窩溝封閉劑臨床應(yīng)用材料和方式及防齲效果的研究
發(fā)布時間：2018-10-05 14:07
【摘要】：齲齒作為口腔最常見疾病之一,其發(fā)生常常伴隨疼痛、咀嚼、美觀和交流障礙問題,影響正常生活,降低生活質(zhì)量。已有的研究表明兒童和青少年恒牙窩溝封閉可以有效減少齲病的發(fā)生。窩溝封閉后的恒牙和未行窩溝封閉的恒牙相比,需要充填修復(fù)的可能更小,需要修復(fù)治療的時間也會推遲,修復(fù)體的范圍也更小。 樹脂和玻璃離子均可用于窩溝點隙的封閉。在本研究一時,有兩種新型玻璃離子上市,glass-carbomer和Ketac Molar Easymix (KMEM)這兩種新型玻璃離子和傳統(tǒng)玻璃離子材料相比在物理機(jī)械強(qiáng)度上有很大的提高。本研究中將這兩種窩溝封閉材料的保留率和防齲效果和臨床上最常用的樹脂材料作比較。另外還比較了一種新的玻璃離子應(yīng)用方式,在應(yīng)用于窩溝時在其完全固化前使用LED光照。即共四組窩溝封閉劑組,由于醫(yī)學(xué)倫理學(xué)原因不設(shè)空白對照組,樹脂組為對照組。我們希望實驗的結(jié)果能夠給于臨床窩溝封閉劑防齲工作實際的指導(dǎo),幫助臨床醫(yī)生針對國情,在沒有有效的復(fù)查系統(tǒng)的情況下,選擇更適用于社區(qū)和學(xué)校的窩溝封閉劑。 另一方面,如果我們能了解具體造成材料之間保留率和防齲效果差異的原因,有助有目的性的改善材料的性質(zhì)。同時,臨床醫(yī)生傾向于使用在口內(nèi)效果有保障的材料。而作為牙科材料要求最高的性質(zhì)就是耐磨性,決定了材料在口內(nèi)的壽命。為了比較樹脂和玻璃離子作為窩溝封閉劑時的耐磨性,我們將窩溝封閉后的離體牙置于體外模擬的咀嚼過程,加入磨耗性的介質(zhì)以加快其磨耗過程。然后測量窩溝封閉劑材料德爾磨耗。輪廓掃描儀掃描磨耗前和磨耗后的牙合面,然后計算材料磨耗的平均高度。 第一部分窩溝封閉防齲實驗 實驗1：窩溝封閉劑4年保留率 目的：研究假設(shè)是,高粘度玻璃離子和glass-carbomer窩溝封閉劑的牙合面和光滑面的完全和部分累計保留率均高于樹脂窩溝封閉劑；LED光照后的高粘度玻璃離子窩溝封閉劑的牙合面和光滑面的完全和部分累計保留率均高于單純的高粘度玻璃離子窩溝封閉劑。 方法：共有405名兒童(平均年齡8歲)納入隨機(jī)臨床試驗。三名牙醫(yī)對這些高患齲風(fēng)險兒童實施第一恒磨牙窩溝封閉。于封閉后半年、1年、2年、3年和四年后對封閉劑保留情況進(jìn)行評分。Kaplan-Meier生存分析、ANOVA和t檢驗用于最終的結(jié)果分析。 結(jié)果：共有1304顆第一恒磨牙被封閉,四年后兒童和窩溝封閉劑的失訪率分別為12.3%和15.4%。不論是根據(jù)傳統(tǒng)的窩溝封閉劑評分標(biāo)準(zhǔn)還是改良標(biāo)準(zhǔn),樹脂窩溝封閉劑在牙合面和光滑面的完全和部分保留率最高,glass carbomer組窩溝封閉劑最低。光照后的高粘度玻璃離子窩溝封閉劑牙合面和光滑面的完全和部分保留率和無光照的高粘度玻璃離子并沒有統(tǒng)計學(xué)差異。 結(jié)論：四年后glass carbomer的保留率最低。LED光照不能提高高粘度玻璃離子窩溝封閉劑的保留率。 實驗2：窩溝封閉劑四年防齲效果 目的：實驗假說是,四年后,光照后的高粘度玻璃離子和glass-carbomer窩溝封閉劑,和比無光照的高粘度玻璃離子和樹脂窩溝封閉劑相比,能保護(hù)更多窩溝點隙不發(fā)生和發(fā)展成牙本質(zhì)齲。 方法：共有405名兒童(平均年齡8歲)納入隨機(jī)臨床試驗。三名牙醫(yī)對這些高患齲風(fēng)險兒童實施第一恒磨牙窩溝封閉。于封閉后半年、1年、2年、3年和四年后對封閉劑保留情況進(jìn)行評分。Kaplan-Meier生存分析、ANOVA和t檢驗用于最終的結(jié)果分析。 結(jié)果：共有1304顆第一恒磨牙被封閉,四年后兒童和窩溝封閉劑的失訪率分別為12.3%和15.4%。四年后有42名兒童發(fā)生包括39處牙合面和7處光滑面在內(nèi)的共46處新生牙本質(zhì)齲。光照后的玻璃離子組未發(fā)生牙本質(zhì)齲的牙合面比例(98%)顯著高于樹脂組(96.4%)和glass-carbomer組(94.5%)。glass-carbomer組未發(fā)生牙本質(zhì)齲的牙合面比例低于無光照的玻璃離子組(97.3%)。四組間未發(fā)生牙本質(zhì)齲的光滑面比例沒有統(tǒng)計學(xué)差異。 意義：光照后的高粘度玻璃離子窩溝封閉劑預(yù)防牙本質(zhì)齲的效果最好。 第二部分：有樹脂涂層的高粘度玻璃離子窩溝封閉劑體外磨耗實驗 目的：測試在高粘度玻璃離子窩溝封閉劑表面涂布樹脂層后是否能增強(qiáng)其耐磨性,并與普通高粘度玻璃離子和樹脂窩溝封閉劑的耐磨性作比較。 方法：48顆外科拔除的第三磨牙分為三組,分別用樹脂(Clinpro),普通高粘度玻璃離子(KMEM)和表面樹脂涂層的高粘度玻璃離子(Equia系統(tǒng))封閉牙合面。在RubRoll咀嚼模擬器和ACTA磨耗性混合液模擬臨床磨耗過程。120,000個咀嚼周期后,用輪廓掃描儀測量窩溝封閉劑和釉質(zhì)的平均高度損失。數(shù)據(jù)分析中使用配對t檢驗和ANOVA檢驗。 結(jié)果：表面磨耗測量的重復(fù)性實驗顯示其可重復(fù)性良好(p=0.303)。三種材料平均磨耗高度分別為29.88μm (Clinpro),36.85μm (KMEM) and35.26μm (Equia系統(tǒng)),沒有統(tǒng)計學(xué)差異。 結(jié)論：表面樹脂涂層的高粘度玻璃離子的耐磨性并不優(yōu)于樹脂或普通高粘度玻璃離子
[Abstract]:As one of the most common diseases in the oral cavity, dental caries often accompanies the problems of pain, depression, beauty and communication disorder, which affects the normal life and reduces the quality of life. It has been shown that the closure of permanent teeth fossa in children and adolescents can effectively reduce the incidence of dental caries. Compared with the permanent teeth closed by the pit ditch closed permanent teeth and the unlined pit ditch, the possibility of filling and repairing needs to be smaller, the treatment time needs to be repaired, and the scope of the restoration body is smaller. both the resin and the glass ions can be used in the pit-gap In this study, there are two new types of glass ionomer listed, glass-carbomer and Ketac Molar Easymox (KMEM), which have great physical mechanical strength compared with traditional glass ionomer materials. In this study, the retention rate and anticaries effect and the most commonly used resin materials were used in the study. In addition, a new method for the application of glass ion is compared, and the LED is used before it is fully cured when applied to the socket groove. No blank control group was set up for the reason of medical ethics. According to the group, we hope that the results of the experiment can be given to the actual guidance of the caries prevention work of the clinical pit and fissure sealant, which can help the clinician to select the socket seal more suitable for the community and the school in the absence of an effective review system. On the other hand, if we can learn more about the difference between the retention rate and the caries prevention effect between materials, it is helpful to improve the purpose. The nature of the material. At the same time, clinicians tend to use the effect in the mouth The highest quality of the dental material is wear resistance, and the material is determined. In order to compare the wear resistance of the resin and the glass ion as the groove sealant, we put the off-body tooth enclosed in the fossa in the process of in vitro simulation, and the wear-resistant medium was added to speed up. Its wearing course is measured, and then the groove sealant material is measured. Material Delwear. Profile scanner scans worn surfaces before and after wear, and then calculates material wear Average height of the first part. Experimental Study on the Closed Anti-caries Experiment of Sub-fossa 1: 4-year retention rate of pit-and-groove sealant: The assumption is that high-viscosity glass ionomer and glass-carbomer socket sealant have full and partial fatigue on the occlusal and smooth surfaces of the sealant. The retention rate is higher than the resin nest sealant; the total and partial cumulative retention of the high-viscosity glass ionomer socket sealant after LED illumination is higher than that of the single Pure high viscosity glass ionomer socket sealant. Method: A total of 405 children Children (mean age 8 years) were included in a randomized clinical trial. Three dentists were high on these The children with caries risk are closed with the first permanent molar fossa. Half year, 1 year, 2 years, 3 years after the closure. Retention of the sealant after year and four years. Kaplan-Meier survival analysis, A NOVA and t test were used for the final analysis of the results. Results: A total of 1304 first permanent molars were closed, and four years later the children and socket were sealed. The loss-of-visit rate of the closing agent was 12. 3% and 15. 4%, respectively. The lowest in the glass carbomer group, and the full and partial retention of the surface and smooth surface of the high-viscosity glass ionomer cement. and there was no statistical difference in the high viscosity glass ions without illumination.: After four years, the retention rate of glass carbomer is the least. LE D Illumination can't improve the high viscosity glass ion nest The retention rate of the fissure sealant. Experiment 2: The purpose of the four-year anti-caries effect of the pit and fissure sealant: the experimental hypothesis is that after four years, the high-viscosity glass ionomer and glass-carbomer after light irradiation dimple sealant, and high viscosity glass ions and trees that are less light Compared with the pit-groove blocking agent, it is possible to protect the gap of more fossa grooves from occurring and develop into dentin. Caries. Methods: A total of 405 children (mean age 8 years) were included. Randomized clinical trial. Three dentists performed the first permanent molar pit closure for children with high dental caries risk After half-year, 1-year, 2-year, 3-year, and four-year closure, the retention of the sealant was scored. Kap Allan-Meier survival analysis, ANOVA, and t test were used for final results analysis. Results: There were 1304 first constant After four years, the loss-of-visit rates of the children and the fissure sealant were 12. 3% and 15. 4%, respectively. There were 42 children with a total of 46 new dentinal caries, including 39 teeth and 7 smooth surfaces. The proportion of dental caries (98%) in the glass ionomer group after illumination was significantly higher than that of the resin group (96.4%) and the glass-carbomer group (94.5%). glass-carbo The ratio of occlusal surface of non-dentinal caries in mer group was lower than that of non-irradiated glass. The proportion of smooth surfaces between the four groups of non-dentinal caries was not lower than that in the group. Significance: Prevention of high-viscosity glass ionomer socket sealant after light irradiation The effect of dentin caries is best. Part 2: High viscosity glass ionomer cement with resin coating In vitro abrasion experiment purpose: Test in high-viscosity glass ionomer cement The wear resistance of the surface-coated resin layer can be enhanced, and compared with the wear resistance of the common high-viscosity glass ionomer and the resin dimple sealant. o) Common high viscosity glass ionomer (KMEM) and surface resin coated high viscosity glass ion (Equia system) closed denture face. Mix in Rubroll wear simulator and ACTA attrition Fluid simulation clinical wear process. 120,000 weeks After the period, the mean height loss of the groove sealant and enamel was measured with a contour scanner. Paired t-test and ANOVA test. Results: Repeatability of surface wear measurements showed good repeatability (p = 0.303). The average wear height of the three materials was 29. 88. m (Clinpro),36.85渭m (KMEM) and35.26渭m (Equ
【學(xué)位授予單位】：武漢大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2014
【分類號】：R781.1
[Abstract]:As one of the most common diseases in the oral cavity, dental caries often accompanies the problems of pain, depression, beauty and communication disorder, which affects the normal life and reduces the quality of life. It has been shown that the closure of permanent teeth fossa in children and adolescents can effectively reduce the incidence of dental caries. Compared with the permanent teeth closed by the pit ditch closed permanent teeth and the unlined pit ditch, the possibility of filling and repairing needs to be smaller, the treatment time needs to be repaired, and the scope of the restoration body is smaller. both the resin and the glass ions can be used in the pit-gap In this study, there are two new types of glass ionomer listed, glass-carbomer and Ketac Molar Easymox (KMEM), which have great physical mechanical strength compared with traditional glass ionomer materials. In this study, the retention rate and anticaries effect and the most commonly used resin materials were used in the study. In addition, a new method for the application of glass ion is compared, and the LED is used before it is fully cured when applied to the socket groove. No blank control group was set up for the reason of medical ethics. According to the group, we hope that the results of the experiment can be given to the actual guidance of the caries prevention work of the clinical pit and fissure sealant, which can help the clinician to select the socket seal more suitable for the community and the school in the absence of an effective review system. On the other hand, if we can learn more about the difference between the retention rate and the caries prevention effect between materials, it is helpful to improve the purpose. The nature of the material. At the same time, clinicians tend to use the effect in the mouth The highest quality of the dental material is wear resistance, and the material is determined. In order to compare the wear resistance of the resin and the glass ion as the groove sealant, we put the off-body tooth enclosed in the fossa in the process of in vitro simulation, and the wear-resistant medium was added to speed up. Its wearing course is measured, and then the groove sealant material is measured. Material Delwear. Profile scanner scans worn surfaces before and after wear, and then calculates material wear Average height of the first part. Experimental Study on the Closed Anti-caries Experiment of Sub-fossa 1: 4-year retention rate of pit-and-groove sealant: The assumption is that high-viscosity glass ionomer and glass-carbomer socket sealant have full and partial fatigue on the occlusal and smooth surfaces of the sealant. The retention rate is higher than the resin nest sealant; the total and partial cumulative retention of the high-viscosity glass ionomer socket sealant after LED illumination is higher than that of the single Pure high viscosity glass ionomer socket sealant. Method: A total of 405 children Children (mean age 8 years) were included in a randomized clinical trial. Three dentists were high on these The children with caries risk are closed with the first permanent molar fossa. Half year, 1 year, 2 years, 3 years after the closure. Retention of the sealant after year and four years. Kaplan-Meier survival analysis, A NOVA and t test were used for the final analysis of the results. Results: A total of 1304 first permanent molars were closed, and four years later the children and socket were sealed. The loss-of-visit rate of the closing agent was 12. 3% and 15. 4%, respectively. The lowest in the glass carbomer group, and the full and partial retention of the surface and smooth surface of the high-viscosity glass ionomer cement. and there was no statistical difference in the high viscosity glass ions without illumination.: After four years, the retention rate of glass carbomer is the least. LE D Illumination can't improve the high viscosity glass ion nest The retention rate of the fissure sealant. Experiment 2: The purpose of the four-year anti-caries effect of the pit and fissure sealant: the experimental hypothesis is that after four years, the high-viscosity glass ionomer and glass-carbomer after light irradiation dimple sealant, and high viscosity glass ions and trees that are less light Compared with the pit-groove blocking agent, it is possible to protect the gap of more fossa grooves from occurring and develop into dentin. Caries. Methods: A total of 405 children (mean age 8 years) were included. Randomized clinical trial. Three dentists performed the first permanent molar pit closure for children with high dental caries risk After half-year, 1-year, 2-year, 3-year, and four-year closure, the retention of the sealant was scored. Kap Allan-Meier survival analysis, ANOVA, and t test were used for final results analysis. Results: There were 1304 first constant After four years, the loss-of-visit rates of the children and the fissure sealant were 12. 3% and 15. 4%, respectively. There were 42 children with a total of 46 new dentinal caries, including 39 teeth and 7 smooth surfaces. The proportion of dental caries (98%) in the glass ionomer group after illumination was significantly higher than that of the resin group (96.4%) and the glass-carbomer group (94.5%). glass-carbo The ratio of occlusal surface of non-dentinal caries in mer group was lower than that of non-irradiated glass. The proportion of smooth surfaces between the four groups of non-dentinal caries was not lower than that in the group. Significance: Prevention of high-viscosity glass ionomer socket sealant after light irradiation The effect of dentin caries is best. Part 2: High viscosity glass ionomer cement with resin coating In vitro abrasion experiment purpose: Test in high-viscosity glass ionomer cement The wear resistance of the surface-coated resin layer can be enhanced, and compared with the wear resistance of the common high-viscosity glass ionomer and the resin dimple sealant. o) Common high viscosity glass ionomer (KMEM) and surface resin coated high viscosity glass ion (Equia system) closed denture face. Mix in Rubroll wear simulator and ACTA attrition Fluid simulation clinical wear process. 120,000 weeks After the period, the mean height loss of the groove sealant and enamel was measured with a contour scanner. Paired t-test and ANOVA test. Results: Repeatability of surface wear measurements showed good repeatability (p = 0.303). The average wear height of the three materials was 29. 88. m (Clinpro),36.85渭m (KMEM) and35.26渭m (Equ
【學(xué)位授予單位】：武漢大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2014
【分類號】：R781.1
【共引文獻(xiàn)】
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