口腔酸碱环境下渗透树脂联合再矿化对釉质白斑治疗稳定性影响的实验研究  

Effect of Resin Infiltration Combined with Remineralization on Stability of Enamel White Spot Lesions in Oral Acid-base Environment

作　　者：王琰 倪恪 贺晶宇 李迎梅 孟庆飞 WANG Yan;NI Ke;HE Jingyu;LI Yingmei;MENG Qingfei(College of Stomatology,Bengbu Medical College,Bengbu 233000,China;Department of Stomatology,Xuzhou Central Hospital,Xuzhou 221000,China;Department of Stomatology,Xuzhou Clinical School of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]蚌埠医学院口腔医学院,安徽蚌埠233000 [2]徐州市中心医院口腔科,江苏徐州221000 [3]徐州医科大学徐州临床学院口腔科,江苏徐州221000

出　　处：《口腔医学研究》2023年第9期821-826,共6页Journal of Oral Science Research

基　　金：江苏省“六个一工程”拔尖人才(编号:LGY2020027);徐州市卫生健康委科技项目(编号:XWKYHT20220114)。

摘　　要：目的:在口腔酸碱循环环境下观察比较渗透树脂联合不同再矿化治疗釉质白斑后釉质粗糙度、硬度以及Ca/P比的变化情况。方法:72颗完整离体前磨牙在牙冠颊面正中切取4 mm×4 mm×2 mm釉质块。在其表面(除颊侧面外)涂布抗酸指甲油后,置于脱矿液中3 d,建立釉质白斑体外脱矿模型。经渗透树脂处理后,用抗酸指甲油覆盖一半釉质面作为自身对照侧,另一半作为实验侧。将样本随机分为3组(n=24),RI组不做再矿化处理,RI/B组行生物活性玻璃处理(2次/日),RI/C组行含氟酪蛋白磷酸肽/无定形磷酸钙(CPP-ACPF)处理(2次/日),共计7 d。除再矿化治疗外,所有样本均置于酸碱循环溶液中。去除对照侧覆盖的指甲油记为酸碱循环前(T_(0)时刻),实验侧为酸碱循环后(T_(1)时刻)。观察并测量各组样本酸碱循环前后粗糙度、显微硬度及Ca/P比并行统计学分析。结果:再矿化和酸碱循环均可显著影响渗透树脂处理后釉质表面粗糙度和Ca/P比(P<0.05)。经酸碱循环后,3组样本的粗糙度值均有增加,但RI/B组增加值(T_(1)-T_(0))最少,RI/C组次之,RI组增加最多(P<0.05);3组显微硬度值均略有降低但无统计学差异(P>0.05);3组Ca/P比均显著性降低(P<0.05),但RI组降低最多,RI/B组降低最少。结论:釉质白斑树脂渗透治疗后,在酸碱循环环境下出现粗糙度增加、硬度及Ca/P比降低;联合生物活性玻璃或CPP-ACPF再矿化治疗,可以有效改善釉质抗脱矿能力,提高渗透树脂治疗稳定性。Objective:To observe and compare the changes of enamel roughness,hardness,and Ca/P ratio after resin infiltration combined with different remineralization treatment in oral acid-base circulation environment(pH cycle).Methods:A 4 mm×4 mm×2 mm enamel block was cut from 72 intact premolars in the center of the buccal surface of the crown.After acid-resistant nail polish was coated on its surface(except buccal side),it was placed in demineralization solution for 3 days to establish an in vitro demineralization model of enamel white spots.After resin infiltration treatment,half of the enamel surface was covered with acid-resistant nail polish as its own control side,and the other half was used as the experimental side.The samples were randomly divided into three groups(n=24).RI group was not treated with remineralization,RI/B group was treated with bioactive glass(twice a day),and RI/C group was treated with phosphopeptide containing fluorine casein/amorphous calcium phosphate(CPP-ACPF)(twice a day)for 7 days.Except for remineralization treatment,all samples were placed in pH cycle solution.The nail polish removed from the control side was recorded as before the pH cycle(time T_(0))and after the pH cycle(time T_(1))on the experimental side.The roughness,microhardness,and Ca/P ratio of each group of samples before and after pH cycle were observed and measured.Results:Both remineralization and pH cycle can significantly affect the enamel surface roughness and Ca/P ratio(P<0.05).After pH cycling,the roughness values of three groups of samples all increased,but the added value of RI/B group(T_(1)-T_(0))was the least,followed by RI/C group and RI group increased the most(P<0.05).The microhardness of three groups decreased slightly without statistical difference(P>0.05).The Ca/P ratio of three groups decreased significantly(P<0.05),but the decrease in RI group was the most,and that in RI/B group was the least.Conclusion:After resin infiltration treatment of enamel white spot lesions,the roughness was increased,and the har

关 键 词：釉质白斑 树脂渗透 含氟酪蛋白磷酸肽/无定形磷酸钙 生物活性玻璃 酸碱循环 

分 类 号：R781[医药卫生—口腔医学]