三种氟化物对预防正畸治疗后牙釉质脱矿的临床效果比较

Clinical effect of different fluorides on prevention of tooth enamel demineralization after orthodontic treatment

目的探讨三种氟化物(含氟牙膏、氟保护漆、氟化泡沫)预防正畸矫治后牙釉质脱矿的临床效果。方法选择在合肥市口腔医院正畸科接受直丝弓矫治的患者80例,随机分为4组:对照组20例,进行日常口腔卫生保健措施,不做其他任何治疗;试验1组20例,选用含氟牙膏刷牙,每日早、中、晚各1次,刷牙时间>3 min;试验2组20例,涂布氟保护漆,矫治器佩戴后每半年涂1次;试验3组20例,选用0.6%的氟化泡沫,每3个月使用1次。所有的实验对象在正畸治疗前和结束拆除正畸托槽后,计算牙面牙釉质脱矿指数,使用激光龋齿探测仪对脱矿程度进行评价。结果对照组及3组试验组脱矿率差异有统计学意义(χ2=6.552,P=0.040)。试验1、2、3组治疗后脱矿指数及激光龋齿探测仪值(DD值)低于对照组,试验2、3组低于试验1组,差异有统计学意义(P<0.05)。试验2和3组数值差异无统计学意义(P>0.05)。结论含氟牙膏、氟保护漆和氟化泡沫均有预防正畸治疗中牙釉质脱矿的作用,氟保护漆和含氟泡沫作用更为明显,使用也方便,值得临床推广。

Objective： To investigate the effect of topical application of fluoride on enamel demineralization after ortho- dontic treatment, compare the role of fluoride toothpaste, fluoride varnish, fluoride foam on enamel demineralization after orthodontic prevention. Methods ： In our department, 80 patients with fixed orthodontic appliances were randomly divided in- to the control group with daily oral care and any other treatment, and the experiment Group 1 with fluoride toothpaste in dai- ly morning, midday and evening, Group 2 coated with fluoride varnish, and Group 3 with 0. 6% fluoride foam once every three months. Calculation of enamel demineralization index, DD examination, evaluation of the degree of carried demineral- ization were observed among four groups. Results： The difference of demineralization in the control group and the experi- ment groups was statistically significant（x2 = 6. 552 ,P = 0. 040）. After the treatment, demineralization index and DD values of test groupl, group 2 and group 3 were lower than those of the control group. Group 2 and group 3 were lower than the control group. Group 2 and group 3 were lower than the group 1. The difference was statistically significant （ P 〈 0. 05 ）. There was no statistically significant difference in group 2 and group 3 （ P 〉 0.05 ）. Conclusion： Fluoride toothpaste, fluoride varnish and fluoride foam have a preventive orthodontic enamel demineralization role. Huoride varnish and fluoride foam are effective and convenient, so they are worthy of promotion.