微研磨联合居家漂白治疗氟斑牙的疗效观察

黄茜 李文妙 邢莉 文小俊

[摘要] 目的 观察皓齿Opalustre微研磨糊剂及Opalescence PF居家漂白套装治疗氟斑牙的临床疗效。方法 选取2017年1月至2020年11月在我院口腔中心就诊的氟斑牙患者36例为研究对象，按照随机数字表法分为观察组和对照组，观察组19例用皓齿Opalustre微研磨糊剂在诊室内行着色牙釉质微打磨，再用10% Opalescence PF居家漂白套装漂白2周，对照组17例仅用Opalustre微研磨糊剂在诊室内行着色牙釉质微打磨。治疗前后用Vita比色板记录牙色变化，同时观察美白后牙齿的敏感程度，按疗效评定标准比较两组的临床效果。 结果 观察组19例患者中有18例治疗后牙色均明显提高，且无明显敏感情况出现。观察组总有效率为94.74%，明显高于对照組的70.58%，差异有统计学意义（P<0.05）。 结论 微研磨联合居家漂白治疗氟斑牙疗效肯定，值得临床推广应用。

[关键词] 微研磨;漂白;氟斑牙;牙色;敏感

[中图分类号] R781.2          [文献标识码] B          [文章编号] 1673-9701（2021）31-0084-04

[Abstract] Objective To observe the clinical efficacy of Opalustre micro-grinding paste and Opalescence PF home bleaching kit in the treatment of dental fluorosis. Methods A total of 36 patients with dental fluorosis who were treated in the dental center of our hospital from January 2017 to November 2020 were selected as the study subjects. According to the random number table method， they were divided into an observation group and a control group. In the observation group， 19 patients in the observation group were given the Opalustre micro-grinding paste to perform colored enamel micro-grinding in the clinic， and then were given 10% Opalescence PF home bleaching kit to bleach for 2 weeks. The 17 patients in the control group were only given Opalustre micro-grinding paste to perform colored enamel micro-grinding in the clinic. Before and after treatment， Vita shade plate was used to record the change of teeth color. At the same time， the sensitivity of the teeth after whitening was observed. The clinical effects were compared between the two groups according to the efficacy evaluation criteria. Results 18 out of the 19 patients in the observation group showed a significant improvement in the teeth color after treatment， and there was no obvious sensitivity. The total effective rate was 94.74% in the observation group， which was higher than that of 70.58% in the control group， and the difference was statistically significant（P<0.05）. Conclusion The combination of micro-grinding and home bleaching is effective in the treatment of dental fluorosis， which is worthy of clinical application.

[Key words] Micro-grinding; Bleaching; Dental fluorosis; Teeth color; Sensitivity

氟斑牙是牙齿发育矿化时期机体摄入过多的氟而导致的一种特殊类型釉质发育不全，临床主要表现为牙釉质出现白垩色或黄褐色着色斑块，严重者出现实质性缺损，影响美观和笑容，甚至影响患者的心理健康。以往氟斑牙的美白治疗有全冠修复、树脂贴面、瓷贴面等方法。全冠修复、贴面修复在治疗过程中需要对天然牙进行部分磨除预备，对牙齿组织及外形造成不可逆性损害，有引起牙髓病变的可能，对牙周组织也有一定的影响，且价格昂贵[1]。相对于传统的全冠及贴面修复，外漂白具有微创、未永久损伤牙齿硬组织、操作简单及可重复性等优点，成为目前氟斑牙治疗的推崇方式。……