护牙素联合氟保护漆促进超声洁牙术后牙体硬组织形态恢复的研究

发布时间：2018-02-01 19:16

本文关键词： 护牙素氟保护漆粗糙度牙本质小管扫描电镜　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景牙周病是口腔的常见病和多发病,轻者出现牙龈红肿,出血,重者牙槽骨吸收、破坏,最终导致牙齿松动,脱落。这会严重影响患者的生活质量,那么,临床上医生怎么来预防这样的问题发生呢?通常医生会建议人们定期对牙齿进行“洗牙”,目前,超声洁牙已经成为人们普遍接受的口腔保健措施,它能高效、快速的对牙结石、黄牙、烟瘢等洗后即可看见显著的效果,不需要麻药就可以完成。但是洁牙后常常会出现一个现象,即超声洁治后牙面较粗糙而且敏感,如不做处理,牙面再着色会更快、更严重并且牙齿敏感不适。目前单纯的抛光对减轻牙面粗糙程度的作用是有限的,对患者敏感的缓解也较低,很难达到满意的临床效果。如何弥补抛光技术存在的缺陷,改善洁牙后牙面的粗糙程度、延缓菌斑、牙结石及色素的沉着的同时改善患者的牙齿敏感,是口腔预防保健工作者急切需要解决的问题。所以本研究在已有研究的基础上,提出“医生干预与患者干预”相结合,局部涂氟与家庭使用护牙素双管齐下的思路,通过建立超声洁牙术后模型,氟保护漆与护牙素进行干预,最后通过扫描电镜、粗糙测试仪、色差分析仪等观察牙釉质、牙本质的改变来探讨氟保护漆与护牙素联合促进超声洁牙术后牙硬组织面表面恢复的作用。本研究分为两部分:第一部分:护牙素联合氟保护漆对超声洁牙术后牙釉质的影响目的:了解超声洁牙术后,联合使用护牙素和氟保护漆对牙釉质表面形态恢复的作用。方法:收集因正畸拔除的健康前磨牙,随机分成A、B、C、D四个组,进行超声洁治后,A组不进行干预,B组进行氟保护漆干预,C组涂布护牙素干预,D组用护牙素联合氟保护漆进行干预,然后在不同时间段进行釉质表面粗糙度的测定、扫描电镜观察以及不同组再着色实验后行色差分析。结果:粗糙度结果显示,超声洁牙后各组的粗糙度值随时间逐渐降低,其中干预组下降较明显,5天后,联合干预组较单独干预组的粗糙度值下降更加明显,差异有统计学意义(P0.05);扫描电镜可观察到超声洁治后,各组牙釉质表面见较深划痕,干预后釉质表面超微结构都有改善,其中护牙素组、氟保护漆组和二者联合组改善较对照组明显,而联合组改变最为明显;外源性染色观察牙面着色,干预组比未干预组着色浅,在干预的3组中,护牙素联合氟保护漆组的术区着色最浅;牙面染色的定量分析可知,外源性染色前后比较,各干预组牙面的染色数值较染色前降低,差异有统计学意义(P0.05),组间比较,联合干预组的染色值最低(P0.05)。结论:护牙素联合氟保护漆比单独使用其中之一能更好地促进超声洁牙后牙釉质表面形态的复原。第二部分:护牙素联合氟保护漆对超声对洁牙术后牙本质的影响目的:了解护牙素联合氟保护漆对超声对洁牙术后牙本质小管的封闭作用。方法:收集因正畸拔除的健康前磨牙,制备成牙本质小块,随机分成A、B、C、D四个组,A组不进行干预,B组进行氟保护漆干预,C组涂布护牙素干预,D组用护牙素联合氟保护漆进行干预,然后在不同时间点用扫描电镜观察牙表面形态结构,再分别进行各组的封闭率比较。结果:扫描电镜可观察到,B、C、D三组干预后均能有效的封闭牙本质小管。其中干预7天后,联合干预组比其它干预组对于牙本质小管的封闭率都高,差异有统计学意义(P0.05),在干预14天后,B、C、D组对牙本质封闭率都较高,差异无统计学意义。结论:护牙素和氟保护漆均能有效的封闭小本质小管,短期内联合使用封闭效果更佳。
[Abstract]:Background periodontitis is a common disease, mild gum swelling, bleeding, absorption, severe alveolar bone destruction, eventually leading to loosening of the teeth off. This will seriously affect the quality of life of patients, so clinical doctors how to prevent such problems occur? Usually doctors would advise people regularly the teeth "Scaling", at present, has become the ultrasonic dental oral health is generally accepted by people, it can efficiently, the dental calculus, yellow teeth fast, so you can see the smoke scar after washing effect, without anesthetic can be completed. But after scaling often appears a phenomenon called ultrasonic scaling the teeth surface is rough and sensitive, if not treated, the tooth surface coloring will be faster, more serious and sensitive teeth discomfort. Simple polishing is limited to reduce the tooth surface roughness effect on corrosion sensitive patients at present The solution is low, it is difficult to achieve a satisfactory clinical effect. How to compensate for the defects of existing polishing technology, improve the surface roughness of dental plaque, delay, dental calculus and pigment deposition and improve the patient's sensitive teeth, oral health care workers is an urgent need to solve the problem. So the Study on the research foundation the doctor put forward, intervention and intervention in patients with combination of topical fluoride and family use tooth mousse two pronged idea, through the establishment of ultrasonic curettage after model, teeth and supporting fluoride varnish in the intervention by the SEM, roughness tester, color analyzer to observe the enamel, dentin to explore the change of teeth and supporting fluor protector combined with ultrasonic dental hard tissue promoting posterior surface recovery. This research is divided into two parts: the first part: tooth element combined with fluoride varnish on the super Objective to influence postoperative tooth enamel sound: To investigate the ultrasonic curettage after the combined use of tooth mousse and fluoride varnish on enamel surface morphology recovery. Methods: premolars extracted for orthodontics, were randomly divided into A, B, C, D four groups of group A after ultrasonic scaling, intervention group B fluoride varnish intervention group C coating dental care interventions, group D combined with fluoride varnish dental care intervention, then the determination of enamel surface roughness at different time, scanning electron microscope and different groups after the experiment Xingse coloring difference analysis. Results: the roughness results show that the roughness of ultrasonic scaling group decreases with time, in the intervention group decreased significantly, after 5 days, the roughness of joint intervention group than in the intervention group decreased more significantly, the difference was statistically significant (P0.05); scanning electron microscope can be observed in ultrasonic cleaning After treatment, the enamel surface see deep scratches, after the intervention of the enamel surface ultrastructure had improved, the tooth element group, fluoride varnish group and the two combined group improved significantly compared with the control group, and combined group the most obvious changes were observed; exogenous tooth surface coloring, the intervention group than non intervention group light color, 3 in the intervention group, dental care combined with fluoride protection paint operation area were the most shallow; the quantitative analysis of tooth surface staining, exogenous staining before and after comparison, the intervention group decreased value of tooth surface staining than before staining, the difference was statistically significant (P0.05), comparison between groups, staining the joint intervention group was the lowest (P0.05). Conclusion: tooth combined with fluoride varnish than using one of them can better promote the enamel surface morphology after ultrasonic dental restoration. Second separate parts: tooth combined with fluoride varnish on the ultrasonic curettage effect on dentin. : understanding the tooth element combined with fluoride varnish in the closed ultrasonic curettage of dentinal tubules. Methods: premolars extracted for orthodontics, prepared dentin pieces, were randomly divided into A, B, C, D four group, A group without intervention, B group of fluoride the intervention group C paint, coating dental care interventions, D group with combined tooth mousse fluoride varnish to intervene, then at different time points by scanning electron microscopy of tooth surface morphology, were compared. Results: the closure rate of each group were detected by scanning electron microscope, B, C, D three groups all the tubules closed dentin effectively. In the intervention 7 days, treatment group was better than the other intervention group for dentinal tubule occlusion, the difference was statistically significant (P0.05), in 14 days after the intervention, B, C, D group of dentin sealing rate is higher, the difference was not statistically significant. Conclusion: tooth mousse and fluoride varnish Can close small tubules effectively in the short term, the combined use of sealing effect is better.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783

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