变色牙的漂白治疗研究

Study on bleaching treatment of discolored teeth

变色牙的漂白治疗是指通过氧化剂的强力氧化作用把色素分解成足够小的分子扩散到牙齿外或者小到只吸收少量的光造成视觉上牙齿变白。氧化剂形成的自由基氧和羟基通过牙釉质孔进入牙本质后破坏有色基团的碳碳双键,色素进一步被降解为更小的分子后溶度降低达到美白效果。漂白治疗分为活髓牙漂白与无髓牙漂白。活髓牙漂白分为诊室内漂白与家庭漂白,常用的诊室内漂白剂为高浓度的过氧化氢(HP)或过氧化脲(CP),家庭漂白常用的漂白剂为低浓度HP或CP。活髓牙漂白最常见不良反应是牙本质敏感。无髓牙漂白主要指诊间漂白,牙颈部外吸收是其最大的不良反应。本文就漂白治疗的原理、适应证、禁忌证、治疗方式、不良反应预防做一综述,旨在为临床变色牙的漂白治疗提供参考。

Bleaching treatment of discolored teeth refers to the visual whitening of teeth caused by the powerful oxidation of oxidizing agents that break down the pigment into molecules small enough to diffuse outside the teeth or small enough to absorb only a small amount of light.The oxygen and hydroxyl radicals formed by the oxidizing agent enter the dentin through the enamel pores and break the carbon-carbon double bond of the colored group,and the pigment is further degraded into smaller molecules with reduced solubility to achieve the whitening effect.Bleaching treatment is divided into vital and pulpless bleaching,and vital bleaching is further divided into in-office bleaching and home bleaching.The commonly used in-office bleaching agent is high concentration hydrogen peroxide(HP)or carbamide peroxide(CP),while the commonly used bleaching agent for home bleaching is low concentration HP or CP.The most common adverse reaction of in-office bleaching is dentin sensitivity.Pulpless bleaching mainly refers to walking bleaching,with cervical external resorption as the most frequently occurring adverse reaction.This paper reviews the principles,indications and contraindications,treatment methods,and prevention of adverse reactions of bleaching treatment,aim ing to provide references for bleaching treatm ent of dis colored teeth in clinic.