本文選題：正畸 + 漂白　； 參考：《第二軍醫(yī)大學(xué)》2016年碩士論文

【摘要】：背景目的:固定正畸后牙齒表面顏色的變化,往往影響患者對正畸后的總體效果評價(jià)。臨床上較多的固定正畸后患者,因牙齒顏色不滿意,而要求進(jìn)行改善牙齒顏色的美容治療。關(guān)于固定正畸前后的顏色變化已有相關(guān)文獻(xiàn)報(bào)道。而對引起固定正畸后牙齒顏色變化相關(guān)原因及相關(guān)治療方法的研究報(bào)道較少。因此,本課題將應(yīng)用離體牙模擬固定正畸托槽粘結(jié)和去粘結(jié)的過程,來分析和探討不同粘結(jié)劑種類以及不同治療方法對牙齒表面粗糙程度和顏色的影響,為固定正畸后變色牙的預(yù)防和治療提供參考。方法:1.選擇A2色離體牙117顆,分成A組(化學(xué)固化樹脂粘結(jié)托槽)、B組(光固化樹脂粘結(jié)托槽)、C組(未粘結(jié)托槽)各39顆。3組樣本浸泡在水中,恒溫37°,2天。2天后,A組、B組離體牙進(jìn)行托槽拆除去粘結(jié),3組各隨機(jī)選擇3顆離體牙進(jìn)行掃描電鏡觀察。2.將剩余A組、B組、C組每組36顆,人工染色劑浸泡7天,染色前后離體牙頰面中1/3分別進(jìn)行分光光度計(jì)測色,記錄明度值L*、紅綠色值a*、黃藍(lán)色值b*。3.染色后A組、B組、C組,每組分別隨機(jī)分成噴砂組、漂白組、空白對照組3個(gè)亞組,每組各12顆離體牙。噴砂組:噴砂機(jī)距離牙面3mm成45°角噴砂20s。漂白組:牙面涂抹35%過氧化氫漂白劑2-3mm厚,冷光美白儀工作燈光照3次,每次10min�？瞻讓φ战M:未處理。在噴砂、漂白處理后分別分光光度計(jì)測色,記錄L*、a*、b*值。4.在A組、B組、C組中隨機(jī)選擇噴砂、漂白處理后離體牙各3顆,進(jìn)行掃描電鏡觀察。結(jié)果:1.掃描電鏡觀察結(jié)果:(1)A組、B組、C組托槽去粘結(jié)后的表面粗糙程度結(jié)果:A組㧐B組㧐C組。(2)A組、B組、C組著色牙,不同處理后的牙面粗糙程度結(jié)果均是:噴砂㧐漂白㧐空白對照。噴砂后和漂白后A組、B組、C組的粗糙程度結(jié)果均是:B組㧐A組㧐C組。2.顏色參數(shù)測量結(jié)果(1)A組、B組、C組離體牙在染色處理后,L*值均減小,a*、b*值均增大。三組兩兩比較,a*、b*的變化量及色差(Δa*、Δb*、ΔE)均有差異,A組㧐B組㧐C組。A組、B組L*的變化量(ΔL*)差異無統(tǒng)計(jì)學(xué)意義,C組與A組、B組的差異均有統(tǒng)計(jì)學(xué)意義,A組、B組㧐C組。(2)甲因素粘結(jié)劑種類(A組、B組、C組)、乙因素處理方法(噴砂、漂白、空白對照)對牙齒顏色的ΔL*、Δa*、Δb*、ΔE均有影響,除了粘結(jié)劑種類對ΔL*無影響,且兩因素間有交互作用。A組、B組、C組兩兩比較,A組與B組的△a*、△b*、△E均無統(tǒng)計(jì)學(xué)差異,而A組與C組、B組與C組均有統(tǒng)計(jì)學(xué)差異,且C組㧐A組、B組。噴砂、漂白、空白對照兩兩比較,其△L*、△a*、△b*、△E均有統(tǒng)計(jì)學(xué)差異,且漂白噴砂空白對照。C組漂白后△L*、△a*、△b*、△E的值均最大。噴砂和漂白后L*值升高,a*、b*值降低。結(jié)論:1.在本實(shí)驗(yàn)條件下,不同托槽粘結(jié)劑對去粘結(jié)后牙面粗糙程度和顏色的影響不同,光固化樹脂粘結(jié)劑組的粗糙程度小且不易染色,可減少托槽去粘結(jié)后牙齒變色的發(fā)生。2.不同托槽粘結(jié)劑的應(yīng)用與噴砂或漂白處理后牙面的粗糙程度相關(guān),化學(xué)固化樹脂粘結(jié)劑組噴砂或漂白后的粗糙程度均小于光固化樹脂粘結(jié)劑組。3.噴砂、漂白的應(yīng)用增加了各組牙面的粗糙程度,但顏色得到了改善,其中漂白的短期效果明顯優(yōu)于噴砂。4.初步建議臨床選擇化學(xué)固化樹脂粘結(jié)劑用于托槽粘結(jié),漂白用于美化托槽去粘結(jié)后牙面顏色,并應(yīng)用拋光技術(shù)鞏固療效,為固定正畸后牙齒顏色美容提供參考。
[Abstract]:Background Objective: the changes in the color of the tooth surface after fixed orthodontics often affect the overall effect evaluation of the patients after orthodontics. The patients with more fixed orthodontics in clinical practice require cosmetic treatment to improve the color of the teeth because of the unsatisfactory color of the teeth. The related literature on the color changes before and after the fixed orthodontics has been reported. There are few reports on the related causes of tooth color change and related treatment methods after orthodontic orthodontics. Therefore, this topic will be used to simulate the process of bonding and disbonding of fixed orthodontic brackets in vitro, to analyze and discuss the effects of different kinds of adhesives and different treatments on the surface roughness and color of teeth, for fixed orthodontic orthodontics. To provide reference for the prevention and treatment of discoloration teeth. Methods: 1. select 117 A2 color isolated teeth, divided into A group (chemical curing resin bonding bracket), group B (light cured resin bond brackets), 39.3 group samples of group C (unbonded brackets) in water, constant temperature 37 degrees, 2 days.2 days, A group, B group tooth with bracket dismantling to bond, the 3 groups were randomly selected. 3 isolated teeth were examined by scanning electron microscopy (SEM) to observe the remaining A group, group B, group C and group C for 7 days and 7 days by artificial colorant. The brightness value L*, red green value a*, A group, B group, C group were randomly divided into the sandblasting group, the bleaching group and the blank group respectively. Group 3 subgroups, each group of 12 teeth. Sandblasting group: sandblasting machine from the tooth surface 3mm into 45 degree angle sandblasting 20s. bleaching group: tooth surface smear 35% hydrogen peroxide bleaching agent 2-3mm thick, cold light whitening instrument lighting 3 times, every time 10min. blank control group: no treatment. After the sandblasting, bleaching, respectively spectrophotometer test color, record L*, a*, b* value.4. in.4. in In group A, group B and group C, random selection of sand spraying and 3 isolated teeth after bleaching were observed by scanning electron microscope. Results: 1. scanning electron microscope observation results: (1) the surface roughness of group A, B group and C group after bonding: A group B group? C group. (2) A group, B group, C group tooth roughness results were all: sandblasting? Bleach? Empty results after different treatment After and after bleaching, the results of the roughness of group A, B group and C group were all: B group? A group? C group.2. color parameter measurement results (1) A, B group and C group, L* value decreased, a*, and chromatic difference (Delta, Delta, delta) were all different. There was no statistical significance in the difference of the quantity (delta L*). The difference between group C and group A and group B had statistical significance, group A, B group and C group. (2) the type of a factor adhesive (A, B, C), and the B factor treatment (sandblasting, bleaching, blank control) had influence on the tooth color Delta L*, Delta a*, Delta and delta, except for the type of adhesive, and there were two factors. There were no statistical differences between group.A, group B and group C 22, Delta a*, Delta b*, and E in group A and B group, while A group and C group, B group and C group were statistically different. The values of delta b* and delta E were both maximum. The L* value increased after sandblasting and bleaching, and a* and b* value decreased. Conclusion: 1. under the conditions of this experiment, different bracket adhesives have different effects on the roughness and color of the tooth surface, and the roughness of the light cured resin binder group is small and not easy to stain, which can reduce the difference of the tooth discoloration after the brackets are bonded to.2.. The application of the bracing binder is related to the roughness of the tooth surface treated with sand blasting or bleaching. The roughness of the chemical curing resin binder group is less than that of the.3.. The application of bleaching increases the roughness of each tooth surface, but the color is improved, and the short-term effect of bleaching is obvious. Better than sandblasting.4., it is suggested that the clinical selection of chemically cured resin binder is used for the bonding of brackets, and bleaching is used to beautify the color of the tooth surface of the brackets, and to consolidate the curative effect by using the polishing technique, and provide a reference for the fixation of orthodontic tooth color beauty.
【學(xué)位授予單位】：第二軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R783.5

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