冲牙器对固定桥桥体龈面微生物构成影响的研究

发布时间：2018-08-11 19:10

【摘要】：[目的]单纯刷牙难以清除全部牙菌斑,为了获得更好的口腔保健效果,我们还会使用牙签、牙线、牙间隙刷和冲牙器。冲牙器俗称“水牙线”,对于冲牙器的研究多集中在牙周炎症治疗和预防以及正畸患者的日常保健,而关于冲牙器对固定桥或种植义齿修复体龈面的作用研究尚少。本课题首先针对临床患者进行实验研究困难的问题进行探索,以开发一种固定桥桥体的替代装置,为我们的研究创造条件,并就获取菌斑全部微生物的方法进行初步探索,改进常见菌斑取样方法所不可避免的局限。最后,本研究利用扫描电镜技术和Illumina Miseq测序技术观察冲牙器对固定义齿桥体龈面菌斑形成情况的影响,并对菌群微生物进行多样性分析,以期初步探明冲牙器对菌斑形成和菌斑微生物构成的影响。[方法]本研究选择第三磨牙拔除时间大于3月且牙槽嵴顶恢复平整的成年健康志愿者6名,采用自身前后对照设计,对照组为“单纯Bass刷牙”,实验组为"Bass刷牙后使用冲牙器”,观察周期随机分为为2天、7天、14天。取得口腔模型后,设计并制作可分离式固定烤瓷桥桥体龈面菌斑取样装置(简称：菌斑取样器)并进行试戴。对本课题所用超声波破碎仪工作模式进行初步探索,取得菌斑样本后,分别在超声波破碎模式为30W/3S、30W/lmin、0W/1.5min和50W/lmin条件下处理,用扫描电镜观察破碎前后菌斑的变化。分析冲牙器对固定桥桥体龈面微生物构成的影响。取得菌斑样本后,立即用扫描电镜观察并记录固定烤瓷桥桥体龈面菌斑取样器表面的菌斑形成情况,观察结束后,利用超声波破碎的方法洗脱固定烤瓷桥桥体龈面菌斑取样器表面的菌斑,获得菌斑悬浮液后,应用Illumina Miseq高通量测序技术对菌斑微生物进行多样性分析,主要是分类学分析。[结果](1)固定烤瓷桥桥体龈面菌斑取样器经志愿者试戴后检测确有菌斑形成并能近似真实的模拟固定桥在患者口内的动度、与牙槽嵴顶接触形式等情况。(2)经过初步实验探索,本课题所用超声破碎仪对于固定烤瓷桥桥体龈面菌斑的洗脱,在工作模式为30W/lmin时洗脱效果最好。(3)肉眼可见实验组所有取样器取出时未见明显食物残渣和软垢,对照组随着时间的延长,逐渐可见薄层软垢和少量食物残渣积聚。(4)电镜下观察实验组和对照组固定义齿桥体龈面菌斑取样器上的菌斑均随着时间的延长逐渐增多增厚且逐渐变得致密,但实验组相对于对照而言,细菌粘附的时间相对延后,且菌斑表面细菌较松散。(5)微生物多样性分析显示实验组菌种总数较对照组少,物种的多样性也少于对照组,但对菌种丰度进行分析,两组中仅罗斯菌存在显著差异(P0.05),而多数与口腔相关细菌如链球菌、普氏菌、梭杆菌等并无显著差异(P0.05)。[结论](1)菌斑成功附着于固定义齿桥体龈面的烤瓷菌斑收集器表面,为下一步的实验工作创造了条件。(2)本课题所用超声破碎仪对于固定烤瓷桥桥体龈面菌斑的洗脱,在工作模式为30W/lmin时洗脱效果最好。(3)刷牙后使用冲牙器,在一定程度范围内抑制了固定桥桥体龈面菌斑的成熟过程,同时菌斑微生物多样性有所减小,但这种减少并无显著差异。(4)在实验周期内,使用冲牙器与否,对固定烤瓷桥桥体龈面的菌斑构成并无显著影响。
[Abstract]:[Objective] Brushing teeth alone is difficult to remove all dental plaque. In order to obtain better oral health care effect, we will also use toothpick, floss, interdental brush and dental punch. There are few studies on the effect of fixed bridge or implant denture on gingival surface.Firstly, this paper explores the difficult problem of experimental study for clinical patients, in order to develop a replacement device for fixed bridge, create conditions for our research, and explore the method of obtaining all microorganisms of plaque, improve the common plaque sampling. Finally, the influence of dental punch on the formation of plaque on the gingival surface of fixed denture bridge was observed by scanning electron microscopy and Illumina Miseq sequencing technique, and the diversity of microflora was analyzed in order to preliminarily explore the effect of dental punch on plaque formation and microflora composition. Six healthy adult volunteers with alveolar crest flattened after extraction of the third molars were selected in this study. The control group was treated with simple Bass brushing and the experimental group was treated with a punch after Bass brushing. The observation period was randomly divided into 2 days, 7 days and 14 days. Separated fixed PFM bridge gingival plaque sampling device (abbreviated as plaque sampler) and test-wear. The work mode of ultrasonic breaker used in this subject was preliminarily explored. After the plaque samples were obtained, they were treated under ultrasonic breaking mode of 30W/3S, 30W/lmin, 0W/1.5min and 50W/lmin, respectively. The breakage was observed by scanning electron microscope. The plaque formation on the gingival surface of fixed PFM bridge was observed and recorded by scanning electron microscopy immediately after the plaque samples were obtained. After the observation, the plaque on the gingival surface of fixed PFM bridge was washed off by ultrasonic breakage. After the plaque suspension was obtained, Illumina Miseq high-throughput sequencing technique was used to analyze the diversity of plaque microorganisms, mainly taxonomic analysis. [Results] (1) The plaque sampler on the gingival surface of fixed PFM bridge was tested by volunteers and formed plaque and could simulate the real fixed bridge in patients. (2) After preliminary experimental exploration, the ultrasonic breaker used in this study had the best effect on the removal of plaque on the gingival surface of fixed PFM bridges when the working mode was 30W/lmin. (3) Visible to the naked eye, no obvious food residue and soft dirt were found in all the samplers in the experimental group, and the control group. With the extension of time, thin layer of soft dirt and a small amount of food residue accumulated. (4) Electron microscopic observation of the experimental group and control group fixed denture bridge plaque sampler on the gingival surface of the plaque gradually thickened and became dense with the extension of time, but the experimental group compared with the control group, the time of bacterial adhesion was relatively delayed, and Microbial diversity analysis showed that the total number of bacteria in the experimental group was less than that in the control group, and the species diversity was also less than that in the control group. However, for the analysis of bacterial abundance, there was only significant difference between the two groups (P 0.05), and most of them had no significant difference with oral bacteria such as Streptococcus, P. and Fusobacterium (P 0.05). [Conclusion] (1) The plaque successfully adhered to the surface of PFM plaque collector on the gingival surface of fixed denture bridge, which created conditions for further experimental work. (2) The ultrasonic breaker used in this study had the best effect on the removal of plaque on the gingival surface of fixed PFM bridge when the working mode was 30W/lmin. (3) After brushing, the teeth were washed with a dental punch. At the same time, the microbial diversity of plaque decreased, but there was no significant difference between the two groups. (4) During the experimental period, the plaque composition of fixed PFM bridges was not significantly affected by the use of dental punch or not.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R783

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