The Observation Of Different Polishing Methods On Extracted Teeth Under Scanning Electron Microscope And The Clinical Effects Of Smoking Patients After Ultrasonic Scaling

Objective: 1 To observe the scratches and smoothness of the enamel surface after scaling and polishing,and to compare the polishing effects on extracted teeth of different methods.2 To compare the scaling effects of different smoking patients by ashort-term effect observation about the plaque and pigment on the teeth of smoking patients after ultrasonic scaling+ silicon particles polishing,and toinvestigate the effects of smoking on tooth surface cleanliness.To select the appropriate scaling interval for smoking patients and to provide theoretical basis and clinical reference for smoking cessation education for smokers.Methods: Experiment one: 60 smooth enamel surface samples were made and randomly divided into 6 groups,each with 10 samples: Blank control group;Ultrasonic scaling group;Rubber cup dipped in toothpaste polishing group;Rubber cup dipped in polishing paste polishing group;Sandblasting polishing group;Silicon particles polishing group.Each group was treated with different methods,then the specimens were observed under scanning electron microscope to see whether there were scratches and its depth and shapes.Experiment two: 90 patients who need supragingival scaling were chosen.According to the smoking situation they were divided into heavy-smoking group(more than 2 years of smoking history,smoking more than 20 cigarettes /day),moderate-smoking group(more than 2 years of smoking history,smoking less than 20 cigarettes/day)and non-smoking group,each with 30 cases.Exclusion criteria: Patients with chronic periodontitis;Patients with dentition defect;people with long-term tea drinking habits;Patients with systemic diseases.In the case of informed consent,supragingival ultrasonic scaling+ silicon particles polishing of patients in each group were accomplished by the same surgeon,and the plaque index(PLI)?pigment index(PI)and calculus index(C I)of all teeth were zero.All the patients were trained with a uniform standard of tooth brushing and oral hygiene methods;After 1 and 3 months of the treatment patients were reviewed,three doctors checked the PLI,PI by blind test method.The average value of PLI and PI were taken.The experimental data were consistent with the normality and homogeneity of variance.Multivariate analysis of variance were used to analyze the data.Results: 1 Electron microscope observation results: 1.1 Blank control group: The enamel surface was smooth and intact,and the enamel column had a regular small circular bulge,which was clearly visible;1.2 Ultrasonic scaling group: There was no normal enamel morphology.The surface structure of enamel was rough,and there were a lot of deep and stripe defects;1.3 Rubber cup dipped in toothpaste polishing group and Rubber cup dipped in polishing paste polishing group: The enamel surface was slightly rough and the edges of concave defects were flattened.The scratches were shallow,and there was no normal enamel morphology.1.4 Sandblasting polishing group: The tooth surface was smooth.there were a small number of light line grinding marks,no obvious scratches.normal enamel column morphology and a small amount of point depressions were seen in some areas;1.5 Silicon particles polishing group: The tooth surface was smooth and similar to the normal tooth.There was some shallow line wear marks,no obvious scratches,and some normal enamel column morphology which were small circular bulges.2 Clinical observation results: 2.1 Immediately after scaling Plaque or pigment wasn't found on the teeth surface of three groups of patients.The PLI,PI and CI of all teeth were zero.2.2 one month after scaling 2.2.1 Plaque on teeth surface Plaque distributed in a line or narrow zone in the cervical parts of some teeth of patients in non-smoking group.Plaque distributed in a narrow zone in the cervical parts of most teeth of patients in moderate-smoking group.Plaque distributed in a part zone in the cervical parts of all teeth of patients in heavy-smoking group.The difference among three groups was statistically significant(P<0.05).PLI of the patients in heavy-smoking group was significantly higher than that in moderate-smoking group(P<0.05).PLI of the patients in moderate-smoking group was significantly higher than that in non-smoking group(P<0.05).2.2.2 Pigment on teeth surface Pigment distributed with scattered spots in the cervical parts of individual teeth of patients in non-smoking group.Pigment distributed with close spots in the cervical parts of few teeth of patients in moderate-smoking group.Pigment distributed in a narrow zone in the cervical parts of most teeth of patients in heavy-smoking group.The difference among three groups was statistically significant(P<0.05).PI of the patients in heavy-smoking group was significantly higher than that in moderate-smoking group(P<0.05).PI of the patients in moderate-smoking group was significantly higher than that in nonsmoking group(P<0.05).2.3 three months after scaling 2.3.1 Plaque on teeth surface Plaque distributed in a narrow zone with the width no more than 1mm in the cervical parts of most teeth of patients in non-smoking group.Plaque distributed in a narrow zone with the width more than 1mm in the cervical parts of most teeth of patients in moderate-smoking group.Plaque distributed in a patchy zone in the cervical parts of all teeth of patients in heavy-smoking group.The difference among three groups was statistically significant (P<0.05).PLI of the patients in heavy-smoking group was significantly higher than that in moderate-smoking group(P<0.05).PLI of the patients in moderate-smoking group was significantly higher than that in non-smoking group(P<0.05).2.3.2 Pigment on teeth surface Pigment distributed in a successional line in the cervical parts of individual teeth of patients in non-smoking group.Pigment distributed in a narrow zone in the cervical parts of most teeth of patients in moderate-smoking group.Pigment distributed in a patchy zone in the cervical parts of all teeth of patients in heavy-smoking group.The difference among three groups was statistically significant(P<0.05).PI of the patients in heavy-smoking group was significantly higher than that in moderate-smoking group(P<0.05).PI of the patients in moderate-smoking group was significantly higher than that in non-smoking group(P<0.05).Conclusions: 1 The tooth surface is rough after supragingival ultrasonic scaling and needs to be polished.2 The polishing methods of rubber cup with toothpaste and with polishing paste can achieve a good polishing effect,and there is no significant difference between the two polishing methods.3 Tooth surface is smooth after sand blasting or silicon particles polishing,and they can both reach the best polishing effect.4 Plaque and pigment attach fast and the effect of scaling maintains a short time for heavy smoking patients after ultrasonic scaling with silicon particles polishing.The interval time of scaling should be shorten appropriately.