發(fā)布時(shí)間：2018-02-01 19:16

  本文關(guān)鍵詞： 護(hù)牙素 氟保護(hù)漆 粗糙度 牙本質(zhì)小管 掃描電鏡　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：背景牙周病是口腔的常見病和多發(fā)病,輕者出現(xiàn)牙齦紅腫,出血,重者牙槽骨吸收、破壞,最終導(dǎo)致牙齒松動(dòng),脫落。這會(huì)嚴(yán)重影響患者的生活質(zhì)量,那么,臨床上醫(yī)生怎么來預(yù)防這樣的問題發(fā)生呢?通常醫(yī)生會(huì)建議人們定期對(duì)牙齒進(jìn)行“洗牙”,目前,超聲潔牙已經(jīng)成為人們普遍接受的口腔保健措施,它能高效、快速的對(duì)牙結(jié)石、黃牙、煙瘢等洗后即可看見顯著的效果,不需要麻藥就可以完成。但是潔牙后常常會(huì)出現(xiàn)一個(gè)現(xiàn)象,即超聲潔治后牙面較粗糙而且敏感,如不做處理,牙面再著色會(huì)更快、更嚴(yán)重并且牙齒敏感不適。目前單純的拋光對(duì)減輕牙面粗糙程度的作用是有限的,對(duì)患者敏感的緩解也較低,很難達(dá)到滿意的臨床效果。如何彌補(bǔ)拋光技術(shù)存在的缺陷,改善潔牙后牙面的粗糙程度、延緩菌斑、牙結(jié)石及色素的沉著的同時(shí)改善患者的牙齒敏感,是口腔預(yù)防保健工作者急切需要解決的問題。所以本研究在已有研究的基礎(chǔ)上,提出“醫(yī)生干預(yù)與患者干預(yù)”相結(jié)合,局部涂氟與家庭使用護(hù)牙素雙管齊下的思路,通過建立超聲潔牙術(shù)后模型,氟保護(hù)漆與護(hù)牙素進(jìn)行干預(yù),最后通過掃描電鏡、粗糙測(cè)試儀、色差分析儀等觀察牙釉質(zhì)、牙本質(zhì)的改變來探討氟保護(hù)漆與護(hù)牙素聯(lián)合促進(jìn)超聲潔牙術(shù)后牙硬組織面表面恢復(fù)的作用。本研究分為兩部分:第一部分:護(hù)牙素聯(lián)合氟保護(hù)漆對(duì)超聲潔牙術(shù)后牙釉質(zhì)的影響目的:了解超聲潔牙術(shù)后,聯(lián)合使用護(hù)牙素和氟保護(hù)漆對(duì)牙釉質(zhì)表面形態(tài)恢復(fù)的作用。方法:收集因正畸拔除的健康前磨牙,隨機(jī)分成A、B、C、D四個(gè)組,進(jìn)行超聲潔治后,A組不進(jìn)行干預(yù),B組進(jìn)行氟保護(hù)漆干預(yù),C組涂布護(hù)牙素干預(yù),D組用護(hù)牙素聯(lián)合氟保護(hù)漆進(jìn)行干預(yù),然后在不同時(shí)間段進(jìn)行釉質(zhì)表面粗糙度的測(cè)定、掃描電鏡觀察以及不同組再著色實(shí)驗(yàn)后行色差分析。結(jié)果:粗糙度結(jié)果顯示,超聲潔牙后各組的粗糙度值隨時(shí)間逐漸降低,其中干預(yù)組下降較明顯,5天后,聯(lián)合干預(yù)組較單獨(dú)干預(yù)組的粗糙度值下降更加明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05);掃描電鏡可觀察到超聲潔治后,各組牙釉質(zhì)表面見較深劃痕,干預(yù)后釉質(zhì)表面超微結(jié)構(gòu)都有改善,其中護(hù)牙素組、氟保護(hù)漆組和二者聯(lián)合組改善較對(duì)照組明顯,而聯(lián)合組改變最為明顯;外源性染色觀察牙面著色,干預(yù)組比未干預(yù)組著色淺,在干預(yù)的3組中,護(hù)牙素聯(lián)合氟保護(hù)漆組的術(shù)區(qū)著色最淺;牙面染色的定量分析可知,外源性染色前后比較,各干預(yù)組牙面的染色數(shù)值較染色前降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較,聯(lián)合干預(yù)組的染色值最低(P0.05)。結(jié)論:護(hù)牙素聯(lián)合氟保護(hù)漆比單獨(dú)使用其中之一能更好地促進(jìn)超聲潔牙后牙釉質(zhì)表面形態(tài)的復(fù)原。第二部分:護(hù)牙素聯(lián)合氟保護(hù)漆對(duì)超聲對(duì)潔牙術(shù)后牙本質(zhì)的影響目的:了解護(hù)牙素聯(lián)合氟保護(hù)漆對(duì)超聲對(duì)潔牙術(shù)后牙本質(zhì)小管的封閉作用。方法:收集因正畸拔除的健康前磨牙,制備成牙本質(zhì)小塊,隨機(jī)分成A、B、C、D四個(gè)組,A組不進(jìn)行干預(yù),B組進(jìn)行氟保護(hù)漆干預(yù),C組涂布護(hù)牙素干預(yù),D組用護(hù)牙素聯(lián)合氟保護(hù)漆進(jìn)行干預(yù),然后在不同時(shí)間點(diǎn)用掃描電鏡觀察牙表面形態(tài)結(jié)構(gòu),再分別進(jìn)行各組的封閉率比較。結(jié)果:掃描電鏡可觀察到,B、C、D三組干預(yù)后均能有效的封閉牙本質(zhì)小管。其中干預(yù)7天后,聯(lián)合干預(yù)組比其它干預(yù)組對(duì)于牙本質(zhì)小管的封閉率都高,差異有統(tǒng)計(jì)學(xué)意義(P0.05),在干預(yù)14天后,B、C、D組對(duì)牙本質(zhì)封閉率都較高,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:護(hù)牙素和氟保護(hù)漆均能有效的封閉小本質(zhì)小管,短期內(nèi)聯(lián)合使用封閉效果更佳。
[Abstract]:Background periodontitis is a common disease, mild gum swelling, bleeding, absorption, severe alveolar bone destruction, eventually leading to loosening of the teeth off. This will seriously affect the quality of life of patients, so clinical doctors how to prevent such problems occur? Usually doctors would advise people regularly the teeth "Scaling", at present, has become the ultrasonic dental oral health is generally accepted by people, it can efficiently, the dental calculus, yellow teeth fast, so you can see the smoke scar after washing effect, without anesthetic can be completed. But after scaling often appears a phenomenon called ultrasonic scaling the teeth surface is rough and sensitive, if not treated, the tooth surface coloring will be faster, more serious and sensitive teeth discomfort. Simple polishing is limited to reduce the tooth surface roughness effect on corrosion sensitive patients at present The solution is low, it is difficult to achieve a satisfactory clinical effect. How to compensate for the defects of existing polishing technology, improve the surface roughness of dental plaque, delay, dental calculus and pigment deposition and improve the patient's sensitive teeth, oral health care workers is an urgent need to solve the problem. So the Study on the research foundation the doctor put forward, intervention and intervention in patients with combination of topical fluoride and family use tooth mousse two pronged idea, through the establishment of ultrasonic curettage after model, teeth and supporting fluoride varnish in the intervention by the SEM, roughness tester, color analyzer to observe the enamel, dentin to explore the change of teeth and supporting fluor protector combined with ultrasonic dental hard tissue promoting posterior surface recovery. This research is divided into two parts: the first part: tooth element combined with fluoride varnish on the super Objective to influence postoperative tooth enamel sound: To investigate the ultrasonic curettage after the combined use of tooth mousse and fluoride varnish on enamel surface morphology recovery. Methods: premolars extracted for orthodontics, were randomly divided into A, B, C, D four groups of group A after ultrasonic scaling, intervention group B fluoride varnish intervention group C coating dental care interventions, group D combined with fluoride varnish dental care intervention, then the determination of enamel surface roughness at different time, scanning electron microscope and different groups after the experiment Xingse coloring difference analysis. Results: the roughness results show that the roughness of ultrasonic scaling group decreases with time, in the intervention group decreased significantly, after 5 days, the roughness of joint intervention group than in the intervention group decreased more significantly, the difference was statistically significant (P0.05); scanning electron microscope can be observed in ultrasonic cleaning After treatment, the enamel surface see deep scratches, after the intervention of the enamel surface ultrastructure had improved, the tooth element group, fluoride varnish group and the two combined group improved significantly compared with the control group, and combined group the most obvious changes were observed; exogenous tooth surface coloring, the intervention group than non intervention group light color, 3 in the intervention group, dental care combined with fluoride protection paint operation area were the most shallow; the quantitative analysis of tooth surface staining, exogenous staining before and after comparison, the intervention group decreased value of tooth surface staining than before staining, the difference was statistically significant (P0.05), comparison between groups, staining the joint intervention group was the lowest (P0.05). Conclusion: tooth combined with fluoride varnish than using one of them can better promote the enamel surface morphology after ultrasonic dental restoration. Second separate parts: tooth combined with fluoride varnish on the ultrasonic curettage effect on dentin. : understanding the tooth element combined with fluoride varnish in the closed ultrasonic curettage of dentinal tubules. Methods: premolars extracted for orthodontics, prepared dentin pieces, were randomly divided into A, B, C, D four group, A group without intervention, B group of fluoride the intervention group C paint, coating dental care interventions, D group with combined tooth mousse fluoride varnish to intervene, then at different time points by scanning electron microscopy of tooth surface morphology, were compared. Results: the closure rate of each group were detected by scanning electron microscope, B, C, D three groups all the tubules closed dentin effectively. In the intervention 7 days, treatment group was better than the other intervention group for dentinal tubule occlusion, the difference was statistically significant (P0.05), in 14 days after the intervention, B, C, D group of dentin sealing rate is higher, the difference was not statistically significant. Conclusion: tooth mousse and fluoride varnish Can close small tubules effectively in the short term, the combined use of sealing effect is better.

【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R783

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本文編號(hào)：1482658