Mank S, Steineck M, Brauchli L
Clinic for Orthodontics and Pediatric Dentistry, University of Basel, Switzerland.
J Orofac Orthop. 2011 Oct;72(5):348-57. doi: 10.1007/s00056-011-0039-y. Epub 2011 Oct 6.
After orthodontic debonding, adhesive removal can lead to rises in pulp temperature, causing histological changes or pulp necrosis. The objective of this study was to measure increases in pulp temperature during adhesive removal using different instruments and various cooling procedures.
A thermoelement was introduced into the pulp chamber of 10 human incisors. The teeth were immersed in a 36°C water bath up to the cementoenamel junction. Two carbide burs, one polishing disk and two rubber points were used for polishing. All measurements were taken over a 10 s period by a single investigator, under slight pressure and with constant motion. Three cooling procedures were examined: no cooling, air cooling and water cooling. Pulp temperatures were measured before polishing and after 10 s of polishing.
Without cooling, the two rubber points revealed clinically relevant temperature increases of 6.1°C and 12.4°C. Cooling with air and with water reduced pulp temperature in conjunction with all polishing methods. Air cooling was most efficient, except in combination with the polishing disk.
Under these study conditions, carbide burs and polishing disks can be used safely and without risk to the pulp, even without cooling. On the other hand, rubber points cause a marked increase in pulp temperature when used without cooling.
正畸去粘结后,去除粘结剂会导致牙髓温度升高,引起组织学变化或牙髓坏死。本研究的目的是使用不同器械和各种冷却程序测量去除粘结剂过程中牙髓温度的升高情况。
将热电偶插入10颗人切牙的髓腔。牙齿浸入36°C水浴中至牙骨质釉质界。使用两个硬质合金车针、一个抛光盘和两个橡皮杯进行抛光。所有测量均由一名研究人员在轻微压力和匀速运动下,在10秒内完成。研究了三种冷却程序:不冷却、风冷和水冷。在抛光前和抛光10秒后测量牙髓温度。
不冷却时,两个橡皮杯使牙髓温度出现临床上有意义的升高,分别为6.1°C和12.4°C。风冷和水冷结合所有抛光方法均可降低牙髓温度。风冷最为有效,但与抛光盘结合使用时除外。
在本研究条件下,即使不冷却,硬质合金车针和抛光盘也可安全使用,不会对牙髓造成风险。另一方面,橡皮杯在不冷却使用时会使牙髓温度显著升高。