不同抛光方法对前牙邻面去釉后邻接触点及龈方牙釉质抛光效果的影响

Influence of Different Polishing Methods on the Polishing Effect of Adjacent Contact Points and Gingival Tooth Enamel of Anterior Teeth after Adjacent Enamel Removal

目的:通过离体牙实验,比较不同抛光方法对邻面去釉后的邻接触点及龈外展隙区域的牙釉质表面粗糙度的影响。方法:选择因正畸或牙周病原因拔除的前牙40颗,随机分为三个实验组和一个对照组,每组20个邻面。各组采用不同的抛光器械进行抛光,Ⅰ组:3M Sof-lex抛光盘;Ⅱ组:3M Sof-lex抛光盘,3M Sof-lex抛光条;Ⅲ组:3M Sof-lex抛光盘,而至Epitex抛光条。Ⅳ组:对照组(未去釉组)。用激光共聚焦显微镜测量各组的邻接触区和邻接触区下方的釉质表面粗糙度,并观察其表面形貌。采用SPSS25.0软件包对数据进行Kruskal-Wallis秩和检验。结果:(1)所有实验组邻接触点区域的釉质表面粗糙度都低于对照组,差异有统计学意义(P<0.05)。其中Ⅰ组的粗糙度最大,其次为Ⅱ组和Ⅲ组。(2)邻接触点下方区域的表面粗糙度Ⅰ组大于对照组,差异有统计学意义(P<0.05),Ⅱ组和Ⅲ组的表面粗糙度小于对照组,差异有统计学意义(P<0.05),且Ⅲ组的表面更光滑。结论:邻面去釉后,牙釉质表面的粗糙度增加,规范的抛光可以降低牙釉质表面粗糙度。邻接触点下方的龈外展隙区域单纯采用机用抛光盘进行抛光效果不佳。采用机用抛光盘结合手用抛光条对邻面去釉后的邻接触区和龈外展隙处的牙釉质进行抛光,可以获得理想的抛光效果。抛光条粒度过渡更好的情况下,抛光效果更好。

Objective:To compare the effects of different polishing methods on the enamel surface roughness of the adjacent contact and the gingival embrasure area after the interproximal enamel reduction(IER).Methods:40 anterior teeth extracted due to orthodontic or periodontal disease were randomly divided into four group(three experimental groups and one control group),each with 10 teeth.Different polishing instruments were used for polishing in each group,groupⅠ:3M Sof lex polishing disc;groupⅡ:3M Sof lex polishing disc,3M Sof lex polishing strip;groupⅢ:3M Sof lex polishing disc,Epitex polishing strip;groupⅣ:control group(no IER).The surface roughness of enamel in each group was measured by Laser scaning confocal microscope(LSCM),and the surface morphology was observed.Results:(1)The enamel surface roughness of the adjacent contact area of all experimental groups was statistically lower than that of the control group(P<0.05).The roughness of groupⅠis the largest,followed by groupⅡand groupⅢ.(2)The surface roughness of the gingival embrasure area in groupⅠwas statistically larger than that in groupⅣ(P<0.05).The surface roughness of groupⅡand groupⅢwas significantly smaller than that in groupⅣ(P<0.05).Conclusion:The surface roughness of enamel increases after IER,and standard polishing can reduce the surface roughness.Simply using polishing disc to polish the enamel located in gingival embrasure is not effective.The ideal polishing effect can be obtained by polishing the enamel with polishing disc and polishing strip.The polishing effect is better when the grain size of polishing strip is smaller.