謝金琅

中文摘要(Abstract):從流行病學(epidemiologic)、實驗(experimental)和臨床研究(clinical research)證明牙齒上鈣化(calcified)和未鈣化(uncalcified)的牙菌斑(plaque)是造成牙周組織疾病(periodontal disease) 發炎(inflammatory)的初期病因學因子(etiologic factor )(1.4.6.25.28-30)，牙結石的形成過程分成三個階段：(1)細菌(bacteria)初期經由唾液薄膜(salivary pellicle)附著在牙齒上。(2)牙菌斑(dental plaque)的構造及生長。(3)牙菌斑的礦化作用。(1.6.11.29.) 人類的牙結石包括了牙齦上(supragingival)及牙齦下(subgingival )的沈澱物(deposits)(Cacioppi, J.T., and Barboriak, J.J., 1967)。牙齦上結石(supragingival calculus)及牙齦下結石(subgingival calculus)兩者的是由牙齒牙菌斑(plaque)的礦化作用(mineralization)形成(1-4.12-14.18-20.)，經常在牙結石的上面覆蓋上一層具有代謝活性的牙菌斑(metabolically active plaque)，牙齦上結石(supragingival calculus)在牙周組織疾病上常是有一個健康(healthy)的牙齦組織(periodontium)，牙齦下結石(subgingival calculus)總是造成破壞性(destructive)的牙周組織疾病(Friskopp, J., et al., 1980)。 本研究收集46位病患(patients)的牙結石檢體，經過固定(fixation)、脫水(dehydrate)、乾燥(drying)、再覆蓋(coating)上一層大約300 Å的金泊覆膜後，在掃描式電子顯微鏡(SEM)下觀察 (4.34.)，牙結石有針狀(needlelike) (4.12.26.)、延伸狀(elongate-like)、大小不同的盤片狀(platelet-like) (4.15.22.26.)、圓石狀(cobblestone-like) (4.14.16.22.23.26.)、立方狀(4.26)等各種不同外形的結晶組成，牙菌斑的外觀有短桿狀的(short rods-like) (2.8.26)、長桿狀的(long rods-like) (2.3.8.9.26.)、纖維絲狀的(filaments-like) (2.3.8.26.)、球狀的(sphers-like) (2.3.8.9.15.26.)、螺旋狀(spiroid-like) (26.)的菌體，附著的上皮細胞(epitheline cell) (2.3.5.8.9.26.)，牙齦出血時附著的血球(blood cell) (2.5.8.26.)。 　　實驗結果顯示牙結石的去除是有益處的，如果有良好的口腔衛生(oral hygiene) (1.25-31)和規則照護的養生之道( regular recall )，可以改善並減少牙結石(dental calculus)及沈澱物(deposition)的產生，進而減少病人產生牙周組織疾病，正確的刷牙方法及牙線的使用，可以改善對牙菌斑的控制。(2.25.28-30.)

英文摘要(Abstract):The role of calcified and uncalcified plaque on teeth as a primary etiologic factor in inflammatory periodontal disease has been demonstrated by epidemiologic, experimmental, and clinical research.(1.4.6.25.28-30) The formation of calculus can be divided into three phases: (1) the initial attchment of bacteria to a tooth via salivary pellicle, (2) the growth and orangization of plaque, and (3) the mineralization of plaque. (1.6.11.29.) Human dental calculus consist of supra- and subgingival deposits (Cacioppi, J.T., and Barboriak, J.J., 1967). Both supragingival and subgingival calculus result from the mineralization of dental plaque. (1-4.12-14.18-20) The calculus is usually covered with metabolically active plaque. Supragingival calculus can be found on a healthy periodontium teeth as well as on periodontal disease teeth. But subgingival calculus is always found on a destructive periodontal disease teeth(Friskopp J., and Hammarstrom L., 1980). Samples of 46 patients were examined with the scanning electron microscope. They were fixed, dehydrated, dried, and coated with approximate 300 Å thick gold. (4.34.) In the experimental group, the calculus was needlelike (4.12.26.), cobblestone-like(4.14.16.22.23.26.), and elongated, and had different shapes and sizes of platelet forms and cuboidal crystals shapes. The plaque appears as short-like rods shapes(2.8.26.), long-like rods shapes(2.3.8.9.26.), filaments shapes(2.3.8.26.), spheric shapes(2.3.8.9.15.26.), spiroids shapes(26.) of bacteria, cuticle epithelium cell(2.3.5.8.9.26.) and blood cell. (2. 5.8. 26.) The results recommend that removal of calculus is more beneficial. The patients with periodontal disease will have less depopsites trouble if they follow a good oral hygiene(1.25-31.) and a regular recall care regimen. Another way to improve plaque control is to use toothbrush and flossing more often. (2.25.28-30.)