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研究生:何佳蓉
研究生(外文):Chia-Jung Ho
論文名稱:以Chlorhexidine改良玻璃離子體之生物與物理特性
論文名稱(外文):Biological and physical properties of chlorhexidine-modified glass ionomer cement
指導教授:李士元李士元引用關係
指導教授(外文):Shyh-Yuan Lee
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:臨床牙醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:116
中文關鍵詞:玻璃離子體填補材料抑菌細胞毒性氟離子釋放
外文關鍵詞:Chlorhexidine diacetateglass ionomer cementantibacterialcell toxicityfluoride ion release test
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以往之文獻報告大多指出,添加1% chlorhexidine (CHX)於玻璃離子體填補材料中,已具有抑菌效果。但考量到CHX本身之生物毒性以及其對於玻璃離子體填補材料可能的負面影響,何種濃度方為適當有必要進一步加以探究。本研究利用高黏稠型玻璃離子體,做為乘載CHX diacetate的釋放媒介。研究中,將CHX diacetate加入高黏稠型玻璃離子體粉末中,分別得到相對重量百分比為0.5%、1%以及2%的濃度為實驗組,未添加CHX diacetate者為對照組。經抑菌測試、細胞毒性試驗、徑向拉伸試驗、表面微硬度試驗、氟離子釋放試驗、顏色穩定試驗、抗磨耗試驗以及掃瞄式電子顯微鏡的觀察,以探討添加CHX diacetate於高黏稠性玻璃離子體填補材料的適當濃度。結果顯示,隨著CHX diacetate的濃度上升,其細胞毒性、抑菌效果以及顏色變化會隨之上升,而徑向拉伸強度、表面微硬度、抗磨耗度以及氟離子釋放能力卻隨之下降。由統計分析之結果顯示,雖然加入CHX diacetate的玻璃離子體填補材料對於S. mutans以及A. actinomycetemcomitans菌皆具有抑制效果,但對於周圍纖維母細胞也會產生顯著的細胞毒性。本研究建議加入CHX diacetate的玻璃離子體填補材料較適用在三明治填補技術中當成基底填補材,或是在輕微牙周炎患者的Class V窩洞採用有添加0.5% CHX diacetate的玻璃離子體當填補材料。
Adding Chlorhexidine (CHX) into glass ionomer cement (GI) has been proved to possess antibacterial benefit. Most of related researches have postulated that 1% CHX added in GI could be applied optimally for clinical use. Regarding to the cell toxicity of CHX itself and other effects that may negatively influence GI, it is worthy to reappraise the optimal concentration of CHX in GI. This study investigated the use of an experimental GIC as a carrier for the release of CHX diacetate at concentrations of 0.5%, 1%, 2%, respectively, of CHX diacetate by w/w as experimental groups. GI without CHX diacetate was used as control. The optimal concentration of CHX in GI was verified by means of antibacterial test, cell toxicity test, diametral tensile strength, surface microhardness tests, fluoride ion release test, the color stability test, wear resistance tests and scanning electron microscopy observation. The results showed that with the increasing concentration of CHX diacetate the cell toxicity, antibacterial ability and color difference were increased. While, diametral tensile strength, microhardness, wear resistance and fluoride release ability were decreased. Although adding CHX diacetate in GI had antibacterial effect to both S. mutans and A. actinomycetemcomitans, but it also demonstrated significant adverse effects on cytotoxicity and wear resistant. We suggested that GI containing CHX should be used as the base material in sandwich technique, and only 0.5% CHX modified GI could be used to restore the class V cavity in patient with mild periodontitis.
中文摘要.....................................................................................................i
英文摘要...................................................................................................iii
目錄...........................................................................................................iv
圖目錄......................................................................................................vii
表目錄.......................................................................................................ix
一、 緒論....................................................................................................1
二、 文獻回顧............................................................................................3
(一)、 齲齒與無傷性填補治療..........................................................3
1. 齲齒成因..................................................................................3
2. 無傷性填補治療......................................................................5
(二)、 玻璃離子體的發展.. ...............................................................6
(三)、 玻璃離子體的硬化機轉..........................................................9
(四)、 玻璃離子體的釋氟機轉........................................................10
(五)、 玻璃離子體的抑菌機制........................................................12
(六)、 玻璃離子體的生物相容性....................................................14
(七)、 玻璃離子體的應用及缺點....................................................16
(八)、 玻璃離子體的改良................................................................17
三、 研究動機、假說及目的...................................................................22
四、 實驗材料與方法..............................................................................24
(一)、 實驗設計流程圖....................................................................25
(二)、 實驗材料與測試....................................................................26
1. 複合式玻璃離子體樣本製作...............................................26
2. 複合式玻璃離子體生物毒性試驗...................................... 26
3. 掃瞄式電子顯微鏡 (SEM) 觀察........................................28
4. 複合式玻璃離子體抑菌試驗...............................................28
5. 複合式玻璃離子體氟離子釋放測試...................................29
6. 複合式玻璃離子體表面微硬度測試....................................31
7. 複合式玻璃離子體表面顏色測試........................................33
8. 複合式玻璃離子體徑向拉伸試驗........................................34
9. 複合式玻璃離子體耐磨耗試驗............................................35
10. 統計分析................................................................................37
五、 結果..................................................................................................39
(一)、 複合式玻璃離子體生物毒性試驗........................................39
(二)、 掃瞄式電子顯微鏡觀察........................................................39
(三)、 複合式玻璃離子體抑菌試驗................................................40
(四)、 複合式玻璃離子體氟離子釋放測試....................................41
(五)、 複合式玻璃離子體表面微硬度測試....................................41
(六)、 複合式玻璃離子體表面顏色測試........................................42
(七)、 複合式玻璃離子體徑向拉伸試驗........................................43
(八)、 複合式玻璃離子體抗磨耗試驗............................................43
六、 討論.................................................................................................45
(一)、 複合式玻璃離子體生物毒性試驗........................................45
(二)、 電子顯微鏡觀察....................................................................47
(三)、 複合式玻璃離子體抑菌試驗...............................................48
(四)、 複合式玻璃離子體之氟離子釋放測試................................50
(五)、 複合式玻璃離子體表面微硬度測試………………………52
(六)、 複合式玻璃離子體表面顏色測試…………………………55
(七)、 複合式玻璃離子體徑向拉伸試驗…………………………56
(八)、 抗磨耗試驗…………………………………………………59
(九)、 臨床考量……………………………………………………61
(十)、 實驗限制……………………………………………………62
七、 結論………………………………………………………………..64
八、 參考文獻…………………………………………………………106

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