喷砂、漂白对托槽去粘结后牙面作用的探讨

发布时间：2018-06-24 15:53

本文选题：正畸 + 漂白　；参考：《第二军医大学》2016年硕士论文

【摘要】：背景目的:固定正畸后牙齿表面颜色的变化,往往影响患者对正畸后的总体效果评价。临床上较多的固定正畸后患者,因牙齿颜色不满意,而要求进行改善牙齿颜色的美容治疗。关于固定正畸前后的颜色变化已有相关文献报道。而对引起固定正畸后牙齿颜色变化相关原因及相关治疗方法的研究报道较少。因此,本课题将应用离体牙模拟固定正畸托槽粘结和去粘结的过程,来分析和探讨不同粘结剂种类以及不同治疗方法对牙齿表面粗糙程度和颜色的影响,为固定正畸后变色牙的预防和治疗提供参考。方法:1.选择A2色离体牙117颗,分成A组(化学固化树脂粘结托槽)、B组(光固化树脂粘结托槽)、C组(未粘结托槽)各39颗。3组样本浸泡在水中,恒温37°,2天。2天后,A组、B组离体牙进行托槽拆除去粘结,3组各随机选择3颗离体牙进行扫描电镜观察。2.将剩余A组、B组、C组每组36颗,人工染色剂浸泡7天,染色前后离体牙颊面中1/3分别进行分光光度计测色,记录明度值L*、红绿色值a*、黄蓝色值b*。3.染色后A组、B组、C组,每组分别随机分成喷砂组、漂白组、空白对照组3个亚组,每组各12颗离体牙。喷砂组:喷砂机距离牙面3mm成45°角喷砂20s。漂白组:牙面涂抹35%过氧化氢漂白剂2-3mm厚,冷光美白仪工作灯光照3次,每次10min。空白对照组:未处理。在喷砂、漂白处理后分别分光光度计测色,记录L*、a*、b*值。4.在A组、B组、C组中随机选择喷砂、漂白处理后离体牙各3颗,进行扫描电镜观察。结果:1.扫描电镜观察结果:(1)A组、B组、C组托槽去粘结后的表面粗糙程度结果:A组㧐B组㧐C组。(2)A组、B组、C组着色牙,不同处理后的牙面粗糙程度结果均是:喷砂㧐漂白㧐空白对照。喷砂后和漂白后A组、B组、C组的粗糙程度结果均是:B组㧐A组㧐C组。2.颜色参数测量结果(1)A组、B组、C组离体牙在染色处理后,L*值均减小,a*、b*值均增大。三组两两比较,a*、b*的变化量及色差(Δa*、Δb*、ΔE)均有差异,A组㧐B组㧐C组。A组、B组L*的变化量(ΔL*)差异无统计学意义,C组与A组、B组的差异均有统计学意义,A组、B组㧐C组。(2)甲因素粘结剂种类(A组、B组、C组)、乙因素处理方法(喷砂、漂白、空白对照)对牙齿颜色的ΔL*、Δa*、Δb*、ΔE均有影响,除了粘结剂种类对ΔL*无影响,且两因素间有交互作用。A组、B组、C组两两比较,A组与B组的△a*、△b*、△E均无统计学差异,而A组与C组、B组与C组均有统计学差异,且C组㧐A组、B组。喷砂、漂白、空白对照两两比较,其△L*、△a*、△b*、△E均有统计学差异,且漂白喷砂空白对照。C组漂白后△L*、△a*、△b*、△E的值均最大。喷砂和漂白后L*值升高,a*、b*值降低。结论:1.在本实验条件下,不同托槽粘结剂对去粘结后牙面粗糙程度和颜色的影响不同,光固化树脂粘结剂组的粗糙程度小且不易染色,可减少托槽去粘结后牙齿变色的发生。2.不同托槽粘结剂的应用与喷砂或漂白处理后牙面的粗糙程度相关,化学固化树脂粘结剂组喷砂或漂白后的粗糙程度均小于光固化树脂粘结剂组。3.喷砂、漂白的应用增加了各组牙面的粗糙程度,但颜色得到了改善,其中漂白的短期效果明显优于喷砂。4.初步建议临床选择化学固化树脂粘结剂用于托槽粘结,漂白用于美化托槽去粘结后牙面颜色,并应用抛光技术巩固疗效,为固定正畸后牙齿颜色美容提供参考。
[Abstract]:Background Objective: the changes in the color of the tooth surface after fixed orthodontics often affect the overall effect evaluation of the patients after orthodontics. The patients with more fixed orthodontics in clinical practice require cosmetic treatment to improve the color of the teeth because of the unsatisfactory color of the teeth. The related literature on the color changes before and after the fixed orthodontics has been reported. There are few reports on the related causes of tooth color change and related treatment methods after orthodontic orthodontics. Therefore, this topic will be used to simulate the process of bonding and disbonding of fixed orthodontic brackets in vitro, to analyze and discuss the effects of different kinds of adhesives and different treatments on the surface roughness and color of teeth, for fixed orthodontic orthodontics. To provide reference for the prevention and treatment of discoloration teeth. Methods: 1. select 117 A2 color isolated teeth, divided into A group (chemical curing resin bonding bracket), group B (light cured resin bond brackets), 39.3 group samples of group C (unbonded brackets) in water, constant temperature 37 degrees, 2 days.2 days, A group, B group tooth with bracket dismantling to bond, the 3 groups were randomly selected. 3 isolated teeth were examined by scanning electron microscopy (SEM) to observe the remaining A group, group B, group C and group C for 7 days and 7 days by artificial colorant. The brightness value L*, red green value a*, A group, B group, C group were randomly divided into the sandblasting group, the bleaching group and the blank group respectively. Group 3 subgroups, each group of 12 teeth. Sandblasting group: sandblasting machine from the tooth surface 3mm into 45 degree angle sandblasting 20s. bleaching group: tooth surface smear 35% hydrogen peroxide bleaching agent 2-3mm thick, cold light whitening instrument lighting 3 times, every time 10min. blank control group: no treatment. After the sandblasting, bleaching, respectively spectrophotometer test color, record L*, a*, b* value.4. in.4. in In group A, group B and group C, random selection of sand spraying and 3 isolated teeth after bleaching were observed by scanning electron microscope. Results: 1. scanning electron microscope observation results: (1) the surface roughness of group A, B group and C group after bonding: A group B group? C group. (2) A group, B group, C group tooth roughness results were all: sandblasting? Bleach? Empty results after different treatment After and after bleaching, the results of the roughness of group A, B group and C group were all: B group? A group? C group.2. color parameter measurement results (1) A, B group and C group, L* value decreased, a*, and chromatic difference (Delta, Delta, delta) were all different. There was no statistical significance in the difference of the quantity (delta L*). The difference between group C and group A and group B had statistical significance, group A, B group and C group. (2) the type of a factor adhesive (A, B, C), and the B factor treatment (sandblasting, bleaching, blank control) had influence on the tooth color Delta L*, Delta a*, Delta and delta, except for the type of adhesive, and there were two factors. There were no statistical differences between group.A, group B and group C 22, Delta a*, Delta b*, and E in group A and B group, while A group and C group, B group and C group were statistically different. The values of delta b* and delta E were both maximum. The L* value increased after sandblasting and bleaching, and a* and b* value decreased. Conclusion: 1. under the conditions of this experiment, different bracket adhesives have different effects on the roughness and color of the tooth surface, and the roughness of the light cured resin binder group is small and not easy to stain, which can reduce the difference of the tooth discoloration after the brackets are bonded to.2.. The application of the bracing binder is related to the roughness of the tooth surface treated with sand blasting or bleaching. The roughness of the chemical curing resin binder group is less than that of the.3.. The application of bleaching increases the roughness of each tooth surface, but the color is improved, and the short-term effect of bleaching is obvious. Better than sandblasting.4., it is suggested that the clinical selection of chemically cured resin binder is used for the bonding of brackets, and bleaching is used to beautify the color of the tooth surface of the brackets, and to consolidate the curative effect by using the polishing technique, and provide a reference for the fixation of orthodontic tooth color beauty.
【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R783.5

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