Sahrmann Philipp, Ronay Valerie, Schmidlin Patrick R, Attin Thomas, Paqué Frank
Clinic of Preventive Dentistry, Periodontology, and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
J Periodontol. 2014 Aug;85(8):1107-14. doi: 10.1902/jop.2014.130629. Epub 2014 Jan 30.
Root surfaces experience continuous abrasive instrumentation during lifelong periodontal maintenance. Periodontists need both effective and minimally abrasive debridement techniques. Air polishing devices might, therefore, constitute a good alternative to mechanical instrumentation. Because little is known of the three-dimensional shape and volume of the abrasion caused by different powders, it is the aim of the study to investigate the three-dimensional extent of these defects.
Cementum-covered roots of 20 extracted human premolars were coated with resin caps, leaving four areas with identical diameter open for instrumentation using bicarbonate powder and glycine powder. Treatment times were 5 and 10 seconds in a first interval and 10 seconds in a second interval. Maximum settings were chosen for power and lavage. The teeth were scanned using microcomputed tomography initially and after every treatment interval. Differences in volume and defect depths were calculated by superimposition of the scans and tested for significance (Wilcoxon test, P <0.001).
Defect volumes (in mm(3)) presented in medians (interquartile ranges) for the bicarbonate powder after 5, 10, 15, and 20 seconds, respectively, were 0.16 (0.11), 0.28 (0.16), 0.32 (0.18), and 0.41 (0.28), and for glycine powder, 0.00 (0.02), 0.01 (0.05), 0.03 (0.11), and 0.06 (0.1). For each time period, abrasion caused by glycine was significantly lower (five- to 20-fold) compared to defects caused by bicarbonate.
In patients with exposed root surfaces, cleaning with bicarbonate powder cannot be recommended. Less abrasive glycine powder, however, demonstrated non-critical substance loss.
在终身牙周维护过程中，牙根表面会经历持续的磨削器械操作。牙周病医生需要有效且磨损最小的清创技术。因此，空气抛光装置可能是机械器械操作的一个很好的替代方法。由于对于不同粉末造成的磨损的三维形状和体积了解甚少，本研究的目的是调查这些缺损的三维范围。
20颗拔除的人类前磨牙的牙骨质覆盖牙根用树脂帽覆盖，留出四个直径相同的区域，用于使用碳酸氢盐粉末和甘氨酸粉末进行器械操作。在第一个时间段治疗时间为5秒和10秒，在第二个时间段为10秒。选择最大功率和冲洗设置。在每次治疗间隔之前和之后，使用微型计算机断层扫描对牙齿进行扫描。通过叠加扫描计算体积和缺损深度的差异，并进行显著性检验（Wilcoxon检验，P<0.001）。
碳酸氢盐粉末在5秒、10秒、15秒和20秒后的缺损体积（以mm³为单位）中位数（四分位间距）分别为0.16（0.11）、0.28（0.16）、0.32（0.18）和0.41（0.28），甘氨酸粉末的分别为0.00（0.02）、0.01（0.05）、0.03（0.11）和0.06（0.1）。在每个时间段，与碳酸氢盐造成的缺损相比，甘氨酸造成的磨损显著更低（低五到二十倍）。
对于牙根表面暴露的患者，不建议使用碳酸氢盐粉末进行清洁。然而，磨损性较小的甘氨酸粉末显示出非临界的物质损失。
