家庭漂白研究进展

家庭漂白在临床上应用广泛。近年来,许多学者对其漂白机理、评价疗效的方法、有效性及稳定性、不良反应及与其它方法的联合应用等方面作了大量的研究。本文就有关资料进行了综述,展示了家庭漂白的一些新的研究内容。     

家庭漂白研究进展

家庭漂白在临床上应用广泛。近年来,许多学者对其漂白机理、评价疗效的方法、有效性及稳定性、不良反应及与其它方法的联合应用等方面作了大量的研究。本文有关资料进行了综述,展示了家庭漂白的一些新的研究内容。     

一种实用的牙齿漂白技术

将国际公认的牙齿漂白药物过氧化脲加入无毒高分子成膜剂配成胶状液 ,涂于干燥牙面1— 2分钟形成附着于牙面的薄膜 ,可维持 1小时以上。此期间过氧化脲分解释放新生氧而将牙齿漂白。临床研究表明 :牙齿增白涂膜是一种安全、有效、实用的漂白牙齿方法。本产品已获中国专利 (专利号 :96 1186 0 5.4 ,PCT/ CN97/ 0 0 0 0 4 )     

牙齿漂白技术规范操作的研究进展

牙齿漂白技术作为牙科美容医学中的一项重要内容越来越多地受到了学者的关注,但如何规范操作,台合理掌握适应证,对提高漂美效果、发展牙齿漂美技术有着重要的作用。该文将对牙齿漂美技术的规范操作做一综述。     

个别托盘的制作及临床应用

在临床上要想获得一件精良的修复体 ,印模的准确与否是关键。印模要求边缘充分伸展 ,以不妨碍唇、颊、舌的生理活动为原则 ,且要使粘膜受力均匀。成品托盘很难达到如此要求 ,只有通过制作个别托盘进行二次印模的制取 ,来提高印模的准确性。　　　　一、二次印模适应症牙列缺失、游离端缺失、多间隙牙列缺损、连续缺牙数目较多者、精密附着体牙齿。二、材料与方法1.材料 :蜡片、自凝塑料粉、自凝单体、石蜡油、蜡刀、拌刀、橡皮碗、水、棉条、量杯、ＧＣ塑料模具。2 .方法 :①根据牙弓大小及缺牙情况 ,选取一付合适的成品托盘 ,调拌适量的海…     

牙齿增白涂膜的临床效果观察

目的：研制一种价廉且使用方便的牙齿增白剂。方法将国际公认的牙齿漂白药过氧化脲加入无毒高分子成膜剂配成胶状液,涂于干牙面１－２分钟形成附着于牙面的薄膜,可维持１小时以上,在临床上观察用此法漂白牙面面烟茶染色及治疗中、轻度氟斑牙、四环素牙的效果,结果漂白牙面烟茶染色的治愈率为９９．４５％,有效率为０．５５％,没有无效者,平均只需涂５．４次,中、轻度氟斑牙、牙面烟茶染色的治愈率为９９．４５％,有效率为０．５５％,没有无效者,平均只需涂５．４次。中、轻度氟斑牙、四环素牙治愈率分别为８４．０９％和７７．７８％,平均需涂膜次数分别为２０．３次和３６．５次。结论牙齿增白涂膜是一种简便有效的漂白牙齿方法,但用于治疗氟斑牙、四环素牙尚需进一步改进。     

低浓度家庭漂白系统的临床应用效果评价

目的:探讨分析10%Opalescence PF漂白系统在天然牙牙齿漂白中的临床效果。方法:选取西安交通大学口腔医院2017～2021年间40例进行牙齿漂白的患者作为研究对象。采用10%Opalescence PF漂白系统进行牙齿漂白，2周后利用Vita easyshade advance电子比色仪对漂白效果进行评价，并进行牙齿敏感度及患者满意度VAS量化分析。结果:40例患者经2周漂白后已行漂白治疗的牙齿颜色色阶均有显著提升(P<0.05),有效率为100%。漂白前后牙齿敏感度无统计学差异(P>0.05),且均表现为轻度敏感，患者对漂白效果满意度为100%,患者满意度与牙齿敏感性无相关性(P>0.05)。结论:10%Opalescence PF漂白系统在天然牙牙齿漂白中有显著效果。     

冠内外漂白和随行漂白对变色无髓牙的疗效评价

目的 评价冠内外漂白和随行漂白对变色无髓牙的漂白。方法 36例39颗变色无髓牙随机分成2组,冠内外漂白组用体积分数10%的过氧化脲漂白剂进行漂白;随行漂白组用体积分数35%的过氧化氢漂白剂进行漂白。记录2组患牙漂白前后的色阶值,计算漂白的有效率和所需时间。结果 冠内外漂白组有效率95%,随行漂白组有效率100%,差异无统计学意义(Z=-0.852,P=0.607)。冠内外漂白组和随行漂白组治疗时长分别为(16.37±1.98)d和(9.16±1.68)d,差异有统计学意义(t=12.125,P<0.001)。结论 冠内外漂白和随行漂白均能有效治疗变色无髓牙,随行漂白疗程更短。     

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。     

过氧化脲漂白凝胶对牙釉质光学性质的影响

目的　探讨过氧化脲漂白凝胶对牙釉质光学性质的影响。方法　采用Opalesence10 %过氧化脲凝胶在 40颗离体前磨牙上作家庭漂白实验。漂白前测出各牙釉质的最大透光度及此时的可见光波长λ 。在漂白 2周、4周、再矿化 1周 ,分别测出可见光波长λ 时牙釉质的透光度。结果　漂白前λ =72 1nm时 ,牙釉质透光度最大 ,为 2 5 .7%。漂白前透光度 (2 5 .7% )与漂白 2周的透光度 (37.9% )及漂白 4周透光度 (39.2 % )与再矿化 1周的透光度 (4 8.4% )有极显著性差异 (P <0 .0 0 1) ,而漂白 2周与漂白 4周的透光度无显著性差异 (P >0 .0 5 )。结论过氧化脲漂白凝胶使牙釉质透光性增强 ,脱色与脱矿作用并存 ,再矿化处理能提高及稳定漂白效果。     

10%过氧化脲漂白内源性着色活髓牙的疗效分析

目的观察10%过氧化脲漂白对不同原因内源性着色活髓牙的漂白效果。方法对36例患者568颗内源性着色活髓牙进行药物漂白治疗,其中增龄性变色牙72颗,四环素牙287颗,氟斑牙209颗。对照Vita比色板,观察记录其治疗前、后的色阶变化并评价其临床疗效。结果经不同时间的漂白治疗后,各组着色牙的色阶值显著降低(P<0.05)。不同原因着色牙的治疗效果不同,但其总体有效率差异无显著性(P>0.05)。结论10%过氧化脲漂白对不同原因导致的内源性着色活髓牙均有较好的漂白作用。     

Effect of bleaching agents and whitening dentifrices on the surface roughness of human teeth enamel

Abstract

Objective. The aim of this in vitro study was to evaluate the surface roughness of human enamel bleached with 10% carbamide peroxide or 10% hydrogen peroxide bleaching agents at different times and also subjected to different superficial cleaning treatments. Materials and methods. One hundred and forty flat enamel samples were divided into 14 groups, Group 1–Group 14 (G1–G14). G1–G7 were treated with 10% carbamide peroxide and different dentifrices, G8–G14 were treated with 10% hydrogen peroxide and different dentifrices (G1 and G8: not brushed as control groups; G2 and G9: brushed with Ipana® toothpaste; G3 and G10: brushed with Clinomyn® toothpaste; G4 and G11: brushed with Moos Dent® toothpaste; G5 and G12: brushed with Signal® toothpaste; G6 and G13: brushed with Colgate® toothpaste; G7 and G14: brushed without dentifrice). A profilometer was used to measure average roughness values of the initial surface roughness and at each 7-day-interval. The bleaching was performed for 6 h a day and the surface cleaning treatment was performed 3-times a day, 2 min each time, for 4 weeks. The samples were stored in distilled water during the test period. Results. Statistical analysis revealed significant differences in surface roughness values over time for all groups except G1 and G8 (not brushed). The results of the surface roughness of all groups were nearly the same. Conclusions. The bleaching with 10% hydrogen peroxide and 10% carbamide peroxide did not alter the enamel surface roughness, but when the bleaching treatment was performed combined with abrasive dentifrices, a significant increase in roughness values was observed.     

不同增稠载体的过氧化脲漂白剂对釉质表面形态的影响

目的:研究不同载体和浓度的过氧化脲(carbamide peroxide,CP)漂白剂对釉质表面形态的影响。方法:分别以Carbopol、PVP、Poloxamer为凝胶增稠载体,配制含100g/L、150g/L和200g/LCP的CP漂白剂(pH6.5)和不含CP的凝胶制剂,利用近期拔除的离体前牙牙冠分组观察CP漂白剂对釉质表面形态的影响。结果:以Carbopol,PVP或Poloxamer作为增稠载体的漂白剂,随着CP浓度的增高,釉质表面从轻度溶解、脱矿,蜂窝状改变,直至正常釉质层消失,"鱼鳞状"的釉柱结构清晰可辨。其中以Poloxamer为增稠载体的漂白剂较之更甚。结论:以Carbopol,PVP或Poloxamer作为增稠载体的漂白剂,随着CP浓度的增高,釉质表面出现不同程度的形貌改变。     

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.     

High-concentrated carbamide peroxide bleaching agents effects on enamel surface

Concern has been expressed regarding the adverse effects of peroxide-containing tooth bleaching agents on enamel surface. This study examined enamel average surface roughness before (baseline) and after an in-office bleaching protocol and investigated the influence of high concentrations of carbamide peroxide gels on its surface staining and morphology. Flat enamel surfaces were submitted to 35 and 37% carbamide peroxide or to no bleaching treatment (n = 10) and evaluated with a profilometer. Eight specimens from each group were randomly selected and immersed in a 2% methylene blue solution. Afterwards, specimens were ground into powder and prepared for the spectrophotometric analysis. Two remained specimens of each group were examined using a scanning electron microscope. Data were subjected to analysis of variance and Tukey test (P > 0.05). Baseline roughness average was statistically similar for all groups, however, 35% carbamide peroxide produced the roughest enamel surfaces. Different concentrations of carbamide peroxide produced similar staining means and enamel surface morphological alterations.     

漂白剂对玻璃离子水门汀类材料充填Ⅴ类洞边缘微渗漏的影响

目的评估漂白凝胶和洁白牙贴对3种不同的玻璃离子水门汀类材料边缘微渗漏的影响。方法在45颗离体健康前磨牙的颊舌侧制备Ⅴ类洞,随机分为A、B、C组,分别使用加强型玻璃离子水门汀KetacTM Molar Easymix、复合体F2000、复合体Dyract AP充填,每个大组再分为3个亚组,第1组和第2组分别使用质量分数14％过氧化氢（HP）洁白牙贴和10％过氧化脲（CP）凝胶进行漂白,第3组为对照组。所有样本置入37 ℃蒸馏水中保存7 d后冷热循环500次,然后进行漂白。漂白21 d后置于碱性品红溶液中染色24 h,沿牙体长轴通过充填体中央颊舌向剖开牙齿,体视显微镜下观察并测量染料渗入窝洞壁的深度。结果2种漂白方式对充填体边缘微渗漏的影响没有明显差异（P>0.05）;与对照组相比,2种漂白方式对B、C组的微渗漏均没有产生明显影响（P>0.05）,但均可使A组的微渗漏增加（P<0.05）。结论10％CP凝胶和14％HP洁白牙贴对充填体边缘微渗漏的影响无明显差异;漂白不会影响复合体的微渗漏,但会增加加强型玻璃离子水门汀的微渗漏。     

过氧化脲漂白剂对釉质显微硬度影响的实验研究

目的:评价不同载体和浓度的过氧化脲(carbam ide peroxide,CP)漂白剂对釉质表面显微硬度的影响。方法:在18个离体前磨牙的颊、舌面各制备2 mm×2 mm的平面,随机分为6组。分别用卡波姆(Car-bopol)、聚乙烯吡咯烷酮(PVP)或泊洛沙姆(poloxam er)为增稠载体的含11%、21%CP的漂白剂,在37℃100%湿度条件下每天漂白6~8 h,持续2周。漂白前、后测量釉质表面的显微硬度。21%CP治疗组在漂白治疗结束后继续浸入人工唾液2周,再次测量显微硬度。结果:11%CP漂白2周后,釉质的显微硬度与漂白前相比没有显著差异(P>0.05);21%CP漂白2周后,釉质的显微硬度明显低于漂白前(P<0.01),继续浸入人工唾液2周,显微硬度明显高于漂白后(P<0.05),但与漂白前相比仍有显著差异(P<0.05)。在相同CP浓度下,不同增稠载体组间的显微硬度没有显著差异(P>0.05)。结论:11%CP漂白剂对釉质的显微硬度没有影响,21%CP漂白剂可明显降低釉质的显微硬度,人工唾液可在一定程度上增加釉质的再矿化能力,不同的增稠载体对釉质的显微硬度没有明显影响。     

In vitro penetration of bleaching agents into the pulp chamber

AIM: To investigate pulp chamber penetration of bleaching agents in teeth following restorative procedures. METHODOLOGY: Bovine lateral incisors were sectioned 3 mm apical to the cemento-enamel junction and the coronal pulpal tissue was removed. Teeth were divided into six groups (n = 10): G1, G2 and G3 were not submitted to any restorative procedure, while G4, G5 and G6 were submitted to Class V preparations and restored with composite resin. Acetate buffer was placed in the pulp chamber and treatment agents were applied for 60 min at 37 degrees C as follows: G1 and G4, immersion into distilled water; G2 and G5, 10% carbamide peroxide (CP) exposure; G3 and G6, 35% CP bleaching. The buffer solution was removed and transferred to a glass tube where leuco crystal violet and horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined spectrophotometrically at 596 nm. A standard curve made with known amounts of hydrogen peroxide was used to convert the optical density values of the coloured samples into microgram equivalents of hydrogen peroxide. Data were submitted to anova and Tukey's test (5%). RESULTS: Amounts of hydrogen peroxide found in the pulp chamber of G2 and G5 specimens (0.1833 +/- 0.2003 micro g) were significantly lower (P = 0.001) when compared to G3 and G6 specimens (0.4604 +/- 0.3981 micro g). Restored teeth held significantly higher (P = 0.001) hydrogen peroxide concentrations in the pulp chamber than intact teeth. CONCLUSION: Higher concentrations of the bleaching agent produced higher levels of hydrogen peroxide in the pulp chamber, especially in restored teeth.