低能量激光照射预防正畸微种植体周围炎的临床效果研究
发布时间：2018-08-03 20:23
【摘要】：目的:本研究选取正畸临床拔牙后采用微种植体作为强支抗的病例,对植入后的微种植体周围牙龈用二极管激光仪照射正畸微种植体周围组织,探讨低能量激光照射(low level laser irradiation,LLLI)预防临床中微种植体周围炎的效果,为低能量激光的临床推广提供依据。方法:选择临床正畸矫正中拔除上颌两侧第一双尖牙并且需要强支抗内收前牙的患者20名。研究开始时间为排齐整平上下颌牙列后,弓丝换至0.018x0.025英寸不锈钢丝,于上颌左右两侧第二双尖牙和第一磨牙颊侧牙根之间的牙槽骨内各植入一颗自攻型微种植体,植入角度与牙齿长轴呈60°。左右两侧的微种植体随机分成实验组和对照组,每组各20例。术后常规口腔卫生宣教,1个月后使用微种植钉镍钛螺旋拉簧150g力量内收两侧上颌前牙。实验组分别于微种植体植入后第0d、3d、7d、14d以及微种植体负载后第0d、3d、7d、14d采用低能量激光照射微种植体周围组织,微种植体暴露在外的三角形区域,每个面邻接的牙龈照射20s,照射三个位点,每个位点20s,共照射1min(能量密度为15.92J/cm2),每月复诊时重新加力,并用弹簧测力计检测力值达到150g,采用同样的方法照射一次直至取下微种植体。对照组模拟照射(无电源照射)。术后1周、4周、12周分别评价实验组和对照组微种植体的菌斑指数、改良龈沟出血指数及探诊深度;记录发生微种植体周围炎及微种植体松动例数;提取微种植体周围液,采用酶联免疫吸附法(ELISA)检测周围液中IL-1β水平。所得数据运用SPSS17.0医学统计软件进行分析,检验水准α=0.05。计数资料采用Fisher确切概率法进行统计学检验。计量资料结果采用平均数±标准差((?)±s)表示,均数比较采用配对t检验。结果:1.在不同的时间点,组间比较结果显示:实验组的三项检测指标(菌斑指数、改良龈沟出血指数及探诊深度)均值均低于对照组,且差异有统计学意义(p0.05)。2.实验组发生微种植体周围炎和松动的例数均为1例;对照组发生微种植体周围炎和松动的数目分别为2例和3例,实验组均少于对照组,差异没有统计学意义(p0.05)。3.对于白介素-1β,在一周时两组的浓度都比较高,之后有所降低,但是实验组的各时间段IL-1β浓度均低于对照组,且差异有统计学意义(p0.05)。结论:低能量激光照射联合口腔卫生宣教可以有效的预防微种植体周围炎,值得临床推广。
[Abstract]:Objective: in this study, microimplants were used as strong Anchorage after clinical extraction of orthodontic teeth, and the gingival tissue around the implants was irradiated with diode laser in orthodontic microimplants. To investigate the effect of low energy laser irradiation on (low level laser radiation LLLI in prevention of peri-implant inflammation in clinic, and to provide the basis for clinical popularization of low energy laser. Methods: twenty patients with bilateral maxillary first canine extraction and need strong Anchorage of adductive anterior teeth were selected for clinical orthodontic correction. At the beginning of the study, the arch wire was replaced with 0.018x0.025 inch stainless steel wire, and a self-penetrating microimplant was implanted into the alveolar bone between the second bicuspid and the first molar buccal root of the left and right sides of the maxilla, after leveling the maxillary and mandibular dentition, the arch wire was replaced with the 0.018x0.025 inch stainless steel wire. The angle of implantation was 60 掳with the long axis of tooth. The microimplants were randomly divided into experimental group and control group with 20 cases in each group. Postoperative oral hygiene education was performed. After 1 month, the bilateral maxillary anterior teeth were retracted with Nickel-titanium helical tension spring 150 g. In the experimental group, the tissue around the microimplant was irradiated with low-energy laser on the 3rd day and the 7th day after the implantation, and the tissue around the implant was irradiated with low-energy laser for 14 days. The adjacent gingiva of each side was irradiated for 20 s, and three sites were irradiated. At each site, 1min (energy density is 15.92J/cm2) was irradiated for 20 s, and reapplied at the time of follow-up visit every month, and the force value of spring dynamometer was 150 g. The same method was used to irradiate the microimplant once until the implants were removed. The control group was exposed to simulated irradiation (without power supply). The plaque index, improved gingival sulcus bleeding index and probing depth of the microimplants in the experimental group and the control group were evaluated 1 week and 12 weeks after operation, and the number of cases of microimplant inflammation and loosening of the microimplant were recorded, and the peri-implant fluid was extracted. Enzyme linked immunosorbent assay (ELISA) was used to detect the level of IL-1 尾 in peripheral fluid. The data were analyzed by SPSS17.0 medical statistical software, and the test level was 0. 05%. The count data were tested by Fisher exact probability method. The mean 卤standard deviation (?) 卤s) and the paired t test were used to compare the mean data. The result is 1: 1. At different time points, the results showed that the mean values of three indexes (plaque index, modified gingival sulcus bleeding index and probing depth) in the experimental group were lower than those in the control group, and the difference was statistically significant (p0.05) .2. The number of microimplant peri-implant inflammation and loosening were 1 in the experimental group and 2 and 3 in the control group, respectively. The experimental group was less than the control group, the difference was not statistically significant (p0.05) .3. For interleukin-1 尾, the concentration of IL-1 尾 in both groups was higher at one week and then decreased, but the concentration of IL-1 尾 in the experimental group was lower than that in the control group at each time, and the difference was statistically significant (p0. 05). Conclusion: low energy laser irradiation combined with oral hygiene education can effectively prevent microimplant periapatitis and is worthy of clinical application.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.5
[Abstract]:Objective: in this study, microimplants were used as strong Anchorage after clinical extraction of orthodontic teeth, and the gingival tissue around the implants was irradiated with diode laser in orthodontic microimplants. To investigate the effect of low energy laser irradiation on (low level laser radiation LLLI in prevention of peri-implant inflammation in clinic, and to provide the basis for clinical popularization of low energy laser. Methods: twenty patients with bilateral maxillary first canine extraction and need strong Anchorage of adductive anterior teeth were selected for clinical orthodontic correction. At the beginning of the study, the arch wire was replaced with 0.018x0.025 inch stainless steel wire, and a self-penetrating microimplant was implanted into the alveolar bone between the second bicuspid and the first molar buccal root of the left and right sides of the maxilla, after leveling the maxillary and mandibular dentition, the arch wire was replaced with the 0.018x0.025 inch stainless steel wire. The angle of implantation was 60 掳with the long axis of tooth. The microimplants were randomly divided into experimental group and control group with 20 cases in each group. Postoperative oral hygiene education was performed. After 1 month, the bilateral maxillary anterior teeth were retracted with Nickel-titanium helical tension spring 150 g. In the experimental group, the tissue around the microimplant was irradiated with low-energy laser on the 3rd day and the 7th day after the implantation, and the tissue around the implant was irradiated with low-energy laser for 14 days. The adjacent gingiva of each side was irradiated for 20 s, and three sites were irradiated. At each site, 1min (energy density is 15.92J/cm2) was irradiated for 20 s, and reapplied at the time of follow-up visit every month, and the force value of spring dynamometer was 150 g. The same method was used to irradiate the microimplant once until the implants were removed. The control group was exposed to simulated irradiation (without power supply). The plaque index, improved gingival sulcus bleeding index and probing depth of the microimplants in the experimental group and the control group were evaluated 1 week and 12 weeks after operation, and the number of cases of microimplant inflammation and loosening of the microimplant were recorded, and the peri-implant fluid was extracted. Enzyme linked immunosorbent assay (ELISA) was used to detect the level of IL-1 尾 in peripheral fluid. The data were analyzed by SPSS17.0 medical statistical software, and the test level was 0. 05%. The count data were tested by Fisher exact probability method. The mean 卤standard deviation (?) 卤s) and the paired t test were used to compare the mean data. The result is 1: 1. At different time points, the results showed that the mean values of three indexes (plaque index, modified gingival sulcus bleeding index and probing depth) in the experimental group were lower than those in the control group, and the difference was statistically significant (p0.05) .2. The number of microimplant peri-implant inflammation and loosening were 1 in the experimental group and 2 and 3 in the control group, respectively. The experimental group was less than the control group, the difference was not statistically significant (p0.05) .3. For interleukin-1 尾, the concentration of IL-1 尾 in both groups was higher at one week and then decreased, but the concentration of IL-1 尾 in the experimental group was lower than that in the control group at each time, and the difference was statistically significant (p0. 05). Conclusion: low energy laser irradiation combined with oral hygiene education can effectively prevent microimplant periapatitis and is worthy of clinical application.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.5
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