Adequate toothbrushing method following periodontal tissue regeneration

本研究的目的是确定牙周组织再生治疗后开始刷牙的适当阶段和最佳刷牙力/时间。在上颌第一和第三前磨牙之间以及下颌第二和第四前磨牙之间形成了4x 4x 4 mm大小。然后在牙根面标记缺口，记录骨缺损的底部。在骨缺损区植入金属基质，诱导牙周炎，用软食喂养8周。在这些治疗之后，去除金属基质并使用Emdogain进行牙周组织再生治疗。实验牙按裂口设计分为4组。对照牙每天使用手动器械进行牙菌斑清除。另外三组在牙周再生治疗后1天（1D）、3天（3D）或7天（7 D）每天进行专业刷牙。刷牙的力度和持续时间分别设定为200 g和20秒。组织学观察发现，在牙龈炎症和牙槽骨改建方面，应力纱布用于控制刷牙力的结果相似。各组均未见明显的炎症反应和沟上皮向下生长。在1/3骨缺损区周围有新生牙槽骨形成。切迹周围可见少量新生牙骨质。然而，在1D、3D狗中观察到部分上皮向下生长。本研究结果表明，牙周手术治疗后第二天可以开始刷牙。

The purpose of the present study was to determine an adequate stage for initiating tooth-brushing and optimal tooth-brushing force/duration following periodontal tissue regenerative therapy.Six beagle dogs were involved in the experiment First, the maxillary second premolar and mandibular third premolar were extracted. 4x4x4 mm of size, was formed between the maxillary first and third premolars and between the mandibular second and fourth premolars. Then, notch was marked on the root surface for recording the bottom of bone defect. In order to induce periodontitis, metal matrix was inserted in the area of bone defect The dogs were then kept for 8 weeks with being fed by soft food. After these treatments, the metal matrix were removed and periodontal tissue regenerative therapy was performed using Emdogain. Experimental teeth were divided into four groups according to the split-mouth design for each dog. The control tooth was given daily plaque removal using a hand instrument. The other three was given daily professional tooth-brushing following 1 day (1D), 3 days (3D), or 7 days (7D) after the periodontal regenerative therapy. The force and duration of tooth-brushing was set for 200g and 20 seconds, respectively. The stress gauze was used for controlling the tooth-brushing force.Histological observation found similar results with respect to gingival inflammation and remodeling of alveolar bone. No marked inflammation and down growth of sulcular epithelium was observed in all the groups. Newly-formed alveolar bone was found around the one-third of initial bone defect area. A little amount of newly formed cementum was observed around the notch. However, epithelial downgrowth was partially observed for 1D, 3D dogs.The results of this study indicate that tooth-brushing can be initiated next day after periodontal surgical treatment.