论文标题:低强度激光照射对牙周组织再生影响的动物实验研究
Effect of Low-power Laser Irradiation on Periodontal Regeneration: An Experimental Animal Study
论文作者 彭庆芳
论文导师 欧炯光,论文学位 硕士,论文专业 口腔临床医学
论文单位 昆明医学院,点击次数 94,论文页数 56页File Size4674k
2004-05-01论文网 http://www.lw23.com/lunwen_86262362/ 牙周炎;动物模型;低强度激光;治疗;牙周组织再生
periodontal diseases;low-power laser;therapy;periodontal regeneration.
[目的]探索低强度激光照射对牙周组织再生的影响，以期寻求治疗牙周炎的新的手段，提高治疗效果；并为开发低强度激光在牙周病治疗中的应用提供实验依据。 [方法]以外科手术翻瓣去骨及金属丝拴丝结扎的方法，形成三只beagle狗上下颌前磨牙及第一磨牙Ⅱ度根分叉病变牙周炎动物模型；将狗牙颌的四个象限随机分为三个实验组和一个翻瓣对照组，实验组为在牙周炎的翻瓣手术治疗中选用不同剂量(4J／cm~2、6J／cm~2、8J／cm~2)的氦氖激光(波长632.8nm、功率6mW)照射实验性牙周病牙的根分叉区及牙根面。进行牙周临床检查、摄X线片，并将三只狗随机分为观察1月、2月、3月处死，获取牙体-牙周组织标本，应用光镜(HE及Masson三色染色)和透射电镜进行形态学研究及扫描电镜电子元素探针分析再生骨组织钙-磷含量等方法，评价低强度氦氖激光照射对牙周组织再生中牙骨质、牙槽骨、牙周膜的影响。 [结果]1．成功形成beagle狗Ⅱ度根分叉病变牙周炎动物模型。牙周检查见实验牙牙龈中-重度炎症，根分叉度(FI)为Ⅱ度，牙周临床附着水平(CAL)有丧失，CAL各组之间经统计学检验无显著性差异，炎症前后三只狗CAL经统计学检验有显著性差异，X-线片检查见实验牙牙槽骨吸收，以根分叉处吸收明显。2．牙周炎经两种方法(单纯翻瓣、翻瓣+激光照射)治疗后，治疗前后各组牙周临床附着水平经统计学检验无显著性差异、X-线片检查牙槽骨无明显变化。3．组织切片观察，单纯翻瓣术组及翻瓣术+激光照射各组牙周组织深部均有炎细胞浸润，两种治疗均无固有牙槽骨修复的表现。各激光治疗组与对照组相比，小剂量(4J／cm~2)的激光照射能使牙周韧带有修复的表现，有较多的成骨细胞形成，松质骨有新骨形成，而剂量大的激光照射组与单纯翻瓣术组相比，无明显的牙周组织再生的表现。透射电镜超微形态观察也与印证了上述结果，即与对照相比，小剂量(4J／cm~2)激光照射可使牙周韧带成纤维细胞增生，功能活跃。而稍大剂量的激光照射未见有明显的改变。4．再生骨组织钙-磷含量电子探针分析，与对照组相比，激光照射过的根分叉区骨组织钙-磷含量百分比(WT％)更接近正常骨组织。 [结论]1．小剂量(4J／cm~2)氦氖激光照射可促进牙周组织再生时牙周膜成纤维细胞胶原合成、牙周韧带修复，松质骨新骨形成活跃。2.氦氖激光照射可使被照松质骨的钙磷含量接近正常值，提示其可促进骨的改建。3.本实验所用剂量氦氖激光照射对牙周组织再生的影响从临床牙周检查及X一线检查看并不优于对照组。4.氦氖激光照射对牙周组织再生的影响还需进一步研究。
[Object]: To investigate the effect of low-power laser irradiation on periodontal regeneration with the hope for finding the new methods to treat periodontitis, improving the efficiency of periodontal tissues regeneration and providing the basis for developing the range of low-power laser application on the therapy of periodontal disease. [Materials and Methods]: All premolars and the first molars of three Beagle dogs were used to create Class II furcation defects model by surgically removing alveolar bone and placing metal ligaments, and randomly assigned to one control group and three treatment groups. The control group was treated by flap operation only. The treatment groups were cured by flap operation plus the low-power He-Ne laser(632. 8nm, 6mw) irradiation with energy setting of 4J/cm2, 6J/cnr\ 8J/cnf respectively on the furcation defects area and exposing root surfaces . The three dogs were randomly divided into three times for observing. The periodontal tissues of 1 month, 2 month and 3 month after treatment were evaluated through oral examination, X-way inspection, light microscope (LM) (hematoxylin and eosin , Masson trichrome), and transmission electron microscope(TEM) respectively. The new formation bone tissue within furcation was detected by scanning electron microscope (SEM). The content of calcium (Ca) and phosphorus (P) in the bone was analyzed by electron probe. [Results] : 1. The Beagle dog Class II furcation diseases model were well created. Among three dogs, the moderate to serious inflammation in the periodontium was observed. Furcation defects index II and clinical attachment level (CAL) loss were found. X-way inspection showed that alveolar bone absorbed apparently especially in furcation area. 2. In both treatment groups and control group, the CAL comparison between prior and post therapy showed no significantly different statistically. Absorption of alveolar bone detected by X-way appeared no obvious changes also. 3. The5descriptive analysis indicated that the group with irradiation of 4J/cra2 He-Ne laser showed the repair of periodontal ligament, more osteoblasts emergence, cancellous bone formation compared with the control group and other laser groups. 4. Compared to the control, furcation alveolar bone elementary analysis for all laser groups displayed the ratio of P205 and CaO (percentage of WT) which was more close to the normal alveolar bone. [Conclusion] : 1. The irradiation of 4J/cnT He-iNe laser can stimulate collagen synthesis of periodontal fibroblast, repair of periodontal ligament, formation of cancellous bone. 2. The ratio of P205/CaO in laser groups is more close to criterion than in the control. 3. There were no apparent advantage for laser treatment group comparison to the control group in the view of the oral examination and X-way inspection using set energy in this study. 4. The effect of He-Ne laser on periodontal regeneration should be studied deeply.
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