劲润牙本质保护膜预防活髓牙全冠制备后牙本质过敏症的扫描电镜观察及临床疗效研究  

The SEM observation and clinical effect of hybrid coat on postoperative hypersensitivity in vital teeth preparation for crown restoration

作　　者：马琰[1] 刘乐华 吴佩玲[1] 

机构地区：[1]新疆医科大学第二附属医院口腔科,乌鲁木齐830028 [2]新疆乌鲁木齐市口腔医院牙体牙髓科,乌鲁木齐830000

出　　处：《新疆医科大学学报》2013年第1期86-89,94,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2011211A040);新疆医科大学科研创新基金(XJC201025)

摘　　要：目的探讨劲润牙本质保护膜(hybrid coat)对活髓牙全冠制备后牙本质过敏症的作用机制及临床疗效。方法制作离体牙标本,扫描式电子显微镜(scanning electron microscopy,SEM)下测量牙本质小管口的密度、直径和相对面积,观察hybrid coat对牙本质小管的封闭作用;选取92颗活髓基牙随机分为劲润组和对照组,采用数值分级测评法(numerical rating scales,NRS)记录患者对全冠制备后基牙冷刺激和机械刺激的反应,评价其临床疗效。结果 SEM下,劲润组大部分小管口被封闭,而对照组图像显示开放的牙本质小管口。劲润组牙本质小管口的密度、直径和相对面积均低于对照组,差异有统计学意义(P<0.05),其中劲润组牙本质小管口平均直径为(10.44±4.65)μm,低于对照组的(16.25±4.44)μm(P=0.007),劲润组牙本质小管的密度为(0.021±0.013)×103个/mm2,低于对照组的(0.146±0.042)×103个/mm2(P=0.000),劲润组牙本质小管的相对面积为(0.25±0.16)%,低于对照组的(2.45±0.91)%(P=0.007);劲润组NRS值由治疗前的(5.39±2.01)降为治疗后的(3.35±1.50),差异有统计学意义(P<0.05)。结论劲润牙本质保护膜可以通过封闭牙本质小管,达到预防活髓基牙牙体预备后牙本质敏感的作用。Objective To explore the mechanic effect and clinical application of hybrid coat on dentin hyper sensitivity in operated vital teeth crown. Methods Under the scanning electron microscopy dentinal tubule diameter, density and relative area were measured to investigate the closure situation of the dentinal tubules by vitro experiment. 92 teeth were divided into two groups randomly, and one was treated with hy brid coat and the others with warm sterile water as control, then Numerical Rating Scales （NRS） was used to evaluate the clinical effects. Results Under the SEM, the most dentin tubules in hybrid coat group were closed, while in control group dentin tubule opened. Dentinal tubule density, diameter and relative area in hybrid coat group was lower than those in the control group and the difference had statistical signif icance （P 〈0.05）. The average diameter （10.44±4. 65） /±m in hybrid coat group was lower than that （16.25±4.44） /,m of the control group （P =0. 007）, the density （0. 021±0. 013） ×10^3/mm2 in hybrid coat group being lower than that （0. 146±0. 042）×10^3/mm2 in the control group （P =0. 000）, and the relative area （0.25±0.16）%in hybrid coat group was lower than that（2.45±0.91）% in the control group （P=0.007. NRS value of hybrid coat group （3.35±1.50） was different from that after treatment（5. 39±2.01） （P 〈0.05）. Conclusion Hybrid coat is effective on relieving the dentin hypersensitivity of the vital teeth prepared. Through the experimental observation, hybrid coat can make a certain effect in the aspect of closing dentinal tubules.

关 键 词：劲润牙本质保护膜 牙本质过敏症 牙本质小管 牙体预备 扫描电镜 

分 类 号：R78[医药卫生—口腔医学]