iindaba

Intshayelelo

Izixhobo ezilungisiweyo zokususa amazinyo aneziphene zisetyenziswa kwi-orthodontics kulutsha nakubantu abadala. Nanamhlanje, ubunzima bezempilo ngomlomo kunye nokunyuka kokudityaniswa kwamacwecwe kunye nentsalela yokutya ngexesha lonyango lwezixhobo ze-multibracket (MBA) zimele umngcipheko owongezelelekileyo1. Ukuphuculwa kwedemeralization, kubangela utshintsho olumhlophe, olungacacanga koqweqwe lwawo luyaziwa njengezilonda ezimhlophe (WSL), ngexesha lonyango nge-MBA sisiphumo esibi nesingathandekiyo kwaye sinokwenzeka emva kweeveki ezi-4 kuphela.

Kule minyaka idlulileyo, ingqalelo ehlawulelweyo ihlawulwe ekutywinweni kwemigangatho ye-buccal kunye nokusetyenziswa kwezitywina ezikhethekileyo kunye nevarnish ye fluoride. Ezi mveliso kulindeleke ukuba zibonelele ngoothintelo lwexesha elide kunye nokhuselo olongezelelekileyo kuxinzelelo lwangaphandle. Abavelisi abohlukeneyo bathembisa ukukhuselwa phakathi kweenyanga ezi-6 ne-12 emva kwesicelo esinye. Kuncwadi lwangoku iziphumo ezahlukeneyo kunye neengcebiso zinokufunyanwa malunga nefuthe lothintelo kunye nokuxhamla kusetyenziso lwezo mveliso. Ukongeza, kukho iingxelo ezahlukeneyo malunga nokumelana noxinzelelo. Iimveliso ezintlanu ezisetyenziswa rhoqo zibandakanyiwe: iitywina ezisekwe kumatywina ePro Seal, Light Bond (zombini iimveliso zeReliance Orthodontic, Itasca, Illinois, USA) naseClinpro XT Varnish (3 M Espe AG Zamazinyo, Seefeld, Germany). Kukwaphononongwa kwakhona i-fluoride varnishes Fluor Protector (i-Ivoclar Vivadent GmbH, i-Ellwangen, eJamani) kunye ne-Protecto CaF2 Nano One-Step-Seal (BonaDent GmbH, Frankfurt / Main, Germany). Ukuhamba okunyangayo, okuphilisa ukukhanya, iradiopaque nanohybrid composite yayisetyenziswa njengeqela elilawulayo (iTetric EvoFlow, Ivoclar Vivadent, Ellwangen, Germany).

Ezi zitywina zintlanu zisetyenziswa rhoqo ziphandwe kwi-vitro ngokuchasene nokuxhathisa kwabo emva kokufumana uxinzelelo loomatshini, umthwalo we-thermal kunye nokuvezwa kwemichiza okubangela ukuba kusebenze i-demineralization kwaye ngenxa yoko yi-WSL.

Ezi hypotheses zilandelayo ziya kuvavanywa:

I-1.

I-2.Alternative hypothesis: Uxinzelelo lweMechanical, thermal kunye neekhemikhali zichaphazela abatywina abaphandiweyo.

Izinto kunye nendlela

Kusetyenziswe amazinyo angaphambili eenkomo angama-192 kolu phando lwe-vitro. Amazinyo eenkomo akhutshwa kwizilwanyana zokuxhela (indawo yokuxhela, eAlzey, eJamani). Iikhrayitheriya zokukhetha amazinyo eenkomo zazingumngxunya- kwaye zingenasiphene, i-enamel ye-vestibular ngaphandle kokutshintsha kombuso wezinyo kunye nobungakanani obaneleyo besithsaba sezinyo4. Ukugcina bekukho kwisisombululo se-0.5% ye-chloramine B5, 6. Ngaphambi nasemva kwesicelo sebrakethi, imiphezulu egudileyo yamazinyo eenkomo aye acocwa nge-oyile- kunye nefluoride-engenanto yokuncamathisela (iZircate Prophy Cola, iDentsply DeTrey GmbH, Konstanz, Germany), ihlanjwe ngamanzi kwaye yomile ngomoya5. Izibiyeli zentsimbi ezenziwe ngentsimbi engena-nickel ngaphandle kwentsimbi zisetyenziselwe isifundo (iMin-Sprint Brackets, Forestadent, Pforzheim, Germany). Zonke izibiyeli ezisetyenzisiweyo ze-UnitekEtching Gel, iTransbond XT Light Cure Adhesive Primer kunye neTransbond XT Light Cure Orthodontic Adhesive (yonke 3 M Unitek GmbH, Seefeld, Germany). Emva kwesicelo sebrakethi, imiphezulu egudileyo yacocwa kwakhona ngeZircate Prophy Cola ukususa nayiphi na intsalela yokuncamathela.5. Ukulinganisa imeko efanelekileyo yeklinikhi ngexesha lokucoca ngoomatshini, isiqwenga se-archwire esinye esingama-2 cm (Forestalloy blue, Forestadent, Pforzheim, Germany) safakwa kwibrakethi ngentambo eyenziwe ngocingo lwangaphambili (0.25 mm, Forestadent, Pforzheim, Germany).

Zizonke zitywina ezihlanu eziphandiweyo kolu phando. Xa kukhethwa imathiriyeli, kuye kwenziwa ireferensi kuvavanyo lwangoku. EJamani, oogqirha bamazinyo abangama-985 babuzwa malunga nezitywina ezisetyenziswa kwizenzo zabo zamazinyo. Ezona zinto zikhankanyiweyo ezintlanu kwezi zilishumi elinanye zikhethiwe. Zonke izixhobo zisetyenziswe ngokungqongqo ngokwemiyalelo yomenzi. I-Tetric EvoFlow isebenze njengeqela elilawulayo elifanelekileyo.

Ngokusekwe kwimodyuli yexesha elilelakho ukuzilinganisa umndilili womthwalo womatshini, onke amatywina abekwa phantsi komthwalo woomatshini kwaye emva koko kuvavanywa. Ibrashi yamazinyo yombane, i-Oral-B yoNonophelo loBuchule 1000 (iProcter kunye neGamble GmbH, iSchwalbach am Taunus, eJamani), yasetyenziswa kolu phononongo ukulinganisa umthwalo woomatshini. Uvavanyo loxinzelelo olubonakalayo luyakhanyisa xa uxinzelelo loqhakamshelwano lomzimba (2 N) ligqithile. I-Oral-B Precision Clean EB 20 (Procter & Gamble GmbH, Schwalbach am Taunus, Germany) zazisetyenziswa njengeentloko zebrashi. Intloko yebrashi yahlaziywa kwiqela ngalinye lovavanyo (okt6 amaxesha). Ngexesha lofundo, intlama yamazinyo efanayo (Elmex, GABA GmbH, Lörrach, Germany) yayihlala isetyenziselwa ukunciphisa ifuthe layo kwiziphumo7. Kuvavanyo lokuqala, umyinge we-ertyisi ubungakanani bepeyinti walinganiswa kwaye wabalwa kusetyenziswa i-microbalance (Uvandlakanyo lohlalutyo loovulindlela, i-OHAUS, iNänikon, iSwitzerland) (385 mg). Intloko yebrashi yayinyibilikisiwe ngamanzi afakiweyo, ifinywe nge-385 mg ye-intlama yamazinyo kwaye ibekwe nje kancinci kumazinyo e-vestibular. Umthwalo woomatshini wawusetyenziswa ngoxinzelelo rhoqo kunye nokubuyela umva kwentshukumo ye-brashi yentloko. Ixesha lokuvezwa lihlolwe ukuya kowesibini. Ibrashi yamazinyo yombane yayihlala ikhokelwa ngumvavanyi ofanayo kulo lonke uthotho lovavanyo. Ulawulo loxinzelelo olubonakalayo lwalusetyenziselwa ukuqinisekisa ukuba uxinzelelo lomzimba (2 N) aluzange lugqithiswe. Emva kwemizuzu engama-30 yokusetyenziswa, ibhrashi yamazinyo yagcwaliswa ngokupheleleyo ukuqinisekisa ukusebenza okungaguquguqukiyo nokugcweleyo. Emva kokuxubha, amazinyo acocwa i-20 s ngesitshizi samanzi kancinci emva koko omiswe ngumoya8.

Imodyuli yexesha esetyenzisiweyo isekwe kwinto yokuba ixesha lokucoca eliphakathi li-2 min9, 10. Oku kungqinelana nexesha lokucoca i-30 s ngekota nganye. Kwindawo yokuzalela phakathi, ugqirha wamazinyo opheleleyo wamazinyo angama-28, okt amazinyo asi-7 ngekota nganye, uqikelelwa. Kwizinyo ngalinye kukho iindawo ezi-3 ezifanelekileyo zamazinyo kwibhashi yamazinyo: i-buccal, i-occlusal kunye nomlomo. Imigca yamazinyo e-mesial kunye ne-distal efanelekileyo kufuneka icocwe nge-floss floss okanye efanayo kodwa ihlala ingenakufikelelwa kwibhrashi yamazinyo kwaye ke inokungahoywa apha. Ngexesha lokucoca ngekota nganye ye-30 s, ixesha lokucoca eliphakathi le-4.29 s ngezinyo ngalinye linokucingelwa. Oku kungqinelana nexesha le-1.43 s ngomphezulu wamazinyo. Isishwankathelo, kunokucingelwa ukuba i-avareji yexesha lokucoca izinyo kwinkqubo yokucoceka imalunga. 1.5 s. Ukuba umntu uthathela ingqalelo indawo yamazinyo e-vestibular ephathwe nge-sealant yomphezulu ogudileyo, umthwalo wokucoca imihla ngemihla we-3 s ngokomndilili unokucingelwa ukucoca amazinyo kabini imihla ngemihla. Oku kungangqamana ne 21 s ngeveki, 84 s ngenyanga, 504 s qho kwiinyanga ezintandathu kwaye ingaqhubeka njengoko kufunwa. Kolu phando ukubonakaliswa kokucoca emva kosuku olu-1, iveki e-1, iiveki ezi-6, iinyanga ezi-3 kunye neenyanga ezi-6 kuye kwalingiswa kwaphandwa.

Ukuze ulinganise umahluko wobushushu owenzeka kwisisu somlomo kunye noxinzelelo olunxulumene noko, ukwaluphala okunganyanzelekanga kwakulinganiswa ne-cycler ye-thermal. Kolu phononongo umthwalo weebhayisikile oshushu (iSetyhula DC10, iThermo Haake, iKarlsruhe, iJamani) phakathi kwe-5 ° C kunye ne-55 ° C kwimijikelo engama-5000 kunye nokuntywiliselwa kunye nexesha lokudonsa le-30 s nganye nganye yenziwa ngokulinganisa ukubonakaliswa kunye nokwaluphala kwabatyibilikisi kangangesiqingatha sonyaka11. Iibhafu zokufudumeza amanzi zazaliswa ngamanzi afakwe amanzi. Emva kokufika kubushushu bokuqala, zonke iisampulu zamazinyo zajikeleza amaxesha angama-5000 phakathi kwephuli ebandayo kunye nedama lobushushu. Ixesha lokuntywiliselwa lalizi-30 s nganye, ilandelwa yidriphu engama-30 kunye nexesha lokudlulisa.

Ukulungiselela ukuhlaselwa kwe-asidi yemihla ngemihla kunye neenkqubo zokunyanzeliswa kwezimbiwa kwizitywina zomlomo, utshintsho lwe-pH lwenziwa. Izisombululo ezikhethiweyo yayiziBuskes12, 13Isisombululo sichazwe amaxesha amaninzi kuncwadi. Ixabiso le-pH yesisombululo se-demineralization 5 kunye nesisombululo sokuphinda senziwe kwakhona yi-7.Izinto ezisonjululwa isisombululo zi-calcium dichloride-2-hydrate (CaCl2-2H2O), potassium dihydrogen phosphate (KH2PO4), HE-PES (1 M ), i-potassium hydroxide (1 M) kunye ne-aqua destillata. Amacandelo esisombululo se-demineralization yi-calcium dichloride -2-hydrate (CaCl2-2H2O), i-potassium dihydrogen phosphate (KH2PO4), i-methylenediphosphoric acid (MHDP), i-potassium hydroxide (10 M) kunye ne-aqua destillata. I-pH-cycling yeentsuku ezi-7 yenziwa5, 14. Onke amaqela ayephantsi kolawulo lwe-22-h kunye ne-2-h demineralization ngemini (ngokutshintsha ukusuka kwi-11 h-1 h-11 h-1 h), ngokusekwe kwiiprotokholi zokuhamba ngebhayisikile esele zisetyenzisiwe kuncwadi15, 16. Izitya zeglasi ezimbini ezinkulu (20 × 20 × 8 cm, 1500 ml3, Simax, Bohemia Cristal, Selb, Germany) ezineziciko zikhethwe njengezikhongozeli apho zonke iisampulu zazigcinwa kunye. Izembozo zazisuswa kuphela xa iisampulu zatshintshwa zayenye itreyi. Iisampulu zagcinwa kubushushu begumbi (i-20 ° C ± 1 ° C) kwixabiso le-pH rhoqo kwizitya zeglasi5, 8, 17. Ixabiso le-pH lesisombululo lajongwa mihla le ngemitha ye-pH (3510 pH Meter, Jenway, Bibby Scientific Ltd, Essex, UK). Yonke imihla yesibini, isisombululo esipheleleyo sasihlaziywa, esathintela ukwehla kwexabiso le-pH. Xa utshintsha iisampulu ukusuka kwesinye isitya ukuya kwesinye, iisampulu zazicocwa ngononophelo ngamanzi afakwe amanzi zaze zomiswa ngejet yomoya ukunqanda ukuxuba izisombululo. Emva kweentsuku ezi-7 ze-pH ngebhayisikile, iisampulu zagcinwa kwi-hydrophorus kwaye zavavanywa ngokuthe ngqo phantsi kwemicroscope. Uhlalutyo lokujonga kolu phando imicroscope yedijithali VHX-1000 enekhamera ye-VHX-1100, i-tripod eshukumayo eyi-S50 ene-VHZ-100 optics, isoftware yokulinganisa i-VHX-H3M kunye nesisombululo esiphakamileyo se-17-intshi ye-LCD (Keyence GmbH, Neu- Isenburg, Jemani) zazisetyenziswa. Iinkalo ezimbini zoviwo ezinamacandelo ali-16 nganye nganye inokuchazwa ngezinyo ngalinye, kube kanye ngokungahambelaniyo kunye ne-apical yesiseko sebracket. Ngenxa yoko, amasimi angama-32 ewonke ngezinyo kunye ne-320 kwimihlaba nganye echazwe kwinqaku lokuvavanya. Ukujongana ngokukuko nokubaluleka kweklinikhi yemihla ngemihla kunye nendlela yokuvavanywa kokubonakalayo kwezitywina ngamehlo, icandelo ngalinye lajongwa phantsi kwemicroscope yedijithali enobukhulu be-1000 ×, kuvavanywa ngokubonakalayo kwaye kwabelwa ukwahluka koviwo. Izinto ezivavanyiweyo zaziyi-0: izinto ezibonakalayo = indawo evavanyiweyo igqunyiwe ngokupheleleyo ngezinto zokutywina, i-1: uphawu olunesiphene = intsimi evavanyiweyo ibonisa ilahleko epheleleyo yezinto okanye ukuncitshiswa okubonakalayo kwindawo enye, apho umphezulu wamazinyo ubonakala, kodwa nge umaleko oshiyekileyo wetywina, 2: Ukuphulukana nezinto ezibonakalayo = intsimi evavanyiweyo ibonisa ilahleko epheleleyo yezinto, indawo yamazinyo iveziwe okanye *: ayinakuvavanywa = umhlaba ovavanyiweyo awunako ukumelwa ngokufanelekileyo okanye isityikitya asifakwanga ngokwaneleyo, ke oku umhlaba uyasilela kuthotho lovavanyo.