Beyond冷光牙齿漂白技术对人牙髓影响的组织病理学研究

目的 探讨Beyond冷光牙齿漂白技术对牙髓的影响.方法 选择因正畸要拔除的40颗活髓牙,对照组(10颗)不做任何处理拔除,其余30颗采用Beyond冷光漂白后分别即刻拔除(15颗)和漂白七天后拔除(15颗).40颗牙齿均制作病理切片,镜下观察牙髓组织形态.结果 所有活髓牙漂白前后均未发现有任何临床症状.漂白后即刻拔除组、七天后拔除组以及对照组在镜下均表现为正常的牙髓组织结构,漂白组较对照组牙髓组织无明显改变.结论 Beyond冷光牙齿漂白技术对活髓牙牙髓无明显不良影响,是一项安全可靠的漂白技术.     

三种牙齿漂白方案的短期效果比较研究

目的:体外评价三种漂白方案对人牙齿漂白的短期效果.方法:36颗刚拔除的人牙,沿唇(颊)舌方向中央剖开去髓后,随机分成三组,联合漂白组(A):38%HP45min/d×1+15%CP 8h/d×4;诊室漂白组(O):38%HP45min/2×2,家庭漂白组(H):15%CP 8h/d×14.分别于漂白前,漂白后即刻(0天),4天、7天、14天、21天用Crystaleye分光光度计电脑比色仪拍摄牙齿唇(颊)面照片,分析测量牙齿体部靠近中线区的漂白前后△E值.结果:疗程结束时,3组漂白效果无统计学差异(P>0.05);3组在漂白结束后4天时与漂白结束△E有统计学差异,但H组在7天后△E无统计学差异,而A、O组2周、3周时仍有统计学差异.结论:三种漂白方案短期内都有颜色回复,但回复量和持续时间不同.     

无髓变色牙内漂白113例疗效观察

目的 评价应用Beyond冷光美白和30％过氧化氢加过硼酸钠漂白技术对无髓变色牙进行牙内漂白的临床疗效.方法 无髓变色牙患者113例随机分为3组,分别采用30％过氧化氢加过硼酸钠(A组)、Beyond冷光美白技术(B组)、Beyond冷光美白技术复合常规内漂白(C组)进行牙内漂白,观察其有效率.结果 第1次复诊时有效率,A组29.7％,B组48.6％,C组68.4％,C组有效率高于另A、B组(P＜0.05).第6次复诊时有效率,A组54.1％,B组76.3％,C组97.3％,C组有效率高于另A、B组(P＜0.05).牙齿变色后与开始牙内漂白的时间间隔越短,达到满意疗效的治疗次数越少,A、B、C组平均治疗次数分别为16次、12次和7次.结论 Beyond冷光美白技术复合常规牙内漂白对无髓变色牙有显著增白作用,常规Beyond冷光美白次之,30％过氧化氢加过硼酸钠漂白技术牙内漂白效果较差.     

氟化物与过氧化氢类漂白剂联用对大鼠牙髓影响的组织病理学观察

目的从组织学水平观察高浓度漂白剂与氟化物联用对大鼠牙髓的影响。方法将60只大鼠按处理方法不同随机分为加NaF漂白组、漂白组和空白组,其中NaF漂白组和漂白组分别按5、10和15 min 3个不同的治疗时间进行漂白处理,然后对即刻、3 d后和7 d后的牙髓情况进行组织病理学观察。结果全部受试牙中仅有1/3出现轻度牙髓反应,没有出现中度或重度牙髓反应,并且这些轻微牙髓反应在治疗结束后即可出现,一般在2周内恢复正常,NaF漂白组和漂白组之间无统计学差异。结论动物实验结果显示高浓度过氧化氢类牙齿漂白治疗可引发轻微、局限性的牙髓反应,漂白治疗术前氟化物的应用对牙髓反应等级无明显影响。     

去髓年轻恒牙牙髓组织再生的动物实验

目的 观察年轻恒牙去髓后牙髓组织的再生状态,研究牙髓组织的再生过程,为进一步探讨牙髓组织的再生机制提供依据.方法 选取4只Beagle犬,每只犬8颗单根管上下颌切牙作为实验牙,拔除上下颌切牙牙髓并使血块充满髓腔,严密封闭开髓孔,分别于术后第7、14、21、28天处死动物,对牙齿及颌骨标本进行组织学观察.对照牙为2颗下颌切牙,未作任何处理.结果 实验第7、14、21、28天实验牙根管内均富含细胞、血管分化良好的新生组织长入,并随观察时间的延长而增多,28 d时新生组织基本长满髓腔.根尖部及根中部可见硬组织沉积,部分牙齿的根管内壁有钙化组织沉积,管壁增厚.对照牙根管内为正常牙髓组织.结论 在保持根管无菌并严密封闭开髓孔的情况下,Beagle犬年轻去髓牙髓腔内可以再生分化良好的牙髓样组织.     

临床活髓牙漂白技术研究进展

近年来临床活髓牙漂白技术得到广泛的推广与运用,各类新技术仍主要围绕过氧化物的漂白作用进行改良,探寻过氧化物最合理的应用方式.但是,过氧化物也会引起牙齿敏感、釉质显微硬度下降等不良反应,如何在预防过氧化物对牙髓等牙体组织的伤害前提下,提升美白效果是当下活髓牙漂白方面的主要研究热点.该文就目前临床活髓牙漂白技术临床效果研究...     

髓室内酸蚀对离体牛牙内漂白后颜色影响研究

目的    研究髓室内酸蚀对离体牛牙内漂白后颜色的影响。方法    60颗离体牛牙样本使用注射器从根尖孔处注入0.5 mL质量浓度为4 g/100 mL的红茶溶液进行染色,之后随机分为2组,其中30颗样本酸蚀30 s后进行牙齿内漂白（酸蚀组）,30颗样本未经酸蚀直接进行牙齿内漂白（未酸蚀组）。两组样本牙分别在染色前、染色后、漂白后即刻及漂白后1、3、5、7 d使用比色仪进行比色,计算色阶改变并进行统计学分析。结果    （1）两组样本牙在漂白后即刻颜色差异不明显,在漂白后1～3 d内颜色回复明显;（2）两组样本牙在3 d内颜色回复最大,在4～7 d内颜色趋于稳定;（3）未酸蚀组样本牙颜色回复高于酸蚀组。结论    髓室内酸蚀可以加强离体牛牙内漂白效果。     

极固宁TM对活髓基牙牙髓组织影响研究

目的 研究极固宁TM对金属烤瓷全冠活髓基牙牙体预备后1、2周牙髓组织形态学的影响。方法 选择2012年1月至2013年8月在福建医科大学附属口腔医院就诊患者15例,因正畸治疗需要而计划拔除40颗前磨牙（同一患者的同颌同名牙20对）,将每对同颌同名牙随机分为对照组和试验组。对照组：金属烤瓷全冠牙体预备后直接用氧化锌丁香油水门汀黏固暂时冠;试验组：在牙预备体上涂布极固宁TM后用氧化锌丁香油水门汀黏固暂时冠。分别于牙体预备后1、2周局麻下拔除同颌同名研究牙。常规组织病理切片,HE染色,显微镜下观察评价牙髓组织反应并测量颊侧髓角的剩余牙本质厚度。结果 金属烤瓷全冠牙体预备后1、2周时,试验组与对照组的牙预备体颊侧髓角的剩余牙本质厚度差异均无统计学意义（P > 0.05）。活髓基牙全冠牙体预备后1周,对照组的牙髓组织炎症反应比试验组严重（P < 0.05）;而牙体预备后2周,对照组与试验组的牙髓组织反应差异无统计学意义（P > 0.05）。不论是金属烤瓷全冠牙体预备后1周或2周,所有样本均未见第三期牙本质的形成。 结论 极固宁TM在金属烤瓷全冠牙体预备后1周时可降低活髓基牙牙髓组织的炎症反应。     

低温冷冻保存对人牙本质和牙髓细胞生物学性能影响的初步研究

目的：比较人离体牙在低温冷冻保存前后的牙本质和牙髓细胞的生物特性,探讨其应用价值。方法：收集需要拔除的无龋坏、无缺损新鲜离体前磨牙或第三磨牙40颗。其中20颗离体牙制成牙本质盘标本,随机分为程序降温组和新鲜拔除组,每组10颗;冻存复苏后,进行力学分析以及用扫描电观察两组标本的牙本质表面和纵剖面。剩余20颗牙使用改良组织块法原代分离牙髓细胞,冻存复苏后,观察分析冻存前后的细胞形态及生长特性。结果：低温冷冻保存复苏后,离体牙的牙本质和牙髓细胞的生长特性的情况均无明显差异。结论：应用程序低温冷冻技术保存牙齿,牙体牙髓组织生物学特性均能保持良好。     

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目的探讨Beyond冷光美白技术对活髓变色牙齿进行漂白时敏感发生情况。方法于2009年6月至2010年3月在解放军第463医院口腔门诊用Beyond冷光美白仪及配套的冷光美白剂对30例患者的活髓变色牙齿进行漂白,其中10例患者术前曾服用止痛剂,分别观察术中、术后24、72h及1周患者牙齿敏感情况。结果术前服用止痛剂者均未出现敏感症状;未服用者术中有14例(70.0%)患者有程度不等的牙齿敏感症状,其中2例(14.3%)患者出现牙髓刺激症状,术后24h17例(85.0%)患者有不同程度牙齿敏感症状,术后72h至1周可自动消除,未见有牙髓炎症状发生。结论 Beyond冷光美白技术对牙髓的刺激性为可复性、短时性、一过性。术前如进行完善彻底检查,给予口服止痛剂,术中规范操作将有助于减少敏感疼痛发生。     

The dental pulp: inflammatory markers and vital bleaching

PURPOSE: To evaluate the expression of specific neuropeptides associated with inflammation, substance-P (SP) and calcitonin gene-related peptide (CGRP), after night guard vital bleaching with 10% carbamide peroxide gel. METHODS: 10 patients with four caries free premolars scheduled for orthodontic extraction had these teeth bleached with 10% Opalescence as follows: tooth #28, no treatment (control); #5, 4 days of bleaching; #12, 2 weeks of bleaching; #21, 2 weeks of bleaching, followed by 2 weeks without treatment. All teeth in the four groups were extracted at the same time. Immediately after extraction the teeth were frozen at -197 degrees C in liquid nitrogen. The pulp samples were prepared for enzyme-linked immunoabsorbent assay (ELISA) to determine the concentrations of the SP, CGRP and total protein in the pulp tissue. RESULTS: The analysis of mean SP and mean CGRP/ng protein/ml resulted in no significant differences among the four groups. It was concluded that the study did not demonstrate an increase in the release of SP and/or CGRP during night guard vital bleaching of teeth with 10% Opalescence.     

活髓牙冷光美白临床效果评价

目的    探讨活髓牙冷光美白的临床效果。方法    选择2011年8月至2014年8月在上海交通大学医学院附属第九人民医院口腔修复科接受Beyond冷光美白治疗的患者206例,按着色原因分为氟斑牙、四环素牙、外源性着色及其他原因4组。用视觉评价法和比色仪法评价漂白对牙色的影响,并追踪漂白后24 h、1周及3个月的牙色反弹情况。用视觉模拟评分法评价漂白完成即刻、漂白后24 h和1周牙敏感度的变化。结果    牙色评价中除四环素牙效果略差外,其他类型的着色牙漂白均有显著效果,且在追踪的3个月内未发现明显的反弹现象。牙漂白后的敏感多出现在漂白后24 h内。除氟斑牙外,其余类型着色牙的敏感程度在漂白24 h后即与漂白前差异无统计学意义（P > 0.05）;氟斑牙在漂白后1周可恢复至漂白前敏感程度。结论    冷光美白用于临床活髓牙漂白可取得基本稳定、满意的效果。     

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??Objective    To evaluate the clinical effectiveness of a light-activated bleaching system on vital teeth. Methods    Two hundred and six cases bleached by ‘Beyond’ light-activated bleaching system during three years were included in the study to evaluate the effectiveness. All the cases were divided into four groups??dental fluorosis??tetracycline stained teeth??extrinsic stained teeth and others. Visual determination of shade and spectrophotometer were used to measure the tooth discoloration immediately after bleaching. After twenty-four hours??one week and three months of follow-up??assess the rebound of color. Assessment of tooth sensitivity was carried out by visual analogue scale immediately??twenty four hours and one week after bleaching. Results    Satisfactory effectiveness was achieved in all groups except the group of tetracycline stained teeth. No obvious rebound of color was observed in the period of three months. Tooth sensitivity only occurred within twenty hours after bleaching. Except in the group of dental fluorosis??after 24 hours of bleaching tooth sensitivity in other groups had no difference ??P > 0.05?? compared with that before bleaching. The level of tooth sensitivity in group of dental fluorosis also recovered within one week. Conclusion    Stable and satisfactory effectiveness can be achieved in vital tooth bleaching by light-activated bleaching system.     

Er:YAG激光应用于牙齿漂白的研究进展

Er:YAG激光漂白作为一种新型牙齿漂白方法,与传统漂白技术相比,Er:YAG激光显著提高了漂白效率,具有安全性高、治疗时间短及漂白效果优异等优点,被广泛应用于临床操作.本文就Er:YAG激光漂白技术的作用原理、漂白特点及对牙体组织结构的影响作一综述.现有文献表明,Er:YAG激光对水和羟基磷灰石的高吸收特性使其可以作...     

Pulp reaction to vital bleaching

This study evaluated the histological changes in dental pulp after nightguard vital bleaching with 10% carbamide peroxide gel. Fifteen patients between 12 and 26 years of age with caries-free first premolars scheduled for orthodontic extraction were treated with 10% Opalescence (Ultradent Products, Inc). Tooth #5 had four days of bleaching, tooth #12 was treated for two weeks, tooth #21 was bleached for two weeks followed by two weeks without treatment and tooth #28, serving as the control, was without treatment. All teeth were extracted at the same time. Immediately after extraction, 4 mm of the most apical portion of the root was sectioned off and each specimen was placed in a vial containing 10% neutral buffered formalin. The samples were prepared for histological evaluation at the Scandinavian Institute of Dental Materials (NIOM) and microscopically examined independently at both NIOM and Indiana University School of Dentistry (IUSD). Pulp reactions were semi-quantitatively graded as none, slight, moderate and severe. Slight pulpal changes were detected in 16 of the 45 bleached teeth. Neither moderate nor severe reactions were observed. The findings indicate that the slight histological changes sometimes observed after bleaching tend to resolve within two weeks post-treatment. Statistical differences existed only between the untreated control and the four-day (p=0.0109) and two-week (p=0.0045) treatment groups. The findings from this study demonstrated that nightguard vital bleaching procedures using 10% carbamide peroxide might cause initial mild, localized pulp reactions. However, the minor histological changes observed did not affect the overall health of the pulp tissue and were reversible within two weeks post-treatment. Therefore, two weeks of treatment with 10% carbamide peroxide used for nightguard vital bleaching is considered safe for dental pulp.     

Longhurst釉质微打磨后漂白牙釉质表面形态的扫描电镜观察

目的：观察牙齿Longhurst法釉质微打磨以及与家庭漂白联合应用后釉质表面形态的变化。方法：24个离体牙随机分为3组,组为对照组,B组采用Longhurst釉质微打磨,即35%磷酸酸蚀,然后钨钢车针打磨,组采用ACLonghurst法打磨后家庭漂白4周,通过扫描电镜观察釉质表面形态的变化。结果：Longhurst法釉质微打磨后牙釉质表层釉柱结构消失,继续漂白4周,釉质不规则孔隙增多。结论：Longhurst是釉质表面的机械磨除,而随后的漂白可造成釉质的脱矿表现。     

Effect of pulp protection technique on the clinical performance of amalgam restorations: three-year results

This study evaluated the influence of the pulp protection technique on clinical performance of amalgam restorations after three years, with particular reference to post-operative sensitivity and secondary caries. One hundred and twenty (120) Class II amalgam restorations (68 premolars, 52 molars; 78 MOD, 42 OD/MO) were placed in 30 participants (four restorations per participant). The restorations were divided into four groups according to the pulp protection technique used: copal varnish; 2% neutral sodium fluoride; adhesive resin and no pulp protection. The parameters evaluated were post-operative sensitivity, staining of the dental structure, tooth vitality, partial or total loss of the restoration and secondary caries. One hundred and eight (108) restorations were available for evaluation after three years. No partial or total loss of restorations had occurred; all teeth were vital, no tooth structure staining or secondary caries was detected in any of the restored teeth. Post-operative sensitivity was observed only in two restorations at baseline and at seven-days. The three-year clinical performance of teeth restored with a high copper dispersed phase amalgam was not affected by the choice of pulp protection technique.     

半导体激光漂白四环素牙的疗效观察

目的:评价半导体激光漂白四环素牙的临床效果和安全性。方法:采用自制漂白糊剂,对9例68个四环素活髓牙进行半导体激光漂白,分别于术前、术后、术后一周和术后一月进行牙髓敏感测试和测色,分析牙髓敏感性及牙色变化。结果:所有漂白的牙齿术后牙髓敏感程度均在正常范围内。术后牙齿增白明显,VITA比色板色级和色差值有显著性改变。结论:半导体激光漂白四环素牙是快速和安全的,短期漂白效果明显。     

Multiple external cervical root resorptions after home whitening treatment: a case report

Invasive multiple cervical root resorptions after vital tooth bleaching is a rare condition. The aim of this article is to present a case of multiple external cervical root resorptions (ECRR) after a misguided home whitening treatment. A 34 year old male patient presented with slight sensitivity and mobility in several teeth. Despite the manufacturer's recommendations, the patient used a 22% carbamide peroxide‐based tooth bleaching gel at home for 4 days consecutively, at night, on the upper and lower arches. Clinical examination revealed gingival swelling, probing depths ranging 5–7 mm on the buccal and proximal surfaces, and grade 2 mobility of the teeth affected by ECRR. Radiographs revealed presence of ECRR in several teeth during initial examination, and development of multiple new lesions 6 months later. The teeth were subsequently extracted. Histological analysis showed multiple dentine lacunae and areas of dentine reparation. The careful use of these products can prevent sequelae such as those reported in this clinical case. As the vital bleaching has a variable success rate, patients should be informed through a consent form of the benefits and risks of tooth bleaching treatment.