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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 劉謙美(Cheing-Meei Liu) | |
dc.contributor.author | Cheng-Tao Lin | en |
dc.contributor.author | 林震濤 | zh_TW |
dc.date.accessioned | 2021-06-13T03:28:52Z | - |
dc.date.available | 2006-08-04 | |
dc.date.copyright | 2006-08-04 | |
dc.date.issued | 2006 | |
dc.date.submitted | 2006-07-27 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/32034 | - |
dc.description.abstract | 傳統非手術性牙周治療,是以手動器械配合音波器械,針對牙根面的牙菌斑、牙結石和受感染的牙骨質,作機械性的清創,已經被證實有顯著的臨床效果。但是,傳統牙周治療由於牙周組織空間狹窄、牙根結構使傳統器械不易進入。所以,牙醫師使用了各種輔助或是另類治療方式,希望能改善機械性清創不足的地方。利用雷射能量密度高,且光束不擴散、可以集中作用於極小面積的特性,能不需直接接觸組織,針對特別的區域作精密的處理。因此,若能應用在牙周治療上,可以利用雷射的特性,清潔傳統牙周器械無法達到的死角,甚至改變牙根面的特性,進而促進牙周結締組織重新附著。
本研究採用釹釔鋁鈣鈦礦石雷射(Nd:YAP laser)和鉺鉻釔鈧鉫石榴石雷射(Er,Cr:YSGG laser)兩種作用機制不同的雷射,針對體外牙的牙根面照射後,分別以光學及掃描式電子顯微鏡紀錄其表面形態變化;另針對鉺鉻釔鈧鉫石榴石雷射處理後的牙根面,與人類齒齦纖維母細胞一起培養,以評估其細胞親合性;並分別使用傅立葉轉換紅外線光譜儀(FTIR)或表面能量分散光譜儀(EDX)分析雷射照射後,牙根面化學組成的可能變化。 實驗結果顯示,接受釹釔鋁鈣鈦礦石雷射照射的牙根面,不會殘留塗抹層,而產生明顯的形態改變,包括火山口凹陷(crater)和周圍的焦黑碳化(charring)現象;傅立葉轉換紅外線光譜儀則顯示位於1240cm-1、1650cm-1處,代表氨基化合物的吸收峰消失,此官能基的消失代表與蛋白質相關的組成有所改變。 鉺鉻釔鈧鉫石榴石雷射,在牙根表面沉積物清除能力上,可以有效地移除牙根面附著的牙結石,但也同時使牙根產生凹陷和粗糙表面;照射後的牙根,齒齦纖維母細胞的附著數較少,可能代表較差的細胞親合性;表面能量分散光譜儀顯示沒有元素組成比例的改變。 在釹釔鋁鈣鈦礦石雷射的實驗中,照射時為停留於單一位置照射10秒鐘,但臨床應用時並非停留於一點給予雷射能量,因此所得的結果只可以供作臨床操作前的參考。未來,還需要進一步研究,釹釔鋁鈣鈦礦石雷射針對牙根硬組織的適當功率設定和照射模式,以減少升溫效應所產生的碳化現象。 鉺鉻釔鈧鉫石榴石雷射的實驗中,雖然模擬了臨床所可能的操作模式,能在不對牙根面產生焦黑碳化或融熔的情況下,有效的清除牙根表面沉積物,但是細胞附著數仍明顯較低。因此在未來,鉺鉻釔鈧鉫石榴石雷射對牙根深層可能產生的升溫效應,及其對牙根面的細胞親合性的可能影響及機制,還有待探討。 | zh_TW |
dc.description.abstract | It has been clinically proven that non-surgical periodontal therapy, that is, mechanical debridement of the bacterial plaque, calculus, and infected cementum on the diseased root surfaces by hand and/or ultrasonic instruments, can relieve the inflammation and improve the clinical parameters of periodontal tissues. The nature of narrow and un-accessable deep, diseasd periodontal structure, however, makes thorough cleaning of diseased tissue a difficult issue. Periodontists have developed various alternative treatments, like chemical irrigation, local antibiotics application, or root conditioning to deal with the above problems. The unique characteristics of the laser, such as high energy density, and collimation, make it a potentially useful tool to deal with periodontally affected tissue. But the proper level of energy ouput and its corresponding effect on local periodontal tissue are still uncertain.
In the study, two types of laser apparatus were used to evaluate the morphological, biological, and elemental changes of root surfaces treated in vitro. The samples treated with Nd:YAP laser were examined under light and scanning electronic microscope to see the morphological changes. Besides, they were tested by Fourier transform infrared(FTIR) spectrometer to verify the chemical changes over surface. The Er,Cr:YSGG laser treated root samples were examined with light and scanning electronic microscope to compare the morphological changes and efficiency of calculus removal with other treatment modalities. These samples were incubated in human fibroblast culture to evaluate the biocompatibility of the lased roots. Energy dispersive X-ray(EDX) analysis was used to evaluate the elemental changes. The results of the study showed that without water cooling, charring and crater-like depressions were noted on Nd:YAP laser treated root surfaces, and changes of chemical bonds were also noted. The calculus could be removed efficiently with either hand curette or Er,Cr:YSGG laser, without charring or compositional changes. The cell attachment assay, however, showed unfavorable results in laser treated root surfaces. The proper energy setting and condition for periodontal hard tissue could be explored before applying Nd:YAP laser in the oral cavity. The possible mechanism that leads to the poor cell attachment to Er,Cr,YSGG laser treated root surfaces is also an interesting issue for future study. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T03:28:52Z (GMT). No. of bitstreams: 1 ntu-95-P92422011-1.pdf: 4174488 bytes, checksum: 688882a8de192cd3c59ffc34de93efbd (MD5) Previous issue date: 2006 | en |
dc.description.tableofcontents | 目錄 3
壹、 摘要 9 一、 中文摘要 9 二、 英文摘要 11 貳、 文獻回顧 13 一、 牙菌斑在牙周炎的致病角色 13 I. 牙菌斑(dental plaque)和牙結石(calculus)的形成與構造 13 II. 牙菌斑和牙結石與牙周炎的關係 15 二、 傳統牙周病治療的方式、效果與限制 19 I. 傳統的牙周治療方式 19 II. 傳統牙周病治療的效果與限制 19 三、 雷射的特性與在醫學上的應用 23 I. 雷射發生的原理和特性 23 II. 雷射在臨床醫學上的發展和演進 25 四、 雷射在牙醫學的運用與研究 26 I. 雷射在一般牙科醫學之應用 26 II. 各種雷射在牙周病學之研究與應用 32 參、 實驗假說HYPOTHESIS 40 肆、 實驗目的SPECIFIC AIMS OF THIS STUDY 41 伍、 實驗一:釹釔鋁鈣鈦礦石(ND:YAP)雷射處理體外牙根表面所產生的形態與組成變化 42 一、 引言 43 二、 實驗材料與方法 46 I. 實驗設備簡介 46 II. 標本選擇條件 47 III. 標本之保存與製備 47 IV. 實驗分組和雷射能量照射 48 V. 牙齒表面型態學的觀察與紀錄 49 VI. 牙齒表面的官能基改變分析 49 三、 實驗結果 50 I. 光學解剖顯微鏡下觀察到的變化 50 II. 掃描式電子顯微鏡的紀錄 52 III. 傅立葉轉換紅外線光譜儀所得到的牙根表面吸收光譜 53 四、 討論 54 陸、 實驗二:鉺鉻釔鈧鉫石榴石雷射對體外牙根的牙結石移除能力、細胞附著、及表面元素分析 58 一、 引言 59 二、 實驗材料與方法 64 I. 實驗設備簡介 64 II. 標本選擇條件 66 III. 標本之保存與製備 66 IV. 實驗分組與處理 67 V. 牙齒表面型態學的觀察與牙結石的紀錄 68 VI. 牙齒表面細胞附著分析(cell attachment assay) 69 VII. 牙根面元素組成分析 71 VIII. 統計方法 71 三、 實驗結果 72 I. 標本面積和原始牙結石面積 72 II. 牙根表面形態學分析 72 III. 牙結石移除能力分析 75 IV. 細胞附著分析 75 V. 牙根面元素分析 76 四、 討論 77 柒、 附圖 89 圖一、LOKKI dt (Nd:YAP laser device) 89 圖二、Leica MZ8 89 圖三、傅立葉轉換紅外線光譜儀(Fourier Transform Infrared Spectrometer, FTIR) 89 圖四、臨界點乾燥機Critical point dryer, K850. 89 圖五、離子鍍膜機Sputter coater, SC502 90 圖六、掃描式電子顯微鏡 Topcon, ABT-60 90 圖七、光學顯微鏡紀錄—對照組 91 圖八A、光學顯微鏡紀錄—實驗組A 91 圖八B、光學顯微鏡紀錄—實驗組A 91 圖九A、光學顯微鏡紀錄—實驗組B 92 圖九B、光學顯微鏡紀錄—實驗組B 92 圖十A、光學顯微鏡紀錄—實驗組C 93 圖十B、光學顯微鏡紀錄—實驗組C 93 圖十C、光學顯微鏡紀錄—實驗組C 93 圖十一、掃描式電子顯微圖—對照組 94 圖十二B、掃描式電子顯微圖—實驗組A 94 圖十二A、掃描式電子顯微圖—實驗組A 94 圖十三A、掃描式電子顯微圖—實驗組B 94 圖十三B、掃描式電子顯微圖—實驗組B 95 圖十三C、掃描式電子顯微圖—實驗組B 95 圖十四、傅立葉轉換紅外線光譜儀所得到的牙根表面吸收光譜 96 圖十五、牙根表面焦黑面積與照射功率的關係 96 圖十六、Waterlase (Er,Cr:YSGG laser device) 97 圖十七A、牙齒切片原始面積的比較—長條圖 97 圖十七B、牙齒原始牙結石面積的比較—長條圖 97 圖十八、牙根表面的肉眼放大觀察—健康牙組 98 圖十九、牙根表面的肉眼放大觀察—牙結石組 98 圖二十A、牙根表面的肉眼放大觀察—牙周刮匙組 98 圖二十B、牙根表面的肉眼放大觀察—牙周刮匙組 98 圖二十一A、牙根表面的肉眼放大觀察—雷射照射組A 99 圖二十一B、牙根表面的肉眼放大觀察—雷射照射組A 99 圖二十二A、牙根表面的肉眼放大觀察—雷射照射組B 99 圖二十二B、牙根表面的肉眼放大觀察—雷射照射組B 99 圖二十三、掃描式電子顯微鏡圖—健康牙組 100 圖二十四、掃描式電子顯微鏡圖—圓形的貼附細胞 100 圖二十五、掃描式電子顯微鏡圖—扁平的貼附細胞 100 圖二十六A、掃描式電子顯微鏡圖—牙結石組 100 圖二十六B、掃描式電子顯微鏡圖—牙結石組 101 圖二十六C、掃描式電子顯微鏡圖—牙結石組 101 圖二十七A、掃描式電子顯微鏡圖—牙周刮匙組 101 圖二十七B、掃描式電子顯微鏡圖—牙周刮匙組 101 圖二十八A、掃描式電子顯微鏡圖—雷射組A 102 圖二十八B、掃描式電子顯微鏡圖—雷射組A 102 圖二十九A、掃描式電子顯微鏡圖—雷射組 B 102 圖二十九B、掃描式電子顯微鏡圖—雷射組 B 102 圖三十、處理前後牙結石百分比的改變量—長條圖 103 圖三十一、細胞附著數的比較—長條圖 103 圖三十二、牙根表面的鈣磷比值(Ca/P ratio) 103 圖三十三、牙根表面鈣和磷所佔的重量比率 103 圖三十四、水對不同波長雷射的吸收係數(Aoki, Sasaki, Watanabe, & Ishikawa, 2004) 104 圖三十五、Hydroxyapatitie對不同波長雷射的吸收係數(白色線條) 104 圖三十六、殘存的牙結石比例和細胞附著數的趨勢 104 圖三十七、塗抹層上的纖維母細胞 105 圖三十八、雷射對牙根的影響--(Folwaczny, Benner, Flasskamp, Mehl, & Hickel, 2003) 105 圖三十九、細胞生長曲線(Freshney, 2000) 105 圖四十、細胞附著分析—n=47、未經調整的原始結果 106 圖四十一、細胞附著分析—n=46、未經調整的原始結果 106 圖四十二、細胞附著分析—ε對yhat繪圖 106 圖四十三、細胞附著數—經過加權最小平方法調整後,ε對yhat繪圖(n=46, q=0.5) 106 捌、 附表 107 表一、Nd:YAP雷射裝置的輸出設定 107 表二、照射後牙根表面的焦黑範圍(mm2) 107 表三、牙齒切片原始面積的比較—回歸模式 108 表四、牙齒切片原始面積的比較—組間比較 109 表五、牙根原始牙結石比例—回歸模式 110 表六、牙根原始牙結石比例—組間比較 111 表七、處理前後牙結石比例的改變量—線性回歸模式(n=40) 112 表八、處理前後牙結石百分比的改變量—組間比較 113 表九、細胞附著數--線性回歸模式(n=46, q=0.5) 114 表十、細胞附著數—組間比較 115 表十一A、EDX分析各主要組成元素的重量百分比 116 表十一B、EDX分析各主要組成元素的重量百分比以鈣為基準調整後的比率(X/Ca) 116 表十二、細胞附著數和牙結石的關係—回歸分析(n=27) 117 表十三、細胞附著分析—n=47、未經調整的原始結果 118 表十四、細胞附著分析—n=46、未經調整的原始結果 119 玖、 附錄 120 一、 前導實驗 120 I. 釹釔鋁鈣鈦礦石(Nd:YAP)雷射照射體外牙根面的元素分析 120 II. 牙根面培養人類齒齦纖維母細胞的條件測試 122 二、 細胞次培養(subculture) 123 壹拾、 參考文獻 125 | |
dc.language.iso | zh-TW | |
dc.title | 受牙周炎侵犯的牙根表面經雷射處理後之形態、生物性質、及元素分析 | zh_TW |
dc.title | The Morphological, Biological, and Elemental Analysis of Periodontitis Affected Root Surfaces After Laser Treatment | en |
dc.type | Thesis | |
dc.date.schoolyear | 94-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 侯連團(Lein-Tuan Hou) | |
dc.contributor.oralexamcommittee | 王大銘 | |
dc.subject.keyword | 非手術性牙周治療,牙科雷射,Nd:YAP,Er,Cr:YSGG,細胞附著分析,掃描式電子顯微鏡,傅立葉轉換紅外線光譜儀,表面能量分散光譜儀, | zh_TW |
dc.subject.keyword | non-surgical periodontal therapy,laser,Nd:YAP,Er,Cr:YSGG,cell attachment assay,SEM,FTIR,EDX, | en |
dc.relation.page | 137 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2006-07-28 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床牙醫學研究所 | zh_TW |
顯示於系所單位: | 臨床牙醫學研究所 |
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