包覆鐵氟龍薄膜矯正器之抗沾黏效果評估; Evaluation in anti-adhesion effect of Teflon-coated brackets

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Title:	包覆鐵氟龍薄膜矯正器之抗沾黏效果評估;Evaluation in anti-adhesion effect of Teflon-coated brackets
Authors:	游琬真;Wan-Chen Yu
Contributors:	中國醫藥大學：臨床醫學研究所碩士班
Keywords:	矯正器;鐵氟龍;抗沾黏;orthodontic bracket;Teflon;anti-adhesion
Date:	2008-06-12
Issue Date:	2009-08-12 14:23:34 (UTC+8)
Abstract:	現代人對於牙齒的功能及美觀愈來愈重視，牙齒的矯正治療也日趨普遍，由於治療時必須在牙齒表面黏著矯正裝置，造成口腔衛生不易維持，在矯正器及周圍常沾黏食物殘渣及牙菌斑，然而由於矯正治療時間往往需要數個月至數年的時間，長期下來罹患齲齒、牙齦炎的機會大大增加，是以研發具抗沾黏效果的鐵氟龍製成之矯正器的構想因應而生。鐵氟龍是一種樹脂，化學名稱為聚四氟乙烯，具有耐熱、耐低溫、耐蝕性、異優的非粘著性及低磨擦係數等特性。本研究之目的為評估鐵氟龍矯正器之抗沾黏效果，比較與一般矯正器沾附食物及牙菌斑的差異。本研究選用日本TOMY公司生產之無hook犬齒金屬矯正器，並製造一壓合模具以抽真空方式將鐵氟龍薄膜壓貼在矯正器上，得到鐵氟龍包覆之矯正器，作為實驗組(T)。實驗分為兩部分： I.口外實驗：將一般矯正器(控制組N)與鐵氟龍矯正器(實驗組T)各40個以微量電子天平秤重的方式得知實驗前的矯正器重量，然後模擬口內進食狀態浸泡在食物中10分鐘，食物分為攪拌中的芝麻糊溶液(S)與煉乳(M)兩組，每組再分浸泡完後馬上漱口(R)與在空氣中靜置10分鐘後再漱口(r)，以攪動的清水模擬漱口情形，共分8組每組各10個矯正器。經過模擬後的矯正器以烤箱加熱蒸發水份，再次秤重，得到的重量扣除矯正器重量，便可得到所沾黏的食物重量。統計方法以雙樣本t檢定(two-sample t-test)比較各組重量變化之差異。 II.口內實驗：選擇9位矯正患者在牙齒表面黏上一般矯正器與鐵氟龍矯正器，以一般矯正方式綁上矯正線及結紮線，經過一個月後，將矯正器上附著之牙菌斑用牙菌斑顯示劑(disclosing agent)染色，然後以數位單眼相機拍攝口內矯正器照片搭配PIA影像分析軟體計算矯正器表面附著之牙菌斑所佔面積百分比。以Mann-Whitney U Test比較各組面積變化之差異。實驗結果顯示： 1.包覆鐵氟龍薄膜的矯正器明顯比一般金屬矯正器具有抗沾黏的特性，且有統計上的差異。 2.當食物黏性增加時，矯正器上所附著食物的量也會增加，雖然如此，包覆鐵氟龍薄膜的矯正器沾附食物的量還是遠小於一般金屬矯正器，可見鐵氟龍確實提供抗沾黏的效果。 3.無論有無鐵氟龍表面處理，馬上漱口與靜置10分鐘後再漱口的沾黏重量增加百分比在統計上是有差異的，由此可知，飲食完後馬上漱口可以大幅減少食物的附著。 4.包覆鐵氟龍薄膜矯正器的牙菌斑附著面積百分比比較小，且凹槽(slot)部位明顯比較乾淨，這個結果對於改善口腔衛生與降低摩擦力預期會有很大的幫助。 During orthodontic active treatment, orthodontists always find food debris and plaque accumulating around the brackets. Because of the long-term orthodontic treatment process, adverse effects such as caries and gingivitis are often noticed if patients do not keep their oral hygiene well. To ensure the quality of orthodontic treatment and to decrease the adverse effects from cleaning difficulty, the thoughts of inventing a Teflon-coated bracket that offers self-cleaning property to maintain an ideal oral hygiene came to our mind. Teflon is a kind of resin. It has unique properties such as heat-resistant, low temperature-resistant, erosion-resistant, low friction coefficient and non-stick property. The purpose of this study is to evaluate the self-cleaning effect of Teflon-coated bracket and compare the difference of attached debris and plaque between normal brackets and Teflon-coated bracket. The study used TOMY?? Preadjusted metal non-hook canine brackets (Micro-arch, Roth type , 0.018 slot). The experiment and procedure were divided into two parts: I.Extra-oral experiment: 40 Normal bracket and 40 Teflon-coated brackets were soaked into a sesame paste and concentrated milk, and divided into two groups: rinse in water for 10 seconds right after soaking and rinse after waiting 10 minutes. Then all the brackets were dried in the 100℃ oven for 1 minute. After all the procedures, the attachment debris was analyzed by Analytical Balance (SHIMADZU AUW120D). II.Intra-oral experiment: There were 9 orthodontic patients for the study. 9 normal brackets and 9 Teflon-coated brackets were bonded on canines. One month later, all the brackets were applied with a disclosing agent and had their photos taken by digital camera. The images were analyzed by computer analysis program (PIA) to observe the quantity of attached plaque. The results of the study: 1.All the Teflon-coated brackets had less attachment of debris than normal brackets. 2.Brackets that were soaked in concentrated milk had more attached debris than which soaked in the sesame paste. 3.Brackets that were rinsed in water for 10 seconds right after soaking had less attached debris than those rinse after waiting 10 minutes. 4.The quantity of the attached plaque of Teflon-coated brackets was less than normal brackets, especially in the slot area. The Teflon-coated bracket has an excellent self-cleaning effect. It is supposed to not only help patients maintain better oral hygiene for decreasing adverse effects such as caries and gingivitis, but also offer a comfortable, effective and frictionless orthodontic tooth treatment. There will be important advancement in orthodontic clinical application.
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