光固化树脂表面处理剂对牙齿美白后反色效应的影响

Effect of dental adhesive bonding agent on tooth whitening color relapse

目的研究光固化树脂表面处理剂是否对牙齿美白后反色效应有所影响。方法将24颗完整的离体磨牙或前磨牙于美白前以分光测色仪SCM-104记录CIE(L*,a*,b*)值作为基准值。在各样本颊侧涂35%浓度的过氧化氢,波长(810±10)nm二极体激光照射完成漂白。以分光比色仪记录美白后釉质表面的ΔE。将24颗样本随机均分为L+B组(表面涂布Adper Single Bond 2 Adhesive光固化树脂表面处理剂)与L组(不涂布Adper Single Bond 2 Adhesive光固化树脂表面处理剂),n=12。记录涂布表面处理剂后的釉质表面色差ΔE1,所有样本保存在蒸馏水中1 h避免脱水,1 h后记录釉质表面色差ΔE2。将L+B组与L组随机各自均分为两小组,其中(L+B)W与LW组浸泡于37℃蒸馏水及(L+B)T与LT组浸泡于37℃茶水中,n=6,完成老化测试。记录各小组各时间点的颜色变化CIE(L1*,a1*,b1*)。对涂布处理剂前后和老化试验后的实验数据进行单因素方差分析和样本均数的t检验。扫描电子显微镜观察各处理样本4周时间点的牙釉质表面微观结构。结果ΔE(8.46±3.7)与ΔE1(8.32±3.97)及ΔE2(7.82±2.74)之间没有显著差异(P>0.05)。老化实验LW与(L+B)W组按各个时间点测定色差值之间均没有统计学差异(P>0.05),LT与(L+B)T组以各时间点比较各组间色差的变化,结果差异均有统计学意义(P<0.05)。扫描电镜显示样本美白处理后的釉质表面存在破坏,空洞。而涂布表面处理剂后的样本釉质可变得光滑。老化实验蒸馏水组样本均只见少量块状染色层、孔洞。茶水(L+B)T组样本表光滑,有部分裂痕,片状染色层颜色分解不明显。而LT组样本表面是有孔洞的粗糙面及清晰的茶水染色层。结论涂布Adper Single Bond 2 Adhesive光固化树脂表面处理剂能够使激光美白后的牙釉质表面变得平滑,降低色层的黏附,从而起到牙齿美白后降低反色效应的作用。

Objective To study the efficacy of light - cured resin surface treatment agent on color relapse phenomenon after dental bleaching treatment. Methods 24 intact molar and premolar in vitro Spectra - colorimeter （ SCM - 104） was performed to detect and record the color variations CIE （ L ＊ , a ＊ , b ＊ ） as a benchmark before whitening procedures. 35% concentration of hydrogen peroxide was coated on the buccal tooth enamel surface with diode laser irradiation （810±10） nm wavelength to complete the teeth whitening treatment. The colorimeter measures the color differences AE which provided comparative values for statistical analysis with diode laser irradiation. 24 samples were randomly divided into Adper Single Bond 2 Adhesive resin treating group （ L ＋ B, n = 12） and comparison group （ L, n = 12 ）. All samples needed to be stored in distilled water for 1 hour to avoid dehydration, and colorimeter was conducted to record color change of the enamel surface AE1 and color change AE2 after one - hour lighting. L ＋ B group was further ran- domly divided into two groups （ L ＋ B） W and （ L ＋ B） T and L group was randomly divided into two groups LW and LT with 6 cases in each subgroup. LW group and （L ＋ B） W group were soaked in 37 ℃ distilled water, whereas LT group and （L ＋ B） T group were soaked in 37℃ tea for aging test. The colorimeter was performed to record the color variations CIE （L1 ＊ , al ＊ , bl ＊ ） at each time point after whitening procedures. All experimental data were analyzed through single factor analysis of variance and sample mean T after aging test before and after the coating treatment. Scanning electron microscope was conducted to observe the enamel surface microstructure of processing samples at any points of each four weeks. Results There was no significant difference between laser whitening AE （ 8.46±3.7 ） and the coating AE1 （ 8.32±3.97 ）, so was it with samples of buccal chromatism AE2 （ 7.82±2.74） after soaking in distilled water for one hour （P 〉 0.05）. Also, there was no statistical difference （ P 〉 0.05） between two groups of LW and （L ＋ B） W at each point soaked in distilled water. However, the results show statistically significant differences （ P 〈 0.05 ） when comparing the change of the color difference between each group of LT and （ L ＋ B） T soaking in the tea. The result from scanning electron microscope observation also show the resin created a smooth enamel surface after whitening procedures. Whether the resin was coated or not in distilled water group had only a small amount of block dyeing layer, holes, weaker roughness than in tea group. Gradual layer of smooth surface, some crack, in conspicuous flake dyeing color layer decomposition could be seen in the Tea group （ L ＋ B）. Rough surface holes and mottled dyeing layer was clearly visible in LT group. Conclusion Through colorimeter on enamel surface color changes and observation on microstructures with scanning electron microscopy, the measurements support the Adper Single Bond 2 Adhesive to be an effective enamel surface resin agent which can weaken color relapse phenomenon after teeth whitening effect by a- chieving a relatively smooth enamel surface and reducing the surface adhesiveness of stainable layer.