔を施した後、イヌ上下顎小臼歯部に抜髄処置を行い、根尖部まで#50~55で拡大した。5%次亜塩素酸ナトリウム溶液と3%過酸化水素水で交互洗浄後、さらに生理食塩水で洗浄した。根管口に綿球をおき、根管を開放状態にして1か月そのまま放置した。さらに、生理食塩水で洗浄後、ペーパーポイントで根管内を完全乾燥し、セメントとレジンにて完全に仮封した。4か月後、歯科用CT(CBCT・コーンビームCT)にて根尖部透過像により、感染根管が作製されたことを確認した(図1)。
上記の難治性感染根管に対して、まず、根管内の細菌数を段階希釈法にて2日間嫌気培養後、コロニーの数をカウントした。釣菌後の根管に6%次亜塩素酸ナトリウムと3%過酸化水素水にてそれぞれ計2mLずつ交互に洗浄を行い、さらに生理食塩水5mLにて根管を洗浄した。引き続き、滅菌ペーパーポイントにて根管内を乾燥し、最終濃度で0.006%w/vの抗菌ナノパーティクルを含有するマイナスナノバブル水あるいはプラスナノバブル水2mLを左側上下顎小臼歯の根管内に注入し洗浄を2分行った。右側上下顎小臼歯は最終濃度0.006%w/vの抗菌ナノパーティクルのみ2mLにて洗浄、あるいはプラスナノバブル水のみ2mLにて洗浄した。その後、左側はマイナスナノバブル水あるいはプラスナノバブル水5mLおよび生理食塩水5mLにて洗浄した。右側は生理食塩水のみ5mLにて洗浄した。ペーパーポイントで根管内を完全乾燥し、左側は洗浄と同様の抗菌ナノパーティクル・ナノバブル水、右側は抗菌ナノパーティクルのみあるいはナノバブル水のみをペーパーポイントに浸して根管内に挿入し、貼薬処置を行い、仮封した(図2参照)。
難治性根管治療開始時および根管治療開始後2か月から4か月のCBCT検査を行った。根尖部の透過像(図4A)をOsiriXプログラムにより画像解析し、体積を測定した。結果は開始前/開始後の体積比で表した。
その結果、抗菌ナノパーティクルのみを根管治療に用いた場合は2か月経過後1.2であり、4か月経過後1.5となり根尖病変の拡大がみられた(図4B)。プラスナノバブル水と抗菌ナノパーティクルを併用した場合、術前と比べて、根管治療開始後3か月の時点において、有意に根尖部の骨添加による根尖透過像(根尖病変)の縮小がみられた(**P<0.01)(図4D)。
(ナノバブル水の個数濃度・粒径分布測定・ゼータ電位測定)
4種類の溶液[50%プラスナノバブル水、50%マイナスナノバブル水、最終濃度0.2%グルコン酸クロルヘキシジンと50%ナノバブル水との混合物、0.2%グルコン酸クロルヘキシジン]をそれぞれ10mLずつ調製した。調製した溶液について、水中に存在する超微細気泡の個数濃度・粒度分布をナノサイトNS500およびZetaViewにより測定した。なお、実施例では、プラスナノバブル水はプラスナノバブル発生装置(NFPNC00003α、アクティベーションブラシ型、大平研究所(株)製)で空気と純水を用いて製造したナノバブル水を用いた。マイナスナノバブル水は歯科用ナノバブル発生装置 FOAMEST 8(登録商標、(株)ナック製)で空気と純水を用いて製造したナノバブル水を用いた。ナノバブル水の%は、ナノバブル発生装置で製造した原液の希釈液における割合を示している。
(ナノバブル水による根管象牙質細管浸透作用)
イヌ抜去歯前歯の擬似根管を#60まで根管拡大形成し、根尖をユニファスト(多目的常温重合レジン、製品名、(株)ジーシー製)にて閉鎖した。5%次亜塩素酸ナトリウム2mLおよび5mL生理食塩水で洗浄し、さらにスメアクリーン(3%EDTA水溶液、製品名、日本歯科薬品(株)製)を2分間根管内に適用し、4℃で生理食塩水内にて保存した。根管内をブローチ綿栓にて乾燥した。薬剤として、最終濃度0.006%(w/v)抗菌ナノパーティクル、0.2%グルコン酸クロルヘキシジン、0.02%塩化ベンザルコニウム、0.12%塩化セチルピリジニウム、最終濃度35μg/mLドキシサイクリン塩酸塩水和物を用いて、マイナスもしくはプラスナノバブル水と混合、あるいは薬剤単独(大塚蒸留水希釈)で用いた。さらに薬剤の浸透を検出するために、自家蛍光をもつテトラサイクリンを最終濃度5mg/mLで混合した。ピペットにて薬液を根管内に輸送して5分間適用し、根管象牙細管内に薬剤を浸透させた。生理食塩水にて洗浄後、ブローチ綿栓にて薬液を除去し、根管内を乾燥させた。歯は歯髄腔が平行になるように金属製の台にユーティリティーワックス(製品名、カボデンタルシステムズジャパン(株)製)、ユニファストIII(超速硬性常温重合レジン、製品名、(株)ジーシー製)にて固定した。ユニファストIIIが硬化したらゼーゲミクロトーム(製品名、来夏マイクロシステムズ(株)製)にて厚さ約300μmの切片標本を作製し、実体蛍光顕微鏡にて観察した。
(ブタ根管象牙質スミヤー層除去)
割りやすいように予めDisc(研磨ディスク)で切れ目を入れたブタ歯の擬似根管をKファイル(製品名、マニー(株)製)にて#70まで根管拡大形成し、5%次亜塩素酸ナトリウム2mL及び3%過酸化水素水2mLにて交互洗浄した。5mL生理食塩水でさらに洗浄、4℃で生理食塩水内にて保存した。薬剤として、0.2%グルコン酸クロルヘキシジン、0.12%塩化セチルピリジニウムを用いて、マイナスもしくはプラスナノバブル水、あるいは大塚蒸留水と混合し、9種類のスミヤー層除去剤2mLを5分間適用し、スミヤー層を洗浄した。生理食塩水にて洗浄後、抜歯柑子にて半分に割り、2%グルタールアルデヒドにて12時間固定し、30、50、70、90、100%エタノールにて脱水後、白金10kVにて蒸着した。蒸着は、マグネトロンスパッタ装置(製品名:MSP-20-UM、(株)真空デバイス製)を用いて導電膜蒸着(スパッターコーティング)により行った。その後、それぞれの標本を走査電子顕微鏡(製品名:VE9800、(株)キーエンス製)にて、根管中央部のところを観察した。
Claims (4)
- 抗菌剤と、ナノバブルとを含有しており、
前記ナノバブルは、その表面がプラスに帯電したプラスナノバブルであることを特徴とする、歯の根管内および根管象牙細管内の感染治療用組成物。 - 前記ナノバブルのゼータ電位がプラスである、請求項1に記載の歯の根管内および根管象牙細管内の感染治療用組成物。
- 前記プラスナノバブルの濃度が1×106~1×109個/mLであり、
前記プラスナノバブルの平均気泡径が10~300nmである、
請求項1または2に記載の歯の根管内および根管象牙細管内の感染治療用組成物。 - 前記抗菌剤が、抗菌ナノパーティクル、抗生剤、抗菌薬、抗真菌剤、抗ウィルス剤、根管拡大剤、抗炎症剤、創傷治癒や組織再生を促進する生理活性物質および幹細胞由来セクレトーム・エクソゾーム・miRNAからなる群のいずれか一つ以上を含む請求項1または2に記載の歯の根管内および根管象牙細管内の感染治療用組成物。
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JP2005245817A (ja) | 2004-03-05 | 2005-09-15 | National Institute Of Advanced Industrial & Technology | ナノバブルの製造方法 |
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JP2011157580A (ja) | 2010-01-29 | 2011-08-18 | Univ Of Shiga Prefecture | オゾン微細気泡の電解合成方法 |
JP2012217516A (ja) | 2011-04-05 | 2012-11-12 | Cogit:Kk | マッサージ用ローラ及びそれを用いたローラ式マッサージ器 |
JP2012217616A (ja) | 2011-04-08 | 2012-11-12 | Lion Corp | 口腔内ケアユニット |
JP2013180956A (ja) | 2012-02-29 | 2013-09-12 | Sunstar Engineering Inc | 殺菌剤組成物 |
WO2016084780A1 (ja) | 2014-11-24 | 2016-06-02 | 有限会社中島工業 | 患部浸透亢進性薬剤組成物 |
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JP2007518828A (ja) | 2004-01-29 | 2007-07-12 | ザ プロクター アンド ギャンブル カンパニー | 生物学的利用可能なレベルが増大した第四級アンモニウム抗菌剤を含む口腔ケア組成物類 |
JP2005245817A (ja) | 2004-03-05 | 2005-09-15 | National Institute Of Advanced Industrial & Technology | ナノバブルの製造方法 |
JP2011157580A (ja) | 2010-01-29 | 2011-08-18 | Univ Of Shiga Prefecture | オゾン微細気泡の電解合成方法 |
JP2012217516A (ja) | 2011-04-05 | 2012-11-12 | Cogit:Kk | マッサージ用ローラ及びそれを用いたローラ式マッサージ器 |
JP2012217616A (ja) | 2011-04-08 | 2012-11-12 | Lion Corp | 口腔内ケアユニット |
JP2013180956A (ja) | 2012-02-29 | 2013-09-12 | Sunstar Engineering Inc | 殺菌剤組成物 |
WO2016084780A1 (ja) | 2014-11-24 | 2016-06-02 | 有限会社中島工業 | 患部浸透亢進性薬剤組成物 |
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