离体牙不同抛光方法扫描电镜观察及吸烟患者洁治后临床效果观察
发布时间：2018-07-25 18:40
【摘要】：目的:1通过扫描电镜观察洁治抛光后釉质表面划痕及光滑度,比较不同方法对洁治后离体牙表面的抛光效果;2通过短期临床观察吸烟患者超声洁治+矽粒子抛光后,牙面菌斑、色素状况,比较不同吸烟量人群洁治后临床效果,探讨吸烟对牙面清洁度的影响。为吸烟患者选择恰当的洁治间隔时间,对吸烟患者进行戒烟宣传教育提供理论依据和临床数据参考。方法:实验一制备釉面光滑平整离体牙样本60个,随机分为6组:空白对照组;超声洁治组;超声洁治后橡皮杯+牙膏抛光组;超声洁治后橡皮杯+抛光膏抛光组;超声洁治后喷砂抛光组;超声洁治后矽粒子抛光组。每组经不同方法处理,制作扫描电镜标本观察牙面清洁情况,有无划痕及其深浅形状。实验二龈上洁治患者90例,依据吸烟情况分为大量吸烟组(2年以上吸烟史,烟量≥20支/天)、少量吸烟组(2年以上吸烟史,烟量20支/天)和不吸烟组,每组30例。排除慢性牙周炎患者;牙列缺损患者;长期饮茶习惯者;系统性疾病患者。患者知情同意情况下,由同一术者对各组患者进行超声龈上洁治术+矽粒子抛光,所有牙齿均达到菌斑指数(PLI)、色素指数(PI)、牙石指数(CI)为零。所有患者做统一标准刷牙方法指导,并进行口腔卫生宣传教育;治疗后1、3个月患者复查,由三名指定医师盲法检查各牙齿PLI、PI,取平均值。实验数据符合“正态,方差齐”,采用多组方差分析进行统计学分析。结果:1扫描电镜(SEM)观察结果:1.1对照组:釉质表面光滑完整,釉柱呈有规则小圆形凸起,清晰可见;1.2超声洁治组:未见正常釉柱形态,牙齿表面粗糙,有较深的条状划痕缺损;1.3超声洁治后橡皮杯蘸牙膏抛光组、超声洁治后橡皮杯蘸抛光膏抛光组:牙齿表面略粗糙,釉面凹状缺损边缘较缓,划痕较浅,未见正常釉柱形态;1.4超声洁治后喷砂抛光组:牙齿表面光滑,未见明显划痕,有少量浅线状磨痕,部分区域见正常釉柱形态及极少量点状凹陷;1.5超声洁治后矽粒子抛光组:牙齿表面光滑,接近正常牙,无明显划痕,可见较少浅线状磨痕,部分区域见正常釉柱形态,呈小圆形凸起。2临床观察结果:2.1洁治后即刻三组患者牙面未见菌斑、色素附着,所有牙齿PLI、PI、CI均为零;2.2洁治后1个月2.2.1牙面菌斑不吸烟组患者部分牙颈部见菌斑呈线状或窄带状分布;少量吸烟组患者多数牙颈部见菌斑呈窄带状分布;大量吸烟组患者所有牙颈部见菌斑呈片状分布。三组差异有统计学意义(P0.05)。大量吸烟组PLI显著高于少量吸烟组(P0.05),少量吸烟组PLI显著高于不吸烟组(P0.05);2.2.2牙面色素不吸烟组患者个别牙见极少量色素呈散在点状分布;少量吸烟组患者在少数牙颈部可见色素呈密集点状分布;大量吸烟组患者多数牙见色素呈窄带状分布。三组差异有统计学意义(P0.05)。大量吸烟组PI显著高于少量吸烟组(P0.05),少量吸烟组PI显著高于不吸烟组(P0.05);2.3洁治后3个月2.3.1牙面菌斑不吸烟组患者多数牙颈部可见菌斑呈宽度不超过1mm的窄带状分布,少量吸烟组患者多数牙颈部见菌斑呈带状分布,宽度超过1mm;大量吸烟组患者所有牙颈部见大量菌斑呈片状分布。三组差异有统计学意义(P0.05)。大量吸烟组PLI显著高于少量吸烟组(P0.05),少量吸烟组PLI显著高于不吸烟组(P0.05)。2.3.2牙面色素不吸烟组患者个别牙颈部见色素呈连续线状分布,少量吸烟组患者多数牙见色素呈窄带状分布,大量吸烟组患者全部牙见色素呈片状分布。三组差异有统计学意义(P0.05)。大量吸烟组PI显著高于少量吸烟组(P0.05),少量吸烟组PI显著高于不吸烟组(P0.05)。结论:1超声龈上洁治后,牙齿表面粗糙,需要进一步抛光。2橡皮杯+牙膏抛光、橡皮杯+抛光膏抛光均能达到较好的抛光效果,牙体表面无明显差异。3喷砂抛光、矽粒子抛光后,牙体表面光滑,抛光效果最好。4吸烟量的增加会使菌斑和色素附着加快,应减少吸烟量,缩短洁治间隔时间。
[Abstract]:Objective: 1 to observe the scratch and smoothness of the surface of the enamel after cleaning and polishing by scanning electron microscope, and compare the effect of different methods to the surface of the isolated teeth after cleaning. 2 through the short-term clinical observation of the smoking patients after ultrasonic cleaning + silica particle polishing, dental plaque and pigment status, the clinical effects of cleaning people after cleaning were compared and the smoking pairs were discussed. The influence of the cleanliness of the tooth surface. For smoking patients to choose the appropriate interval time, to provide theoretical basis and clinical data reference for smoking patients to give up smoking. Methods: 60 samples of smooth and smooth enamel were prepared by experiment, and were randomly divided into 6 groups: blank control group, ultrasonic cleaning group, rubber cup and toothpaste after ultrasonic cleaning. Light group, after ultrasonic cleaning rubber cup + polishing paste polishing group, ultrasonic cleaning after cleaning and polishing group, after ultrasonic cleaning, silicon particle polishing group. Each group was treated by different methods, the scanning electron microscope specimens were made to observe the tooth cleanliness, there were no scratches and the deep and shallow shape. Experimental two gingival cleaning patients 90 cases, according to smoking conditions were divided into a large number of smoking groups (2 Smoking history, smoke more than 20 / day), a small number of smoking groups (over 2 years of smoking history, smoking 20 / day) and non smoking group, 30 cases in each group, excluding chronic periodontitis, dentition defects, long-term tea drinking habits, systemic disease patients. Patients with systemic diseases. Patients in the same operation were treated with ultrasonic gingival cleaning plus silicon by the same operator. Particle polishing, all teeth reached the plaque index (PLI), pigment index (PI), and the tooth stone index (CI) was zero. All patients were guided by the unified standard method of brushing the teeth and carrying out oral hygiene education. After the treatment, the patients were reexamined for 1,3 months, and the PLI, PI, and the mean value of each tooth were examined by three designated doctors. The experimental data conformed to "normal, variance". "Qi", using multiple groups of variance analysis to carry out statistical analysis. Results: 1 scanning electron microscopy (SEM) observation results: 1.1 control group: the enamel surface is smooth and complete, the glaze column has a regular small circular convex, clearly visible; 1.2 ultrasonic cleaning group: no normal form of glaze, the surface of the teeth, a deeper strip scratch defect; 1.3 ultrasonic after cleaning rubber cup. Dipping toothpaste polishing group, after ultrasonic cleaning rubber cup dipping polishing paste polishing group: the tooth surface is slightly rough, the enamel concave defect edge is slow, the scratch is shallow, no normal form of glaze, 1.4 ultrasonic cleaning after the sandblasting group: the tooth surface is smooth, no obvious scratch, a small number of shallow line marks, part of the area see normal form and a very small number of glaze column form and a very small amount Point shape depression; 1.5 ultrasonic cleaning after silicon particle polishing group: smooth surface of the teeth, close to normal teeth, no marked scratch, less shallow linear grinding marks, and part of the normal enamel shape, a small circular convex.2 clinical observation results: 2.1 after cleaning three groups of patients without dental plaque, pigment attachment, all teeth PLI, PI, CI are zero; 2.2 1 months after cleaning, there were linear or narrow banded distribution of plaque in the partial tooth neck of the patients with 2.2.1 dental plaque nonsmoking group. In a small number of smoking groups, most of the teeth were narrow and banded in most of the teeth, and the plaque distribution in the neck of a large number of smokers was flaky. The difference between the three groups was statistically significant (P0.05). The number of PLI in a large number of smoking groups was significantly higher than that of less. The PLI of smoking group (P0.05) was significantly higher than that in the non smoking group (P0.05), and a small amount of pigment in the patients with 2.2.2 tooth pigment non smoking group was scattered on the point like distribution, and a small number of smoking groups showed a dense dot distribution in a few teeth neck, and most of the smokers in the smoking group showed a narrow strip distribution. The three groups were different. Statistical significance (P0.05). A large number of smoking group PI significantly higher than a small number of smoking group (P0.05), a small number of smoking group PI was significantly higher than the non smoking group (P0.05); 2.3 after 3 months after cleaning, the majority of the dental plaque of the dental plaque of the majority of the teeth showed the width of the plaque was not more than 1mm in the narrow-band distribution, a small number of smokers with the majority of the teeth showed the plaque in the neck. In a large number of smokers, there was a large number of plaque distribution in the neck of a large number of smokers. The difference between the three groups was statistically significant (P0.05). The PLI in a large number of smoking groups was significantly higher than that in a small number of smoking groups (P0.05), and the PLI in a small number of smoking groups was significantly higher than that in the non smoking group (P0.05) in the.2.3.2 dental pigment nonsmoking group. In a small number of smoking groups, most of the smokers showed a narrow strip distribution and a large number of smoking groups were all dental pigments flaky. The three groups were statistically significant (P0.05). A large number of smoking groups were significantly higher in PI than a small number of smoking groups (P0.05), and a small number of smoking groups were significantly higher than the non smoking group (P0.05). Conclusion: after 1 ultrasonic gingival cleaning, the group of smoking group was significantly higher than that of non smoking group (P0.05). The surface of the tooth is rough, it needs further polishing.2 rubber cup + toothpaste polishing, rubber cup + polishing paste polishing can achieve better polishing effect, there is no obvious difference between the tooth surface and.3, the surface of the tooth is smooth and the best polishing effect of.4 will make the plaque and pigment attach faster, and reduce the amount of smoking and shrink. Short cleaning interval.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.9
本文编号：2144694
[Abstract]:Objective: 1 to observe the scratch and smoothness of the surface of the enamel after cleaning and polishing by scanning electron microscope, and compare the effect of different methods to the surface of the isolated teeth after cleaning. 2 through the short-term clinical observation of the smoking patients after ultrasonic cleaning + silica particle polishing, dental plaque and pigment status, the clinical effects of cleaning people after cleaning were compared and the smoking pairs were discussed. The influence of the cleanliness of the tooth surface. For smoking patients to choose the appropriate interval time, to provide theoretical basis and clinical data reference for smoking patients to give up smoking. Methods: 60 samples of smooth and smooth enamel were prepared by experiment, and were randomly divided into 6 groups: blank control group, ultrasonic cleaning group, rubber cup and toothpaste after ultrasonic cleaning. Light group, after ultrasonic cleaning rubber cup + polishing paste polishing group, ultrasonic cleaning after cleaning and polishing group, after ultrasonic cleaning, silicon particle polishing group. Each group was treated by different methods, the scanning electron microscope specimens were made to observe the tooth cleanliness, there were no scratches and the deep and shallow shape. Experimental two gingival cleaning patients 90 cases, according to smoking conditions were divided into a large number of smoking groups (2 Smoking history, smoke more than 20 / day), a small number of smoking groups (over 2 years of smoking history, smoking 20 / day) and non smoking group, 30 cases in each group, excluding chronic periodontitis, dentition defects, long-term tea drinking habits, systemic disease patients. Patients with systemic diseases. Patients in the same operation were treated with ultrasonic gingival cleaning plus silicon by the same operator. Particle polishing, all teeth reached the plaque index (PLI), pigment index (PI), and the tooth stone index (CI) was zero. All patients were guided by the unified standard method of brushing the teeth and carrying out oral hygiene education. After the treatment, the patients were reexamined for 1,3 months, and the PLI, PI, and the mean value of each tooth were examined by three designated doctors. The experimental data conformed to "normal, variance". "Qi", using multiple groups of variance analysis to carry out statistical analysis. Results: 1 scanning electron microscopy (SEM) observation results: 1.1 control group: the enamel surface is smooth and complete, the glaze column has a regular small circular convex, clearly visible; 1.2 ultrasonic cleaning group: no normal form of glaze, the surface of the teeth, a deeper strip scratch defect; 1.3 ultrasonic after cleaning rubber cup. Dipping toothpaste polishing group, after ultrasonic cleaning rubber cup dipping polishing paste polishing group: the tooth surface is slightly rough, the enamel concave defect edge is slow, the scratch is shallow, no normal form of glaze, 1.4 ultrasonic cleaning after the sandblasting group: the tooth surface is smooth, no obvious scratch, a small number of shallow line marks, part of the area see normal form and a very small number of glaze column form and a very small amount Point shape depression; 1.5 ultrasonic cleaning after silicon particle polishing group: smooth surface of the teeth, close to normal teeth, no marked scratch, less shallow linear grinding marks, and part of the normal enamel shape, a small circular convex.2 clinical observation results: 2.1 after cleaning three groups of patients without dental plaque, pigment attachment, all teeth PLI, PI, CI are zero; 2.2 1 months after cleaning, there were linear or narrow banded distribution of plaque in the partial tooth neck of the patients with 2.2.1 dental plaque nonsmoking group. In a small number of smoking groups, most of the teeth were narrow and banded in most of the teeth, and the plaque distribution in the neck of a large number of smokers was flaky. The difference between the three groups was statistically significant (P0.05). The number of PLI in a large number of smoking groups was significantly higher than that of less. The PLI of smoking group (P0.05) was significantly higher than that in the non smoking group (P0.05), and a small amount of pigment in the patients with 2.2.2 tooth pigment non smoking group was scattered on the point like distribution, and a small number of smoking groups showed a dense dot distribution in a few teeth neck, and most of the smokers in the smoking group showed a narrow strip distribution. The three groups were different. Statistical significance (P0.05). A large number of smoking group PI significantly higher than a small number of smoking group (P0.05), a small number of smoking group PI was significantly higher than the non smoking group (P0.05); 2.3 after 3 months after cleaning, the majority of the dental plaque of the dental plaque of the majority of the teeth showed the width of the plaque was not more than 1mm in the narrow-band distribution, a small number of smokers with the majority of the teeth showed the plaque in the neck. In a large number of smokers, there was a large number of plaque distribution in the neck of a large number of smokers. The difference between the three groups was statistically significant (P0.05). The PLI in a large number of smoking groups was significantly higher than that in a small number of smoking groups (P0.05), and the PLI in a small number of smoking groups was significantly higher than that in the non smoking group (P0.05) in the.2.3.2 dental pigment nonsmoking group. In a small number of smoking groups, most of the smokers showed a narrow strip distribution and a large number of smoking groups were all dental pigments flaky. The three groups were statistically significant (P0.05). A large number of smoking groups were significantly higher in PI than a small number of smoking groups (P0.05), and a small number of smoking groups were significantly higher than the non smoking group (P0.05). Conclusion: after 1 ultrasonic gingival cleaning, the group of smoking group was significantly higher than that of non smoking group (P0.05). The surface of the tooth is rough, it needs further polishing.2 rubber cup + toothpaste polishing, rubber cup + polishing paste polishing can achieve better polishing effect, there is no obvious difference between the tooth surface and.3, the surface of the tooth is smooth and the best polishing effect of.4 will make the plaque and pigment attach faster, and reduce the amount of smoking and shrink. Short cleaning interval.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.9
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