着色型氟斑牙微创治疗的美学效果观察  

Aesthetic effect of minimally invasive therapy on stained dental fluorosis

作　　者：张文怡[1] 孙迎春[1] 张健[2] Zhang Wenyi;Sun Yingchun;Zhang Jian(Prosthodontics Department, Stomatological Hospital of Tianjin Medical University, Tianjin 300070, China;Oral and Maxillofacial Surgery Department, Stomatological Hospital of Tianjin Medical University, Tianjin 300070, China)

机构地区：[1]天津医科大学口腔医院修复科,300070 [2]天津医科大学口腔医院颌面外科,300070

出　　处：《中华地方病学杂志》2019年第10期800-805,共6页Chinese Journal of Endemiology

摘　　要：目的观察皓齿低浓度家庭美白剂联合微研磨膏及渗透树脂的微创美白技术对着色型氟斑牙的美学治疗效果。方法选取2017年6月至2018年6月就诊于天津医科大学口腔医院的23例着色型氟斑牙患者,所有患者均采用"微研磨膏+10%低浓度皓齿家庭美白凝胶+渗透树脂"的微创美白技术,用VITA美学比色板记录治疗前后色阶,观察美学治疗效果。治疗前对牙面着色区取点,并用青红黄黑(CMYK)色值表进行比色、记录,根据颜色深浅将氟斑牙分为轻、中、重度,治疗后1周及半年记录所选点的CMYK色值,计算着色斑的脱色率;并用数字化疼痛评判法(VAS)记录患者的牙敏感度。结果经微创美白治疗后,23例氟斑牙患者的92颗牙齿,有91颗色阶提高在5个以上,有1颗在2~4,总体有效率为100.00%(92/92)。在微创美白治疗后1周,轻、中、重度氟斑牙着色斑脱色率分别为100.00%(100/100)、100.00%(120/120)、97.78%(88/90)。在治疗后半年复查,轻、中、重度脱色率与治疗1周时比较差异无统计学意义(P均> 0.05)。VAS评判敏感率为91.30%(21/23),几乎所有患者在微创美白治疗过程均出现轻、中度牙本质敏感症状,治疗结束后牙齿敏感症状均消失。结论微创美白治疗对着色型氟斑牙有显著的脱色美白效果,并具有一定的稳定性且治疗结束后无牙齿敏感,值得临床推广应用。Objective To observe the aesthetic effect of low concentration of at-home bleaching combined with microabrasion and resin infiltration on stained dental fluorosis. Methods Twenty-three patients with stained dental fluorosis were selected from June 2017 to June 2018 in Stomatological Hospital of Tianjin Medical University. All patients were treated with minimally invasive whitening technology of microabrasion, 10% low concentration of at-home bleaching and resin infiltration. The aesthetic treatment effect was observed before and after treatment by VITA aesthetic shade guide matching. Stained spots were chosen and colorimetric assay was performed using CMYK shade guide before treatment. According to the color of the splash, the light and shade were divided into light grade, medium grade and heavy grade. The CMYK data of the selected spot and complete decolorization ratio (stain decolorization rate) were recorded 1 week and half a year after treatment. Meanwhile, tooth sensitivity was recorded using visual analogue scale (VAS). Results The shades of 92 teeth of 23 dental fluorosis patients were increased more than 5 degrees after a series of whitening treatment, 1 tooth was 2-4 degrees, and the total effective rate was 100.00%(92/92). Decolorization rates of light grade, medium grade and heavy grade were 100.00%(100/100), 100.00%(120/120) and 97.78%(88/90), respectively, 1 week after treatment. Half a year after treatment, bleaching decolorization rate had no significant difference compared with that of 1 week after treatment (P > 0.05). Tooth sensitivity was 91.30%(21/23). Almost all patients had mild and moderate teeth sensitivity during treatment. The symptoms of tooth sensitivity were disappeared after the treatment. Conclusions The whitening technology of microabrasion, 10% low concentration of at-home bleaching and resin infiltration has a significant decolorization whitening effect, and has a certain degree of stability and no sensitive teeth after treatment. It is worthy of clinical application.

关 键 词：氟中毒 牙 家庭美白 微研磨膏 渗透树脂 治疗效果 

分 类 号：R783[医药卫生—口腔医学]