1、Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用超声波技超声波技术在牙体术在牙体牙髓治疗牙髓治疗中的应用中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用内容内容第一章第一章:趋势趋势第二章第二章:什么是什么是 PiezonPiezon?第三章第三章:牙周治疗牙周治疗 第四章第四章:牙体牙髓治疗牙体牙髓治疗第五章第五章:充填治疗充填治疗第六章：修复资料第六章：修复资料手册附录手册附录Electro Medical Systems Piezon
2、 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Chapter 1趋势趋势Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用趋势:终身保持牙齿 口腔预防医学口腔预防医学牙周治疗牙周治疗微小损伤性治疗微小损伤性治疗牙体牙髓治疗牙体牙髓治疗以上治疗均可使用以上治疗均可使用Piezon 超声技术超声技术Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用趋势:美容治疗 美容修复美容修复:树脂树脂PMTC(专业性清洁牙齿专业性清洁牙齿)正畸治疗正畸
3、治疗牙齿漂白牙齿漂白以上治疗均可使用以上治疗均可使用Piezon超声技术超声技术Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用什么是什么是PiezonPiezon?Chapter 2Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon 手柄Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon 超声震动原理Electro Medical Systems Pie
4、zon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用直线运动和椭圆形运动Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用冷却的水量冷却的水量Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon 手柄Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Mini Piezon迷你型洁牙机迷你型洁牙机水冷却水冷却最经典的牙周治最经典的牙周治疗设备，同时适疗设备，
5、同时适用于牙体牙髓超用于牙体牙髓超声治疗声治疗Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Mini Master 自带输液泵和水瓶自带输液泵和水瓶:无需外接水源无需外接水源可使用水或药液可使用水或药液(直接适用于牙周治疗冲洗直接适用于牙周治疗冲洗及更管治疗的各种需求）及更管治疗的各种需求）Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon Master 600自带输液泵和自带输液泵和双双水瓶水瓶:无需外接水源无需外接水源可使用水或药液
6、可使用水或药液(直接适用于牙周治疗冲洗直接适用于牙周治疗冲洗及更管治疗的各种需求）及更管治疗的各种需求）Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Chapter 3牙周治疗Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Chapter 4牙髓治疗Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用从髓腔进入从髓腔进入根管治疗根管治疗Piezon 用于牙髓治疗Electro
7、Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Endo 持针器为为EMS ISO k型锉型锉设计设计,用于连接手用于连接手柄与根管锉柄与根管锉Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用正弦振荡EMS Piezon的振
8、荡方式为:正弦驻波振荡Ahmad et al,Int.Endo J 1993Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Eleazer教授,Louisville大学,USA VideoElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用 冲洗冲洗 持续的冲洗持续的冲洗Electro Medical Systems Piezon
9、超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Root canal cleaned by handCleaned with EMS Endo systemPictures courtesy of the University of Nancy,FranceElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用法国南锡大学 Bottero Cornillac&Bonnin的研究,1988用扫描电镜比较用扫描电镜比较Piezon Master系统与系统与手工预备根管的效果手工预备根管的效果。Electro Medic
10、al Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用南锡大学牙本质小管，表面无残屑牙本质小管，表面无残屑Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用南锡大学放大放大10倍倍 超声根管预备没有改变根管原有的弧度超声根管预备没有改变根管原有的弧度Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗
11、中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙
12、体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超
13、声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗
14、中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙
15、体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超
16、声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用-more compact better seal-faster Ultrasound activated tip for lateral Guttapercha condensation.Its design maximises lateral flow.Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用CALCIFICATIONS REMOVAL Special design for high powerRT1 Instrument Better visibil
17、ity Diamond coating for higher efficiency Pointed shape for easier canal finding and primary access to root canalElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用RT2 InstrumentACCESS TO BROKEN INSTRUMENTSACCESS TO BROKEN INSTRUMENTS Innovative application Improves access Less invasive de
18、ntin removal around broken instrumentElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用RT3 InstrumentREMOVAL OF BROKEN INSTRUMENTSREMOVAL OF BROKEN INSTRUMENTS Very fine form to allow greater access Non-invasive finishing allows for maximum conservation of dentine Fixed on an endochuck fo
19、r better ergonomics and higher flexibilityElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用123 Broken instrument 1 RT2 improving access to instrument Root canal is straighter 2.Access to broken instrument is easier.RT3 liberating the instrument 3.Freed root canal.Pictures courtesy of Dr.
20、Enrique Martinez Merino,SpainElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon 用于牙体牙髓治疗倒充填倒充填根管治疗根管治疗Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Dr.Berutti Retro 工作尖工作尖工作尖末端覆盖金刚砂工作尖末端覆盖金刚砂Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical
21、Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Berutti博士,Secretary of Italian Endo Ass.VideoElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Chapter 5充填治疗Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon 用于充填治疗P
22、iezon 备洞系统备洞系统用于窝洞预备用于窝洞预备Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon备洞系统备洞系统Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用演示演示Piezon备洞系统备洞系统 Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中
23、的应用PCS-INSTRUMENTE SBm,SBd AND SBFINISHING OF CAVITY MARGINSPhasing of proximal cavity marginsPREPARATION OF MINOR DEFECTSOpening of minor occlusal defectsBetter margins and less marginal leakage for composite restorationsPreparation of minor buccal defectsElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中
24、的应用超声技术在牙体牙髓治疗中的应用Chapter 6修复治疗Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon用于贴面预备Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon用于贴面预备Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用去桩核（干工作）去桩核（干工作）Piezon用于修复治疗Electro Medical Systems Piezon 超声技
25、术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用D尖 专门设计用专门设计用于去桩核于去桩核Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用 D工作尖专门设计用于去桩Piezon tip D30,000 per secElectro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon 用于修复治疗用于修复治疗Piezon SP工作尖工作尖 用于液化有触变特性的水门汀用于液化有触变特性的水门汀Electro Medical Systems Piezon
26、 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon用于液化有触变特性的水门汀用于液化有触变特性的水门汀Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用嵌体就位嵌体就位Piezon用于液化有触变特性的水门汀Piezon SP工作尖30,000 per sec有触变特性的水门汀磷酸锌水门汀树脂Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用从从EMS 公司远眺百朗峰公司远眺百朗峰Electro Medical Systems P
27、iezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon 超声技术与牙周治疗超声技术与牙周治疗 1 TOPICAUTHORJOURNALSUMMARYCross Infection ControlAllison et.al.J.Can Dent Assoc.19940,12%CHX used a subgingival irrigant during scaling revealed CHX group had 25%bacteremia,control group had 75%bacteremia.LavageBaehni et al.J.Clin.Perio
28、199230 second ultrasonic exposure reduced spirochetes&motile rods to 0.1%.Test were done in vivo and in vitro.Ultrasonic Healing Biagini et al.J.Perio 1988Gingival repair as shown with biopsies and gingival crevicular fluid presented equal healing between hand vs.ultrasonic instruments.AccessBowerJ.
29、Perio 197958%of furcations are more narrow than narrowest curet.Cementum RemovalChiew et.alJ.Clin Perio 1991This study supports growing clinical belief as to the therapeutic importance of the removal of bacterial plaque and its products rather than removal of root surface material.Time Efficiency wi
30、th Ultrasonics Copulos et al.J.Perio 1993Compared clinical parameters of ultrasonic instruments vs.hand instruments.Instrumentation time significantly reduced with UI 3.9 mins vs.5.9 mins for HI.Cementum RemovalCorbet et.alJ.Clin Perio 1993Complete cementum removal not attainable nor desirable.Root
31、smoothness is questioned in relation to achieving gingival health.Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用Piezon超声技术与牙周治疗超声技术与牙周治疗2TOPICAUTHORJOURNALSUMMARYUltrasonicsSuperficial CleaningCorbet et.alJ.Clin Perio 1993The efficacy and cavitational activity of ultrasonics is advant
32、ageous.Superficial cleaning may be all that is achieved by subgingival instrumentation and all that is necessary to be biologically acceptable.Time Efficiency with Ultrasonics DragooInt J Perio Dent 1992Compared hand vs.unmodified vs.modified ultrasonic instruments.Modified ultrasonic instruments we
33、re superior for scaling,pocket penetration,efficiency,less root damage and time:9.6 min for hand vs.6.8 ultrasonic instruments.Time Efficiency with Ultrasonics DriskoCurrent Opin Perio 1993Modified ultrasonic instruments produced clean roots with least damage better access better calculus removal an
34、d less operator fatigue.Root planing with hand instruments could be considered overinstrumentation.Cross Infection ControlFine et.al,J.Perio 1992Listerine used as pre-procedural mouthrinse produced a 94,1%reduction in bacteria.Cementum RemovalFukazawa and NishimuraJ.Perio 1994Only superficial cement
35、um removal is warranted.Gingival fibroblasts in the cementum are necessary for reattachment.Attempts at total cementum removal could be detrimental.Nonsurgical TherapyHouJ.Med.Science 1987Ultrasonic scaling can provide successful nonsurgical therapy.AccessLeon&VogelJ.Perio 1987Modified UI equal in C
36、lass I and superior in Class II furcations compared to curets.LavageMoore et al.J.Clin.Perio 1986Teeth washed for 1 minute had 39%less LPS.Teeth washed with mechanical action for 1 minute had 60%less LPS.99%of LPS can be removed by gentle cleaning procedures.Electro Medical Systems Piezon 超声技术在牙体牙髓治
37、疗中的应用超声技术在牙体牙髓治疗中的应用Piezon超声技术与牙周治疗超声技术与牙周治疗3 TOPICAUTHORJOURNALSUMMARYAccess depthCRAJune 1998EMS Perio Slim tip had the best interproximal&subgingival access evaluated.Root SmoothnessOHehirRDH 1993Tissue response not smoothness should be end point.Ultrasonic HealingOosterwall et al.J.Clin Perio 19
38、87Compared hand vs.ultrasonic instruments showed pocket reduction and bleeding scores in 6-9 mm pockets were equal.Ultrasonic HealingOosterwall et al.J.Clin Perio 1987Compared hand vs.ultrasonic instruments showed pocket reduction and bleeding scores in 6-9 mm pockets were equal.Ultrasonic HealingSm
39、art et.al.J.Clin Perio 1990First paper to suggest the term“debridement“.After using ultrasonic instruments,LPS levels were comparable to that of healthy uninvolved teeth.Suggested light pressure and overlapping strokes.Risk Factors Stoltenberg et alJ.Perio 1993Cigarette smokers have strong risk indi
40、cators for increased probing depth.Ultrasonic HealingTorfasonJ.Clin Perio 1979Compared hand vs.ultrasonic instruments,showed pocket reduction&gingival health were similar.UI debridement alone may be of value in treatment of periodontal pockets.Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治
41、疗中的应用AIR-FLOW 喷砂技术与牙周治疗喷砂技术与牙周治疗TOPICAUTHORJOURNALSUMMARYEffect of an air-powder abrasive system on in vitro root surfacesAtkinson,DR.Cobb,CM.and Killoy,WJJ Periodontol.1984Air powder abrasive provides a uniformly smooth surface.All debris was eliminated.Root detoxification was accomplished.Air powd
42、er abrasive systems appear to have considerable potential for treatment of periodontally diseased root surfaces.Effect of an air powder abrasive system on root surfaces in periodontal surgeryHorning,GM.Cobb,CM and Killoy,WJJ Clin Periodontol.1087The in vivo results revealed that the air powder techn
43、ique resulted in an unusually white smooth,apparently clean surface.There was good access into the proximal flutings and furcations.Bacteria was found to be totally absent from these surfaces.In vitro evaluation of air-powder polishing as an adjunct to ultrasonic scaling on periodontally involved ro
44、ot surfacesLavigne,CK.Naumann,RK.Munley,MM.and Suzuki,JBJ Dent Hyg.1988Results indicated:Ultrasonic and ultrasonic plus air polisher does not adversely effect the smoothness and cleanliness of root surfaces;the quality of the surfaces treated with both methods were not significantly altered as compa
45、red to controls.Effects of an air-powder abrasive device used during periodontal flap surgery in dogsPippin,DJ.Crooks,WE.Barker,BF.Walters,PL.and Killoy,WJ.J.Periodontol.1988 Sites receiving the abrasive spray on root surfaces healed well.At day 7,healing was noted and little inflammation was presen
46、t.Researchers believe that air polishing is an effective adjunct to hand instrumentation during periodontal flap surgery.Electro Medical Systems Piezon 超声技术在牙体牙髓治疗中的应用超声技术在牙体牙髓治疗中的应用AIR-FLOW 与种植体修复与种植体修复TOPICAUTHORJOURNALSUMMARYAn SEM evaluation of the in-vitro effects of an air-abrasive system on v
47、arious implant surfacesBarnes,CM Fleming LS.and Mueninghoff,L.A.Int J.Oral Implant 1991No disruption of the surface integrity was detectable after 10 seconds of air powder abrasive spray.The authors contend that 10 seconds of air polisher application is approximately the equivalent of 6 month recall
48、 visits for 10 years.Effect of hygiene instrumentation on titanium abutments:A SEM studyHomiak,AW.Cook,P.A.and DeBoer,J.J Prosthet Dent.1992Rubber cup with tin oxide appeared to smooth the machined grooves after 10 simulated visits.Air powder abrasive appeared to smooth rough jagged edges after one
49、treatment,additional application appeared to further smooth the grooves.Effects of titanium implant abutment surface irregularities on plaque accumulation in vivoMcCollum,JA.ONeal,RB.Brennan,WA.Van Dyke,TE and Horner,JA.J Periodontol.1992Total mean percent surface of plaque was as follows:control-53
50、.09%,plastic scaler-55.29%,rubber cup/pumice-52.59%.ANOVA revealed no significant difference between groups or within groups.Effects of an air-powder abrasive system on plasma-sprayed titanium implant surfacesParham,PL.Cobb,CM.French,AA.Love,JW.Drisko,CL.and Killoy,WJJ Oral Implant 1989The specimens
