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標題: | 探討鉺雅鉻雷射對粗糙鈦板表面牙周病致病菌的殺菌效果和細胞貼附能力 In vitro evaluation of the bactericidal effect and fibroblast attachment on contaminated rough titanium surfaces treated with Er : YAG laser |
作者: | Ya-Ting Jhang 張雅婷 |
指導教授: | 陳漪紋(Yi-Wen Chen) |
關鍵字: | 鉺雅鉻雷射,牙齦??菌,人類牙齦纖維母細胞,粗糙鈦金屬表面,植體周圍炎, Er:YAG laser,Porphyromonas gingivalis,human gingival fibroblast,rough titanium surface,peri-implantitis, |
出版年 : | 2018 |
學位: | 碩士 |
摘要: | 背景:人工植牙使用於重建咬合已經有60 年的歷史,研究指出植體周圍炎的盛行率很高,而目前尚沒有一個有效的方式去完全解決植體周圍炎的問題,因此本研究想要藉由鉺雅鉻雷射的介入去觀察模擬植體周圍炎的鈦板其滅菌情形及其後續的細胞貼附結果。
實驗材料與方法:本實驗使用四級純鈦的鈦板,共有六個組別,第一組是對照組只有鈦板,第二到第六組接種P. gingivalis模擬植體周圍炎。第三組將其使用0.12%的氯己定做沖洗;第四組使用鈦金屬刮匙做清創;第五組使用鉺雅鉻雷射做滅菌;第六組先使用鈦金屬刮匙再合併鉺雅鉻雷射做滅菌。接著使用電子顯微鏡觀察鈦板表面的情形,並藉由螢光染色觀察P. gingivalis活/死菌的分佈情形,以及測量表面粗糙度及接觸角的分析,並觀察不同處理後細菌的內毒素是否有改變,後續在螢光顯微鏡下進行牙齦纖維母細胞貼附的觀察。 實驗結果:實驗的研究結果顯示,單純使用0.12%的氯己定無論是滅菌效果或細胞貼附情形都不佳。鈦金屬刮匙的滅菌效果雖不錯但對於細菌內毒素似乎作用有限,且鈦板的表面被改變。鈦金屬刮匙與雷射對於移除細菌同樣有效,雖然電子顯微鏡的定性分析顯示雷射組別殘存細菌量較少,但兩組在螢光分析上並未有統計上的顯著差異。第五組和第六組經雷射處理的結果,內毒素減少的效果為最佳。細胞貼附的情形以第六組為最佳,但和第四組及第五組並不具有統計上的顯著差異。 結論:就目前的研究結果來說,鉺雅鉻雷射可以有效於移除鈦板上地細菌和內毒素對於後續人類牙齦纖維母細胞貼附情形都有極佳的結果,後續還會使用骨母細胞做進一步的測試與分析。 Studies have reported a high prevalence of peri-implantitis with radiographic marginal bone loss. Evidence to date indicates that no available treatments result in total resolution of established peri-implantitis. The aim of this study was to investigate the bactericidal effect and fibroblast attachment on contaminated titanium surface treated with erbium-doped yttrium aluminium garnet (Er:YAG) laser. Materials and Methods: Grade IV titanium discs were incubated with a suspension of Porphyromonas gingivalis (P. gingivalis) (ATCC® 33277TM) in brain heart infusion (BHI) broth. Six groups (n=6) with a total of 36 titanium discs were prepared. Group 1 was the negative control. Group 2 to 6, titanium discs were incubated with P. gingivalis biofilm. Group 3, 0.12 % Chlorhexidine was used for irrigation. Group 4, titanium curette was used for debridement. Group 5, Er:YAG laser irradiation was performed at pulse energy 80 mJ and frequency 25 pulse per second. Group 6, Curette debridement was followed by Er:YAG laser irradiation. After various treatments, surface roughness and hydrophilicity were measured. The residual bacterial was examined by scanning electron microscope and confocal laser scanning microscope, and the residual lipopolysaccharide was examined by Lymulus amoebocyte lysate (LAL) assay. Then, the adhered human gingival fibroblast (HGF) cells were quantified by fluorescent microscope. Results: Chlorhexidine irrigation or curette debridement alone couldn’t remove bacteria efficiently. Titanium curette could remove bacteria efficiently, but had limited effect on LPS. Er:YAG laser alone could remove bacteria as effective as titanium curette, and Er:YAG laser was most effective in removing LPS. Er:YAG laser combined with curette debridement has highest amount of adhered HGF cells. Though there was no significant difference between titanium curette, Er:YAG laser, and combined group. Conclusion: Er:YAG laser would be a promising therapy to treat peri-implantitis by removing bacterial remnants without altering titanium surface. Further studies are warranted to evaluate the potential of osteoblast adhesion after Er:YAG laser treatment. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/79118 |
DOI: | 10.6342/NTU201802650 |
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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