nūhou

Hoʻolauna

Hoʻohana ʻia nā mīkini pono no ka hemo ʻana o nā niho malpositioned i nā orthodontics no nā ʻōpio a me nā mākua. ʻOiai i kēia lā, ʻo ka hoʻomaʻemaʻe waha paʻakikī a me ka hoʻonui ʻia o ka hōʻiliʻili o ka pā a me nā koena o ka meaʻai i ka manawa o ka therapy me nā meahana multibracket (MBA) e hōʻike ana i kahi pilikia caries hou aʻe.1. ʻO ka hoʻomohala ʻana o ka demineralization, ke kumu o ke keʻokeʻo, nā loli opaque i ka enamel i ʻike ʻia ʻo nā leona keʻokeʻo keʻokeʻo (WSL), i ka wā o ka mālama ʻana me MBA kahi hopena pinepine a makemake ʻole ʻia a hiki ke hana ma hope o 4 mau pule.

I nā makahiki i hala iho nei, ua hoʻonui ʻia ka nānā ʻana i ka sila ʻana i nā papa buccal a me ka hoʻohana ʻana i nā sila sila a me nā varnish fluoride. Manaʻo kēia mau huahana i ka pale lōʻihi caries a me ka pale hou aku i nā koʻikoʻi kūwaho. Hoʻohiki nā mea hana like ʻole i ka pale ma waena o 6 a me 12 mau mahina ma hope o hoʻokahi noi. I nā puke i kēia manawa hiki ke loaʻa nā hopena a me nā ʻōlelo aʻoaʻo e pili ana i ka hopena pale a me ka pono no ka noi ʻana o ia huahana. Eia hou, aia kekahi mau ʻōlelo e pili ana i kā lākou kūpaʻa i ke koʻikoʻi. Ua hoʻokomo ʻia ʻelima mau huahana i hoʻohana pinepine ʻia: nā sealants i hoʻokumu ʻia Pro Seal, Light Bond (ʻo nā huahana Orthodontic Reliance, Itasca, Illinois, USA) a me Clinpro XT Varnish (3 M Espe AG Dental Products, Seefeld, Kelemānia). Noi pū ʻia nā varnish fluoride ʻelua Fluor Protector (Ivoclar Vivadent GmbH, Ellwangen, Kelemānia) a me Protecto CaF2 Nano One-Step-Seal (BonaDent GmbH, Frankfurt / Main, Kelemānia). Ua hoʻohana ʻia kahi laulima, hoʻomālamalama kukui, radiopaque nanohybrid hui e like me ka pūʻulu mana maikaʻi (Tetric EvoFlow, Ivoclar Vivadent, Ellwangen, Kelemānia).

Nānā ʻia kēia mau sila ʻelima i vitro i kā lākou kūpaʻa ʻana ma hope o ka ʻike ʻana i ke kaomi mīkini, ka ukana mehana a me ka hopena kemika e hana ana i ka demineralization a no laila WSL.

E hoʻāʻo ʻia nā kuhiakau aʻe:

Kuhiakau 1.Null: ʻaʻole pili ka mechanical, thermal a me nā koʻikoʻi kemika i nā sila i ʻimi ʻia.

2. Kuhiakau hou: Hoʻopilikia nā mīkini, hoʻomehana a me nā mea ʻino i nā sila i ʻimi ʻia.

Nā meahana a me nā hana

Ua hoʻohana ʻia nā niho mua o ka bovine 192 i kēia in vitro study. Lawe ʻia nā niho bovine mai nā holoholona luku (hale luku, Alzey, Kelemania). ʻO nā pae koho no nā niho bovine he caries- a me ka kīnā ʻole, enamel vestibular me ka loli ʻole o ka niho a me ka nui o ka lei o ka niho.4. Aia kahi mālama i kahi hopena 0.5% chloramine B5, 6. Ma mua a ma hope o ka noi bracket, hoʻomaʻemaʻe hou ʻia nā papa helehelena o nā niho bovine āpau me ka hamo aila a me ka floride-free polishing (Zircate Prophy Paste, Dentsply DeTrey GmbH, Konstanz, Kelemānia), holoi ʻia me ka wai a hoʻomaloʻo ʻia me ka ea5. ʻO nā paʻa hao i hana ʻia me ka kila kila ʻole no nickel i hoʻohana ʻia no ke aʻo ʻana (Mini-Sprint Brackets, Forestadent, Pforzheim, Kelemānia). Hoʻohana ʻia nā pale āpau i ka UnitekEtching Gel, Transbond XT Light Ches Adhesive Primer a me Transbond XT Light Cure Orthodontic Adhesive (ʻo 3 M Unitek GmbH, Seefeld, Kelemānia). Ma hope o ka noi bracket, ua hoʻomaʻemaʻe hou ʻia nā wahi laumania me ka Zircate Prophy Paste e hemo ai i nā koena hoʻopili.5. No ka hoʻohālikelike ʻana i ke kūlana olakino maikaʻi i ka hoʻomaʻemaʻe ʻana o ka mīkini, kahi ʻelua cm lōʻihi hoʻokahi archwire ʻāpana (Forestalloy blue, Forestadent, Pforzheim, Kelemānia) i hoʻopili ʻia i ka bracket me kahi ligature wire preformed (0.25 mm, Forestadent, Pforzheim, Kelemānia).

Ua ʻimi ʻia kahi huina o nā sila he ʻelima i kēia noi ʻana. I ke koho ʻana i nā pono, ua kuhikuhi ʻia i kahi ana ʻana o kēia wā. I Kelemania, ua nīnau ʻia nā kauka niho 985 e pili ana i nā sila i hoʻohana ʻia i kā lākou hana orthodontic. ʻO nā mea i ʻōlelo ʻia ʻelima o ka ʻumikūmākahi mea i wae ʻia. Ua hoʻohana pololei ʻia nā mea āpau e like me nā ʻōlelo a ka mea hana. Ua lawelawe ʻo Tetric EvoFlow ma ke ʻano he pūʻulu mana maikaʻi.

Hoʻokumu ʻia i kahi module manawa hoʻomohala pilikino ʻia e simulate i ka awelika o ka ukana mīkini, ua hoʻokau ʻia nā mea sila a pau i kahi ukana mīkini a laila ua hoʻāʻo ʻia. Ua hoʻohana ʻia kahi palaki niho, Oral-B Professional Professional 1000 (Procter & Gamble GmbH, Schwalbach am Taunus, Kelemānia) i kēia noi e hoʻohālikelike i ka ukana mechanical. Mālamalama kahi kaha kaomi ʻike ke hoʻonui ʻia ke kaomi pili pilikino (2 N). Ua hoʻohana ʻia ʻo Oral-B Precision Clean EB 20 (Procter & Gamble GmbH, Schwalbach am Taunus, Kelemānia) ma ke ʻano he poʻo poli niho. Ua hoʻomaikaʻi hou ʻia ke poʻo palaki no kēlā me kēia hui hoʻāʻo (ie6 mau manawa). I ka wā o ke aʻo ʻana, hoʻohana mau ʻia ka toothpaste (Elmex, GABA GmbH, Lörrach, Kelemānia) i mea e hōʻemi ai i ka hopena o ka hopena.7. I kahi hoʻokolohua mua, ua ana ʻia ka pālākiō peʻa-nui o ka toothpaste a helu ʻia me ka hoʻohana ʻana i kahi microbalance (Pioneer analitical analysis, OHAUS, Nänikon, Switzerland) (385 mg). Hoʻopulu ʻia ke poʻo palaki me ka wai hoʻomaʻemaʻe, hoʻomaʻū ʻia me 385 mg awelika toothpaste a hoʻonoho ʻia ma ka papa o ka niho vestibular. Hoʻohana ʻia ka ukana mīkini me ka kaomi mau a me nā neʻe ʻana o mua a me nā neʻe hope o ke poʻo palaki. Ua nānā ʻia ka manawa hōʻike i ka lua. Ua alakaʻi mau ʻia ka poli niho uila e ka mea nānā like ma nā hōʻike hōʻike āpau. Ua hoʻohana ʻia ke kaomi kaomi ʻike e ʻike pono ʻaʻole i ʻoi aku ka nui o ke kaomi pilina (2 N). Ma hope o 30 min o ka hoʻohana, hoʻopiha piha ʻia ka palaki niho e hōʻoia i ka hana mau a me ka piha. Ma hope o ka palaki ʻana, hoʻomaʻemaʻe ʻia nā niho no 20 s me kahi ʻāpana māmā o ka wai a laila hoʻomaloʻo ʻia me ka ea8.

Hoʻokumu ʻia ke module manawa i ka manaʻo o ka manawa maʻamau o ka hoʻomaʻemaʻe he 2 min9, 10. Kūlike kēia i kahi manawa hoʻomaʻemaʻe o 30 s per quadrant. No kahi niho kuʻuna, he niho niho piha no 28 mau niho, ʻo ia hoʻi he 7 mau niho o ka quadrant. No kēlā me kēia niho he 3 mau niho āpau e pili ana no ka palaki niho: buccal, occlusal a me waha. Pono e hoʻomaʻemaʻe ʻia nā ʻāpana mesial a me distal kokoke i ka niho me nā pulupulu niho a i ʻole nā ​​ʻano like akā ʻaʻole hiki ke kiʻi ʻia no ka palaki niho a no laila hiki ke haʻalele ʻole ʻia ma aneʻi. Me kahi manawa hoʻomaʻemaʻe no kēlā me kēia quadrant o 30 s, hiki ke manaʻo ʻia kahi manawa hoʻomaʻemaʻe maʻamau o 4.29 s no kēlā me kēia niho. Kūlike kēia i ka manawa o 1.43 s no ka pā niho. I ka hōʻuluʻulu manaʻo, hiki ke manaʻo ʻia ʻo ka awelika o ka manawa hoʻomaʻemaʻe o kahi pae niho ma kēlā me kēia kaʻina hana hoʻomaʻemaʻe. 1.5 s. Inā manaʻo kekahi i kahi o ka niho vestibular i mālama ʻia me kahi sila laumania, hiki ke manaʻo ʻia kahi ukana hoʻomaʻemaʻe o 3 s i kēlā me kēia lā no ka hoʻomaʻemaʻe niho ʻelua i kēlā me kēia lā. Kūlike kēia me 21 s i kēlā me kēia pule, 84 s i kēlā me kēia mahina, 504 s i kēlā me kēia ʻeono mahina a hiki ke hoʻomau ʻia e like me ka makemake. I loko o kēia noi ʻana ka hōʻike hoʻomaʻemaʻe ma hope o 1 lā, 1 pule, 6 pule, 3 mahina a me 6 mau mahina i simulate a ʻimi ʻia.

I mea e hoʻohālikelike ai i nā ʻokoʻa mahana i loko o ka waha o ka waha a me nā pilikia e pili ana, ua hoʻohālikelike ʻia ka ʻelemakule hana me kahi cycler thermal. I loko o kēia hoʻopaʻa ʻana ka ukana paikikala uila (Circulator DC10, Thermo Haake, Karlsruhe, Kelemania) ma waena o 5 ° C a me 55 ° C ma 5000 mau pōʻaiapuni a me ka manawa immersion a me ke kulu o 30 s i kēlā me kēia mea i hana ʻia e hoʻohālikelike ai i ka hōʻike a me ka ʻelemakule o nā sila. no ka hapalua makahiki11. Hoʻopiha ʻia nā ʻauʻau wela me ka wai pulu. Ma hope o ka hōʻea ʻana i ka mahana mua, oscillated 5000 mau manawa niho a pau ma waena o ka wai anuanu a me ka loko wai wela. ʻO ka manawa immersion he 30 s kēlā me kēia, a ukali ʻia e kahi 30 drip a me ka manawa hoʻololi.

I mea e hoʻohālikelike ai i ka hoʻouka waikawa o kēlā me kēia lā a me nā hana mineralization ma nā sila i nā lua o ka waha, ua lawe ʻia kahi pānaʻi loli. ʻO nā hāʻina i koho ʻia ʻo ia nā Buskes12, 13ka hopena i wehewehe ʻia i nā manawa he nui i ka palapala. ʻO ka waiwai pH o ka hopena demineralization he 5 a ʻo ka hopena remineralization he 7. ʻO nā ʻāpana o nā hopena remineralization he calcium dichloride-2-hydrate (CaCl2-2H2O), potassium dihydrogen phosphate (KH2PO4), HE-PES (1 M ), potassium hydroxide (1 M) a me aqua destillata. ʻO nā ʻāpana o ka hopena demineralization ka calcium dichloride -2-hydrate (CaCl2-2H2O), potassium dihydrogen phosphate (KH2PO4), methylenediphosphoric acid (MHDP), potassium hydroxide (10 M) a me aqua destillata. Ua lawe ʻia kahi 7-lā pH-paikikala5, 14. Hoʻopili ʻia nā hui āpau i ka remineralization 22-h a me ka demineralization 2-h i kēlā me kēia lā (e hoʻololi ana mai 11 h-1 h-11 h-1 h), ma muli o nā kaʻina paikikala pH i hoʻohana ʻia i nā puke.15, 16. ʻElua mau kīʻaha kīʻaha nui (20 × 20 × 8 cm, 1500 ml3, Simax, Bohemia Cristal, Selb, Kelemania) me nā poʻi i koho ʻia i mau ipu i mālama pū ʻia nā ʻāpana āpau. Wehe wale ʻia nā uhi ke hoʻololi ʻia nā laʻana i loko o ka pā ʻē aʻe. Ua mālama ʻia nā laʻana ma ka mahana o ka lumi (20 ° C ± 1 ° C) i ka waiwai o ka pH mau i nā ipu aniani5, 8, 17. Nānā ʻia ke kumu kūʻai o ka hopena ma kahi o ka mika mika (3510 pH Meter, Jenway, Bibby Scientific Ltd, Essex, UK). I kēlā me kēia lā ʻelua, ua hoʻohou hou ʻia ka hopena piha, i pale ai i kahi kulu kūpono o ka waiwai pH. Ke hoʻololi nei i nā laʻana mai kahi pā i kahi ʻē aʻe, hoʻomaʻemaʻe pono ʻia nā laʻana me ka wai hoʻomaʻemaʻe a laila hoʻomaloʻo ʻia me kahi jet air e pale ai i ka hoʻohuihui ʻana i nā hopena. Ma hope o ke kaʻa heʻe 7 lā, mālama ʻia nā laʻana i ka hydrophorus a loiloi pono ʻia ma lalo o ka microscope. No ke aniani aniani i kēia noi ʻana i ka microscope uila VHX-1000 me ka pahupaʻi uila VHX-1100, ka tripod S50 hiki ke hoʻoneʻe ʻia me nā optika VHZ-100, ka polokalamu ana VHX-H3M a me ka monitor LCD 17-ʻoki kiʻekiʻe kiʻekiʻe (Keyence GmbH, Neu- Ua hoʻohana ʻia ʻo Isenburg, Kelemania). ʻElua māla e nānā ai me 16 mau māla pākahi i hiki ke wehewehe ʻia no kēlā me kēia niho, i ka manawa o ka incisy a me ka apical o ka waihona paʻa. A ʻo kahi hopena, he 32 mau māla no kēlā me kēia niho a me 320 mau māla no kēlā me kēia meahana i wehewehe ʻia i kahi moʻo hoʻāʻo. I mea e kamaʻilio maikaʻi ai i ka pilina koʻikoʻi o kēlā me kēia lā a me ka hoʻokokoke ʻana i ka ʻike maka o nā mea sila me ka maka maka ʻole, ua ʻike ʻia kēlā me kēia māina ma lalo o ka microscope uila me kahi hoʻonui 1000 ×, nānā loiloi ʻia a hāʻawi ʻia i kahi loli hoʻokolokolo. ʻO nā loli hoʻokolohua he 0: mea = ua uhi paʻa ʻia ka māla i nānā ʻia me nā mea sealing, 1: sealant hema ʻole = hōʻike ke kahua i ninaninau ʻia i ka nalowale piha o nā mea a i ʻole ka hoʻoliʻiliʻi nui i hoʻokahi manawa, kahi i ʻike ʻia ka ʻili o ka niho, akā me ka ke koena o ka wepa, 2: Nalo ka waiwai = hōʻike ka māla i ninaninau i kahi nalo o nā mea āpau, hōʻike ʻia ka ʻili o ka niho a i ʻole *: ʻaʻole hiki ke loiloi = ʻaʻole hiki ke hōʻike pono ʻia ka māla i nānā ʻia a ʻaʻole lawa paha ka hoʻopili ʻana. hāʻule ke kahua no ka moʻo hoʻāʻo.