评价漂白剂对银氨氟化处理的脱矿幼儿恒牙釉质颜色和显微硬度变化的影响：一项体外研究。
Evaluation of bleaching agent effects on color and microhardness change of silver diamine fluoride-treated demineralized primary tooth enamel: An in vitro study.
机构信息
Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
BMC Oral Health. 2022 Aug 12;22(1):347. doi: 10.1186/s12903-022-02371-3.
BACKGROUND
The present study aimed to assess the impact of application of fluoridated- 10% carbamide peroxide (CP) with or without potassium iodide (KI) on silver diamine fluoride (SDF)-treated enamel surface in the primary teeth.
METHODS
After stained-remineralized caries lesions (s-RCLs) creation, 96 teeth were randomly allocated to four experimental groups: Group 1:SDF-treated enamel followed by 8-h/day application of 10% CP for 2 weeks; Group 2: SDF-treated enamel followed by 15-min/day application of 10% CP for 3 weeks; Group 3: SDF + KI-treated enamel followed by 8-h/day application of 10% CP for 2 weeks; and Group 4: SDF + KI-treated enamel followed by 15-min/day application of 10% CP for 3 weeks. Enamel microhardness (EMH) test (n = 12) and spectrophotometric color assessment (n = 12) was performed at four stages: baseline (intact enamel), demineralized enamel, aged remineralized-stained enamel, and after final intervention. Sixteen samples were used for SEM evaluation. Data were analyzed with the paired t-test, one-way ANOVA, and Tukey's post-hoc test (p < 0.05).
RESULTS
EMH values in all groups showed significant decrease after demineralization (all, p < 0.00001). All samples showed complete recovery of EMH values (%REMH) after SDF application compared to demineralization (%REMH) (p = 0.971). Bleaching caused a slight decrease in %REMH for all groups. However, the differences were not statistically significant (p = 0.979). SEM findings revealed no changes in enamel porosity after bleaching. Bleaching application ameliorated the discoloration in all groups (all, p < 0.00001). All samples in Groups 2 and 4 had significantly lighter color after 21 days as compared to 14-day exposure to the bleaching material (both, p < 0.00001).
CONCLUSIONS
SDF application on demineralized primary tooth enamel completely recovered enamel microhardness. 10% carbamide peroxide effectively bleached SDF stain without causing significant decrease in EMH values. Color improvement was more evident with the use of KI immediately after SDF application. Both 15-min and 8-h application of fluoridated CP resulted in statistically similar color enhancement in primary teeth.
背景
本研究旨在评估应用含氟 10%过氧化脲（CP）联合或不联合碘化钾（KI）对经银氨氟化（SDF）处理后的乳牙釉质表面的影响。
方法
在产生染色再矿化龋损（s-RCLs）后，将 96 颗牙齿随机分配至四个实验组：第 1 组：SDF 处理后的釉质，随后应用 10% CP 每天 8 小时，持续 2 周；第 2 组：SDF 处理后的釉质，随后应用 10% CP 每天 15 分钟，持续 3 周；第 3 组：SDF+KI 处理后的釉质，随后应用 10% CP 每天 8 小时，持续 2 周；第 4 组：SDF+KI 处理后的釉质，随后应用 10% CP 每天 15 分钟，持续 3 周。在四个阶段（完整釉质、脱矿釉质、老化再矿化染色釉质和最终干预后）对釉质显微硬度（EMH）测试（n=12）和分光光度比色评估（n=12）进行了检测。对 16 个样本进行了 SEM 评估。使用配对 t 检验、单因素方差分析和 Tukey 事后检验（p<0.05）对数据进行了分析。
结果
所有组的 EMH 值在脱矿后均显著降低（均，p<0.00001）。与脱矿相比，所有 SDF 处理后的样本的 EMH 值均有完全恢复（%REMH）（p=0.971）。漂白处理后所有组的%REMH 值均略有下降。然而，差异无统计学意义（p=0.979）。SEM 结果显示，漂白后釉质的孔隙率无变化。所有组的漂白处理均改善了变色情况（均，p<0.00001）。与 14 天暴露于漂白材料相比，第 2 组和第 4 组的所有样本在 21 天后的颜色明显更浅（均，p<0.00001）。
结论
SDF 应用于脱矿的乳牙釉质可完全恢复釉质显微硬度。10% CP 可有效漂白 SDF 染色，而不会导致 EMH 值显著降低。SDF 处理后立即使用 KI 可更明显地改善颜色。10% CP 氟化物的 15 分钟和 8 小时应用均可使乳牙的颜色增强达到统计学相似的效果。
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