三种黏结材料对中、重度氟斑牙正畸托槽脱落率的影响

Effect of three bonding adhesives on the orthodontic bracket loss rate in treating moderate and severe dental fluorosis

背景:由于氟斑牙釉质的特殊结构,氟斑牙患者在正畸治疗中,采用的传统黏结材料常导致托槽与牙面之间的黏结强度降低,托槽频繁脱落,严重影响了氟斑牙患者的疗效。目的:观察3种不同黏结材料黏结中、重度氟斑牙临床托槽脱落率的差别。方法:选择正畸氟斑牙患者15例(共288颗),年龄13～26岁,男6例,女9例,随机分为3组,分别用京津釉质黏合剂黏接托槽、光固化流动树脂+Single Bond 2黏结剂黏接托槽、氟斑牙表面釉质少量磨除直接贴面黏接托槽,观察托槽的脱落率。结果与结论:3个月后京津釉质黏合剂黏接托槽组、光固化流动树脂+Single Bond 2黏结剂黏接托槽组、氟斑牙表面釉质少量磨除直接贴面黏接托槽组托槽的总脱落率分别为65.6%,20.5%,2.5%。3种黏结材料临床托槽脱落率差异有非常显著性意义(P<0.01)。提示表面釉质少量磨除直接贴面黏接托槽效果最好,其次为光固化流动树脂+Single Bond 2黏结剂黏接托槽组,两者都明显优于京津釉质黏合剂黏接托槽组。由于直接贴面需要磨除部分牙体组织,部分患者难以接受,因此在不破坏牙体组织前提下用光固化流动树脂+Single Bond 2黏结剂黏接托槽代替传统的京津釉质黏合剂黏接托槽可以有效降低中、重度氟斑牙托槽的脱落率。

BACKGROUND：Because of the special structure of enamel fluorosis,the traditional bonding adhesives often lower the bonding strength and increase bracket loss rate,which affected the therapeutic effects seriously.OBJECTIVE：To observe the clinical bracket loss rate differences among the 3 different bonding adhesives in treating moderate and severe dental fluorosis.METHODS：A total of 15 cases（total 288 teeth）with dental fluorosis were selected,including 6 males and 9 females,aged 13-26 years.All cases were randomly divided into 3 groups,and treated by using Beijing-Tianjin enamel adhesive bonding brackets,photo-curing-flowable Resin＋Single Bond 2 adhesive bonding brackets and a small amount of dental fluorosis of enamel surfaces were ground and bonding bracket,the loss rate of brackets were observed.RESULT AND CONCLUSION：The total loss rates of the Beijing-Tianjin-enamel adhesive bonding bracket group,photo-curing flowable resin＋Single Bond 2 adhesive bonding bracket group,and a small amount of dental fluorosis of enamel surfaces were ground and bonding bracket group were 65.6%,20.5%,and 2.5%,respectively.There was significant difference in bracket loss rate among bonding adhesives（P0.01）.It suggested that a small amount of surface enamel were ground and bonding bracket got the best effect,followed by photo-curing flowable resin＋Single Bond 2 adhesive bracket bonding group,both of them were significantly better than the Beijing-Tianjin-enamel adhesive bracket bonding group.Because veneering directly requires to grind part of the tooth structure which is difficult to accept for some patients,therefore,under the premise of not destroying the tooth structure,using photo-curing flowable resin＋Single Bond 2 adhesive bonding of brackets instead of the traditional Beijing-Tianjin enamel adhesive bonding of brackets can effectively reduce the loss rate of brackets for moderate and severe dental fluorosis.