氟化物及再矿化物对牙本质小管封闭效果的研究

目的：探索氟化物及再矿化物对牙本质小管的封闭效果。方法：选择8个因正畸治疗拔除的前磨牙,制作牙本质暴露模型,分为4组,每组2个牙。空白对照组：牙本质暴露模型牙不作任何处理;单纯酸蚀组：离体牙模型涂320g/L正磷酸凝胶酸蚀1min后冲洗,林格氏液中保存;酸蚀序列给药组：离体牙模型经酸蚀后涂敷100g/L氟化钠凝胶1h,冲洗,吹干后涂敷再矿化凝胶1h,冲洗后置林格氏液中保存,每天一次,连续7d;非酸蚀序列给药组：按酸蚀序列给药组方法,只是序列给药前不进行酸蚀处理,每天一次,连续7d。然后应用扫描电镜观察各组标本牙横断面和纵面牙本质表面的形貌改变;应用电子能谱仪测量各实验面氟、磷、钙元素质量分布比例的变化。结果：扫描电镜图像可以看到酸蚀序列给药组及非酸蚀序列给药组的牙本质表面有大量矿物质堆积覆盖,且酸蚀序列给药组矿物质表面层均匀、厚实。电子能谱仪检测显示,横断面边缘点氟含量比例在非酸蚀序列给药组明显增高,纵面表面检测氟、钙元素的比例在酸蚀序列给药组及非酸蚀序列给药组均显著增高,以酸蚀序列给药组更显著。结论：对牙本质敏感症的治疗,若采用酸蚀--氟化物--再矿化物涂敷的治疗程序,氟元素可以向缺损面深层渗透,在暴露的牙本质上形成表面层,或者沉积,堵塞牙本质小管,从而使牙本质小管的封堵作用更加完善。

An experimental study on the effects of occlusion of dentinal tubules by fluoride and remineralization

Objective：To research the occlusion of fluoride gel and remineralization gel on dentinal tubules. Method： 8 premolars were divided into 4 groups randomly. Ground adamantine layer, and made the dentinal canals completely exposed. Group 1 didn＇t do any treatment to the premolars and made it as the blank group： group 2 just etched the premolars with 320 g / L orthophosphoric acid gel. group 3 as the etching and sequential medication administration team, applied 100 g / L sodium fluoride gel lh once every day after etching, washed the fluoride gel out by water, dried the premolars, applied remineralization gel one lh once every day,and then conserved them in the Ringer＇s solution,repeated this process 7 days; group 4 as the non-etching and sequential medication administration team, according to the group 3, but no etching process. Observed the occlusion on the dentinal tubules,measured the F,P, Ca elements quality distribute of the premolars surface by the electron spectrometer. Result： We can find that the dentinal tubules were completely covered with the mineral substance in group 3 and group 4 by the scanning electron microscope,and the mineral substance layer was more well-proportioned and thicker in group 3 the content of the F proportion was notably heighten in the premolars＇ transverse section marginal point and the content of the F and Ca proportion were remarkably heighten in the premolars＇ vertical section by the electron spectrometer. Conclusion： If we use the treatment of etching - fluoride - remineralization to cure the dental hypersensitiveness, the element F can permeate to the deep layer of the coloboma, form the superficial layer of the exposed dentine and occlude the dentinal tubules, the effective of the dental hypersensitiveness could better improve.