牙漂白后酪蛋白磷酸多肽-无定形磷酸钙局部处理对正畸托槽抗剪切力的影响

Effect of casein phosphopeptide-amorphouscalcium phosphate(CPP-ACP) treatment on the shear bond strength of orthodontic brackets after tooth bleaching

目的 :探讨牙漂白后局部使用酪蛋白磷酸多肽-无定形磷酸钙(CPP-ACP)表面处理对正畸托槽抗剪切力的影响。方法:100颗因正畸需要拔除的前磨牙随机分为5组,每组20颗,采用以下不同方法进行处理。1未处理;2 10%过氧化脲漂白剂;338%过氧化氢漂白剂;410%过氧化脲漂白剂+CPP-ACP;538%过氧化氢漂白剂+CPP-ACP。5组样本使用全酸蚀黏结剂与金属托槽黏结后进行抗剪切强度测试,同时记录黏结剂残留指数。采用SPSS13.0软件包中的ANOVA和Bonferroni检验对数据进行统计学分析。结果:第2组(10%过氧化脲)和第3组(38%过氧化氢)托槽的抗剪切强度分别为(12.45±3.18)MPa和(12.68±3.60)MPa,较未处理组(20.39±4.83)MPa显著下降(P<0.05)。CPPACP处理后,第4组(10%过氧化脲+CPP-ACP)和第5组((38%过氧化氢+CPP-ACP)的抗剪切强度较第2组和第3组均略有上升,差异无显著性(P>0.05)。CPP-ACP表面处理后,第4和第5组的黏结剂残留指数较第2组和第3组无显著改变。结论:漂白剂表面处理降低了正畸托槽的抗剪切力,而漂白剂联合CPP-ACP表面处理未进一步降低正畸托槽的抗剪切力,提示牙漂白后,局部使用CPP-ACP对正畸托槽的黏结强度影响较小。

PURPOSE： To evaluate the effect of casein phosphopeptide-amorphouscalcium phosphate （CPP-ACP） treatment on the shear bond strength of orthodontic brackets after tooth bleaching. METHODS： One hundred extracted human premolars were randomly divided and treated according to 5 groups （n=20） ： （1） no treatment; （2）10% carbamide peroxide bleaching; （3）38% hydrogen peroxide bleaching; （4） 10% carbamide peroxide bleaching and CPP-ACP paste; （5）38% hydrogen peroxide bleaching and CPP-ACP paste. In all groups, the brackets were bonded using a conventional acid-etch and bond system （Transbond XT, 3M Unitek, Monrovia, Calii）. The shear bond strength adhesive remnant index （ARI） of the brackets were determined and the data was analyzed by ANOVA and Bonferronl test using SPSS13.0 software package. RESULTS： The use of 10% earbamide peroxide and 38% hydrogen peroxide bleaching significantly decreased the shear bond strength of orthodontic brackets when compared with untreated group （P〈0.05）. After combination of tooth bleaching and CPP-ACP treatment, group 4 （10% carbamide peroxide bleaching ＋ CPP-ACP） and group 5 （38% hydrogen peroxide bleaching ＋ CPP-ACP） showed higher levels of shear bond strength than group 2 and 3; however,no significant difference was found （P〉0.05）. The ARI did not show any significant difference before and after CPP-ACP treatment. CONCLUSIONS：After tooth bleaching, CPP-ACP treatment have little influence on the shear bond strength of orthodontic brackets. [Key words] Bleaching; Casein phosphopeptide-amorphouscalcium phosphate; Shear bond strength; Carbamide peroxide; Hydrogen peroxide