Preservation of root cementum: a comparative evaluation of power-driven versus hand instruments
Preservation of root cementum: a comparative evaluation of power-driven versus hand instruments
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DOI：
10.1111/idh.12249
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发表时间：
2018-05-01
影响因子：
2.4
通讯作者：
Pilloni, A.
中科院分区：
文献类型：
--
作者：
Bozbay, E.;Dominici, F.;Pilloni, A.
目的：本研究旨在评估三种不同的牙周治疗方法对牙周病患牙残余牙骨质的影响，并与手用器械进行比较。牙骨质可以影响牙周细胞的活性，在牙周治疗中可能起重要的调节作用。牙周治疗的理想方法包括去除生物膜、牙石和内毒素，同时保留根面牙骨质。材料和方法：48个无龋，单根牙的患者诊断为严重的慢性牙周炎，采用四种不同的方法处理前提取。分别用手动刮匙（HC）、压电超声洁牙器（U）、压电超声洁牙器+空气抛光（U + AP）或单独使用空气抛光（AP）在一个邻位进行龈下器械化。拔牙后，使用解剖显微镜和扫描电镜对器械固定和非器械固定部位进行分析，以测量残留牙骨质的数量和表面特征。结果：龈下器械固定后，冠状牙骨质剩余率分别为：U组84%，U + AP组80%，AP组94%，HC组65%。虽然龈下器械的牙骨质的根尖部分表现出6%的保留牙骨质相比，冠状部分，保留牙骨质的量与AP仍然显着大于HC。扫描电镜观察发现，HC根面最光滑，AP次之，而U或U + AP根面出现沟槽和划痕。结论：本研究表明，AP在保存牙骨质方面优于U器械，而HC是去除牙骨质的最有效器械。
Objectives: The purpose of this study was to evaluate the effects of three distinct periodontal treatment methods in comparison with hand instrumentation on residual cementum of periodontal diseased teeth. Cementum can influence the activities of periodontal cells and may play an important regulatory role in periodontal treatment. The ideal method for periodontal therapy involves removal of biofilm, calculus and endotoxin while preserving root cementum. Material and methods: Forty-eight caries free, single-rooted teeth in patients diagnosed with severe chronic periodontitis were treated using four different methods prior to extraction. The teeth were instrumented subgingivally at one approximal site either by hand curettes (HC), piezoelectric ultrasonic scalers (U), piezoelectric ultrasonic scalers following air polishing (U + AP) or air polishing (AP) alone. Following extraction of teeth, instrumented and non-instrumented sites were analysed with a dissecting microscope and SEM for measurement of the amount of and surface characteristics of residual cementum. Results: The percentage of coronal cementum remaining following subgingival instrumentation was 84% for U, 80% for U + AP, 94% for AP and 65% for HC. Although subgingival instrumentation of apical portions of the cementum demonstrated 6% less retained cementum in comparison with coronal portions, the amount of retained cementum with AP was still significantly greater than with HC. SEM results found the smoothest root surfaces were produced by the HC followed by the AP, while root surfaces instrumented by U or U + AP presented grooves and scratches. Conclusions: This study demonstrated that AP was superior to U devices in preserving cementum, whereas HC were the most effective instruments in removing cementum.