全脱位牙延期再植根面牙周膜不同去除方法的研究
发布时间：2018-12-15 04:58
【摘要】：目的：全脱位牙延期再植前需要去除其根面坏死的牙周膜，以预防炎性吸收。去除的方法有很多种，但是目前仍没有公认的最佳方法，故本研究的主要目的在于寻求一种去除根面坏死牙周膜的最佳方法。 材料和方法：取35颗因正畸需要拔除的健康右下第一前磨牙，室温下干燥保存超过1小时，随机平均分为5组；分别进行以下处理：1、阴性对照组，2、手术刀片刮除根面坏死牙周膜，3、1%次氯酸钠溶液浸泡实验牙5分钟，4、2%次氯酸钠溶液浸泡实验牙5分钟，5、1%次氯酸钠溶液浸泡实验牙10分钟。然后每组随机取两颗牙，用戊二醛固定，电镜下观察牙周膜残留和牙骨质缺损情况；剩余5颗牙用中性福尔马林固定，盐酸甲酸脱钙，包埋，取根中、根尖1/3，连续横切片，HE染色，光镜下观察，ImagePro软件计算统计分析牙周膜残留和牙骨质缺损情况。所得数据经方差齐性检验后，用组间单因素方差分析和Tukey's检验来判断显著性差异。 结果：牙周膜残留方面，阴性对照组有62.33%的区域存在残留，刀片刮除组有22.42%残留，次氯酸钠溶液处理组残留分别为1%次氯酸钠溶液浸泡5分钟组0.885%，2%次氯酸钠溶液浸泡5分钟组0.386%，1%次氯酸钠溶液浸泡10分钟组0.237%；阴性对照组显著高于刀片刮除组和三个次氯酸钠溶液处理组（P＜0.05），刀片刮除组显著高于三个次氯酸钠处理组（P＜0.05），但三个不同浓度和时间的次氯酸钠溶液处理组之间没有统计学差异（P＞0.05）。牙骨质缺损方面，，阴性对照组为0.031%，刀片刮除组为7.90%，次氯酸钠溶液处理组分别为1%次氯酸钠溶液浸泡5分钟组0.084%，2%次氯酸钠溶液浸泡5分钟组0.065%，1%次氯酸钠溶液浸泡10分钟组0.057%；刀片刮除组显著高于阴性对照组和三个次氯酸钠溶液处理组（P＜0.05）；而阴性对照组和三个次氯酸钠溶液处理组之间没有统计学差异（P＞0.05）。 结论：在本实验的条件下，刀片刮除法既无法去净根面坏死牙周膜，又会导致根面牙骨质层的破坏，故不值得推荐。次氯酸钠溶液处理法能在有效去除根面牙周膜的同时很好地保持牙骨质层的完整性，是一种理想的方法；但是具体最佳的处理浓度和时间有待进一步研究。
[Abstract]:Objective: to prevent inflammatory absorption, the periodontal membrane of root surface necrosis should be removed before delayed replantation of total dislocation teeth. There are many ways to remove periodontal membrane, but there is still no accepted optimal method, so the main purpose of this study is to find the best way to remove the root surface necrotic periodontal membrane. Materials and methods: 35 healthy lower right first premolars which needed to be extracted due to orthodontics were dried for more than 1 hour at room temperature and were randomly divided into 5 groups. The experimental teeth were treated as follows: 1, negative control group, 2, operation blade scraping root surface necrotic periodontal membrane, 3% sodium hypochlorite solution immersion experimental teeth for 5 minutes, 4% sodium hypochlorite solution immersion experimental teeth for 5 minutes, 2% sodium hypochlorite solution for 5 minutes, and 2% sodium hypochlorite solution for 5 minutes. The teeth were immersed in 1% sodium hypochlorite solution for 10 minutes. Then two teeth in each group were randomly selected and fixed with glutaraldehyde. The residual periodontal membrane and cementum defect were observed under electron microscope. The remaining 5 teeth were fixed with neutral formalin, decalcified with formic acid, embedded, taken from root, 1 / 3 of root tip, continuous transverse slice, HE staining, observed under light microscope, the residual periodontal membrane and cementum defect were calculated and analyzed by ImagePro software. After homogeneity test of variance, significant difference was judged by univariate ANOVA and Tukey's test. Results: there were 62.33% residual areas in negative control group, 22.42% in blade scraping group and 0.885% in sodium hypochlorite solution treatment group, respectively. 2% sodium hypochlorite solution immersion for 5 min group 0.386% sodium hypochlorite solution immersion 10 minutes group 0.237; Negative control group was significantly higher than blade scraping group and three sodium hypochlorite solution treatment group (P < 0.05), blade scraping group was significantly higher than three sodium hypochlorite treatment group (P < 0.05). However, there was no significant difference among the three sodium hypochlorite solution groups (P > 0.05). For cementum defect, 0.031 in negative control group, 7.90 in blade curettage group, 0.084 in sodium hypochlorite solution treatment group, respectively, in 5 minutes immersion group with 1% sodium hypochlorite solution, 0. 084% sodium hypochlorite solution for 5 minutes, and 0. 084% sodium hypochlorite solution for 5 minutes. Immersion in 2% sodium hypochlorite solution for 5 minutes in 0.065% sodium hypochlorite solution for 10 minutes in group 0.057; The blade curettage group was significantly higher than the negative control group and the three sodium hypochlorite solution treatment groups (P < 0.05), but there was no statistical difference between the negative control group and the three sodium hypochlorite solution treatment groups (P > 0.05). Conclusion: under the condition of this experiment, the method of blade curettage can not only remove the periodontal membrane of root surface necrosis, but also lead to the destruction of root surface cementum layer, so it is not worthy of recommendation. Sodium hypochlorite solution treatment method can effectively remove the root periodontal membrane and maintain the integrity of cementum layer, which is an ideal method, but the specific optimal treatment concentration and time need to be further studied.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.12
[Abstract]:Objective: to prevent inflammatory absorption, the periodontal membrane of root surface necrosis should be removed before delayed replantation of total dislocation teeth. There are many ways to remove periodontal membrane, but there is still no accepted optimal method, so the main purpose of this study is to find the best way to remove the root surface necrotic periodontal membrane. Materials and methods: 35 healthy lower right first premolars which needed to be extracted due to orthodontics were dried for more than 1 hour at room temperature and were randomly divided into 5 groups. The experimental teeth were treated as follows: 1, negative control group, 2, operation blade scraping root surface necrotic periodontal membrane, 3% sodium hypochlorite solution immersion experimental teeth for 5 minutes, 4% sodium hypochlorite solution immersion experimental teeth for 5 minutes, 2% sodium hypochlorite solution for 5 minutes, and 2% sodium hypochlorite solution for 5 minutes. The teeth were immersed in 1% sodium hypochlorite solution for 10 minutes. Then two teeth in each group were randomly selected and fixed with glutaraldehyde. The residual periodontal membrane and cementum defect were observed under electron microscope. The remaining 5 teeth were fixed with neutral formalin, decalcified with formic acid, embedded, taken from root, 1 / 3 of root tip, continuous transverse slice, HE staining, observed under light microscope, the residual periodontal membrane and cementum defect were calculated and analyzed by ImagePro software. After homogeneity test of variance, significant difference was judged by univariate ANOVA and Tukey's test. Results: there were 62.33% residual areas in negative control group, 22.42% in blade scraping group and 0.885% in sodium hypochlorite solution treatment group, respectively. 2% sodium hypochlorite solution immersion for 5 min group 0.386% sodium hypochlorite solution immersion 10 minutes group 0.237; Negative control group was significantly higher than blade scraping group and three sodium hypochlorite solution treatment group (P < 0.05), blade scraping group was significantly higher than three sodium hypochlorite treatment group (P < 0.05). However, there was no significant difference among the three sodium hypochlorite solution groups (P > 0.05). For cementum defect, 0.031 in negative control group, 7.90 in blade curettage group, 0.084 in sodium hypochlorite solution treatment group, respectively, in 5 minutes immersion group with 1% sodium hypochlorite solution, 0. 084% sodium hypochlorite solution for 5 minutes, and 0. 084% sodium hypochlorite solution for 5 minutes. Immersion in 2% sodium hypochlorite solution for 5 minutes in 0.065% sodium hypochlorite solution for 10 minutes in group 0.057; The blade curettage group was significantly higher than the negative control group and the three sodium hypochlorite solution treatment groups (P < 0.05), but there was no statistical difference between the negative control group and the three sodium hypochlorite solution treatment groups (P > 0.05). Conclusion: under the condition of this experiment, the method of blade curettage can not only remove the periodontal membrane of root surface necrosis, but also lead to the destruction of root surface cementum layer, so it is not worthy of recommendation. Sodium hypochlorite solution treatment method can effectively remove the root periodontal membrane and maintain the integrity of cementum layer, which is an ideal method, but the specific optimal treatment concentration and time need to be further studied.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.12
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