多根牙龈下超声和手工刮治临床疗效及离体牙图像分析

The clinical and in vitro evaluation of manual and ultrasonic subgingival scaling using image analysis

目的 比较超声细线器和传统手工法对多根牙龈下刮治的临床和离体牙的除石效果。方法 12例中、重度牙周炎患者的 2 4颗磨牙 ,分别经两种方法刮治后 1个月 ,评价临床指标的改善。另外 6例牙周炎患者的12颗应拔的牙 ,刮治后用图像分析仪 ,离体观察刮治后根面和根分叉区残留菌斑、牙石的百分比。结果 两种方法治疗后 ,临床指标均有改善 (P <0 .0 5 ) ,当附着水平≥ 7mm时 ,细线器组优于手工组。在离体牙的根分叉区 ,细线器的除石效果优于手工 ,而非根分叉区则相反 ,但均无统计学意义的差异。结论 超声细线器刮治也是清除多根牙龈下菌斑、牙石及治疗牙周炎的一种有效手段 。

Objective To compare the effectiveness of traditional hand curetts and ultrasonic instrumentation (slimline) in subgingival scaling.Methods In clinical study,24 molar teeth were randomly treated with gracey curettes or slimline.Probing depth (PD),Bleeding Index (BI) and Clinical Attachment Level (CAL) were re-examined at 1 month after scaling.In vitro study,9 molar teeth (45areas) were extracted after scaling by hand or slimline,another 3 untreated molars (15areas) were selected as control.The residual plaque and calculus were analyzed using computer-assisted image analysis.Results No significant differences were found between the two methods.But,when baseling CAL was greater than 7mm the slimline treatment was more effective than curette (P< 0.05 ).In vitro,slimline scaling in furcation area was less in percent calculus remaining than hand curets.However,hand instrumentation was superior to slimline in non-furcation areas.Conclusion The results suggest that ultrasonic (slimline) scaling is also an effective method for subgingival calculus removal on molar teeth,especially in furcation area.