生物活性玻璃与氟保护漆联合应用治疗牙本质过敏症临床疗效研究

Effects of bioactive glass combined with fluor varnish on dentin hypersensitivity

目的评价含生物活性玻璃成分的脱敏剂与氟保护漆联合应用对牙本质小管的堵塞效果及治疗牙本质过敏症(dentin hypersensitivity,DH)的临床疗效。方法选择2013年6月到2014年6月到中国医科大学口腔医学院干诊科就诊的59例DH患者的120颗患牙,随机分为A组(41颗)、B组(39颗)、C组(40颗),分别使用氟保护漆、奥敏清及氟保护漆与奥敏清联合涂布敏感处,应用视觉模拟评分(visual analogue scale,VAS)法评价其疗效。另选择因正畸需要拔除的完整无龋坏前磨牙20颗,制备成敏感模型后随机分为a、b、c、d四组,每组5颗,a、b、c三组处理方法同上述A、B、C组,d组为空白对照组,用蒸馏水进行处理,扫描电镜观察各组牙本质小管的堵塞情况。结果 A、B、C三组的VAS评分值在处理即刻均明显下降,且随时间推移均有增高趋势;有效率比较,A、C两组在1个月时差异有统计学意义(P<0.05),其他各组间在各时点差异均无统计学意义(P>0.05);各组内比较,A组即刻与1个月时差异具有统计学意义(P<0.05)。扫描电镜观察a、b、c三组牙本质小管均有不同程度堵塞,其中以联合应用组效果最佳。结论含生物活性玻璃成分的脱敏剂与氟保护漆联合应用堵塞牙本质小管的效果最佳,且具有较好的临床效果。

Objective To evaluate the effect of bioactive glass combined with fluor varnish on dentin hypersensitivity by both in vitro and in vivo study. Methods Totally 120 teeth of 62 patients with dentin hypersensitivity were collected and randomly divided into three groups and treated with fluor varnish （Group A, 41 cases）, Ominq desensitizer （Group B, 39 cases）and Ominq desensitizer combined with fluor varnish（Group C, 40 cases） respectively. Then the clinical cu- rative effects were evaluated by the VAS score. In addition, 20 freshly extracted human premolars were selected and made sensitive dentin models, then were randomly divided into four groups （n＇ =5） ： Group a, b and c were treated the same as clinical procedures and Group d was set up to deal with distilled water as a blank control. Then the plugging ef- fects of dentin tubules were analyzed by SEM. Results The VAS scores of all the three groups decreased obviously and rised over time. Comparing all the groups, the effective rate of the groups had no significant differences in each moment （P 〉 0.05）, except for Group A and C in one month （P 〈 0.05）. The effective rate of Group A showed significant differ- enees immediately compared with that of one month. Conclusion Treatment with fluor protector combined with Ominq desensitizer shows better occluding effects in the dentin tubules and demonstrates better clinical curative effects.