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Comprehensive Evaluation of the Different Basic Periodontal Treatment Techniques

Author: ZhouLiHua
Tutor: WangQinTao；DongGuangYing；WangXinWen
School: Fourth Military Medical University
Course: Clinical Stomatology
Keywords: Periodontitis Basic treatment Surface roughness Cell adhesion Cell proliferation
CLC: R781.4
Type: Master's thesis
Year: 2011
Downloads: 84
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Abstract

Periodontal disease is a chronic infectious disease caused by microorganisms in the plaque, periodontal support, clinical common hazard is chronic periodontitis, has become the leading cause of adult tooth loss. Periodontitis as a chronic disease and its treatment is a long-term process of gradual implementation, including a variety of means, orderly, individualized treatment programs for each patient to formulate. Periodontal therapy as a treatment of periodontal overall premise is the core and the main content of the periodontal treatment, the effect of the consolidation, the fundamental way to prevent recurrence, affecting the efficacy of good or bad a critical stage [1]. Supragingival scaling using instruments to remove the surface of the tooth plaque, tartar, scaling and root planing to eliminate pathogenic factors, the purpose of promoting the reattachment of connective tissue, is the most important in the treatment of periodontal the most crucial and the most basic content. Currently, clinical instruments Gracey curette and ultrasonic scaler. Gracey curette area dedicated scalers, which is characterized by a unique blade and long, curved neck, the various curved design makes the complex shape of root-scaling operation is relatively easy. However, due to the complexity of the root surface morphology and after dental loss site, hand instruments used during the deep parts of points and the posterior region of operation, there are a number of drawbacks, such as the operating difficulties, low efficiency, the patient feels discomfort, postoperative root surface sensitive, doctor tired susceptible to carpal tunnel syndrome. With the development of ultrasound technology, ultrasonic treatment because of its convenient operation, saving time and efficient gradually become the mainstream of periodontal therapy. However, the two major categories of ultrasonic treatment (piezoelectric ceramic or magnetostrictive) are mostly low-frequency ultrasound, its sharp movement in the process of using easy root surface vibrations cause the patient discomfort, and might even be root surface formation damage;, cavitation work, own sprinkler and local exudate produced aerosol contains a large number of pathogens likely to cause ablation area and surrounding cross-infection. In the the periodontal treatment process, the works of different therapeutic devices, efficiency, correct selection will largely affect the efficacy and the patient's response; patient visits may generate tension and fear, will be a direct result of postpone or evade treatment, missed the best time of treatment, resulting in heavier periodontal tissue destruction, the impact of the effect of periodontal treatment. Therefore, to ensure clean, scaling quality on the basis of how to relieve the pain of patients, to improve the comfort of treatment, so as to stabilize the patient's mental state is an important aspect of improving periodontal treatment. Vector periodontal therapy instrument is the latest development of a dental ultrasonic treatment system. Vector system is different from the traditional methods of periodontal therapy that can get the exact effect at the same time, in the course of treatment to reduce the patient's pain, to ease the patient's fear. But domestic yet there is little special in vitro and in clinical trials to comprehensively compare and evaluate the Vector system with conventional periodontal treatment efficacy and the advantages and disadvantages of clinical reasonable application brings certain difficulties. This study from in vitro experiments and clinical trials Vector system, Gracey instruments and conventional ultrasonic scaling is used for the treatment of chronic periodontitis foundation near term efficacy was assessed to provide some guidance for the selection of clinical treatment . Objective: different periodontal treatment in vitro observation technology vivo experiments comparing different periodontal treatment of chronic periodontal root surface roughness of chronic periodontitis teeth and periodontal ligament cell adhesion and proliferation; the treatment of inflammation of the clinical application of characteristics as well as patients of different therapeutic devices dental fear level; comprehensive evaluation Vector system, Gracey instruments and ultrasonic scaling on the basis of chronic periodontitis treatment effect. Method: 1, choose 24 of the unplug the teeth due to chronic periodontitis, were randomly divided into three groups: Gracey curette treated with conventional ultrasonic scaling treatment group and Vector system treated in vitro root planing. Prepared after processing the root slice. Each group were two root pieces using an atomic force microscope to observe the surface roughness, two root slice the root surface morphology using scanning electron microscopy. Each group to take another 12 root pieces in their previous vaccination periodontal ligament fibroblasts, 1,3,5 days after inoculation, using scanning electron microscopy of cell adhesion and cell counts using DAPI staining. 2, 30 patients with chronic periodontitis were randomly divided into the Gracey curette Group and Vector systems group two sets of line gingival scaling and root planing, with 15 cases each. Fill in the Dental Fear Scale preoperative detection of various clinical indicators (probing the Bleeding Index BOP, gingival index GI, to explore probing depth PD); January after having to fill dental fear scale; 1,3,6 detection the clinical indicators. Results: 1, atomic force microscopy results show The Vector group root surface surface roughness slightly lower than Gracey group was significantly lower than the ultrasound group. From a scanning electron microscope to: Gracey the group root surface part of the region of cementum missing, dentinal tubules exposed; visible part of the region of the root surface of the conventional ultrasound group irregular scratches, smooth root surface of the Vector Group. 1 days after inoculation cells Vector group and Gracey cell adhesion similar periodontal ligament fibroblasts attached to a relatively large; compared with Gracey, Vector Group full extension in the first three days of cells Patches trend to 5 The day is completely integrated into the film. Vector group and Gracey group root-chip cell number and proliferation is no significant difference between the two sets of the number of cells was significantly higher than the ultrasound group, with a statistically significant difference. Vector system and Gracey device therapy may make patients with bleeding on probing (BOP) positive rate significantly lower mean gingival index (GI) and probing depth (PD). The majority of patients with obvious feeling the Vector system better comfort than hand instruments group, the Vector system can achieve painless or slightly pain could be tolerated. DFS subjective scales: Gracey patients after treatment DFS score than before treatment improved DFS the Vector group patients after treatment the score significantly lower; contrast between the two groups show Vector group and Gracey group DFS score change statistics significance. Conclusion: The Vector system after root planing, smooth root surface can be formed in the case of a relatively small loss of root substance. This is a reasonable choice for mild periodontal maintenance therapy. 2. Polishing liquid Vector system can root planing to promote attachment and proliferation of fibroblasts. Vector system root planing and the Gracey equipment similar treatment effect can be obtained. Vector systems for hand instruments can reduce the patient's the psychological fear level in periodontal treatment as well as treatment stimulates Anxiety can better maintain the stability of the patient's mental state, thereby enhancing patient compliance.

Comprehensive Evaluation of the Different Basic Periodontal Treatment Techniques

Abstract

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