无髓变色牙漂白治疗的疗效观察

本文介绍使用３０％过氧化氢溶液加过硼酸钠糊剂进行髓腔封药，一般经３～５次治疗即能使无髓变色牙齿恢复自然颜色，７４例病人，牙髓变色时间最短３年，最长２０年。结果痊愈５６例占７５．７％，好转１５例占２０．３％，有效率９６％，失败３例占４％。     

超声波在无髓变色牙漂白术中的应用

目的观察超声波在无髓变色牙漂白术中的效果。方法选择120例共178颗因死髓或根管治疗后的无髓变色牙进行漂白治疗。保留根管充填物,在根管口龈下2mm下用磷酸锌水门汀密封。漂白剂为30%过氧化氢液和等量的过硼酸钠,用时调成糊剂。把漂白剂棉球放入髓室。用超生波探头接触棉球30～60s后更换棉球,反复4～5次,再放置漂白糊剂用磷酸锌水门汀密封。每隔3天漂白1次。结果显效:139颗牙(78.09%),有效:37颗牙(20.79%),无效:2颗牙(1.12%)。结论应用超声波辅助漂白剂进行无髓牙漂白简便、省时。     

无髓变色牙内漂白术后1年临床效果观察

目的 探讨无髓变色牙内漂白临床效果及术后1年内颜色反弹情况,以期指导临床和提示预后。方法对20例无髓变色牙进行内漂白治疗,分别于漂白前、漂白后即刻、漂白后第1、3、6、9、12月使用电脑比色仪对变色牙进行颜色测量,获得不同时间点牙体颈、中、切各部位颜色的L^*、a^*、b^*值,计算出漂白前后颜色变化量ΔE^*、ΔL^*、Δa^*、Δb^*,并观察ΔE^*、ΔL^*、Δa^*、Δb^*在颈、中、切部随时间的变化情况,分析颜色反弹速度(V^*)以及反弹率(P^*)。结果 20例无髓变色牙内漂白后即刻颜色改变平均ΔE^*为14.99。漂白后牙体颈部和中部ΔE^*、ΔL^*在1、3、6、9、12月减小,差异有统计学意义,自漂白后第9个月起,牙体中部及颈部颜色的反弹速度较第1个月...     

无髓变色牙的漂白

目的：研究两种漂白剂对无髓变色牙的漂白效果，为临床应用提供参考。方法：将85例共96颗无髓变色牙随机分成A、B两组，分别用30％过氧化氢溶液和10％过氧化氢凝胶进行漂白治疗一个疗程，并比较其疗效。结果：A组良好率为89．58％，B组良好率为85．42％，两组有效率均为100％，漂白有效率差别没有统计学意义(P＞0．05)，结论：两种漂白剂作用效果大致相同，采用30％过氧化氢溶液和10％过氧化服凝胶进行漂白操作简单，效果显著。     

变色牙内漂白疗法的临床应用

目的：探讨变色牙内漂白疗法的安全性及临床疗效。方法：需作内漂白的牙齿行根管治疗术后,髓腔内置入30％过氧化氢小棉球暂封,达到正常色泽后用复合树脂进行充填。3年后复查。结果：75个牙3年后复查68个牙,有效率达97．06％。结论：内漂白法治疗变色牙可恢复到正常牙色范围。     

无髓变色牙冠内漂白的实验研究

无髓变色牙冠内漂白的实验研究山东省滨州医学院附属医院（２５６６０３）王青山王燕赵波前牙牙髓坏死后，牙冠会变成灰暗色至棕色，对美观影响较大，冠内封药漂白是治疗该病快捷有效的方法。本实验的目的就是体外观测比较３０％Ｈ２Ｏ２、２０％ＮａＯＨ＋３０％Ｈ２Ｏ２...     

无髓变色牙的漂白疗法（附64例临床观察）

自1989年以来,我们对64例因死髓或根管治疗后的无髓变色牙,进行了漂白治疗,取得了较为满意的效果,现报道如下: 1 材料与方法 适应征 牙冠无严重破坏,根尖病变通过治疗可保留的变色前牙。 漂白前的准备 死髓牙先做根管治疗及严密的根管充填。如已做根管治疗,自舌侧将大部分充填物去除,暴露洞内牙本质,根管口以磷酸锌粘固粉严密充填覆盖。 药物 30％过氧化氢(H_2O_2),凡士林。 漂白方法 牙齿窝洞预备完毕后,严密隔湿,吹干,用凡士林涂于患牙及邻牙周围软组织。将浸有30％过氧化氢的小棉球放入洞内,选择大小适合的充填器,在火焰上加热后,压于窝洞内棉球上,反复     

无髓变色牙漂白治疗30例临床分析

目的:评价无髓变色牙漂白治疗的效果。方法:对30例33颗无髓变色、牙冠完整的前牙使用15%过氧化脲进行诊间和夜间漂白相结合、冠内和冠外联合漂白治疗,并与以30%过氧化氢冠内漂白组作为对照;同时,对实验组有效病例在治疗后1a复查,应用SPSS17.0软件包对所得数据进行统计学分析。结果:15%过氧化脲联合漂白组疗效显著高于30%过氧化氢冠内漂白组,2组差异有统计学意义。1a后复查牙颜色的色阶数值变化,无统计学意义。结论:15%过氧化脲进行诊间和夜间漂白相结合、冠内和冠外联合漂白,能有效治疗无髓变色牙。     

高频电刀漂白法治疗无髓变色牙的临床效果

对象和方法 1.适应症:牙冠唇面无严重缺损,经严密根管充填的变色前牙。 2.漂白前准备:(1)从冠舌面取出窝洞及髓室的充填物,保留根管充填物。(2)清理髓室,去尽髓角处残髓,显露洞内牙本质。(3)在根管口以下2mm处,用磷酸锌水门汀密封。 3.器械与药物:(1)1141型高频电刀(上海手术器械八厂生产)。(2)漂白剂:30％双氧水与等量的过硼酸钠,临用时调拌成糊剂。(3)酸处理液:50％磷酸。(4)无水酒精。(5)凡士林等。 4.漂白方法:(1)髓室内用无水酒精涂擦,脱脂。(2)酸处理液涂髓室壁2分钟,水冲洗。(3)凡士林涂龈缘。(4)隔湿,涂无水酒精,吹干。(5)浸漂白剂棉球置入髓室,高频电刀工作头接近棉球(图1),间     

Beyond冷光美白术对无髓变色牙的临床疗效观察

目的:评价应用Beyond冷光美白技术采用内外联合漂白方式对无髓变色牙的临床疗效。方法:选择牙齿变色病人180例,随机分成3组,分别采用内漂白、外漂白、内外联合漂白技术进行治疗,观察其有效率;对进行内外联合漂白的外伤变色牙的外伤时间和漂白次数进行统计分析。结果:1周后,内外联合漂白有效率达到95%,4周后,内外联合漂白有效率达到98.3%,与其他组相比均具有统计学意义;外伤导致牙齿变色并进行内外联合漂白的病人,外伤时间与漂白次数成正比。结论:Beyond冷光美白技术采用内外联合漂白方式对无髓变色牙有明显的增白作用。     

10%过氧化脲漂白无髓牙的临床研究

目的 :评价 10 %过氧化脲对变色无髓牙的漂白效果。方法 :对 8例患者的 8颗变色无髓牙 ,制作含储药池的扇形个别托盘 ,并开放舌侧髓室口 ,去除根充牙胶至釉牙骨质界下 2～ 3mm ,然后用玻璃离子覆盖 2～ 3mm。治疗中 ,患者临睡前将 10 %过氧化脲注入髓室及个别托盘的储药池内 ,从而同时从内外两侧对无髓牙进行漂白。患者晨起后 ,清洁牙齿 ,用无菌棉球充填髓室。治疗结束后 ,暂时充填髓腔 ,两周后改行光固化充填。结果 :8颗变色无髓牙在 3周内均获得满意效果。无髓牙漂白所用时间与着色时间成正比。结论 :10 %过氧化脲能有效地治疗变色无髓牙。     

Surface morphology changes in human enamel, dentin and cementum following bleaching: a scanning electron microscopy study

Abstract Extracted human premolars were cut, cleaned and divided into 6 experimental groups. Each group was treated with one of the following bleaching materials: 30% hydrogen peroxide, 10% carbamide peroxide, sodium perborate, Nu-Smile, Opalescence and DentlBright. Morphological changes in tooth surface occurred following treatment with most bleaching agents. Hydrogen peroxide and DentlBright were associated with surface changes in all dental tissues. Hydrogen peroxide, DentlBright, Nu-Smile and Opalesceilce were mainly associated will) surface changes in the cementum, which exhibited more changes than the other tissues.     

The effects of internal tooth bleaching regimens on composite-to-composite bond strength

BackgroundThe authors conducted an in vitro study to investigate the influence of several internal bleaching regimens on the composite-to-composite shear bond strength of a dental core buildup material.MethodsThe authors fabricated 72 specimens from a resin-based composite core buildup and assigned them randomly to six groups (four experimental and two control groups) (n = 12 per group), according to the following bleaching agents: sodium perborate mixed with distilled water (SP/W); sodium perborate mixed with 3 percent hydrogen peroxide (SP/HP-3); sodium perborate mixed with 30 percent hydrogen peroxide (SP/HP-30); 35 percent hydrogen peroxide (HP-35). After the 12-day bleaching procedures, the authors applied a calcium hydroxide dressing for two weeks. The two control groups consisted of unbleached specimens that either did not receive (C1) or did receive (C2) the calcium hydroxide dressing. The authors cleaned and silanized the resin-based composite specimens and coated them with an intermediate adhesive resin before applying fresh composite material. They measured composite surface roughness and shear bond strength and performed statistical analyses of the data.ResultsUnbleached specimens in groups C1 and C2 exhibited significantly lower composite-to-composite bond strength and significantly lower surface roughness than did specimens in groups SP/W and SP/HP-3. Bond strength in group HP-35 was significantly lower than that in group SP/W.ConclusionInternal bleaching regimens that involve the use of sodium perborate mixed with water or 3 percent hydrogen peroxide might increase the composite-to-composite interfacial bond strength.Clinical ImplicationsNone of the internal bleaching regimens in this study had an adverse effect on the composite-to-composite interfacial bond strength.     

Review of the current status of tooth whitening with the walking bleach technique

Internal bleaching procedures such as the walking bleach technique can be used for whitening of discoloured root-filled teeth. The walking bleach technique is performed by application of a paste consisting of sodium perborate-(tetrahydrate) and distilled water (3% H2O2), respectively, in the pulp chamber. Following a critical review of the scientific literature, heating of the mixture is contra-indicated as the risk of external cervical resorption and the formation of chemical radicals is increased by application of heat. An intracoronal dressing using 30% H2O2 should not be used in order to reduce the risk of inducing cervical resorption. This review provides advice based on the current literature and discusses how the walking bleach technique can lead to successful whitening of non-vital root-filled teeth without the risks of side-effects.     

An in vitro comparison of the bleaching efficacy of 35% carbamide peroxide with established intracoronal bleaching agents

AIM: To evaluate the bleaching efficacy of 35% carbamide peroxide, 35% hydrogen peroxide and sodium perborate for intracoronal bleaching of root filled discoloured teeth. METHODOLOGY: Extracted premolars were artificially stained using whole blood then root canal treatment was performed. After obturation, a 2 mm intermediate base was placed 1 mm below the buccal amelo-cemental junction. Intracoronal bleaching was performed in 11 teeth per group, using either 35% carbamide peroxide gel (group CP), 35% hydrogen peroxide gel (group HP) or sodium perborate mixed with distilled water (group SP). The bleaching agents were replaced after 7 days. The shade of the teeth was evaluated at day 0, 7 and 14. The results were analysed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U-test. RESULTS: At the end of 7 days, both groups CP and HP lightened by 8 +/- 3 Vita tab positions, respectively, whereas group SP lightened by 5 +/- 3 tab positions (P < 0.05). At the end of the second bleaching period at day 14, group CP and HP lightened by a further 2 +/- 2 and 2 +/- 3 tab positions, respectively, whereas group SP lightened by a further 3 +/- 4 tab positions. There were no statistical differences between groups at day 14. CONCLUSIONS: Thirty-five per cent carbamide peroxide and 35% hydrogen peroxide were equally effective for intracoronal bleaching, and significantly better than sodium perborate after 7 days. After 14 days, there were no significant differences between the groups. Thirty-five per cent carbamide peroxide can be recommended as an equally effective alternative to hydrogen peroxide for intracoronal bleaching.     

Extraradicular diffusion of hydrogen peroxide and pH changes associated with intracoronal bleaching of discoloured teeth using different bleaching agents

AIM: To evaluate the extraradicular pH and hydrogen peroxide (HP) diffusion when either 35% carbamide peroxide (CP), 35% HP or sodium perborate (SP) is used for intracoronal bleaching of artificially discoloured teeth. METHODOLOGY: Single rooted extracted human premolars were stained with whole blood cells. After shaping and cleaning, they were root filled and a base cement placed 1 mm below the buccal cementoenamel junction (CEJ). Four cemental defects were prepared just below the CEJ on each root surface. The teeth were randomly divided into four groups of 11 specimens, and intracoronally bleached using CP, HP, SP or distilled water (CL). Each tooth was suspended in a vial of distilled water and bleached for 7 days. The pH of the extraradicular distilled water was tested at 0, 1, 2 and 7 days and the HP that diffused through the root quantified using the Ferrous Oxidation-Xylenol Orange 2 Assay. The results were analysed using the one-way anova and Scheffe tests. RESULTS: Carbamide peroxide produced the greatest increase and HP the least pH change (P < 0.05 except day 1), SP was intermediate. From day 1 onwards, radicular diffusion of HP was greatest with HP and least with CP (P < 0.01), again SP was intermediate. There was no significant difference between CP and SP. CONCLUSIONS: Carbamide peroxide had very low levels of extraradicular diffusion of HP, in the presence of cemental defects. It could be an alternative to the other intracoronal bleaching agents.     

Opalescence PF��ͥ������װƯ������Ч������

目的评价Opalescence PF家庭美白系统漂白牙齿的临床疗效。方法随机选择2007年8月至2010年12月在暨南大学附属惠州口腔医院治疗的着色牙患者60例(四环素牙组和氟斑牙组各30例),用含15%过氧化脲的Opalescence PF家庭美白套装进行牙齿漂白,用美能达接触式色彩色差计分析并比较治疗前后牙面色度的变化,记录受试者术中牙齿酸痛的发生率,并复查评价疗效稳定性。结果用含15%过氧化脲的Opalescence PF家庭美白系统漂白后,四环素牙组与氟斑牙组牙面平均L*,a*,b*值与治疗前比较差异均有统计学意义(均P<0.05),平均色差分别为3.89和4.21;术中2组均有部分患者出现不同程度牙齿酸痛症状,但停药后4～5h均能缓解;治疗后6个月,氟斑牙漂白有效率仍达90%(27/30),四环素牙的漂白有效率为86.7%(26/30),与治疗结束时(93.3%和96.7%)比较,差异均无统计学意义(均P>0.05)。结论 Opalescence PF家庭美白系统治疗着色牙效果显著并具有一定稳定性。     

活髓牙漂白引起牙齿敏感的研究进展

漂白引起的牙齿敏感(BS)是活髓牙漂白最常见的不良反应,影响了患者接受漂白治疗的舒适度和满意度,也增加了临床对活髓漂白治疗安全性的担忧.本文旨在从BS的临床特点、病因学理论、可能的影响因素和防治措施作一综述.     

A quantitative comparison of traditional and non-peroxide bleaching agents

Abstract— Single-rooted premolar teeth, stained with blood utilizing the technique devised by Freccia & Peters (1981), were subjected to traditional and non-peroxide bleaching agents. Colour changes were recorded over a period of 7 days using a Speedmaster R75-CP Reflection Densitometer. The most efficient removal of staining occurred after the application of 30% hydrogen peroxide, with sodium perborate being 75% as effective. AU bleaching agents realized their optimum efficacy within the first 3 days. A combination of three enzymes (amylase, lipase and trypsin) with disodium edetate was not as effective as the routine bleaching agents; however, the combination did have a modifying effect on the blood stains. It is suggested that other non-peroxide agents should be investigated to determine their efficacy in removing staining from experimentally induced blood-stained teeth.