氟保护漆与含氟自酸蚀粘结剂预防固定正畸治疗早期釉质脱矿的临床研究

Effect of Fluoride Varnish and Self-etching Bonding System on Prevention of Enamel Decalcification in Early Orthodontic Treatment

目的:对氟保护漆与含氟自酸蚀粘结剂预防固定正畸治疗早期釉质脱矿的临床效果进行对比研究,寻找一种更为有效的氟化物应用方法。方法:随机选择接受固定正畸治疗的青少年患者22名,在每个患者的1区和3区使用含氟自酸蚀粘结剂粘固托槽,在2区与4区常规酸蚀后使用化学固化型京津釉质粘结剂粘固托槽,随后涂布氟保护漆。采用DIAGNOdent激光荧光诊断仪分别对不同区域的牙面釉质脱矿程度进行定量诊断,并在患者1个月、3个月复诊时重复监测。结果:粘结完成即刻与粘结后1个月时,含氟自酸蚀粘结剂使用区(1区、3区)与涂氟保护漆区(2区、4区)之间DIAGNOdent读数均有显著性差异(P<0.05),前者读数低于后者。粘结后3个月时,两组间的DIAGNOdent读数无显著性差异。结论:含氟自酸蚀粘结剂降低了正畸托槽粘结时釉质的脱矿程度,在一定程度上有利于减轻正畸治疗早期釉质脱矿的进一步发生、发展。氟保护漆在促进脱矿釉质再矿化方面的作用优于含氟自酸蚀粘结剂。

Objective： To evaluate the effect of fluoride varnish and self--etching fluoride--releasing bonding sys- tem on prevention of enamel decalcification in early orthodontic treatment, and from these two agents, the best flu- oride was chosen. Methods： Twenty two patients treated with fixed appliance were randomly selected. The brackets were bonded with self--etching bonding system in the quarter of number 1 and 3. After conventional etching on en- amel in the quarter of number 2 and 4, the brackets were bonded with composite resin enamel adhesive. The enamel decalcification of all quarters were detected by DIAGNOdent, the fluoride vanish was applied on the enamel surface around brackets in the quarter of number 2 and 4 subsequently. The detection were repeated after one and three months. Results： Immediately after bonding and one month later, the DIAGNOdent readings of self--etching bond- ing system region was lower significantly than that of composite resin enamel adhesive region （P〈~0.05）, but there was no significant statistically difference after three months. Conclusion： The application of self--etching bonding system can decrease enamel decalcification after brackets bonding, and to some extent prevent the development of enamel decalcification in early orthodontic treatment. Fluoride varnish had better effect on enamel remineralization.