- 學位論文
以填充物填滿牙周囊袋而黏著於犬隻3、4級牙周病牙面之效果評估
Effect of filling stuffs into the periodontal pocket to adhere to the grade 3 and 4 teeth of periodontal disease in dogs
摘要
牙周病( periodontal disease，PD )是犬隻常見之疾病，通常依其嚴重度分為4級。犬隻第3、4級PD因有明顯之牙周囊袋、齒槽骨溶蝕和齒齦萎縮，單靠除去牙菌斑和齒石，以及勤於刷牙或經常口腔給藥阻止牙菌斑之復發，往往難予改善其一般狀況。本研究之目的在評估以填充物填滿牙周囊袋而黏著於犬隻3、4級PD牙面之效果。所選48隻實驗犬依牙周囊袋深度指數 (probing depth index)，分為犬齒3級PD組、前臼齒3級PD組、犬齒4級PD組及前臼齒4級PD組等4組，每組各有24顆PD牙齒。供試犬在麻醉下行肉眼檢查 (包括牙菌斑、牙結石、牙齦、牙周囊袋出血、牙齒搖動和齒槽骨毀損等指數) 、全口牙齒X光檢查 (齒槽骨毀損指數)、牙周囊袋或牙菌斑刮取物細菌培養以及血液學檢查後，4組再各自分為A、B、C和D等4小組，A小組以3M VetbondTM (一種組織黏著劑)，而B小組以HYGENIC repair acrylicR (一種能迅速黏合修復義齒之丙烯酸酯類物)，充填牙周囊袋並黏著於PD齒上， C小組先以3M組織黏著劑充填黏著，再覆蓋一層丙烯酸酯和塗抹一層3M 組織黏著劑，D小組以丙烯酸酯充填黏著，再塗抹一層3M 組織黏著劑。其後，每天檢查齒齦變化及填充物黏著狀況，每週行牙齒 X光檢查，於填充物 鬆脫時自牙周囊袋採樣行細菌培養。結果第4級PD犬隻在上述處理後，其牙齒疼痛狀態於進食時可立即見到明顯改善；全部供試牙齒自處置後約第7天起，其肉眼檢查之牙齦、牙周囊袋出血和牙齒動搖等指數可獲得顯著改善，在不同充填方式間(小組間)、不同牙齒間 (犬齒與前臼齒間、上顎齒與下顎齒間)、不同品種犬隻間均無特殊之差異，但在填充物鬆脫後全部供試牙齒之齒齦亦易回復到以前之狀態；填充物固定在PD齒上之期間 (天)依不同之充填方式 (4小組間) 有顯著 (P<0.05)之差異，不論第3級PD組或第4級PD組，犬齒或臼齒，均以D小組為最長 (48.8±3.3天至53.2±5.0天)，其次為B小組 (32.8±6.1 天至37.3±6.3天)，然後C小組 (26.2±5.5天至30.3±5.0天)、A小組 (19.3±6.3 天至21.7±5.7天)。 關鍵詞：犬牙周病、牙周囊袋、3M組織黏著劑、HYGENIC齒修復用丙烯酸
並列摘要
Periodontal disease (PD) is a common disease in dogs, which is usually divided into four grades base on the severity. It is difficult to improve the general condition of grade 3 and 4 PD in dogs simply with removing the dental plaque and calculus and frequently brushing the teeth or applying oral medicine to prevent the recurrence of dental plaque, because the formation of obvious periodontal pocket, alveolar bone erosion and gum atrophy. The aim of this study is to evaluate the effect of filling stuffs into the periodontal pocket to adhere to the grade 3 and 4 teeth of periodontal disease in dogs. Fourty-eight dogs selected for this study was divided into four groups of grade 3 PD of canine teeth, grade 3 PD of premolar teeth, grade 4 PD of canine teeth, and grade 4 PD of premolar teeth, with 24 PD teeth in each group, based on the probing depth index. After the gross (including the dental plaque, dental calculus, gingiva, sulcus bleeding, dental mobility and alveolar bone damage indices), full-mouth radiography (alveolar bone destroy index), scraping the periodontal pocket or dental plaque for bacterial isolation, and hematological examinations under general anesthesia, four groups were individually subdivided into four subgroups of A, B, C and D. Subgroup A was filled with 3M VetbondTM (a tissue adhesive) and Subgroup B was filled with the HYGENIC repair acrylicR ( a fast-bonding acrylic repair material for repairing dentures) into the periodontal pockets to adhere to the PD teeth. Subgroup C was filled with 3M VetbondTM first, sequently covered with a layer of acrylic acid powder and a layer of 3M tissue adhesive. Subgroup D was filled with HYGENIC repair acrylicR first, sequently covered with a layer of 3M tissue adhesive. Then, the changes of gingival condition and the attachment state of fillings were checked every day, dental radiography was conducted every week, bacterial isolation from periodontal pocket was performed while the attachment of fillings became loose. The results showed that the inprovement of dental painful condition in the dogs with grade 4 PD was immediately and obviously found in the feeding after above treatments. The gingiva, sulcus bleeding and mobility indices in gross examination could be remarkably improved in all the tested teeth from the 7th days around of treatment, no special difference was found among different filling types (subgroups), different teeth (between canine and premolar teeth, or between mandibular and supramaxillary teeth) or different species of dogs. But the gingival conditions of all the tested teeth were also easily returned to the former states after fillings became loose. The periods (days) of the fillings to fix on the PD teeth was significant difference (P<0.05) depending on the different filling types (among four subgroups), and D subgroups in each group were the most long regardless of the grade 3 and 4 PD groups (from 48.8±3.3 days to 53.2±5.0 days), either canine or premolar teeth. Next was the B subgroups (from 32.8±6.1 days to 37.3±6.3 days), followed by C subgroups (from 26.2±5.5 days to 30.3±5.0 days) and A subgroups (from 19.3±6.3 days to 21.7±5.7 days). Keywords：Canine periodontosis,Periodontal pocket, 3M tissue adhesive, HYGENIC repair acrylic