【作者】 闫智奇；

【导师】 朱玲；

【作者基本信息】 南京医科大学 ， 口腔临床医学， 2009， 硕士

【摘要】 空气喷磨是微创去腐制洞技术的一种,由Black提出,它是通过一束高速运动的三氧化二铝粒子,以很高的动能撞击牙体组织而产生切割作用。它具备一些传统方法所没有的优点,如产热少、噪音小、无震动、安全、不需麻醉以及可最大限度保存牙体组织等。对于具有牙科恐惧症儿童患者的龋病治疗具有重要的临床意义。本研究目的:探讨空气喷磨备洞对乳牙树脂充填的影响,为空气喷磨技术在临床上的应用提供理论依据。第一部分:儿童畏惧症相关因素分析目的:探讨儿童牙科畏惧症(dental fear, DF)的发生情况及产生原因。方法:采用临床焦虑行为级别评定量表对209例儿童牙病患者进行调查及统计分析。治疗前问卷式调查、填表,治疗后记录患儿DF发生情况。结果:不同年龄儿童的DF发生率无统计学差异;不同性别及是否有牙科经历的儿童,DF发生率有统计学差异。而疼痛是诱发畏惧症的主要原因,其次是涡轮机(牙钻)备洞。结论:儿童DF的发生与患儿不良的牙科经历、疼痛、涡轮机(牙钻)备洞等因素有关。儿童DF直接影响儿童牙病的防治工作第二部分空气喷磨对乳牙树脂充填微渗漏的影响目的:体外评价空气喷磨备洞与常规涡轮机备洞对乳牙树脂充填微渗漏的影响。方法:对照组(Ⅰ, n=12)对人离体乳磨牙常规备洞,其余组分别用27μm(Ⅱ,n=12)和50μm(Ⅲ,n=12)氧化铝微粒空气喷磨备洞。每组抽取2颗样本,其中一颗牙齿进行酸蚀,均行扫描电镜对比观察。余留牙树脂充填、热循环处理后亚甲基蓝溶液染色。结果:1. 27μm氧化铝微粒空气喷磨与常规涡轮机备洞比较无显著差别(p>0.05)。50μm氧化铝颗粒空气喷磨较常规涡轮机备洞能显著减少乳牙树脂充填的微渗漏(p<0.05)。但50μm与27μm组间无显著差别(p>0.05)。2.扫描电镜观察:空气喷磨加酸蚀样本的牙齿表面形态与单纯空气喷磨或常规涡轮机备洞者比较,呈规则的蜂窝状。结论: 50μm氧化铝颗粒空气喷磨可显著减少乳牙树脂充填的微渗漏。第三部分空气喷磨对乳牙三种充填材料黏接性能的影响目的:体外评价空气喷磨技术应用于乳牙后,对不同材料微渗漏与微拉伸强度的影响。方法:1.Ⅰ-Ⅲ组样本用50μm氧化铝微粒空气喷磨备洞后,分别用纳米复合树脂、流动纳米树脂及光固化纳米玻璃离子三种材料充填窝洞。热循环处理后亚甲基蓝溶液染色观察微渗漏情况。2.Ⅳ、Ⅴ组样本切除冠部釉质暴露牙本质后,空气喷磨技术处理,分别用复合树脂与流动树脂充填。采用微拉伸技术,测试样本断裂时的最大应力。结果:1.微渗漏:三组间充填体微渗漏率差异有显著性(p<0.001),以流动树脂微渗漏率最低(p<0.05)。2.微拉伸:两组间微拉伸强度无显著差别(p>0.05)。结论:可流动纳米树脂用于乳牙空气喷磨备洞后充填可获得较好的边缘封闭性。更多还原

【Abstract】 The air abrasion is one kind of minimally invasive dentistry. It was proposed by Black and cuts by dashing against the dental tissue with high kinetic energy, through a bunch of high-speed aluminum oxide particles. It has some advantages which traditional methods don’t have, such as producing less heat, making less noise, no vibration, safety, without anesthesia, as well as to maximize the preservation of teeth, and so on. It’s full of important clinical significance to treatment the children who have decayed tooth but with dental fear.Part 1 Investigation of children’s dental fearObjective: To investigate the reason and related factors of children’s dental fear(DF). Methods: A total of 209 children who came to see dentists were evaluated using clinical ratings of anxiety and comparative behavior evaluation system, and the data statistically analyzed. Results: The survey showed that no significant difference in the incidence of DF between children of different ages, but there was significant difference among children with different sex, different dental experiences. Conclusion: The children’s DF was closely related to their ages, dental experiences,pain, turbine engine and so on.Part 2 Microleakage of composite resin restorations in primary molars after preparation with bur or air abrasion. Objective: The aim of this study was to assess microleakage in class I cavities prepared by air abrasion or high-speed dental bur in primary molars and restored with the composite resin.Methods: Thirty primary molars were equally divided into 3 groups. Group I (n=12,the control): preparation by high-speed; group II(n=12): preparation by air abrasion, using 27μm aluminum oxide particles; group III(n=12): preparation by air abrasion, using 50μm aluminum oxide particles. Two primary molars of each group,which one of them was etching,were observed by SEM. Preparations were placed with composite resin. All the primary molars in each group were thermocycled and dye penetration was evaluated in order scale. Results: 1. No significant differences existed between groups I and group II(p>0.05),but a statistical difference between groups I and groups III(p<0.05). 2. The tooth preparated by air abrasion with etching showed characteristic“honeycomb“pattern in SEM-micrograghs. Conclusion: Air abrasion preparation did influence microleakage in class I restorations with the composite resin.Part 3 Microleakage and microtensile bond stregth of different filling materials restorations in primary molars after preparation with air abrasion.Objective: The aim of this study was to assess microleakage and microtensile bond stregth in class I cavities prepared by air abrasion in primary molars and restored with different filling materials.Methods: 1. Group I - III: preparation by air abrasion, using 50μm aluminum oxide particles. Restorations filled with the composite resin, the flowable composites and the light-curing nano-lonomer restorative respectively. All primary molars in each group were thermocycled and dye penetration was evaluated in order scale. 2. GroupⅣ-Ⅴ: Superficial occlusal dentin were abrased with 50μm aluminum oxide particles, and a crown of different crued resin composite bonded . Microtensile testing was used to examine the microtensile bond strength.Results: 1. Statistcal analyses revealed a significant differences(p<0.001)in microleakage amomg three materials.The flowable composites showed the less microleakage compared to others(p<0.05). 2. No significant difference was found in the composite resin group and the flowable composites group(p>0.05). Conclusion: It can be conclued that flowable composites may be recommended to improve the marginal seal of a restoration.更多还原