基于micro-CT评估3种去龋方法清除龋损组织效果及微创潜力的研究  

Evaluating the caries excavation effect and minimally invasive potential of three caries excavation methods using micro-CT

作　　者：王茹燕 张力 刘苗苗 WANG Ruyan;ZHANG Li;LIU Miaomiao(Department of Stomatology,Suzhou Municipal Hospital,The Affiliated Suzhou Hospital of Nanjing Medical University,Gusu School,Nanjing Medical University,Suzhou 215004,China;Department of Prosthodontics,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China;Department of Cariology and Endodontics,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China)

机构地区：[1]苏州市立医院口腔科,南京医科大学附属苏州医院,南京医科大学姑苏学院,江苏苏州215004 [2]南京大学医学院附属口腔医院,南京市口腔医院口腔修复科,南京大学口腔医学研究所,江苏南京210008 [3]南京大学医学院附属口腔医院,南京市口腔医院牙体牙髓病科,南京大学口腔医学研究所,江苏南京210008

出　　处：《口腔疾病防治》2024年第9期695-701,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金(82101063)。

摘　　要：目的使用微型计算机断层扫描(micro-computerized tomography,micro-CT)评价传统球钻去龋法、去腐凝胶辅助去龋法和龋显像笔辅助去龋法的清除龋损组织效果和微创潜力。方法本研究已获得医院生物医学研究伦理委员会审批及患者知情同意。收集30颗有牙本质龋的磨牙或前磨牙,随机分为3组,分别使用传统球钻去龋法(传统球钻组)、去腐凝胶去龋法(去腐凝胶组)和龋显像笔去龋法(龋显像笔组)对样本进行去龋处理,并记录每个样本的去龋操作时间,去龋前后均使用micro-CT进行扫描并记录每颗牙齿的龋损及健康牙体体积。根据去龋前后的龋损体积及去龋前后的健康牙体体积分别评估3种去龋方法的清除龋损组织效果、微创潜能。结果在去龋时间方面,去腐凝胶组所用时间(501.7±143.6)s高于传统球钻组(263.9±121.2)s和龋显像笔组(284.2±135.6)s,差异具有统计学意义(P<0.01);传统球钻组和龋显像笔组差异无统计学意义。在清除龋损组织效果方面,残余龋损体积与初始龋损体积的比值传统球钻组(0.087±0.04)最低,去腐凝胶组(0.51±0.10)最高,龋显像笔组(0.36±0.10)介于前两组之间,差异有统计学意义(P<0.01)。在微创潜能方面,去龋前后健康牙体体积比值传统球钻组(0.87±0.05)低于去腐凝胶组(0.99±0.01)和龋显像笔组(0.98±0.01),差异有统计学意义(P<0.01);去腐凝胶组和龋显像笔组差异无统计学意义。结论传统球钻组操作时间最短,但会过多去除健康牙本质和脱矿牙本质,微创潜能最差。去腐凝胶组可保留脱矿牙本质和全部健康牙本质,微创潜能最好,但清除龋损组织效果不佳,操作时间较长。龋显像笔组可以保留部分脱矿牙本质和健康牙本质,具有一定微创潜力,临床操作时间适中。Objective To evaluate the caries excavation efficacy and minimally invasive potential of three dentine caries excavation methods including traditional excavation,chemomechanical excavation,and fluorescence-aided caries excavation using micro-computerized tomography(micro-CT).Methods This study was approved by the Biomedical Research Ethics Committee,and all patients provided informed consent.Thirty molars and premolars with dentin caries were collected and randomly divided into three groups.The samples were obtained by traditional excavation(traditional excavation group),chemomechanical excavation(chemomechanical excavation group),and fluorescence-aided caries excavation(fluorescence-aided caries excavation group),and the operation time for each sample was recorded.Micro-CT was used to scan and record the caries volume and healthy tooth volume of each tooth before and after caries excavation.The caries excavation efficacy and minimally invasive potential of the three caries excavation methods were evaluated based on the caries volume and the healthy tooth volume before and after caries excavation.Results In terms of caries excavation operation time,the chemomechanical excavation group(501.7 s±143.6 s)had a longer operation time than the traditional excavation group(263.9 s±121.2 s)and the fluorescence-aided caries excavation group(284.2 s±135.6 s),with a statistically significant difference(P<0.01);there was no significant difference between the traditional excavation group and the fluorescence-aided caries excavation group.In terms of caries excavation efficacy,the ratio of residual caries volume to initial caries volume was determined in the traditional excavation group(0.087±0.04),followed by the fluorescence-aided caries excavation group(0.36±0.10),and the chemomechanical excavation group was the highest(0.51±0.10);the observed disparity between the groups exhibited statistical significance(P<0.01).In terms of minimally invasive potential,the ratio of the traditional excavation group(0.87±0.05)was lowe

关 键 词：龋齿 矿化牙本质 牙本质深龋 化学机械去龋 荧光辅助去龋 选择性去龋 龋齿微创治疗 微型计算机断层扫描 去龋效率 

分 类 号：R78[医药卫生—口腔医学]