離體牙不同拋光方法掃描電鏡觀察及吸煙患者潔治后臨床效果觀察
發(fā)布時間：2018-07-25 18:40
【摘要】：目的:1通過掃描電鏡觀察潔治拋光后釉質(zhì)表面劃痕及光滑度,比較不同方法對潔治后離體牙表面的拋光效果;2通過短期臨床觀察吸煙患者超聲潔治+矽粒子拋光后,牙面菌斑、色素狀況,比較不同吸煙量人群潔治后臨床效果,探討吸煙對牙面清潔度的影響。為吸煙患者選擇恰當?shù)臐嵵伍g隔時間,對吸煙患者進行戒煙宣傳教育提供理論依據(jù)和臨床數(shù)據(jù)參考。方法:實驗一制備釉面光滑平整離體牙樣本60個,隨機分為6組:空白對照組;超聲潔治組;超聲潔治后橡皮杯+牙膏拋光組;超聲潔治后橡皮杯+拋光膏拋光組;超聲潔治后噴砂拋光組;超聲潔治后矽粒子拋光組。每組經(jīng)不同方法處理,制作掃描電鏡標本觀察牙面清潔情況,有無劃痕及其深淺形狀。實驗二齦上潔治患者90例,依據(jù)吸煙情況分為大量吸煙組(2年以上吸煙史,煙量≥20支/天)、少量吸煙組(2年以上吸煙史,煙量20支/天)和不吸煙組,每組30例。排除慢性牙周炎患者;牙列缺損患者;長期飲茶習慣者;系統(tǒng)性疾病患者�；颊咧橥馇闆r下,由同一術(shù)者對各組患者進行超聲齦上潔治術(shù)+矽粒子拋光,所有牙齒均達到菌斑指數(shù)(PLI)、色素指數(shù)(PI)、牙石指數(shù)(CI)為零。所有患者做統(tǒng)一標準刷牙方法指導,并進行口腔衛(wèi)生宣傳教育;治療后1、3個月患者復(fù)查,由三名指定醫(yī)師盲法檢查各牙齒PLI、PI,取平均值。實驗數(shù)據(jù)符合“正態(tài),方差齊”,采用多組方差分析進行統(tǒng)計學分析。結(jié)果:1掃描電鏡(SEM)觀察結(jié)果:1.1對照組:釉質(zhì)表面光滑完整,釉柱呈有規(guī)則小圓形凸起,清晰可見;1.2超聲潔治組:未見正常釉柱形態(tài),牙齒表面粗糙,有較深的條狀劃痕缺損;1.3超聲潔治后橡皮杯蘸牙膏拋光組、超聲潔治后橡皮杯蘸拋光膏拋光組:牙齒表面略粗糙,釉面凹狀缺損邊緣較緩,劃痕較淺,未見正常釉柱形態(tài);1.4超聲潔治后噴砂拋光組:牙齒表面光滑,未見明顯劃痕,有少量淺線狀磨痕,部分區(qū)域見正常釉柱形態(tài)及極少量點狀凹陷;1.5超聲潔治后矽粒子拋光組:牙齒表面光滑,接近正常牙,無明顯劃痕,可見較少淺線狀磨痕,部分區(qū)域見正常釉柱形態(tài),呈小圓形凸起。2臨床觀察結(jié)果:2.1潔治后即刻三組患者牙面未見菌斑、色素附著,所有牙齒PLI、PI、CI均為零;2.2潔治后1個月2.2.1牙面菌斑不吸煙組患者部分牙頸部見菌斑呈線狀或窄帶狀分布;少量吸煙組患者多數(shù)牙頸部見菌斑呈窄帶狀分布;大量吸煙組患者所有牙頸部見菌斑呈片狀分布。三組差異有統(tǒng)計學意義(P0.05)。大量吸煙組PLI顯著高于少量吸煙組(P0.05),少量吸煙組PLI顯著高于不吸煙組(P0.05);2.2.2牙面色素不吸煙組患者個別牙見極少量色素呈散在點狀分布;少量吸煙組患者在少數(shù)牙頸部可見色素呈密集點狀分布;大量吸煙組患者多數(shù)牙見色素呈窄帶狀分布。三組差異有統(tǒng)計學意義(P0.05)。大量吸煙組PI顯著高于少量吸煙組(P0.05),少量吸煙組PI顯著高于不吸煙組(P0.05);2.3潔治后3個月2.3.1牙面菌斑不吸煙組患者多數(shù)牙頸部可見菌斑呈寬度不超過1mm的窄帶狀分布,少量吸煙組患者多數(shù)牙頸部見菌斑呈帶狀分布,寬度超過1mm;大量吸煙組患者所有牙頸部見大量菌斑呈片狀分布。三組差異有統(tǒng)計學意義(P0.05)。大量吸煙組PLI顯著高于少量吸煙組(P0.05),少量吸煙組PLI顯著高于不吸煙組(P0.05)。2.3.2牙面色素不吸煙組患者個別牙頸部見色素呈連續(xù)線狀分布,少量吸煙組患者多數(shù)牙見色素呈窄帶狀分布,大量吸煙組患者全部牙見色素呈片狀分布。三組差異有統(tǒng)計學意義(P0.05)。大量吸煙組PI顯著高于少量吸煙組(P0.05),少量吸煙組PI顯著高于不吸煙組(P0.05)。結(jié)論:1超聲齦上潔治后,牙齒表面粗糙,需要進一步拋光。2橡皮杯+牙膏拋光、橡皮杯+拋光膏拋光均能達到較好的拋光效果,牙體表面無明顯差異。3噴砂拋光、矽粒子拋光后,牙體表面光滑,拋光效果最好。4吸煙量的增加會使菌斑和色素附著加快,應(yīng)減少吸煙量,縮短潔治間隔時間。
[Abstract]:Objective: 1 to observe the scratch and smoothness of the surface of the enamel after cleaning and polishing by scanning electron microscope, and compare the effect of different methods to the surface of the isolated teeth after cleaning. 2 through the short-term clinical observation of the smoking patients after ultrasonic cleaning + silica particle polishing, dental plaque and pigment status, the clinical effects of cleaning people after cleaning were compared and the smoking pairs were discussed. The influence of the cleanliness of the tooth surface. For smoking patients to choose the appropriate interval time, to provide theoretical basis and clinical data reference for smoking patients to give up smoking. Methods: 60 samples of smooth and smooth enamel were prepared by experiment, and were randomly divided into 6 groups: blank control group, ultrasonic cleaning group, rubber cup and toothpaste after ultrasonic cleaning. Light group, after ultrasonic cleaning rubber cup + polishing paste polishing group, ultrasonic cleaning after cleaning and polishing group, after ultrasonic cleaning, silicon particle polishing group. Each group was treated by different methods, the scanning electron microscope specimens were made to observe the tooth cleanliness, there were no scratches and the deep and shallow shape. Experimental two gingival cleaning patients 90 cases, according to smoking conditions were divided into a large number of smoking groups (2 Smoking history, smoke more than 20 / day), a small number of smoking groups (over 2 years of smoking history, smoking 20 / day) and non smoking group, 30 cases in each group, excluding chronic periodontitis, dentition defects, long-term tea drinking habits, systemic disease patients. Patients with systemic diseases. Patients in the same operation were treated with ultrasonic gingival cleaning plus silicon by the same operator. Particle polishing, all teeth reached the plaque index (PLI), pigment index (PI), and the tooth stone index (CI) was zero. All patients were guided by the unified standard method of brushing the teeth and carrying out oral hygiene education. After the treatment, the patients were reexamined for 1,3 months, and the PLI, PI, and the mean value of each tooth were examined by three designated doctors. The experimental data conformed to "normal, variance". "Qi", using multiple groups of variance analysis to carry out statistical analysis. Results: 1 scanning electron microscopy (SEM) observation results: 1.1 control group: the enamel surface is smooth and complete, the glaze column has a regular small circular convex, clearly visible; 1.2 ultrasonic cleaning group: no normal form of glaze, the surface of the teeth, a deeper strip scratch defect; 1.3 ultrasonic after cleaning rubber cup. Dipping toothpaste polishing group, after ultrasonic cleaning rubber cup dipping polishing paste polishing group: the tooth surface is slightly rough, the enamel concave defect edge is slow, the scratch is shallow, no normal form of glaze, 1.4 ultrasonic cleaning after the sandblasting group: the tooth surface is smooth, no obvious scratch, a small number of shallow line marks, part of the area see normal form and a very small number of glaze column form and a very small amount Point shape depression; 1.5 ultrasonic cleaning after silicon particle polishing group: smooth surface of the teeth, close to normal teeth, no marked scratch, less shallow linear grinding marks, and part of the normal enamel shape, a small circular convex.2 clinical observation results: 2.1 after cleaning three groups of patients without dental plaque, pigment attachment, all teeth PLI, PI, CI are zero; 2.2 1 months after cleaning, there were linear or narrow banded distribution of plaque in the partial tooth neck of the patients with 2.2.1 dental plaque nonsmoking group. In a small number of smoking groups, most of the teeth were narrow and banded in most of the teeth, and the plaque distribution in the neck of a large number of smokers was flaky. The difference between the three groups was statistically significant (P0.05). The number of PLI in a large number of smoking groups was significantly higher than that of less. The PLI of smoking group (P0.05) was significantly higher than that in the non smoking group (P0.05), and a small amount of pigment in the patients with 2.2.2 tooth pigment non smoking group was scattered on the point like distribution, and a small number of smoking groups showed a dense dot distribution in a few teeth neck, and most of the smokers in the smoking group showed a narrow strip distribution. The three groups were different. Statistical significance (P0.05). A large number of smoking group PI significantly higher than a small number of smoking group (P0.05), a small number of smoking group PI was significantly higher than the non smoking group (P0.05); 2.3 after 3 months after cleaning, the majority of the dental plaque of the dental plaque of the majority of the teeth showed the width of the plaque was not more than 1mm in the narrow-band distribution, a small number of smokers with the majority of the teeth showed the plaque in the neck. In a large number of smokers, there was a large number of plaque distribution in the neck of a large number of smokers. The difference between the three groups was statistically significant (P0.05). The PLI in a large number of smoking groups was significantly higher than that in a small number of smoking groups (P0.05), and the PLI in a small number of smoking groups was significantly higher than that in the non smoking group (P0.05) in the.2.3.2 dental pigment nonsmoking group. In a small number of smoking groups, most of the smokers showed a narrow strip distribution and a large number of smoking groups were all dental pigments flaky. The three groups were statistically significant (P0.05). A large number of smoking groups were significantly higher in PI than a small number of smoking groups (P0.05), and a small number of smoking groups were significantly higher than the non smoking group (P0.05). Conclusion: after 1 ultrasonic gingival cleaning, the group of smoking group was significantly higher than that of non smoking group (P0.05). The surface of the tooth is rough, it needs further polishing.2 rubber cup + toothpaste polishing, rubber cup + polishing paste polishing can achieve better polishing effect, there is no obvious difference between the tooth surface and.3, the surface of the tooth is smooth and the best polishing effect of.4 will make the plaque and pigment attach faster, and reduce the amount of smoking and shrink. Short cleaning interval.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R783.9
本文編號：2144694
[Abstract]:Objective: 1 to observe the scratch and smoothness of the surface of the enamel after cleaning and polishing by scanning electron microscope, and compare the effect of different methods to the surface of the isolated teeth after cleaning. 2 through the short-term clinical observation of the smoking patients after ultrasonic cleaning + silica particle polishing, dental plaque and pigment status, the clinical effects of cleaning people after cleaning were compared and the smoking pairs were discussed. The influence of the cleanliness of the tooth surface. For smoking patients to choose the appropriate interval time, to provide theoretical basis and clinical data reference for smoking patients to give up smoking. Methods: 60 samples of smooth and smooth enamel were prepared by experiment, and were randomly divided into 6 groups: blank control group, ultrasonic cleaning group, rubber cup and toothpaste after ultrasonic cleaning. Light group, after ultrasonic cleaning rubber cup + polishing paste polishing group, ultrasonic cleaning after cleaning and polishing group, after ultrasonic cleaning, silicon particle polishing group. Each group was treated by different methods, the scanning electron microscope specimens were made to observe the tooth cleanliness, there were no scratches and the deep and shallow shape. Experimental two gingival cleaning patients 90 cases, according to smoking conditions were divided into a large number of smoking groups (2 Smoking history, smoke more than 20 / day), a small number of smoking groups (over 2 years of smoking history, smoking 20 / day) and non smoking group, 30 cases in each group, excluding chronic periodontitis, dentition defects, long-term tea drinking habits, systemic disease patients. Patients with systemic diseases. Patients in the same operation were treated with ultrasonic gingival cleaning plus silicon by the same operator. Particle polishing, all teeth reached the plaque index (PLI), pigment index (PI), and the tooth stone index (CI) was zero. All patients were guided by the unified standard method of brushing the teeth and carrying out oral hygiene education. After the treatment, the patients were reexamined for 1,3 months, and the PLI, PI, and the mean value of each tooth were examined by three designated doctors. The experimental data conformed to "normal, variance". "Qi", using multiple groups of variance analysis to carry out statistical analysis. Results: 1 scanning electron microscopy (SEM) observation results: 1.1 control group: the enamel surface is smooth and complete, the glaze column has a regular small circular convex, clearly visible; 1.2 ultrasonic cleaning group: no normal form of glaze, the surface of the teeth, a deeper strip scratch defect; 1.3 ultrasonic after cleaning rubber cup. Dipping toothpaste polishing group, after ultrasonic cleaning rubber cup dipping polishing paste polishing group: the tooth surface is slightly rough, the enamel concave defect edge is slow, the scratch is shallow, no normal form of glaze, 1.4 ultrasonic cleaning after the sandblasting group: the tooth surface is smooth, no obvious scratch, a small number of shallow line marks, part of the area see normal form and a very small number of glaze column form and a very small amount Point shape depression; 1.5 ultrasonic cleaning after silicon particle polishing group: smooth surface of the teeth, close to normal teeth, no marked scratch, less shallow linear grinding marks, and part of the normal enamel shape, a small circular convex.2 clinical observation results: 2.1 after cleaning three groups of patients without dental plaque, pigment attachment, all teeth PLI, PI, CI are zero; 2.2 1 months after cleaning, there were linear or narrow banded distribution of plaque in the partial tooth neck of the patients with 2.2.1 dental plaque nonsmoking group. In a small number of smoking groups, most of the teeth were narrow and banded in most of the teeth, and the plaque distribution in the neck of a large number of smokers was flaky. The difference between the three groups was statistically significant (P0.05). The number of PLI in a large number of smoking groups was significantly higher than that of less. The PLI of smoking group (P0.05) was significantly higher than that in the non smoking group (P0.05), and a small amount of pigment in the patients with 2.2.2 tooth pigment non smoking group was scattered on the point like distribution, and a small number of smoking groups showed a dense dot distribution in a few teeth neck, and most of the smokers in the smoking group showed a narrow strip distribution. The three groups were different. Statistical significance (P0.05). A large number of smoking group PI significantly higher than a small number of smoking group (P0.05), a small number of smoking group PI was significantly higher than the non smoking group (P0.05); 2.3 after 3 months after cleaning, the majority of the dental plaque of the dental plaque of the majority of the teeth showed the width of the plaque was not more than 1mm in the narrow-band distribution, a small number of smokers with the majority of the teeth showed the plaque in the neck. In a large number of smokers, there was a large number of plaque distribution in the neck of a large number of smokers. The difference between the three groups was statistically significant (P0.05). The PLI in a large number of smoking groups was significantly higher than that in a small number of smoking groups (P0.05), and the PLI in a small number of smoking groups was significantly higher than that in the non smoking group (P0.05) in the.2.3.2 dental pigment nonsmoking group. In a small number of smoking groups, most of the smokers showed a narrow strip distribution and a large number of smoking groups were all dental pigments flaky. The three groups were statistically significant (P0.05). A large number of smoking groups were significantly higher in PI than a small number of smoking groups (P0.05), and a small number of smoking groups were significantly higher than the non smoking group (P0.05). Conclusion: after 1 ultrasonic gingival cleaning, the group of smoking group was significantly higher than that of non smoking group (P0.05). The surface of the tooth is rough, it needs further polishing.2 rubber cup + toothpaste polishing, rubber cup + polishing paste polishing can achieve better polishing effect, there is no obvious difference between the tooth surface and.3, the surface of the tooth is smooth and the best polishing effect of.4 will make the plaque and pigment attach faster, and reduce the amount of smoking and shrink. Short cleaning interval.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R783.9
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