正畸治疗中氟化物抑制牙釉质脱矿的体外研究

Inhibition of enamel decalcification with fluoride during orthodontic treatment in vitro

目的通过KaVo DIAGNOdent激光荧光诊断仪定量测量牙釉质表面矿化程度和扫描电镜(SEM)观察超微结构,研究固定矫治中牙釉质脱矿的发生及局部应用氟化物的预防作用。方法选择60颗离体前磨牙为研究对象,随机分为4组。分别用复合树脂粘结剂(DM正畸釉质粘结剂)和正畸专用自酸蚀光固化粘结剂(Transbond^(TM) Plus Self Etching Primer)粘结托槽。其中两组涂Fluor Protector氟漆。在人工脱矿液及人工唾液中交替浸泡60d。用KaVo DIAGNOdent激光荧光诊断仪测量托槽周围釉质表面的脱矿程度,并选取试样用扫描电镜观察牙釉质表面。结果利用DIAGNOdent进行人工龋损的定量诊断:各组样本处理前的DIAGNOdent的读数基线值无统计学差异。经酸性溶液中脱矿和人工唾液处理后各组的DIAGNOdent读数值均有升高,差异有统计学意义(P<0.05)。用扫描电镜观察发现应用氟化物后牙釉质表面的超微结构表面反应物沉积增多,凹陷减少,表面平整。结论氟化物对体外环境下托槽周围釉质脱矿有明显的抑制作用。

Objective To investigate the effect of local application with fluoride on enamel decalcification during orthodontic treatment. Methods Sixty extracted premolars were randomly divided into 4 groups： edgewise brackets were bonded with composite resin （DM） or with resin- modified glass ionomer（ TransbondTM Plus Self Etching Primer） ; and fluoride vanish was applied on the enamel surface of samples in two group. After the artificial caries attack for 60 d, the enamel lesions of demineralization was observed by KaVo DIAGNOdent and scanning election microscopy （SEM）. Results The quantitative analysis by DIAGNOdent showed that there was no significantly difference among each group before treatment; the values of DIAGNOdent were higher after dipping into demineralization solution and there were statistically significant differences between each group （P 〈 0.05 ）. SEM demonstrated that in fluoride treatment groups the surface was more even and hollows were lighter; the mineral was absorbed more equally in enamel surface and linked together. Conclusion Local application of fluoride can inhibit demineralization in vitro.