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標題: | 超音波能量對牙本質切割效率、齲齒移除及牙髓傷害之影響 The Effect of Ultrasonic Energy on Dentin Cutting Efficiency, Carious Removal and Pulp Damage |
作者: | Pei-Hsuan Huang 黃旆萱 |
指導教授: | 林俊彬(Chun-Pin Lin) |
關鍵字: | 超音波頻率,振幅,牙本質移除率,人工齲齒,牙髓活性, ultrasonic frequency,amplitude,dentin cutting efficiency,artificial caries,pulp vitality, |
出版年 : | 2012 |
學位: | 碩士 |
摘要: | 過去超音波能量應用於齒質切割的研究多著重於市售產品間的比較,實驗設計上變因的控制困難。另超音波在頻率改變時具有選擇性切割的特性,此特性對於口腔顎面手術或其他牙科治療十分有利,可確保周圍軟組織的安全,但卻不利於齲齒的移除。傳統上常使用旋轉型器械移除齲齒,於治療深度齲齒時若操作不當常會造成牙髓意外暴露;若不慎移除過多牙髓組織,則不利牙髓活性之保存。
本研究擬用下列方式來探討超音波能量對牙本質切割、齲齒移除以及對牙髓組織的傷害:(1)使用光纖干涉儀測量32kHz、40kHz、56kHz、66kHz驅動下超音波刀頭在X軸、Y軸及Z軸方向的振幅;(2)使用萬用拉力測試機建立標準化超音波–牙本質之切削測試模型,並比較相同能量不同頻率下的超音波對於牙本質與脫鈣牙本質的移除率;(3)建立可信任之實驗動物模型,並使用組織學評分來比較高速氣動牙鑽及超音波骨刀機對牙髓組織的影響。當頻率上升時,Y軸的振幅隨之變小;切割牙本質的最佳頻率為32kHz,最差為56kHz;而移除脫鈣牙本質最好的頻率為40kHz。在牙髓組織反應的實驗中,高速氣動牙鑽組牙髓立即反應的分數較高,表示傷害較大;超音波組於牙髓長期反應的分數較高,顯示其對組織長期活性的保存較有利。市售的超音波骨刀機頻率大多在30kHz左右,本研究發現66kHz也有不錯的效果,且頻率提高可望切割軟組織,值得進一步探討。另超音波於牙髓組織的傷害性較高速氣動牙鑽小,可望取代之成為深部齲齒治療的利器。 The past researchers only put emphasis on comparisons of ultrasonic cutting abilities among the commercial products. Due to difficulties in experimental designs, less attention was paid to effects of different frequencies and amplitudes on cutting dental tissues. Selective cutting ability of ultrasound is beneficial to oral and maxillofacial surgery or other dental treatments. Protection of surrounding soft tissues could be obtained, but caries removal with ultrasonic energy is difficult. We usually treat dental caries with rotary instruments. Accidental pulp exposure may occur if we use the instruments improperly. As excessive tissue was removed, unfavorable influences on the preservation of pulp vitality could happen.To investigate the impacts of ultrasonic energy on dentin cutting, caries removal and pulp damage, the following methods were used: (1) To measure the amplitudes of 32kHz, 40kHz, 56kHz and 66kHz along X-axis, Y-axis and Z-axis with fibro-optic interferometer. (2) To establish a standardized ultrasound-dentin cutting test model with instron and to compare cutting efficiencies of dentin and demineralized dentin of different frequencies. (3) To set up a reliable experimental animal model and use a histological scoring system to evaluate effects of air-driven high-speed dental handpiece and ultrasonic device on dental pulp tissues.As the ultrasonic frequency increased, the amplitude along the Y-axis became smaller. The amplitudes along the X-axis and Z-axis showed little difference among each group. Dentin cutting efficiency of 32kHz was the best while efficiency of 56kHz was the worst. The best frequency to remove demineralized dentin was 40kHz, but there was no statistically significant difference between 40kHz and 56kHz as well as 56kHz and 66kHz. Higher score of immediate pulp reaction obtained from High-speed group indicated that more pulp damage was caused by the air-driven high-speed dental handpiece. Higher score of long-term pulp response obtained from Ultrasonic group revealed that ultrasonic cutting was more favorable for preservation of pulp vitality.Recently, frequency provided by commercial ultrasonic devices is around 30kHz. It is also shown in our study that the frequency is the most suitable for cutting dental hard tissue or bone. In our study, dentin cutting efficiency of 66kHz was also good and it could cut soft tissue. The frequency of 66Hz seemed worthy of further investigation. On the other hand, ultrasonic devices do less harm to the dental pulp tissue, and it may become a potential instrument for replacement of rotary instruments to treat deep caries and prevent from excessive pulp damage. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/64598 |
全文授權: | 有償授權 |
顯示於系所單位: | 臨床牙醫學研究所 |
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