不同漂白方式对不同类型天然牙漂白治疗的效果评估

Efficacy evaluation of different bleaching methods on different types of natural teeth

目的评价不同漂白方式对美学区不同类型天然牙的漂白效果。方法选择本院修复科2018年11月至2019年1月进行天然牙漂白的患者40例。采用随机数字表法将患者分为2组(n=20):诊室漂白组患者接受1次诊室漂白治疗;诊室-家庭联合漂白组的患者在1次诊室漂白基础上联合家庭漂白治疗(佩戴注入漂白剂的专用托盘,8 h/d,2周)。采用Materialise 3-matic建模软件和3D打印技术设计、制作出牙齿测色专用个性化导板,配合电脑比色仪VITA Easyshade测色及计算色差。比较两组治疗完成前后患者不同类型天然牙(中切牙、尖牙、前磨牙)的色差值ΔE、亮度差值ΔL~*、红绿差值Δa~*以及黄蓝差值Δb~*。结果不同漂白方式的ΔE、ΔL~*、Δa~*、Δb~*值差异有统计学意义(P<0.05),不同类型天然牙的ΔE、Δa~*、Δb~*值差异有统计学意义(P<0.05),漂白方式和牙齿类型对Δa~*值的影响存在交互效应(P<0.05)。诊室-家庭联合漂白组3种类型天然牙的Δa~*值显著低于诊室漂白组(P<0.05),诊室-家庭联合漂白组中尖牙、前磨牙的Δa~*值显著低于中切牙(P<0.05)。结论不同类型天然牙接受诊室-家庭联合漂白红色减弱效果均比诊室漂白好,诊室-家庭联合漂白对尖牙、前磨牙红色减弱的效果优于中切牙。

Objective To investigate the efficacy of different bleaching methods on the different types of natural teeth in aesthetic area.Methods Forty patients undergoing natural tooth bleaching in our department of prosthetics from November 2018 to January 2019 were prospective enrolled in this study.They were randomly divided into in-office bleaching group and in-office and family bleaching group(n=20 for each group).The patients from the former group received an in-office treatment only once,and those from the latter group received a take-home bleaching treatment(with custom-made tray,8 h/d)for 2 weeks after an in-office treatment.Materialise 3-matic modeling software and 3 D printing technology were used to manufacture the individualized guides for tooth color measurement.Using the spectrophotometer VITA Easyshade and the individualized guides,the color difference was calculated.We compared theΔE(chromatic aberration),ΔL~*(luminance difference),Δa~*(red green difference),Δb~*(yellow blue difference)values of incisors,canines and premolars between the 2 groups before and after treatment.Results Significant differences were seen inΔE,ΔL~*,Δa~*andΔb~*values between the 2 different bleaching methods(P<0.05).There were significant differences inΔE,Δa~*andΔb~*values among different types of natural teeth(P<0.05).Mutual effect onΔa~*value was observed in bleaching methods and tooth types(P<0.05).TheΔa~*values of 3 types of natural teeth treated by a combined in-office and at-home bleaching treatment were lower than their corresponding teeth treated by in-office bleaching treatment(P<0.05).In a combined in-office and at-home bleaching group,theΔa~*values of canines and premolars were lower than those of central incisors(P<0.05).Conclusion The red fading effects of all types of natural teeth treated by a combined in-office and at-home bleaching therapy are better than those of all types of natural teeth treated by in-office therapy,especially in canines and premolars than central incisors.