即刻牙本质封闭技术对氟斑牙牙本质粘接的影响  

Effects of immediate dentin sealing technique on dentin bonding of teeth with fluorosis

作　　者：解静 黄晓宇 张美凤 孙正帆 郭玲 XIE Jing;HUANG Xiaoyu;ZHANG Meifeng;SUN Zhengfan;GUO Ling(Department of Prosthodontics,the Affiliated Stomatology Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属口腔医院修复科,四川泸州646000

出　　处：《西南医科大学学报》2021年第2期134-137,共4页Journal of Southwest Medical University

基　　金：中华口腔医学会口腔健康促进与口腔医学发展西部临床科研基金(CSA-W2019-07);四川省卫生厅基金项目(16RJ173)。

摘　　要：目的:评价即刻牙本质封闭技术(immediate dentin sealing technique,IDS)应用于氟斑牙后对其牙本质表面形态及不同程度氟斑牙牙本质粘接强度的影响。方法:收集选取因牙周病拔除的48颗非龋性氟斑牙,按Thylstrup和Fejerskov指数(TFI)分和干预措施进行分组。先按Thylstrup和Fejerskov指数(TFI)分为4个组:正常组(TFI=0)、轻度组(TFI=1~3)、中度组(TFI=4~5)、重度组(TFI=6~9)。再在每个大组下分成两个亚组:对照组和干预组。对照组用生理盐水处理牙本质表面,干预组用即刻牙本质封闭处理牙本质表面。每组选择一个样本行扫描电子显微镜观察,剩余样本牙本质表面粘接复合树脂块(4mm×4 mm×3 mm)后行微拉伸粘接强度测试。结果:IDS组的平均拉伸粘接强度均高于对照组,差异均具有统计学意义(F=46.01,P <0.001);随着氟斑牙严重程度加重,拉伸强度逐渐降低,差异均具有统计学意义(F=35.77,P <0.001);电镜观察发现随着氟斑牙严重程度加重,牙不同处理方法下牙本质小管封闭率和树脂突数量及长度都有所下降,即刻牙本质封闭组的牙本质小管封闭率和形成的树脂质量都优于其余各组。结论:即刻牙本质封闭技术可以有效提高氟斑牙牙本质封闭率及氟斑牙牙本质粘接强度,但粘接强度随氟斑牙严重程度的加重而降低。Objective:To evaluate the effects of immediate dentin sealing(IDS)on the dentin surface morpholo⁃gy and the dentin bond strength of teeth with fluorosis.Methods:Forty-eight non-carious teeth with fluorosis ex⁃tracted due to periodontal disease were collected and divided into four groups according to the Thylstrup and Fejer⁃skov index(TFI):normal group(TFI=0),mild group(TFI=1~3),moderate group(TFI=4~5),and severe group(TFI=6~9).Each group was further divided into two subgroups:control group and intervention group.The dentin surface was treated with normal saline in the control group,and with IDS in the intervention group.For every group,one sample was observed by a scanning electron microscope,and the remaining samples received bonding of a com⁃posite resin block(4 mm×4 mm×3 mm)to the surface of dentin and then microtensile bond strength testing.Results:The mean tensile bond strength of the IDS groups was significantly higher than that of the control groups(F=46.01,P<0.001).The tensile bond strength significantly decreased as the severity of dental fluorosis increased(F=35.77,P<0.001).According to electron microscopy,the sealing rate of dentin tubules and the number and length of resin tags decreased with the increasing severity of dental fluorosis,regardless of treatment modalities;the sealing rate and the quality of resin formation were significantly better in the IDS groups than in the other groups.Conclusion:IDS can effectively improve the dentin sealing rate and dentin bond strength of teeth with fluorosis,but the bond strength decreases with the increasing severity of dental fluorosis.

关 键 词：氟斑牙 牙本质 即刻牙本质封闭 粘接强度 

分 类 号：R781.2[医药卫生—口腔医学]