nkhani

Chiyambi

Zipangizo zokhazikika zochotsera mano opindika zimagwiritsidwa ntchito mu orthodontics kwa achinyamata komanso achikulire. Ngakhale masiku ano, ukhondo wovuta wamlomo komanso kuchuluka kwa zolembera ndi zotsalira zanyengo panthawi yamankhwala ogwiritsira ntchito ma multibracket (MBA) zikuwonjezeranso ngozi ina1. Kukula kwa demineralization, kuyambitsa kusintha koyera, kosasunthika mu enamel kumadziwika kuti zotupa zoyera (WSL), panthawi yamankhwala a MBA ndizovuta zomwe zimachitika pafupipafupi ndipo zimatha kuchitika patangotha ​​masabata 4 okha.

M'zaka zaposachedwa, chidwi chochulukirapo chaperekedwa pakusindikiza malo amtundu wa buccal ndikugwiritsa ntchito zotsekera zapadera ndi ma varnishi a fluoride. Zogulitsazi zikuyembekezeka kupereka zoteteza kwa nthawi yayitali komanso chitetezo china kuzipsinjo zakunja. Opanga osiyanasiyana amalonjeza kutetezedwa pakati pa miyezi 6 ndi 12 mutagwiritsa ntchito kamodzi. M'mabuku apano zotsatira zosiyanasiyana ndi malingaliro atha kupezeka okhudzana ndi njira zodzitetezera ndikupindulira pakugwiritsa ntchito mankhwalawa. Kuphatikiza apo, pali mawu osiyanasiyana okhudzana ndi kukana kwawo kupsinjika. Zinthu zisanu zomwe amagwiritsidwa ntchito mobwerezabwereza zidaphatikizidwa: zophatikiza zojambulidwa za Pro Seal, Light Bond (zonse Reliance Orthodontic Products, Itasca, Illinois, USA) ndi Clinpro XT Varnish (3 M Espe AG Dental Products, Seefeld, Germany). Anafufuzidwanso anali ma fluoride varnishes Fluor Protector awiri (Ivoclar Vivadent GmbH, Ellwangen, Germany) ndi Protecto CaF2 Nano One-Step-Seal (BonaDent GmbH, Frankfurt / Main, Germany). Chosunthika, chopepuka, chopopera cha radiyoque nanohybrid chinagwiritsidwa ntchito ngati gulu lowongolera (Tetric EvoFlow, Ivoclar Vivadent, Ellwangen, Germany).

Zisindikizo zisanuzi zomwe amagwiritsidwa ntchito pafupipafupi adafufuzidwa mu vitro pakulimbana kwawo atakumana ndi zovuta zamakina, kutentha kwa mafuta komanso kuwonekera kwa mankhwala komwe kumayambitsa demineralization ndipo chifukwa chake WSL.

Malingaliro otsatirawa ayesedwa:

1.Null hypothesis: Makina, matenthedwe ndi kupsinjika kwa mankhwala sizimakhudza ma sealants omwe amafufuzidwa.

2.Zosintha zina: Zovuta zamagetsi, zamatenthedwe komanso zamankhwala zimakhudza omwe adasindikizidwa.

Zida ndi njira

Mano akutsogolo kwa bovine 192 adagwiritsidwa ntchito pophunzira mu vitro. Mano a ng'ombe amachokera ku nyama zophera (malo ophera, Alzey, Germany). Njira zosankhira mano a bovine zinali zopanda kanthu- zopanda chilema, enamel yopanda vestibular popanda kusintha kwa dzino komanso kukula kokwanira kwa korona wa dzino4. Kusungira kunali mu 0.5% yankho la chloramine B.5, 6. Pambuyo ndi pambuyo pobowolera bulaketi, mawonekedwe osalala a mano onse a ng'ombe adatsukidwanso ndi mafuta opukutira mafuta ndi fluoride (Zircate Prophy Paste, Dentsply DeTrey GmbH, Konstanz, Germany), kutsukidwa ndi madzi ndikuumitsidwa ndi mpweya5. Mabakiteriya achitsulo opangidwa ndi chitsulo chosapanga dzimbiri chopanda faifi tambala adagwiritsidwa ntchito pophunzira (Mini-Sprint Brackets, Forestadent, Pforzheim, Germany). Mabakiteriya onse amagwiritsa ntchito UnitekEtching Gel, Transbond XT Light Cure Adhesive Primer ndi Transbond XT Light Cure Orthodontic Adhesive (onse 3 M Unitek GmbH, Seefeld, Germany). Pambuyo pakugwiritsa ntchito bulaketi, malo osalala owoneka bwino adatsukidwanso ndi Zircate Prophy Paste kuti achotse zotsalira zilizonse zomatira5. Pofuna kutengera momwe zinthu ziliri pakutsuka kwamakina, chidutswa cha archwire chimodzi (Forestalloy blue, Forestadent, Pforzheim, Germany) chidagwiritsidwa ntchito pa bulaketi ndi waya wopangidwiratu (0.25 mm, Forestadent, Pforzheim, Germany).

Zisindikizo zisanu zonse zidafufuzidwa mu kafukufukuyu. Posankha zinthuzo, adanenanso za kafukufuku waposachedwa. Ku Germany, madokotala a mano 985 adafunsidwa za zisindikizo zomwe amagwiritsidwa ntchito pochita zamatsenga. Zida zisanu zomwe zatchulidwa kwambiri pa khumi ndi chimodzi zidasankhidwa. Zipangizo zonse zidagwiritsidwa ntchito mosamalitsa malinga ndi malangizo a wopanga. Tetric EvoFlow idakhala gulu lowongolera.

Kutengera gawo lodziyimira lokha kuti linganize kuchuluka kwa makina, zisindikizo zonse zimayang'aniridwa ndikuwunika. Chikwama chamagetsi chamagetsi, Oral-B Professional Care 1000 (Procter & Gamble GmbH, Schwalbach am Taunus, Germany), chidagwiritsidwa ntchito phunziroli poyerekeza kuchuluka kwa makina. Kuwunika kowonera kumawunikira pomwe kulumikizana kwakuthupi (2 N) kupitilira. Oral-B Precision Clean EB 20 (Procter & Gamble GmbH, Schwalbach am Taunus, Germany) adagwiritsidwa ntchito ngati mitu ya mswachi. Mutu wa burashi udapangidwanso pagulu lililonse loyesa (ie nthawi 6). Pakafukufuku, mankhwala otsukira mano omwewo (Elmex, GABA GmbH, Lörrach, Germany) amagwiritsidwa ntchito nthawi zonse kuti muchepetse mphamvu pazotsatira7. Poyesa koyambirira, kuchuluka kwa mtola wa mankhwala otsukira mano adayesedwa ndikuwerengedwa pogwiritsa ntchito microbalance (Pioneer analytical balance, OHAUS, Nänikon, Switzerland) (385 mg). Mutu wa burashi unkakhathamira ndi madzi osungunuka, wothira mankhwala otsukira mano a 385 mg komanso osakhazikika pamwamba pa dzino la vestibular. Katundu wonyamulawo amagwiritsidwa ntchito ndi kupsinjika kosalekeza komanso kusunthira kutsogolo ndi kubwerera kumbuyo kwa mutu wa burashi. Nthawi yowonekera idayang'aniridwa kwachiwiri. Msuwachi wamagetsi nthawi zonse amatsogoleredwa ndi woyesa yemweyo pamayeso onse oyesa. Kuwongolera kowonera kunagwiritsidwa ntchito kuwonetsetsa kuti kukhudzana ndi thupi (2 N) sikunapitirire. Pambuyo pakugwiritsa ntchito mphindi 30, mswachi udakonzedwanso kuti uwonetsetse kuti ukugwira bwino ntchito. Pambuyo kutsuka, mano adatsukidwa kwa 20 s ndikuthira pang'ono kwamadzi kenako ndikuumitsa ndi mpweya8.

Nthawi yomwe imagwiritsidwa ntchito potengera lingaliro loti nthawi yoyeretsa ndi 2 min9, 10. Izi zikugwirizana ndi nthawi yoyeretsa ya 30 s pa kotala iliyonse. Pazachikale pakati, kuyerekezera kwathunthu kwa mano 28, mwachitsanzo mano 7 pa kotala iliyonse, kumaganiziridwa. Pa dzino lililonse pali malo 3 oyenera a mswachi: buccal, occlusal ndi pakamwa. Malo azino oyandikira ndi a mesial ndi distal amayenera kutsukidwa ndi mano kapena zina zotere koma nthawi zambiri sizimafikiridwa ndi mswachi ndipo chifukwa chake zitha kunyalanyazidwa pano. Ndi nthawi yoyeretsera pa quadrant ya 30 s, nthawi yoyeretsera ya 4.29 s pa dzino itha kuganiziridwa. Izi zikugwirizana ndi nthawi ya 1.43 s pamano pamano. Mwachidule, titha kuganiza kuti nthawi yayitali yoyeretsa ya dzino pakutsuka ili pafupi. 1.5 s. Ngati wina angaganizire za mano a vestibular omwe amathandizidwa ndi yosalala pamwamba, kuyeretsa tsiku lililonse kwa ma 3 s kumatha kuganiziridwa kawiri kuyeretsa mano tsiku lililonse. Izi zitha kufanana ndi 21 s pa sabata, 84 pamwezi, 504 s miyezi isanu ndi umodzi iliyonse ndipo zitha kupitilizidwa monga momwe mungafunire. Pakafukufukuyu kuyerekezera pambuyo pa tsiku limodzi, sabata limodzi, masabata 6, miyezi itatu ndi miyezi 6 kunayesedwa ndikuwunikidwa.

Pofuna kutsanzira kusiyanasiyana kwa kutentha komwe kumachitika m'kamwa ndi zovuta zomwe zimakhudzidwa, ukalamba wofananira udafanizidwa ndi njinga yamoto. Pakafukufukuyu kutentha kwa njinga zamoto (Circulator DC10, Thermo Haake, Karlsruhe, Germany) pakati pa 5 ° C ndi 55 ° C pama 5000 ndi kumiza ndi kutaya nthawi ya 30 s iliyonse kunachitika mofananamo kuwonekera ndi ukalamba wa osindikizawo kwa theka la chaka11. Mabafa otentha anali atadzazidwa ndi madzi osungunuka. Titafika kutentha koyamba, zitsanzo zonse zamazinyo zidazungulira nthawi 5000 pakati pa dziwe lozizira ndi dziwe lotentha. Nthawi yomiza inali 30 s iliyonse, yotsatira ndikudontha kwa 30 s ndi nthawi yosamutsira.

Pofuna kufanizira kuukira kwa asidi tsiku ndi tsiku komanso njira zama mineralization pazisindikizo zam'kamwa, pH idasintha mawonekedwe. Mayankho omwe adasankhidwa anali a Buskes12, 13Yankho limafotokozedwa kangapo m'mabuku. Mphamvu ya pH yankho la demineralization ndi 5 ndipo yankho la remineralization ndi 7. Zapadera za mayankho a remineralization ndi calcium dichloride-2-hydrate (CaCl2-2H2O), potaziyamu dihydrogen phosphate (KH2PO4), HE-PES (1 M ), potaziyamu hydroxide (1 M) ndi aqua destillata. Zida za demineralization solution ndi calcium dichloride -2-hydrate (CaCl2-2H2O), potaziyamu dihydrogen phosphate (KH2PO4), methylenediphosphoric acid (MHDP), potaziyamu hydroxide (10 M) ndi aqua destillata. Kuyenda panjinga kwamasiku 7 kunachitika5, 14. Magulu onse adayang'aniridwa ndi 22-h remineralization ndi 2-h demineralization patsiku (kusinthasintha kuchokera ku 11 h-1 h-11 h-1 h), kutengera pH njinga zoyendetsera kale zomwe zidagwiritsidwa ntchito m'mabuku15, 16. Mbale ziwiri zazikulu zamagalasi (20 × 20 × 8 cm, 1500 ml3, Simax, Bohemia Cristal, Selb, Germany) okhala ndi zivindikiro adasankhidwa ngati zotengera momwe zitsanzo zonse zimasungidwa limodzi. Zovundikazo zimangochotsedwa pomwe zitsanzozo zidasinthidwa kukhala thireyi ina. Zitsanzozo zimasungidwa kutentha kwapakati (20 ° C ± 1 ° C) pamtengo wokhazikika wa pH m'm mbale zamagalasi5, 8, 17. Mtengo wa pH wa yankho udayang'aniridwa tsiku lililonse ndi pH mita (3510 pH Meter, Jenway, Bibby Scientific Ltd, Essex, UK). Tsiku lililonse lachiwiri, yankho lathunthu limasinthidwa, zomwe zimalepheretsa kutsika kwa pH. Mukasintha zitsanzo kuchokera ku mbale imodzi kupita ku inayo, zitsanzozo zimatsukidwa mosamala ndi madzi osungunuka kenako ndikuumitsidwa ndi ndege yopewera kusakaniza mayankho. Pambuyo panjinga yamasiku 7 ya pH, zitsanzozo zidasungidwa mu hydrophorus ndikuyesedwa mwachindunji pansi pa microscope. Pamawonekedwe owoneka bwino mu kafukufukuyu digito yamagetsi VHX-1000 yokhala ndi VHX-1100 kamera, katatu S50 yonyamula ndi VHZ-100 Optics, pulogalamu yoyezera VHX-H3M komanso chowunikira chapamwamba cha 17-inchi LCD (Keyence GmbH, Neu- Isenburg, Germany) adagwiritsidwa ntchito. Magawo awiri owunikira omwe ali ndi magawo 16 amtundu uliwonse amatha kutanthauziridwa ndi dzino lililonse, kamodzi kosavuta komanso kosavuta pamunsi. Zotsatira zake, magawo okwana 32 pa dzino ndi minda 320 pachinthu chilichonse adatanthauzidwa pamayeso oyesa. Pofuna kuthana ndi kufunikira kwakanthawi kofunikira kwamankhwala ndikufikira pakuwunika kwa ma sealant ndi diso, gawo lililonse limayang'aniridwa ndi maikulosikopu ya digito yokhala ndi kukulitsa kwa 1000 ×, kuyesedwa kowoneka bwino ndikupatsidwa mayeso osiyanasiyana. Mitundu yoyeserera inali 0: zakuthupi = mundawo woyesedwa umaphimbidwa ndi zinthu zosindikiza, 1: chosalimba chisindikizo = munda wofufuzidwayo ukuwonetsa kutayika kwathunthu kwa zinthu kapena kuchepetsedwa kwakukulu panthawi imodzi, pomwe dzino limawonekera, koma ndi zotsalira zotsalira za sealant, 2: Kutaya kwazinthu = gawo lomwe lidayesedwa likuwonetsa kutayika kwathunthu, dzino likuwululidwa kapena *: silingayesedwe = gawo lomwe layesedwa silingayimilidwe mokwanira kapena chosindikizira sichimayikidwa mokwanira, ndiye izi munda walephera pamndandanda woyeserera.