牙齒共振頻率之臨床探討 論 文 摘 要 論文名稱：牙齒共振頻率之臨床探討 私立台北醫學院口腔復健醫學研究所 研究生姓名：王茂生 畢業時間：八十八學年度第二學期 指導教授：李勝揚 博士 林哲堂 博士 在口腔醫學的臨床診斷上，到目前為止仍缺乏有效的設備或方法可以評估或檢測牙周之邊界狀態。臨床上有關牙周病的檢查及其病變之診斷工具， 如牙周探針(periodontal probe)、牙周計(periodontometry)、牙周檢測計(PeriotestO, Germany)、及放射線X光等方法，雖有某種程度上之定性價值，卻無法得到精確定量的結果，並易導致人為誤讀。本研究目的在於探討以牙齒的自然頻率值預測牙周附連高度喪失（attachment loss）程度的可行性，以期發展一套新的牙周狀態診斷方法及工具。 本研究以體內模態測試法檢測 1196 顆牙齒，包括門齒、犬齒、第一小臼齒、及第一大臼齒的自然頻率值，以牙周附連高度喪失(attachment loss) 5 mm為判定之依據，當牙周之附連高度喪失≧ 5 mm 即界定為牙周病，< 5 mm 即為健康牙齒，在實驗方法上以衝擊槌激發牙齒共振，並利用麥克風接收振動訊號。利用牙齒的自然頻率作為牙周狀態的評估依據，並與傳統的牙周附連高度結果比較。 研究結果顯示，牙齒的自然頻率在上、下、左、右四個象限間沒有明顯的差異，而不同解剖型態的牙齒在發生牙周病之後，其自然頻率均有減少的現象，其中前牙(含門齒及犬齒)的自然頻率值在發生牙周病時平均為1.26 ± 0.1 kHz，明顯地比健康時的平均值1.34 ± 0.18 kHz要來的低( p < 0.01 )，而後牙(含 第一小臼齒及第一大臼齒)在發生牙周病時其自然頻率的平均 值( 1.22 ± 0.13 kHz )亦較健康時( 1.27 ± 0.18 kHz )要低 ( p < 0.05 )。 本研究之結果顯示，自然頻率分析確實可以有效地作為偵測牙齒牙周狀態之臨床應用，且其可定量以及非侵入、非破壞及最小接觸的特性，在牙周病的早期檢測與預防上提供了一極佳之新思維方向。

Clinical investigation of resonance frequency in human teeth Title of Thesis: CLINICAL INVESTIGITION OF RESONANCE FREQUENCY IN HUMAN TEETH Author: Wang, Mao-Sheng Thesis directed by : Lee, Sheng-Yang Ph. D. Lin, Che-Tong Ph. D Currently in the field of clinical medicine, there is no effective equipment or method to evaluate and measure boundary conditions of periodontal tissue. Periodontal probe, radiography, PeriotestO and Periodontometry etc., are commonly used methods in the diagnosis and detection of periodontal disease. Unfortunately, these methods provide only limited quality of data, no precise quantity, which can lead to misinterpretation. The purpose of this study was to evaluate the possibility of using a new method to examine the attachment loss of periodontal tissue in terms of natural frequency. In this study, 1196 natural teeth including central incisor, canine, first premolar and first molar were first examined by conventional probing method. Attachment loss of 5 mm was adopted as an indication for periodontal disease. On the other hand, natural frequencies of these tested teeth were measured using a series of in vivo model testing experiments. The teeth were triggered into vibration by an impulse hammer (PCB Piezotronics,.Inc.), and the vibration response was received by an acoustic sensor. The frequencies were used to evaluate periodontal conditions and compared with the results obtained from the attachment loss measurements. Our results showed that there was no obvious difference in natural frequency among upper-lower-left-right quadrant of teeth, but instead, it showed a statistically significant decrease in natural frequency between teeth with periodontal disease. The natural frequency of anterior teeth (central incisor and canine) with periodontal disease was found to be at 1.26 ± 0.10 kHz which is lower significantly ( p < 0.01 ) than that of healthy condition ( 1.34 ± 0.18 kHz ). On the other hand, the mean frequency for diseased posterior teeth (first premolar and first molar, 1.22 ± 0.13 kHz) is also decreased significantly ( p < 0.05 ) as compared to healthy condition ( 1.27 ± 0.18 kHz ). Natural frequency analysis seems to be an effective method in measuring the periodontal condition of teeth. Moreover, it can serve as a non-invasive, non-destructive and minimum contact method for early quantifiable testing and prevention of periodontal disease. This test can give us an insight into a new vision.