Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
BMC Oral Health. 2024 Mar 21;24(1):365. doi: 10.1186/s12903-024-04011-4.
Treating white spot lesions (WSLs) with resin infiltration alone may not be sufficient, raising questions about its compatibility with other treatments amid controversial or incomplete data. Therefore, this study aimed to assess the aesthetic feasibility of resin infiltration combined with bleaching, as well as its potential mechanical effect on ceramic bonding to WSLs.
One hundred and fifty flat enamel surfaces of bovine incisors were prepared. Ninety specimens were deminerailized and randomly assigned to three groups(n = 30): post-bleaching resin infiltration (Bl-R), pre-bleaching resin infiltration (R-Bl), and only resin infiltration (R). Color, surface roughness and microhardness were assessed in immediate, thermocycling and pigmentation tests. The remaining sixty samples were randomly assigned to three groups (n = 20): control (Ctrl), bonding (Bo), pre-bonding resin infiltration (R-Bo). Shear bonding strength, failure mode, micro-leakage depth and interface morphology were evaluated after ceramic bonding. The Tukey test and analysis of variance (ANOVA) were used for statistical analysis.
For the effect of resin infiltration and bleaching on WSLs, the R-Bl group showed the worst chromic masking ability, with the highest |ΔL|, |Δa|, |Δb|, and ΔE values after treatment. Compared with those in the Bl-R group, the R-Bl and R groups showed significant time-dependent staining, which is possibly attributed to their surface roughness. For the effect of resin infiltration on the adhesive properties of WSLs, resin infiltration reduced the staining penetration depth of WSLs from 2393.54 ± 1118.86 μm to 188.46 ± 89.96 μm (P < 0.05) while reducing WSLs porosity in SEM observation.
Post-bleaching resin infiltration proved to be advantageous in the aesthetic treatment of WSLs. Resin infiltration did not compromise bonding strength but it did reduce microleakage and enhance marginal sealing. Overall, resin infiltration can effectively enhance the chromatic results of treated WSLs and prevent long-term bonding failure between ceramics and enamel. Based on these findings, the use of post-bleaching resin infiltration is recommended, and resin infiltration before ceramic bonding is deemed viable in clinical practice.
单独使用树脂渗透治疗白斑（WSL）可能不够，鉴于现有数据存在争议或不完整，这引发了对其与其他治疗方法兼容性的质疑。因此，本研究旨在评估树脂渗透联合漂白的美学可行性，以及其对 WSL 陶瓷粘结的潜在机械影响。
制备 150 个牛切牙釉面平整表面。90 个标本脱矿并随机分为三组（n=30）：漂白后树脂渗透（Bl-R）、漂白前树脂渗透（R-Bl）和仅树脂渗透（R）。即刻、热循环和着色试验评估颜色、表面粗糙度和显微硬度。其余 60 个样本随机分为三组（n=20）：对照组（Ctrl）、粘结组（Bo）、粘结前树脂渗透组（R-Bo）。陶瓷粘结后评估剪切粘结强度、失效模式、微渗漏深度和界面形态。采用 Tukey 检验和方差分析（ANOVA）进行统计学分析。
对于树脂渗透和漂白对 WSL 的影响，R-Bl 组的显色遮罩能力最差，处理后 |ΔL|、|Δa|、|Δb|和 ΔE 值最高。与 Bl-R 组相比，R-Bl 和 R 组在时间上显示出明显的染色，这可能归因于它们的表面粗糙度。对于树脂渗透对 WSL 粘结性能的影响，树脂渗透将 WSL 的染色渗透深度从 2393.54±1118.86μm 降低到 188.46±89.96μm（P<0.05），同时在 SEM 观察中降低了 WSL 的孔隙率。
漂白后树脂渗透在 WSL 的美学治疗中证明是有利的。树脂渗透不会降低粘结强度，但会减少微渗漏并增强边缘密封。总体而言，树脂渗透可以有效增强处理后的 WSL 的显色效果，并防止陶瓷和釉质之间的长期粘结失败。基于这些发现，推荐使用漂白后树脂渗透，并且在临床实践中认为在陶瓷粘结前进行树脂渗透是可行的。
