激光联合氟钾酚醛树脂对牙本质小管封闭作用的实验研究

摘要/Abstract

摘要： 【摘要】目的：通过扫描电镜观察刷牙实验前后氟钾酚醛树脂脱敏剂（fluorine potassium phenolic resin desensitizer，FR）、激光、激光联合氟钾酚醛树脂脱敏剂对牙本质小管的封闭情况，探讨不同脱敏方法对牙本质小管的封闭效果及抗洗刷能力。为临床上激光联合氟钾酚醛树脂脱敏剂的应用提供实验依据和理论支持。方法：选择新鲜拔除的第三磨牙48颗，要求牙冠完整、无龋损，制备成3mm*3mm*2.5mm的牙本质模块，根据表面脱敏方法不同随机分为四组：A组对照组；Ｂ组为氟钾酚醛树脂脱敏剂组；C组激光组；D组为激光联合氟钾酚醛树脂脱敏剂组。B、Ｃ、D三组脱敏处理后，每组均随机选择6个标本作为即刻组，其余6个标本作为磨损组，进行刷牙实验。每组随机选择一半标本沿牙本质方向纵行劈开，用于观察纵剖面。扫描电镜观察四组样本牙本质小管的表面封闭情况及纵剖面牙本质小管的封闭深度，所得的数据均在SPSS24.0软件上进行统计学分析。结果：1、B、C、D三组均能在牙本质表面形成有效封闭（P＜0.05），D组具有更佳的封闭效果。2、纵剖面观察,B/D两组封闭深度差异无统计学意义（P＞0.05），均深于C组（P＜0.05）。3、刷牙磨耗试验后B/C/D三组牙本质小管口的封闭效果有统计学差异（P＜0.05），两两比较，D组表面封闭性优于B、C两组（P＜0.05），B组优于C组（P＜0.05）；4、纵剖面封闭深度比较，B、 D两组均大于C组（P＜0.05）。结论：1. 氟钾酚醛树脂脱敏剂、激光、激光和氟钾酚醛树脂脱敏剂联合应用均能在牙本质表面形成有效封闭。2. 激光和氟钾酚醛树脂脱敏剂联合应用对牙本质小管的封闭效果要优于单用脱敏剂或激光，更能耐受机械性刷洗，效果持久而稳定；激光封闭牙本质小管的深度较小，且抗机械性刷洗的能力较差。

关键词: 激光, 氟钾酚醛树脂脱敏剂, 牙本质过敏症, 扫描电镜, 牙本质小管

Abstract: 【 abstract 】 objective: The sealing effect of dentin tubule and anti-brushing ability of different desensitization methods were observed by scanning electron microscope.evaluateing zhe effect of potassium fluoride resin desensitizer, laser and laser combined with potassium fluoride phenolic resin desensitizer.So that providing experimental basis and theoretical support for the clinical application of laser combined with fluoropotassium phenolic resin desensitizer.Methods: 48 caries free third molars were selected and prepared into 3mm*3mm*2.5mm dentin blocks.They were randomly divided into four groups according to different desensitization methods.Group A :control group; Group B :potassium fluoride phenolic resin desensitizer group; Group C :laser group; Group D : laser combined with fluoropolyphenolic resin desensitizer group. In group B/C/D, 6 samples were randomly selected as immediate group and the remaining 6 samples were selected as wear group for the brushing experiment. Half of the dentin specimens were randomly selected to be split in each group to observe the longitudinal profile. The surface closure of the dentinal tubules of the blank group and the test group was observed by scanning electron microscope.The morphological analysis was performed about the representative areas to observe the closure depth of dentin tubules in longitudinal profile. Using SPSS 24.0 analyze all date .Results: 1. Group B, group C and group D could effectively block the dentin surface （p ＜ 0.05）. 2. In pairwise comparison, there was no statistical difference in the depth of closure between the b/d groups（p ＞0.05）, however, both are deeper than group C（p ＜0.05）.3. After brushing tooth, The differences among the three groups in sealing dentin tubule orifice were significant（p ＜ 0.05）. group D was better than groupB and group C, groupB was better than group c （p ＜ 0.05）.4. After brushing tooth ,as the depth of longitudinal section ,group B and group D were deeper than group C （p ＜ 0.05）. Conclusion:1.Fluorine potassium phenolic resin desensitizer ,laser and the combination of laser and fluorine potassium phenolic resin desensitizer can effective seal dentin surface.2.The effect of the combination of laser and potassium fluoropotassium phenolic resin desensitizing on sealing dentinal tubules is better and more durable than that of desensitizing agent or laser alone. The depth of laser-closed dentinal tubules is small, and the ability of mechanical brushing is poor.

Key words: laser, Potassium fluoride phenolic resin desensitizer, Dentin hypersensitivity, SEM, dentinal tubules

王芳孙慧斌李泽雨孙莉青. 激光联合氟钾酚醛树脂对牙本质小管封闭作用的实验研究[J]. 口腔医学, 2020, 40(9): 786-791.

参考文献 15

[1]	中华口腔医学会牙本质敏感专家组，牙本质敏感的诊断和防治指南[J].中华口腔医学杂志，2009,44（3）：132-134.)。
[2]	Braennstroem M，Astroem A. A study on the mechanism of painelicited from the dentin ［J］. J Dent Res，1964，43（4）：619-625.
[3]	高德，李荣亮，李绍辉. 应用酚醛树脂液治疗牙本质敏感症自身对照疗效观察[J].口腔医学，2002 , 22（4）：206-207.
[4]	王芳，高德，牛晓阳. 3种脱敏剂治疗颌支托窝牙本质敏感症的临床观察[J]. 口腔材料器械杂志，2016,25（4）：221-224.
[5]	Renton-HarPer,P Midda,M.Nd:YAG laser treatment of dentinal hypersensitivity. .BritishDental Journal. 1992:172:13-16）
[6]	高德，牛晓阳，李荣亮，王芳. 含氟钾酚醛树脂脱敏剂的临床疗效[J]. 牙体牙髓牙周病学杂志，2014,24（6）：374.
[7]	Mordan NJ，Barber PM，Gillam DG. The dentine disc-a reviewof its applicability as a model for the in vitro testing of dentine hy?persensitivity［J］. J Oral Rehabil，1997，24（2）：148-156.
[8]	黄燕华，谢思静，葛久禹，等. 两种脱敏剂对牙本质小管封闭作用及其耐磨性研究[J].中国实用口腔科杂志，2014，7（3）：155-159.
[9]	Grossman L． A systematic method for the treatment of hypersen-sitive dentine［J］． J Am Dent Assoc，1935，22: 592 － 598．
[10]	Chu CH,Lo EC,Microhardness of dentine in primary teeth after topical fluoride applications[J]. J Dent , 2008,36(6):387-391.
[11]	Rizzante FA， Maenosono RM， Duarte MA， et al． In vitroevaluation of dentin hydraulic conductance after 980 nm diodelaser irradiation［J］． J Periodontol，2016，87( 3) : 320－326．
[12]	Gholami GA，Fekrazad Ｒ，Esmaiel-Nejad A，et al． An e-valuation of the occluding effects of Er; Cr: YSGG，Nd:YAG，CO2and diode lasers on dentinal tubules: A scanningelectron microscope in vitro study ［J］． Photomed LaserSurg，2011，29( 2) : 115 － 121．
[13]	Lee BS，Chang CW，Chen WP，et al． In vitro study of dentin hypersensitivity treated by Nd: YAG laser and bioglass［J］． DentMater J，2005，21: 511 － 519．
[14]	李向新，龚永庆，王统伍．半导体激光联合 MS－COAT 脱敏剂治疗牙本质过敏症的临床效果［J］．实用临床医学，2008，9( 11) : 82 － 84．
[15]	Camerlingo C，Lepore M，Gaeta GM，et al． Er: YAG laser treat-ments on dentine surface: micro－ Raman spectroscopy and SEManalysis［J］． J Dent，2004 JUL，32( 5) : 399 － 405．