沖牙器對(duì)固定橋橋體齦面微生物構(gòu)成影響的研究
發(fā)布時(shí)間：2018-08-11 19:10
【摘要】：[目的]單純刷牙難以清除全部牙菌斑,為了獲得更好的口腔保健效果,我們還會(huì)使用牙簽、牙線、牙間隙刷和沖牙器。沖牙器俗稱“水牙線”,對(duì)于沖牙器的研究多集中在牙周炎癥治療和預(yù)防以及正畸患者的日常保健,而關(guān)于沖牙器對(duì)固定橋或種植義齒修復(fù)體齦面的作用研究尚少。本課題首先針對(duì)臨床患者進(jìn)行實(shí)驗(yàn)研究困難的問題進(jìn)行探索,以開發(fā)一種固定橋橋體的替代裝置,為我們的研究創(chuàng)造條件,并就獲取菌斑全部微生物的方法進(jìn)行初步探索,改進(jìn)常見菌斑取樣方法所不可避免的局限。最后,本研究利用掃描電鏡技術(shù)和Illumina Miseq測(cè)序技術(shù)觀察沖牙器對(duì)固定義齒橋體齦面菌斑形成情況的影響,并對(duì)菌群微生物進(jìn)行多樣性分析,以期初步探明沖牙器對(duì)菌斑形成和菌斑微生物構(gòu)成的影響。[方法]本研究選擇第三磨牙拔除時(shí)間大于3月且牙槽嵴頂恢復(fù)平整的成年健康志愿者6名,采用自身前后對(duì)照設(shè)計(jì),對(duì)照組為“單純Bass刷牙”,實(shí)驗(yàn)組為"Bass刷牙后使用沖牙器”,觀察周期隨機(jī)分為為2天、7天、14天。取得口腔模型后,設(shè)計(jì)并制作可分離式固定烤瓷橋橋體齦面菌斑取樣裝置(簡(jiǎn)稱：菌斑取樣器)并進(jìn)行試戴。對(duì)本課題所用超聲波破碎儀工作模式進(jìn)行初步探索,取得菌斑樣本后,分別在超聲波破碎模式為30W/3S、30W/lmin、0W/1.5min和50W/lmin條件下處理,用掃描電鏡觀察破碎前后菌斑的變化。分析沖牙器對(duì)固定橋橋體齦面微生物構(gòu)成的影響。取得菌斑樣本后,立即用掃描電鏡觀察并記錄固定烤瓷橋橋體齦面菌斑取樣器表面的菌斑形成情況,觀察結(jié)束后,利用超聲波破碎的方法洗脫固定烤瓷橋橋體齦面菌斑取樣器表面的菌斑,獲得菌斑懸浮液后,應(yīng)用Illumina Miseq高通量測(cè)序技術(shù)對(duì)菌斑微生物進(jìn)行多樣性分析,主要是分類學(xué)分析。[結(jié)果](1)固定烤瓷橋橋體齦面菌斑取樣器經(jīng)志愿者試戴后檢測(cè)確有菌斑形成并能近似真實(shí)的模擬固定橋在患者口內(nèi)的動(dòng)度、與牙槽嵴頂接觸形式等情況。(2)經(jīng)過(guò)初步實(shí)驗(yàn)探索,本課題所用超聲破碎儀對(duì)于固定烤瓷橋橋體齦面菌斑的洗脫,在工作模式為30W/lmin時(shí)洗脫效果最好。(3)肉眼可見實(shí)驗(yàn)組所有取樣器取出時(shí)未見明顯食物殘?jiān)蛙浌?對(duì)照組隨著時(shí)間的延長(zhǎng),逐漸可見薄層軟垢和少量食物殘?jiān)e聚。(4)電鏡下觀察實(shí)驗(yàn)組和對(duì)照組固定義齒橋體齦面菌斑取樣器上的菌斑均隨著時(shí)間的延長(zhǎng)逐漸增多增厚且逐漸變得致密,但實(shí)驗(yàn)組相對(duì)于對(duì)照而言,細(xì)菌粘附的時(shí)間相對(duì)延后,且菌斑表面細(xì)菌較松散。(5)微生物多樣性分析顯示實(shí)驗(yàn)組菌種總數(shù)較對(duì)照組少,物種的多樣性也少于對(duì)照組,但對(duì)菌種豐度進(jìn)行分析,兩組中僅羅斯菌存在顯著差異(P0.05),而多數(shù)與口腔相關(guān)細(xì)菌如鏈球菌、普氏菌、梭桿菌等并無(wú)顯著差異(P0.05)。[結(jié)論](1)菌斑成功附著于固定義齒橋體齦面的烤瓷菌斑收集器表面,為下一步的實(shí)驗(yàn)工作創(chuàng)造了條件。(2)本課題所用超聲破碎儀對(duì)于固定烤瓷橋橋體齦面菌斑的洗脫,在工作模式為30W/lmin時(shí)洗脫效果最好。(3)刷牙后使用沖牙器,在一定程度范圍內(nèi)抑制了固定橋橋體齦面菌斑的成熟過(guò)程,同時(shí)菌斑微生物多樣性有所減小,但這種減少并無(wú)顯著差異。(4)在實(shí)驗(yàn)周期內(nèi),使用沖牙器與否,對(duì)固定烤瓷橋橋體齦面的菌斑構(gòu)成并無(wú)顯著影響。
[Abstract]:[Objective] Brushing teeth alone is difficult to remove all dental plaque. In order to obtain better oral health care effect, we will also use toothpick, floss, interdental brush and dental punch. There are few studies on the effect of fixed bridge or implant denture on gingival surface.Firstly, this paper explores the difficult problem of experimental study for clinical patients, in order to develop a replacement device for fixed bridge, create conditions for our research, and explore the method of obtaining all microorganisms of plaque, improve the common plaque sampling. Finally, the influence of dental punch on the formation of plaque on the gingival surface of fixed denture bridge was observed by scanning electron microscopy and Illumina Miseq sequencing technique, and the diversity of microflora was analyzed in order to preliminarily explore the effect of dental punch on plaque formation and microflora composition. Six healthy adult volunteers with alveolar crest flattened after extraction of the third molars were selected in this study. The control group was treated with simple Bass brushing and the experimental group was treated with a punch after Bass brushing. The observation period was randomly divided into 2 days, 7 days and 14 days. Separated fixed PFM bridge gingival plaque sampling device (abbreviated as plaque sampler) and test-wear. The work mode of ultrasonic breaker used in this subject was preliminarily explored. After the plaque samples were obtained, they were treated under ultrasonic breaking mode of 30W/3S, 30W/lmin, 0W/1.5min and 50W/lmin, respectively. The breakage was observed by scanning electron microscope. The plaque formation on the gingival surface of fixed PFM bridge was observed and recorded by scanning electron microscopy immediately after the plaque samples were obtained. After the observation, the plaque on the gingival surface of fixed PFM bridge was washed off by ultrasonic breakage. After the plaque suspension was obtained, Illumina Miseq high-throughput sequencing technique was used to analyze the diversity of plaque microorganisms, mainly taxonomic analysis. [Results] (1) The plaque sampler on the gingival surface of fixed PFM bridge was tested by volunteers and formed plaque and could simulate the real fixed bridge in patients. (2) After preliminary experimental exploration, the ultrasonic breaker used in this study had the best effect on the removal of plaque on the gingival surface of fixed PFM bridges when the working mode was 30W/lmin. (3) Visible to the naked eye, no obvious food residue and soft dirt were found in all the samplers in the experimental group, and the control group. With the extension of time, thin layer of soft dirt and a small amount of food residue accumulated. (4) Electron microscopic observation of the experimental group and control group fixed denture bridge plaque sampler on the gingival surface of the plaque gradually thickened and became dense with the extension of time, but the experimental group compared with the control group, the time of bacterial adhesion was relatively delayed, and Microbial diversity analysis showed that the total number of bacteria in the experimental group was less than that in the control group, and the species diversity was also less than that in the control group. However, for the analysis of bacterial abundance, there was only significant difference between the two groups (P 0.05), and most of them had no significant difference with oral bacteria such as Streptococcus, P. and Fusobacterium (P 0.05). [Conclusion] (1) The plaque successfully adhered to the surface of PFM plaque collector on the gingival surface of fixed denture bridge, which created conditions for further experimental work. (2) The ultrasonic breaker used in this study had the best effect on the removal of plaque on the gingival surface of fixed PFM bridge when the working mode was 30W/lmin. (3) After brushing, the teeth were washed with a dental punch. At the same time, the microbial diversity of plaque decreased, but there was no significant difference between the two groups. (4) During the experimental period, the plaque composition of fixed PFM bridges was not significantly affected by the use of dental punch or not.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R783
本文編號(hào)：2177964
[Abstract]:[Objective] Brushing teeth alone is difficult to remove all dental plaque. In order to obtain better oral health care effect, we will also use toothpick, floss, interdental brush and dental punch. There are few studies on the effect of fixed bridge or implant denture on gingival surface.Firstly, this paper explores the difficult problem of experimental study for clinical patients, in order to develop a replacement device for fixed bridge, create conditions for our research, and explore the method of obtaining all microorganisms of plaque, improve the common plaque sampling. Finally, the influence of dental punch on the formation of plaque on the gingival surface of fixed denture bridge was observed by scanning electron microscopy and Illumina Miseq sequencing technique, and the diversity of microflora was analyzed in order to preliminarily explore the effect of dental punch on plaque formation and microflora composition. Six healthy adult volunteers with alveolar crest flattened after extraction of the third molars were selected in this study. The control group was treated with simple Bass brushing and the experimental group was treated with a punch after Bass brushing. The observation period was randomly divided into 2 days, 7 days and 14 days. Separated fixed PFM bridge gingival plaque sampling device (abbreviated as plaque sampler) and test-wear. The work mode of ultrasonic breaker used in this subject was preliminarily explored. After the plaque samples were obtained, they were treated under ultrasonic breaking mode of 30W/3S, 30W/lmin, 0W/1.5min and 50W/lmin, respectively. The breakage was observed by scanning electron microscope. The plaque formation on the gingival surface of fixed PFM bridge was observed and recorded by scanning electron microscopy immediately after the plaque samples were obtained. After the observation, the plaque on the gingival surface of fixed PFM bridge was washed off by ultrasonic breakage. After the plaque suspension was obtained, Illumina Miseq high-throughput sequencing technique was used to analyze the diversity of plaque microorganisms, mainly taxonomic analysis. [Results] (1) The plaque sampler on the gingival surface of fixed PFM bridge was tested by volunteers and formed plaque and could simulate the real fixed bridge in patients. (2) After preliminary experimental exploration, the ultrasonic breaker used in this study had the best effect on the removal of plaque on the gingival surface of fixed PFM bridges when the working mode was 30W/lmin. (3) Visible to the naked eye, no obvious food residue and soft dirt were found in all the samplers in the experimental group, and the control group. With the extension of time, thin layer of soft dirt and a small amount of food residue accumulated. (4) Electron microscopic observation of the experimental group and control group fixed denture bridge plaque sampler on the gingival surface of the plaque gradually thickened and became dense with the extension of time, but the experimental group compared with the control group, the time of bacterial adhesion was relatively delayed, and Microbial diversity analysis showed that the total number of bacteria in the experimental group was less than that in the control group, and the species diversity was also less than that in the control group. However, for the analysis of bacterial abundance, there was only significant difference between the two groups (P 0.05), and most of them had no significant difference with oral bacteria such as Streptococcus, P. and Fusobacterium (P 0.05). [Conclusion] (1) The plaque successfully adhered to the surface of PFM plaque collector on the gingival surface of fixed denture bridge, which created conditions for further experimental work. (2) The ultrasonic breaker used in this study had the best effect on the removal of plaque on the gingival surface of fixed PFM bridge when the working mode was 30W/lmin. (3) After brushing, the teeth were washed with a dental punch. At the same time, the microbial diversity of plaque decreased, but there was no significant difference between the two groups. (4) During the experimental period, the plaque composition of fixed PFM bridges was not significantly affected by the use of dental punch or not.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R783
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