清除儿童外源性牙面黑色素两种方法的疗效比较

Comparison of the Therapeutic Effects of Two Methods for Removing Black Tooth Stain in Children

目的比较采用赤藓糖醇喷砂法和矽粒子旋转抛光法治疗儿童外源性牙面黑色素沉着(extrinsic black tooth stain,EBS)的临床疗效。方法筛选符合纳入标准的3~12岁儿童48名,通过改良Lobene色斑指数记录色素水平,采用自身半口对照,随机将左右侧分为试验组和对照组,试验组用赤藓糖醇喷砂法,对照组用矽粒子旋转抛光法清除牙齿唇颊面EBS,记录操作时间,进行治疗感受评分,评价治疗安全性,采用“色素积分(score)除以操作时间(second)”计算清洁效率(S/s),随访治疗后3个月和6个月色素再附着水平,通过SPSS23.0软件分析试验结果。结果治疗前唇颊面左右两侧色素得分差异无统计学意义,舌腭面色素得分大于唇颊面,牙面不同分区的色素得分有统计学差异。试验组的效率高于对照组[(0.06±0.05)S/s vs(0.04±0.02)S/s,P<0.001]。8例(16.7%)研究对象对喷砂治疗感到紧张,7例(14.6%)研究对象喷砂治疗过程中出现牙龈出血。治疗前、治疗后3个月、6个月试验组和对照组色素水平差异无统计学意义(P>0.05)。结论虽然赤藓糖醇喷砂更容易导致牙龈出血,使儿童紧张,但其清除色素效率更高,值得临床推广。

Objective To compare the clinical efficacy of using erythritol air-polishing and silica particle polishing for treating extrinsic black tooth stain(EBS)in children.Methods 48 children aged 3-12 years who met the inclusion criteria were selected.The Lobene stain index was used to record the pigment level,and a self-half-mouth control was used to randomly divide the left and right sides into the experimental group or control group.The experimental group was treated with erythritol air-polishing,and the control group was treated with silica particle air-abrasion to remove EBS on the labial and buccal surfaces of the teeth.The operation time,treatment experience score,and safety were recorded,and the cleaning efficiency(S/s)was calculated using the“pigment score divided by operation time”formula.The pigment reattachment level was followed up at 3 and 6 months after treatment using SPSS 23.0 software for analysis.Results There was no significant difference in pigment scores between the left and right sides before treatment,but the pigment score on the lingual and palatal surfaces was higher than that on the labial and buccal surfaces,and there was a statistically significant difference in pigment scores among different areas of the teeth.The efficiency of the experimental group was higher than that of the control group[(0.06±0.05)S/s vs(0.04±0.02)S/s,P<0.001].8(16.7%)of the study subjects felt nervous during air-polishing treatment,and 7(14.6%)had gum bleeding during the process.There was no difference in pigment levels between the experimental and control groups before treatment,at 3 months,or at 6 months after treatment.Conclusion Although erythritol air-polishing may cause more gum bleeding and nervousness in children,its pigment removal efficiency is higher and it is worth promoting clinically.