微研磨-冷光美白-渗透治疗术后氟斑牙的树脂-牙釉质复合体的理化性能改变

甘桂秋 王刚 李英良

【摘要】 目的：探究微研磨-冷光美白-渗透治疗术对氟斑牙的树脂-牙釉质复合体理化性能的影响。方法：选取2017年1月-2018年9月本院因治疗需要已拔除的氟斑牙42颗。按照随机数字表法将其分为治疗组（采用微研磨-冷光美白-渗透治疗）与对照组（采用单纯的冷光美白治疗），各21颗。比较两组牙齿治疗前后色度学、表面形态、显微硬度和粗糙度等理化性能的改变。结果：治疗后，治疗组复合体色阶、粗糙度均优于对照组，差异均有统计学意义（P<0.05）;治疗前后，两组显微硬度比较，差异均无统计学意义（P>0.05）;对照组牙齿在电镜下观察，牙齿表面可见明显的白垩状斑块，斑纹、延迟断裂、缺损等情况;治疗组牙齿色泽均匀一致，未见斑纹或隐约存在不规则细微斑纹。结论：研磨-冷光美白-渗透治疗术是一种高效、安全、可靠的氟斑牙治疗技术，值得在临床上得到广泛的推广应用。

【关键词】 氟斑牙; 微研磨-冷光美白-渗透治疗; 树脂-牙釉质复合体; 理化性能

【Abstract】 Objective：To investigate the effect of microabrasion-cold light whitening-penetration therapy on the physical and chemical properties of resin-enamel complex of dental fluorosis.Method：A total of 42 dental fluorosis have been extracted in our hospital for treatment from January 2017 to September 2018 were selected.According to the random number table method，they were divided into treatment group（microabrasion-cold light whitening-penetration therapy）and control group（simple cold light whitening therapy），21 cases in each group.The changes of chroma，surface morphology，microhardness and roughness before and after treatment between two groups were compared.Result：After treatment，the color order and roughness of complex in treatment group were better than those of control group，the differences were statistically significant（P<0.05）.The microhardness of two groups before and after treatment was compared，the differences was not statistically significant（P>0.05）.Under electron microscopy，there were obvious chalky plaques，markings，delayed rupture and defects on the surface of the teeth in control group，the teeth in treatment group had uniform color，and no irregular or subtle markings were found.Conclusion：Microabrasion-cold light whitening-penetration therapy is an effective，safe and reliable technique for dental fluorosis treatment，which is worthy of wide clinical application.

【Key words】 Dental fluorosis; Microabrasion-cold light whitening-penetration therapy; Resin-enamel complex; Physical and chemical propertiesFirst-authors address：Dental Branch of Zhongshan Peoples Hospital，Zhongshan 528400，China

doi：10.3969/j.issn.1674-4985.2019.15.040

氟斑牙（Dental fluorosis）又稱斑釉，是一种水中高氟造成牙齿白垩色或褐色斑块的公共卫生疾病[1]，流行病学显示，我国总体发病率约13.4%，且儿童青少年发病率更高[2-3]。氟斑牙主要表现是牙釉质的形态与颜色的发育异常，症状轻的患者牙齿表面可呈现出不透明斑块、色泽暗黄无光泽，严重的氟斑牙患者牙齿表面会出现棕黄色或者黄褐色大斑块，甚至牙表面出现凹陷、实质缺损的功能性改变。牙齿的颜色可关系到个人形象及人际交往，尤其是青少年对注重外观且较为敏感，不及时有效治疗氟斑牙将会对患者的牙齿美观及功能造成极大的威胁，甚至产生焦虑、抑郁等不良的社会心理反应[4]。……