| Objective: Periodontal basic treatment is the precondition and key to successful treatment of periodontal disease.The core of basic treatment is subgingival scaling and root planning(SRP).The use of ultrasonic instruments for SRP has greatly improved the clinical efficacy and work efficiency,but at the same time it also has effects on the surface of the root of the tooth,resulting in symptoms such as tooth sensitivity.This experiment through the observation of the vector linear motion tip,elliptical motion tip treatment of chronic periodontitis clinical efficacy and impact on the root surface,for the clinical application of ultrasonic axillar tip to provide reference.Methods1 Select 30 teeth of a single tooth removed due to severe periodontitis and randomly divided into 3 groups: 1 vector linear motion work tip group(VS group)2 oval motion work tip group(ES group)3 traditional manual curettage device Groups(HS group),10 in each group were subjected to an external root planning procedure.After the curettage was completed,the operation time of each root surface was recorded.The morphology of the root surface was observed under a stereo microscope and a scanning electron microscope and images were taken.2 According to the diagnostic criteria for chronic periodontitis proposed by the American Academy of Periodontology classification seminar in 1999,20 patients chronic periodontitis were randomized from the outpatient department of stomatology in Hebei Provincial Stomatological Hospital.The age range was 21 to 49 years old and average age was 36,including 12 females and 8 males.In vivo experiments were conducted with left and right half-mouth self-control,randomized,single-blind.In one week after supragingival scaling,left and right halves of the patients were randomly divided into : 1 VS groups : using vector linear motion tip was used for subgingival scaling and root planning.2 ES group: using elliptical motion tip to perform subgingival scaling and root planning;observe and record the probing depth(PD)in both groups at 1 week(baseline)and 4 weeks after treatment.The clinical attachment level(CAL)and bleed on probing(BOP)were used.After the treatment was completed,the visual analog scale(VAS)was used to record the patient's pain scores for the two groups and recorded.For each group of clinical operation time,two groups of patients with short-term changes in pain were recorded on the telephone 1 to 3 days after completion of the treatment.3Analysis of experimental results using SPSS21.0 software: experimental data are expressed as mean ± standard deviation(?X±S),the in vitro experimental operation time was analyzed by one-way analysis of variance,and the clinical indicators,clinical operation time,and subjective pain perception(VAS value)of the patients in vivo were all analyzed by the t-test.P<0.05 was statistically different..Results1 Effect on the root surfaceComparison of in vitro operating time(seconds): VS group used time(120±11.57)s,ES group used time(43.55±5.35)s,HS group used time(66.44±7.06)s,above data showed that VS group took the longest,obviously more than the ES group and the HS group,while the ES takes the shortest time.Analysis of variance showed that the differences in the duration of operation between the three groups were statistically significant(P<0.05),indicating that the vector linear motion tip has a longer operating time.Scanning electron microscopy observation showed that the root surface of VS group was relatively smooth,and the cementum was intact and continuous,a small amount of smear layer remained.After ES treatment,the root surface morphology was irregular,and the cementum was discontinuous,there was a small amount of irregularity,traces and smear layers remained.In the HS group,the treated root surface was rough and covered a smear layer,and many linear scratches and irregular smear layers were observed.2 Comparison of various clinical indicatorsVS group and ES group had significant improvement in clinical indicators after treatment,clinical symptoms of gingival redness basically subsided,probing blood loss,texture of the gums from fragile soft to fragile.Paired-sample t-test analysis showed that there was no significant difference in PD,BOP,and CAL between the two groups after treatment(P>0.05).There was a statistically significant difference between the two groups in indicators PD,BOP,and CAL(P<0.05).4 weeks after treatment,PD,BOP,and CAL values were lower in both groups than at baseline.The results showed that the ultrasonic tips of the two movement methods improved after the treatment,and all of them could effectively reduce periodontal tissue inflammation.Both of them can achieve good curative effect and there is no significant difference in the therapeutic effect.During the treatment,the patients' pain intensity evaluation(VAS value)was compared between the two groups of work tips.The two groups were at the same medium power.The independent sample t-test showed that the pain value immediately after treatment was:(37.25±7.38)in the VS group,the ES group was(74.25±9.5),and there was a statistically significant difference between the two groups(P<0.05).The VAS values at 1 to 3 days after treatment were significantly lower in the VS group than in the ES group,indicating that the vector linear motion tip can effectively reduce the patient's Treat pain.Comparison of the clinical treatment time of the two groups of work tips(minute min),the comparison of clinical operation time between the two groups at the same medium power,half-oral treatment time: VS group(64.02 ± 8.54)min,ES group(26.66 ± 6.25)min.The results show that the vector linear motion tip treatment takes more time than the elliptical motion tip.Conclusions1.The vector linear motion tip,elliptical motion tip,and traditional manual curettage device can effectively remove plaque and calculus.2.The vector linear motion tip has relatively longer time for underarm squeegee treatment,but has less influence on the root surface and can better preserve the shape of the root surface.3.Vector linear motion tip can effectively reduce periodontal tissue inflammation,restore periodontal tissue morphology,improve clinical symptoms,significantly increase patient comfort,and can be widely used in clinical treatment of chronic periodontitis. |
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