izindaba

Isingeniso

Imishini elungisiwe yokususwa kwamazinyo abekwe kabi isetshenziswa kuma-orthodontics kubo bobabili abantu abadala nasebekhulile. Ngisho nanamuhla, inhlanzeko yomlomo enzima kanye nokuqoqeka okwandayo kokuqongelela kwamacwecwe nezinsalela zokudla ngesikhathi sokwelapha ngemishini ye-multibracket (MBA) kumelela ingozi eyengeziwe1. Ukuthuthukiswa kokukhishwa kwamaminerali, okubangela ushintsho olumhlophe, olungajwayelekile koqweqwe lwawo kwaziwa njengezilonda zamabala amhlophe (WSL), ngenkathi ukwelashwa nge-MBA kungumphumela ohlangothini ovamile futhi ongathandeki futhi kungenzeka ngemuva kwamasonto amane nje.

Eminyakeni yamuva nje, kunakwe kakhulu ukubekwa uphawu kwezindawo ze-buccal nokusetshenziswa kwama-sealant akhethekile namavanishi e-fluoride. Le mikhiqizo kulindeleke ukuthi ihlinzeke ngokuvimbela ama-caries okuhlala isikhathi eside kanye nokuvikelwa okungeziwe ekucindezelekeni kwangaphandle. Abakhiqizi abahlukahlukene bathembisa ukuvikelwa phakathi kwezinyanga eziyisithupha kuya kwezingu-12 ngemuva kwesicelo esisodwa. Emibhalweni yamanje imiphumela ehlukile nezincomo kungatholakala mayelana nomphumela wokuvimbela kanye nenzuzo ekusetshenzisweni kwemikhiqizo enjalo. Ngaphezu kwalokho, kunezitatimende ezahlukahlukene maqondana nokumelana kwabo nengcindezi. Imikhiqizo emihlanu esetshenziswa njalo ifakiwe: i-composite based sealants Pro Seal, Light Bond (yomibili iReliance Orthodontic Products, Itasca, Illinois, USA) kanye neClinpro XT Varnish (3 M Espe AG Dental Products, Seefeld, Germany). Kuphinde kwaphenywa ama-fluoride varnishes Fluor Protector amabili (i-Ivoclar Vivadent GmbH, i-Ellwangen, i-Germany) ne-Protecto CaF2 Nano One-Step-Seal (BonaDent GmbH, Frankfurt / Main, Germany). I-flowable, elapha ukukhanya, i-radiopaque nanohybrid composite yasetshenziswa njengeqembu elilawulayo elihle (iTetric EvoFlow, Ivoclar Vivadent, Ellwangen, Germany).

Lawa ma-sealant ayisihlanu asetshenziswa njalo aphenywa nge-vitro maqondana nokumelana kwawo ngemuva kokubhekana nengcindezi yemishini, umthwalo oshisayo nokuchayeka kwamakhemikhali okubangela ukwehliswa kwemvelo futhi ngenxa yalokho iWSL.

Imibono elandelayo izohlolwa:

I-1.Null hypothesis: Izingcindezi zemishini, ezishisayo nezamakhemikhali azithinti ama-sealants aphenywayo.

Ukucabanga okuhlukile kwe-2: Ukucindezelwa kwemishini, ukushisa kanye namakhemikhali kuthinta ama-sealants aphenywayo.

Izinto nendlela

Kusetshenziswe amazinyo angaphambili wezinkomo ayi-192 kulolu cwaningo lwe-vitro. Amazinyo ezinkomo akhishwa ezilwaneni ezihlatshwayo (indawo yokubulala, e-Alzey, eJalimane). Indlela yokukhetha yamazinyo wezinkomo yayingamakhemikhali- futhi yayingenasici, i-vestibular koqweqwe lwawo ngaphandle kokushintsha kombala wamazinyo nosayizi owanele womqhele wamazinyo4. Isitoreji besisisombululo esingu-0.5% chloramine B5, 6. Ngaphambi nangemva kokufakwa kubakaki, indawo ebushelelezi evundile yawo wonke amazinyo ezifuyo ihlanzwe ngokungeziwe ngopende wokupholisha ongenawo uwoyela ne-fluoride (iZircate Prophy Paste, iDentsply DeTrey GmbH, iKonstanz, Germany), ihlanjululwe ngamanzi futhi yomiswa ngomoya5. Abakaki bensimbi abenziwe ngensimbi engagqwali engenayo i-nickel basetshenziselwe ucwaningo (Ama-Mini-Sprint Brackets, i-Forestadent, i-Pforzheim, i-Germany). Onke amabakaki asebenzise i-UnitekEtching Gel, iTransbond XT Light Cure Adhesive Primer neTransbond XT Light Cure Orthodontic Adhesive (yonke 3 M Unitek GmbH, Seefeld, Germany). Ngemuva kokufakwa kubakaki, izindawo ezibushelelezi ze-vestibular zahlanzwa futhi nge-Zircate Prophy Paste ukususa noma yiziphi izinsalela zokubambelela5. Ukulingisa isimo esifanele somtholampilo ngesikhathi sokuhlanza ngomshini, ucezu lwe-archwire olulodwa olungu-2 cm (Forestalloy blue, Forestadent, Pforzheim, Germany) lufakwe kubakaki nge-preformed wire ligature (0.25 mm, Forestadent, Pforzheim, Germany).

Bangu-sealant abayisihlanu abaphenyiwe kulolu cwaningo. Ekukhetheni izinto zokwakha, kubhekiswe kwinhlolovo yamanje. EJalimane, odokotela bamazinyo abangama-985 babuzwa ngama-sealant asetshenziswa emisebenzini yabo ye-orthodontic. Izinto ezinhlanu okukhulunywe ngazo kakhulu kwezilishumi nanye zikhethiwe. Zonke izinto zisetshenziswe ngokuqinile ngokwemiyalo yomkhiqizi. I-Tetric EvoFlow isebenze njengeqembu elilawulayo elihle.

Ngokuya ngemodyuli yesikhathi esizimele ukulingisa isilinganiso semithwalo yemishini, wonke ama-sealants afakwa kumthwalo wokulungiswa futhi ahlolwa kamuva. Ibhulashi lamazinyo kagesi, i-Oral-B Professional Care 1000 (Procter & Gamble GmbH, Schwalbach am Taunus, Germany), lisetshenziswe kulolu cwaningo ukulingisa umthwalo owenziwa ngomshini. Ukuhlolwa kwengcindezi ebonakalayo kukhanya lapho ingcindezi yokuxhumana nomzimba (2 N) idluliwe. I-Oral-B Precision Clean EB 20 (Procter & Gamble GmbH, Schwalbach am Taunus, Germany) yasetshenziswa njengamakhanda wamabhulashi wamazinyo. Inhloko yebhulashi ivuselelwe iqembu ngalinye lokuhlola (izikhathi ezingama-6). Ngesikhathi kwenziwa ucwaningo, umuthi wokuxubha ofanayo (u-Elmex, GABA GmbH, Lörrach, Germany) wawusetshenziswa njalo ukunciphisa umthelela wawo emiphumeleni7. Esivivinyweni sokuqala, isilinganiso samaphoyinti esilinganiselwe silinganiswa futhi sabalwa kusetshenziswa i-microbalance (ibhalansi yokuhlaziya iPioneer, i-OHAUS, iNänikon, iSwitzerland) (385 mg). Ikhanda lebhulashi laliswakanyiswe ngamanzi acolisisiwe, limanziswa ngomuthi wokuxubha ophakathi nendawo ongu-385 mg futhi labekwa nje endaweni yezinyo le-vestibular. Umthwalo wemishini wawusetshenziswa ngengcindezi engaguquki nokuhamba okuphindayo nokuhamba emuva kwekhanda lokuxubha. Isikhathi sokuvezwa sihlolwe kwesesibili. Ibhulashi lamazinyo kagesi lalihlale liqondiswa ngumhloli ofanayo kulo lonke uchungechunge lokuhlolwa. Ukulawulwa kwengcindezi ebonakalayo kusetshenziselwe ukuqinisekisa ukuthi ingcindezi yokuxhumana komzimba (2 N) ayidluli. Ngemuva kokusetshenziswa kwamaminithi angama-30, isixubho sagcwaliswa ngokugcwele ukuqinisekisa ukusebenza okungaguquguquki nokugcwele. Ngemuva kokuxubha, amazinyo ahlanzwa ama-20 s ngesifutho samanzi esincane bese esomiswa ngomoya8.

Imodyuli yesikhathi esetshenzisiwe isuselwa ekucabangeni ukuthi isikhathi sokuhlanza esimaphakathi singama-2 min9, 10. Lokhu kufana nesikhathi sokuhlanza esingu-30 s nge-quadrant ngayinye. Okwamazinyo amaphakathi, ukucatshangelwa okugcwele kwamazinyo angama-28, okungukuthi amazinyo ayi-7 nge-quadrant ngayinye, kucatshangwa. Ngezinyo ngalinye kunezindawo ezi-3 ezifanele zamazinyo zebhulashi lamazinyo: i-buccal, i-occlusal kanye nomlomo. Indawo yamazinyo eseduze ne-mesial ne-distal kufanele ihlanzwe nge-floss floss noma efanayo kodwa imvamisa ayitholakali kubhulashi lamazinyo ngakho-ke inganakekelwa lapha. Ngesikhathi sokuhlanza i-quadrant ngayinye yama-30 s, isikhathi sokuhlanza esimaphakathi esingu-4.29 s ngezinyo ngalinye kungacatshangwa. Lokhu kufana nesikhathi esingu-1.43 s ebusweni bezinyo ngalinye. Ngokufingqa, kungacatshangwa ukuthi isikhathi sokuhlanza esimaphakathi sendawo yezinyo ngenqubo ngayinye yokuhlanza siseduze. 1.5 s. Uma umuntu ebheka indawo yamazinyo e-vestibular ephethwe nge-surface sealant ebushelelezi, umthwalo wokuhlanza nsuku zonke we-3 s ngokwesilinganiso ungacatshangelwa ukuhlanzwa izinyo kabili ngosuku. Lokhu kuzohambisana nama-21 s ngeviki, ama-84 ngenyanga, ama-504 s njalo ezinyangeni eziyisithupha futhi kungaqhutshwa njengokufiswa. Kulolu cwaningo ukuvezwa kokuhlanzwa ngemuva kosuku olungu-1, isonto eli-1, amasonto ayisithupha, izinyanga ezi-3 nezinyanga eziyisithupha kwalingiswa kwaphenywa.

Ukuze ulingise ukwehluka kwamazinga okushisa okwenzeka emgodini womlomo nezingcindezi ezihambisana nakho, ukuguga okufakelwayo kwalingiswa nge-cycler eshisayo. Kulolu cwaningo umthwalo wokuhamba ngebhayisikili oshisayo (Circulator DC10, Thermo Haake, Karlsruhe, Germany) phakathi kuka-5 ° C no-55 ° C ngemijikelezo engama-5000 kanye nesikhathi sokucwilisa nokuconsa sama-30 s ngasinye senziwa ukufanisa ukuvezwa nokuguga kwabalimi isigamu sonyaka11. Izindawo zokugeza ezishisayo zagcwaliswa ngamanzi acolisisiwe. Ngemuva kokufinyelela ezingeni lokushisa lokuqala, wonke amasampula amazinyo akhombisa izikhathi ezingama-5000 phakathi kwechibi elibandayo nedamu lokushisa. Isikhathi sokucwiliswa sasingu-30 s lilinye, kulandelwa i-30 s drip nesikhathi sokudlulisa.

Ukuze ulingise ukuhlaselwa kwe-asidi nsuku zonke kanye nezinqubo zamaminerali kuma-sealants emlonyeni womlomo, ukuvezwa kwe-pH kwenziwa. Izixazululo ezikhethiwe kube yiBuskes12, 13Isixazululo sichazwe kaningi ezincwadini. Inani le-pH lesixazululo se-demineralization liyi-5 kanti isisombululo se-remineralization ngu-7. Izingxenye zezixazululo ze-remineralization yi-calcium dichloride-2-hydrate (CaCl2-2H2O), potassium dihydrogen phosphate (KH2PO4), HE-PES (1 M ), i-potassium hydroxide (1 M) ne-aqua destillata. Izingxenye zesisombululo se-demineralization yi-calcium dichloride -2-hydrate (CaCl2-2H2O), i-potassium dihydrogen phosphate (KH2PO4), i-methylenediphosphoric acid (MHDP), i-potassium hydroxide (10 M) ne-aqua destillata. Kwenziwa i-pH-cycling yamalanga ayi-75, 14. Onke amaqembu afakwa ngaphansi kokuvuselelwa kabusha kwe-22-h kanye ne-2-h demineralization ngosuku (kushintshana kusuka ku-11 h-1 h-11 h-1 h), ngokususelwa kumaphrothokholi wamabhayisikili e-pH asevele asetshenziswa ezincwadini15, 16. Izitsha ezimbili ezinkulu zengilazi (20 × 20 × 8 cm, 1500 ml3, Simax, Bohemia Cristal, Selb, Germany) ezinamabhodlela zakhethwa njengeziqukathi lapho wonke amasampula ayegcinwa khona ndawonye. Izembozo zazisuswa kuphela lapho amasampula eguqulwa ayokwenziwa elinye ithileyi. Amasampula ayegcinwa ekamelweni lokushisa (20 ° C ± 1 ° C) ngenani le-pH elihlala njalo ezitsheni zengilazi5, 8, 17. Inani le-pH lesisombululo lahlolwa nsuku zonke ngemitha ye-pH (3510 pH Meter, Jenway, Bibby Scientific Ltd, Essex, UK). Njalo ngosuku lwesibili, isixazululo esiphelele sasivuselelwa, okuvimbele ukwehla okungabakhona kunani le-pH. Lapho kushintshwa amasampula kusuka kwesinye isidlo kuye kwesinye, amasampula ahlanzwa ngokucophelela ngamanzi afakwe i-distilled abese omiswa ngendiza yomoya ukugwema ukuxuba izixazululo. Ngemuva kokuhamba ngebhayisikili kwe-pH yezinsuku eziyi-7, amasampula agcinwa ku-hydrophorus futhi ahlolwa ngqo ngaphansi kwemicroscope. Ukuhlaziya okubonakalayo kulolu cwaningo imicroscope yedijithali i-VHX-1000 enekhamera ye-VHX-1100, i-tripod eshukumayo engu-S50 ene-VHZ-100 optics, isoftware yokulinganisa i-VHX-H3M kanye ne-high-resolution 17-inch LCD monitor (Keyence GmbH, Neu- Isenburg, Germany) kwasetshenziswa. Izinkambu ezimbili zokuhlola ezinemikhakha eyi-16 ngayinye zingachazwa ngezinyo ngalinye, kanye kanye nokuxakaniseka kwesisekelo sabakaki. Njengomphumela, izinkambu ezingama-32 sezinyo ngalinye nezinkambu ezingama-320 ngento ngayinye zachazwa ochungechungeni lokuhlola. Ukubhekana kahle nokubaluleka komtholampilo kwansuku zonke nokusondela ekuhlolweni okubukwayo kwama-sealants ngamehlo, inkambu ngayinye ibhekwe ngaphansi kwesibonakhulu sedijithali esinokukhulisa okungu-1000 ×, kuhlolwe ngokubuka futhi kwabelwa ukuguquguquka kokuhlolwa. Ukuhlukahluka kokuhlolwa kwakungu-0: impahla = inkambu ehlolwayo imbozwe ngokuphelele ngezinto zokuvala uphawu, i-1: i-sealant enesici = inkambu ehlolwayo ikhombisa ukulahleka okuphelele kwempahla noma ukwehliswa okukhulu ngesikhathi esisodwa, lapho kubonakala khona amazinyo, kepha nge ungqimba olusele lwe-sealant, 2: Ukulahleka kwempahla = inkambu ehloliwe ikhombisa ukulahleka okuphelele kwezinto, indawo yamazinyo ivezwe noma *: ayikwazi ukuhlolwa = inkambu ehloliwe ayikwazi ukumelwa ngokwanele noma i-sealer ayisetshenziswanga ngokwanele, khona-ke lokhu inkambu yehluleka ochungechungeni lokuhlola.