VivaSens脱敏剂在牙齿冷光美白术中预防牙本质敏感的应用及效果评价

Application of VivaSens desensitizer in preventing dental hypersensitivity in cold light bleaching and evaluation on its effect

目的：探讨Beyond冷光美白治疗前应用VivaSens脱敏剂对美白术后牙齿敏感治疗的有效性及对美白效果的影响，阐明其在冷光美白术中的应用价值。方法：选择门诊牙齿冷光美白患者15例，共299颗患牙。以患者的上颌牙列或下颌牙列（包括前牙及前磨牙）的牙列整体作为观察单位，随机确定每个患者上颌牙列或下颌牙列作为实验组和对照组。实验组患者15例，共150颗患牙，其中上颌牙列8个，下颌牙列7个；对照组15例，共149颗患牙，其中上颌牙列7个，下颌牙列8个。实验组术前使用VivaSens脱敏剂，对照组应用安慰剂。术前、术后应用探针测试法和冷空气测试法测定并记录患者患牙的敏感度，记为0～10。术后发放调查问卷，询问术后24和48h有无牙齿敏感症状。术前、术后应用Vita比色板进行比色并做色阶记录。结果：术后即刻，实验组101颗患牙（94．0％）和对照组全部患牙（100％）出现了牙本质敏感，牙本质敏感发生率组间比较差异有统计学意义（P〈0．01）；术后24h，实验组有22颗患牙（14．7％）、对照组有75颗患牙（50．3％）仍有牙本质敏感症状，牙本质敏感发生率组间比较差异有统计学意义（P〈0．01）；术后48h，实验组患牙牙本质敏感症状均消失，对照组仍有16颗患牙（10．7％）有牙本质敏感症状，牙本质敏感发生率组间比较差异有统计学意义（P〈0．01）。实验组各阶段牙本质敏感度均低于对照组（P〈0．05）。Vita比色板比色，术后与术前比较，实验组与对照组均提高了约5个色阶，2组问美白效果比较差异无统计学意义（P〉0．05）。结论：VivaSens脱敏剂能有效降低冷光美白术后牙本质敏感发生率和敏感度，而且不影响冷光美白的效果。

Objective To investigate the effect of using the VivaSens desensitizier on tooth-whitening surface before bleaching with Beyond cold light and efficacy of bleaching and to clarify its application value in cold light bleaching. Methods 15 patients who deserved the treatment were chosen, in total of 299 teeth, their upper or lower dentitions were used as a sample. The upper dentitions （including anterior teeth and premolar teeth） or lower dentitions （including anterior teeth and premolar teeth ） from the same patient were randomly divided into experimental group （n=15, 150 teeth, 8 upper dentitions, 7 lower dentitions） and control group （n= 15, 149 teeth, 7 upper dentitions, 8 lower dentitions）. Before bleaching, the VivaSens desensitizer was applied on the buccal surfaces in experimental group, and a placebo gel was applied on the buccal surfaces in control group. The tooth hypersensitivities of the patients were measured by probe and cold air test before and after treatment with a 0-to-10 scale, and the postoperative questionnaires about dental hypersensitivity after 24 and 48 h were performed. The tooth shades were determined by comparison with a Vita Shade Guide. Results 101 teeth （94%） in experimental group and all of teeth in control group experienced dental hypersensitivity right after bleaching （P〈0.01）. After 24 h, 22 teeth （14.7%） in experimental group still had dental hypersensitivity, while 75 teeth （50.3%） in control group had, there was significant difference of incidence of dental hypersensitivity between two groups （P〈0. 01）; after 48 h, the dental hypersensitivity in experimental group disappeared, but 16 teeth （10.7%） in control group still had, there was significant difference of incidence of dental hypersensitivity between two groups （P〈0. 01）. The dental hypersensitivities in experimental groups during different stages were lower than those in control group （P〈0.05）. The Vita Shade Guide results showed that before and after bleaching, experimental and control group showed a change of 5 Shade Guide Units after treatment compared with before treatment; and there was no difference of bleaching effect between two groups （P〉0.05）. Conclusion VivaSens desensitizer could effectively reduce the incidence and intensity of postoperative hypersensitivity without affecting the bleaching effect.