不同方法处理牙面对光固化窝沟封闭效果的影响

Influence of different treatment methods on the sealing effect of light-curing pit and fissure sealant

目的探讨采用不同方法处理牙面对窝沟封闭效果的影响。方法 48颗离体前磨牙随机分为4组(n=12):A组(低速手机小毛刷清洁窝沟+窝沟封闭术),B组(高速金刚砂车针预备窝沟+窝沟封闭术),C组(50μm氧化铝微粒喷磨窝沟+窝沟封闭术),D组(27μm氧化铝微粒喷磨窝沟+窝沟封闭术)。偏光显微镜下观察测量封闭剂渗入深度,计算封闭剂渗透率。扫描电镜下观察窝沟封闭剂与牙体组织之间的密合度及结合界面的状况。结果扫描电镜和偏光显微镜结果显示,B组、C组和D组的封闭剂均能渗入到窝沟底部,无空泡出现。B组、C组和D组渗透率均高于A组,差异有统计学意义(P<0.05)。结论微粒喷磨与高速锥形金刚砂针预备窝沟,能有效增强窝沟封闭剂的渗透性;使用27μm微粒处理可疑龋牙面后行窝沟封闭术,可以达到良好的封闭效果。

Objective To explore the effects of different ways of treating tooth surface on pit and fissure sealant.Methods Forty-eight isolated premolars were randomly divided into 4 groups（n=12）：group A（cup-shaped brush sealant technique＋pit and fissure sealant）,group B（enameloplasty sealant technique＋pit and fissure sealant）,group C（50μm alumina oxide particles air abrasion＋pit and fissure sealant）,group D（27μm alumina oxide particles air abrasion＋pit and fissure sealant）.The infiltration depth of the sealants were observed by stereomicroscope,and then the infiltration rate of sealants was calculated.Scanning electron microscope was used to observe the marginal adaptation and interface condition between pit and fissure sealant and tooth.Results The results of scanning electron microscopy and polarized light microscopy showed that the sealant in group B,group C and group D could infiltrate into the bottom of the fossa and no cavitation occurred.Osmotic pressure in group B,group C and group D was higher than that in group A,and the difference was statistically significant（P〈0.05）.Conclusion Compared with traditional cup-shaped brush pit and fissure sealant,50μm,27μm aluminum oxide particle air abrasion and enameloplasty sealant technique with high-speed tapered emery needle can effectively enhance the permeability of the sealants,etching technique and lightcured sealant can achieve a good fit and seal.In order to achieve a good seal,27μm particles air abrasion should be used to process the tooth with deeper pits and fissures or suspicious caries cases before pit and fissure sealant.