發(fā)布時(shí)間：2018-08-03 20:23

【摘要】：目的:本研究選取正畸臨床拔牙后采用微種植體作為強(qiáng)支抗的病例,對(duì)植入后的微種植體周圍牙齦用二極管激光儀照射正畸微種植體周圍組織,探討低能量激光照射(low level laser irradiation,LLLI)預(yù)防臨床中微種植體周圍炎的效果,為低能量激光的臨床推廣提供依據(jù)。方法:選擇臨床正畸矯正中拔除上頜兩側(cè)第一雙尖牙并且需要強(qiáng)支抗內(nèi)收前牙的患者20名。研究開始時(shí)間為排齊整平上下頜牙列后,弓絲換至0.018x0.025英寸不銹鋼絲,于上頜左右兩側(cè)第二雙尖牙和第一磨牙頰側(cè)牙根之間的牙槽骨內(nèi)各植入一顆自攻型微種植體,植入角度與牙齒長(zhǎng)軸呈60°。左右兩側(cè)的微種植體隨機(jī)分成實(shí)驗(yàn)組和對(duì)照組,每組各20例。術(shù)后常規(guī)口腔衛(wèi)生宣教,1個(gè)月后使用微種植釘鎳鈦螺旋拉簧150g力量?jī)?nèi)收兩側(cè)上頜前牙。實(shí)驗(yàn)組分別于微種植體植入后第0d、3d、7d、14d以及微種植體負(fù)載后第0d、3d、7d、14d采用低能量激光照射微種植體周圍組織,微種植體暴露在外的三角形區(qū)域,每個(gè)面鄰接的牙齦照射20s,照射三個(gè)位點(diǎn),每個(gè)位點(diǎn)20s,共照射1min(能量密度為15.92J/cm2),每月復(fù)診時(shí)重新加力,并用彈簧測(cè)力計(jì)檢測(cè)力值達(dá)到150g,采用同樣的方法照射一次直至取下微種植體。對(duì)照組模擬照射(無電源照射)。術(shù)后1周、4周、12周分別評(píng)價(jià)實(shí)驗(yàn)組和對(duì)照組微種植體的菌斑指數(shù)、改良齦溝出血指數(shù)及探診深度;記錄發(fā)生微種植體周圍炎及微種植體松動(dòng)例數(shù);提取微種植體周圍液,采用酶聯(lián)免疫吸附法(ELISA)檢測(cè)周圍液中IL-1β水平。所得數(shù)據(jù)運(yùn)用SPSS17.0醫(yī)學(xué)統(tǒng)計(jì)軟件進(jìn)行分析,檢驗(yàn)水準(zhǔn)α=0.05。計(jì)數(shù)資料采用Fisher確切概率法進(jìn)行統(tǒng)計(jì)學(xué)檢驗(yàn)。計(jì)量資料結(jié)果采用平均數(shù)±標(biāo)準(zhǔn)差((?)±s)表示,均數(shù)比較采用配對(duì)t檢驗(yàn)。結(jié)果:1.在不同的時(shí)間點(diǎn),組間比較結(jié)果顯示:實(shí)驗(yàn)組的三項(xiàng)檢測(cè)指標(biāo)(菌斑指數(shù)、改良齦溝出血指數(shù)及探診深度)均值均低于對(duì)照組,且差異有統(tǒng)計(jì)學(xué)意義(p0.05)。2.實(shí)驗(yàn)組發(fā)生微種植體周圍炎和松動(dòng)的例數(shù)均為1例;對(duì)照組發(fā)生微種植體周圍炎和松動(dòng)的數(shù)目分別為2例和3例,實(shí)驗(yàn)組均少于對(duì)照組,差異沒有統(tǒng)計(jì)學(xué)意義(p0.05)。3.對(duì)于白介素-1β,在一周時(shí)兩組的濃度都比較高,之后有所降低,但是實(shí)驗(yàn)組的各時(shí)間段IL-1β濃度均低于對(duì)照組,且差異有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:低能量激光照射聯(lián)合口腔衛(wèi)生宣教可以有效的預(yù)防微種植體周圍炎,值得臨床推廣。
[Abstract]:Objective: in this study, microimplants were used as strong Anchorage after clinical extraction of orthodontic teeth, and the gingival tissue around the implants was irradiated with diode laser in orthodontic microimplants. To investigate the effect of low energy laser irradiation on (low level laser radiation LLLI in prevention of peri-implant inflammation in clinic, and to provide the basis for clinical popularization of low energy laser. Methods: twenty patients with bilateral maxillary first canine extraction and need strong Anchorage of adductive anterior teeth were selected for clinical orthodontic correction. At the beginning of the study, the arch wire was replaced with 0.018x0.025 inch stainless steel wire, and a self-penetrating microimplant was implanted into the alveolar bone between the second bicuspid and the first molar buccal root of the left and right sides of the maxilla, after leveling the maxillary and mandibular dentition, the arch wire was replaced with the 0.018x0.025 inch stainless steel wire. The angle of implantation was 60 擄with the long axis of tooth. The microimplants were randomly divided into experimental group and control group with 20 cases in each group. Postoperative oral hygiene education was performed. After 1 month, the bilateral maxillary anterior teeth were retracted with Nickel-titanium helical tension spring 150 g. In the experimental group, the tissue around the microimplant was irradiated with low-energy laser on the 3rd day and the 7th day after the implantation, and the tissue around the implant was irradiated with low-energy laser for 14 days. The adjacent gingiva of each side was irradiated for 20 s, and three sites were irradiated. At each site, 1min (energy density is 15.92J/cm2) was irradiated for 20 s, and reapplied at the time of follow-up visit every month, and the force value of spring dynamometer was 150 g. The same method was used to irradiate the microimplant once until the implants were removed. The control group was exposed to simulated irradiation (without power supply). The plaque index, improved gingival sulcus bleeding index and probing depth of the microimplants in the experimental group and the control group were evaluated 1 week and 12 weeks after operation, and the number of cases of microimplant inflammation and loosening of the microimplant were recorded, and the peri-implant fluid was extracted. Enzyme linked immunosorbent assay (ELISA) was used to detect the level of IL-1 尾 in peripheral fluid. The data were analyzed by SPSS17.0 medical statistical software, and the test level was 0. 05%. The count data were tested by Fisher exact probability method. The mean 鹵standard deviation (?) 鹵s) and the paired t test were used to compare the mean data. The result is 1: 1. At different time points, the results showed that the mean values of three indexes (plaque index, modified gingival sulcus bleeding index and probing depth) in the experimental group were lower than those in the control group, and the difference was statistically significant (p0.05) .2. The number of microimplant peri-implant inflammation and loosening were 1 in the experimental group and 2 and 3 in the control group, respectively. The experimental group was less than the control group, the difference was not statistically significant (p0.05) .3. For interleukin-1 尾, the concentration of IL-1 尾 in both groups was higher at one week and then decreased, but the concentration of IL-1 尾 in the experimental group was lower than that in the control group at each time, and the difference was statistically significant (p0. 05). Conclusion: low energy laser irradiation combined with oral hygiene education can effectively prevent microimplant periapatitis and is worthy of clinical application.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R783.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 羅文秀;陳文靜;王震東;韶青華;厲丹丹;何宏玉;;磨牙后區(qū)微種植體支抗豎直下頜近中阻生第二磨牙的臨床應(yīng)用[J];口腔醫(yī)學(xué);2016年10期

2 李艷;段小燕;;半導(dǎo)體激光照射預(yù)防正畸微種植體周圍炎的臨床研究[J];激光雜志;2016年04期

3 吳欣;劉國(guó)元;蔣勇聯(lián);;微種植體和J鉤在上頜前突患者矯治中的支抗效果比較[J];上�？谇会t(yī)學(xué);2015年05期

4 張曉歌;唐甜;趙志河;丁寅;;正畸應(yīng)力刺激下純鈦微種植體周圍炎模型及骨改建[J];中國(guó)組織工程研究;2015年38期

5 馬麗輝;李Z真，

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