本文選題：牙胚外傷 + 氟斑牙��； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：實(shí)驗(yàn)?zāi)康慕⒋笫笱琅咄鈧胺哐酪鹧烙再|(zhì)發(fā)育異常模型,對(duì)發(fā)育異常牙進(jìn)行冷光美白,酸蝕處理,觀察其微觀變化,為臨床美學(xué)治療提供參考。實(shí)驗(yàn)方法將1d齡30只SD大鼠隨機(jī)分為三組,每組10只。空白對(duì)照組(A組)大鼠自由生長(zhǎng)。牙胚外傷組(B組),在大鼠下頜切牙區(qū),平行于下頜前牙生長(zhǎng)方向,對(duì)大鼠下頜骨垂直加壓一10N/5mm2的力,建立牙胚外傷大鼠動(dòng)物模型。氟斑牙組(C組),待大鼠3周齡,配制50mg/l的氟化水,每天自由飲用,建立氟斑牙動(dòng)物模型。實(shí)驗(yàn)1個(gè)月后,動(dòng)物模型建立,記錄牙齒發(fā)育狀況。然后引頸處死大鼠,剝離大鼠下切牙。再將各組實(shí)驗(yàn)牙(每組18顆)隨機(jī)分為3組(n=3),每組6顆牙齒,進(jìn)行空白對(duì)照(分別標(biāo)記為A0,B0,CO),冷光美白處理(分別標(biāo)記為A1,B1,C1),酸蝕處理(分別標(biāo)記為A2,B2,C2).然后將各組實(shí)驗(yàn)牙進(jìn)行處理前后大體比較,電鏡掃描觀察及能譜分析,觀察各組實(shí)驗(yàn)牙在不同處理前后的變化及釉質(zhì)表面微觀形態(tài)和礦物元素Ca,P含量的變化。結(jié)果1.牙胚外傷及高濃度氟都可引起牙釉質(zhì)的發(fā)育異常。2.牙齒發(fā)育情況:A組牙齒均正常萌出,牙釉質(zhì)發(fā)育未見異常。B組出現(xiàn)牙齒移位萌出4例,單個(gè)下前牙萌出2例,釉質(zhì)出現(xiàn)白斑6例。C組出現(xiàn)釉質(zhì)表面白堊斑4例,棕白相間條紋6例,牙釉質(zhì)缺損4例。3.牙釉質(zhì)比較:正常牙釉質(zhì)表面光滑,牙呈淡黃色,顏色均勻。牙胚外傷牙釉質(zhì)表面有白斑形成,與正常釉質(zhì)界限清楚,在無白斑處,牙釉質(zhì)表現(xiàn)為乳白色。氟斑牙釉質(zhì)大面積白堊斑,或有黃白相間條紋,牙齒黃染,有牙釉質(zhì)缺損。冷光美白后肉眼觀察三組牙變化均不明顯。在酸蝕后三組牙釉質(zhì)表面均變成白色不透明,氟斑牙黃染去除。4.SEM結(jié)果示:表面未處理時(shí),正常牙A0組牙齒表面平整光滑,牙釉質(zhì)表面有一層無結(jié)構(gòu)釉質(zhì)覆蓋,無牙釉質(zhì)缺損。外傷牙B0組,牙齒表面整體光滑,出現(xiàn)較多裂隙,或可見釉質(zhì)表面凸凹不平,出現(xiàn)釉質(zhì)脫礦區(qū)。氟斑牙C0組非白堊斑區(qū)牙釉質(zhì)表面光滑,與正常牙無區(qū)別,白堊斑區(qū)釉質(zhì)表面粗糙,在釉質(zhì)缺損區(qū)可見暴露的釉柱結(jié)構(gòu)及大面積裂紋存在,部分牙釉質(zhì)缺損可見深層牙本質(zhì)結(jié)構(gòu)。冷光美白處理后:A2組可見牙齒表面變化不明顯,僅在高倍鏡下可見表面變得粗糙,出現(xiàn)一些小的凸凹不平。B2組礦化不良區(qū)釉質(zhì)表面脫礦明顯。C2組可見釉質(zhì)表面脫礦不明顯,或僅有鱗屑狀脫礦。酸蝕處理后:A1組能清晰看到釉柱結(jié)構(gòu)清晰,排列整齊。釉柱與釉間隙界限分明。B1組牙釉質(zhì)結(jié)構(gòu)可見,與釉間隙界限清楚,但釉柱間距增寬,排列無正常牙整齊。C1組可見釉柱部分缺失,晶體結(jié)構(gòu)松散,釉柱排列不緊密。5.能譜分析結(jié)果示:未處理牙釉質(zhì)表面,在外傷牙,氟斑牙釉質(zhì)發(fā)育異常區(qū)Ca,P含量較正常牙低(P0.05)。冷光美白后B1,C1與A1相比,Ca,P含量均有所增高(P0.05),但B1,C1間比較無統(tǒng)計(jì)學(xué)意義。在酸蝕后,A2,B2,C2三組間Ca,P含量比較無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論牙胚外傷引起的牙釉質(zhì)發(fā)育異常與氟斑牙引起的牙釉質(zhì)發(fā)育異常表面結(jié)構(gòu)存在一定的差異,其表面結(jié)構(gòu)對(duì)冷光美白的敏感性存在差異,在臨床工作中針對(duì)不同原因引起的牙釉質(zhì)發(fā)育不全的處理要不同。
[Abstract]:Objective to establish an abnormal model of tooth enamel development caused by dental trauma and dental fluorosis in rats. Cold light whitening, acid etching treatment and microscopic changes were used to provide reference for clinical aesthetic treatment. 30 SD rats of 1D age were randomly divided into three groups, 10 rats in each group. The free growth of the blank control group (group A). The injury group (group B), in the mandibular incisor region, parallel to the direction of the mandibular anterior tooth growth, the rat model of tooth embryo trauma was established by the force of one 10N/5mm2 in the vertical compression of the mandible of the rat. The dental fluorosis group (group C) was 3 weeks old, and the fluorinated water of 50mg/l was prepared, and the model of dental fluorosis was established every day. The animal model after 1 months of experiment was the animal model. And then the tooth development was recorded. Then the rats were killed and the rats were stripped to the lower incisors. Then the experimental teeth (18 in each group) were randomly divided into 3 groups (n=3), each group had 6 teeth, and the blank control (labeled as A0, B0, CO), the cold light whitening treatment (respectively labeled as A1, B1, C1), acid etching treatment (respectively marked as A2, B2, C2). Then each experiment was carried out. General comparison of teeth before and after treatment, scanning electron microscope observation and energy spectrum analysis, observed the changes of the teeth before and after different treatments, the micromorphology of the enamel surface and the change of the mineral element Ca, P content. Results 1. tooth embryo trauma and high concentration of fluoride can cause the development of the tooth enamel with abnormal.2. tooth development: the teeth of group A are normally erupted. There were 4 cases of tooth displacement and eruption in group.B, 2 cases of single anterior teeth eruption and 6 cases of enamel surface Cretaceous spot in group.C, 6 cases of brown and white stripes, 4 cases of enamel defect and 4.3. enamel, the normal enamel surface was smooth, the tooth was pale yellow, and the enamel surface of tooth embryo trauma was white. The plaque was formed and clearly defined with the normal enamel. In the absence of leukoplakia, the enamel showed milk white. The large area of Cretaceous plaque in the enamel of the dental fluorosis, or the yellow and white stripes, the teeth yellow dye, and the enamel defect. After the cold light whitening, the changes of the three groups of teeth were not obvious. The three groups of enamel surface became white and opacity after acid etching, and the dental fluorosis was yellow. The results of dyeing and removal of.4.SEM showed that when the surface was not treated, the surface of the normal tooth A0 was smooth and smooth, and the enamel surface had a layer of unenamel covering and no enamel defect. In group B0 of the traumatic teeth, the surface of the teeth was smooth, more fissures appeared, or the enamel surface was not flat, and the enamel demealization appeared. The enamel enamel in group C0 of dental fluorosis was not Cretaceous area. The quality of the surface was smooth, and there was no difference from the normal teeth. The enamel surface was rough in the Cretaceous area. The exposed enamel structure and large area cracks were found in the enamel defect area, and the deep dentin structure was visible in some enamel defects. After cold light whitening treatment, the A2 group showed that the surface changes of the teeth were not obvious and the surface became rough and appeared only under high magnification. The enamel surface demineralization of some small convex and concave.B2 group mineralized areas was obvious in group.C2. The demineralization of enamel surface was not obvious, or only scaly demineralization. After acid etching treatment: the A1 group could clearly see the structure of the glaze column clear and orderly. The enamel structure of the.B1 group was clearly visible, but the boundary between the glaze and the glaze was clear, but the glaze column was clear, but between the glaze columns. In.C1 group without normal teeth, partial deletion of the enamel column, loose crystal structure and non tight.5. spectrum analysis showed that the enamel surface was not treated, Ca in the traumatic tooth, Ca of enamel development in the dental fluorosis, P content was lower than that of normal tooth (P0.05). B1, C1 and A1, C1 and A1, C1 and P content increased (P0.05). There was no statistical significance between B1 and C1. After acid etching, there was no significant difference between Ca and P in A2, B2 and C2 three groups (P0.05). Conclusion the abnormal enamel development caused by tooth germ injury and abnormal surface structure of enamel induced by dental fluorosis were different, and the sensitivity of surface structure to cold light whitening was different in clinical work. The treatment of enamel hypoplasia caused by different reasons is different.

【學(xué)位授予單位】：鄭州大學(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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