Sozkes Sarkis, Chomyszyn-Gajewska Maria, Dudzik Agata, Olszewska-Czyz Iwona
Biomaterials Department, Biomedical Engineering Corlu Faculty, Tekirdag Namik Kemal University, 59860 Tekirdag, Turkey.
Department of Bioengineering, Civil Engineering and Environmental Engineering, U.A. Whitaker College of Engineering, Florida Gulf Coast University, Fort Myers, FL 33907, USA.
Materials (Basel). 2025 May 23;18(11):2441. doi: 10.3390/ma18112441.
Smoking is a major risk factor for a variety of oral diseases. In particular, smoking-induced dental stains have been shown to be more refractory than those in non-smokers. Hydroxyapatite (HAP) is a biomimetic material that has been shown to be helpful in many oral health applications; however, its efficacy in stain removal in smokers and non-smokers is uncertain. To compare the effects of HAP toothpaste on the removal/control of extrinsic tooth discoloration in smokers and non-smokers. The secondary goal was to compare smokers and non-smokers in terms of staining extent and response to HAP. A total of 100 adults (50 smokers, 50 non-smokers) who met the inclusion and exclusion criteria were invited to participate in the study. At baseline and 2 weeks after the intervention, the same examiner performed clinical observations, including measurements of anterior tooth stain using the approximal plaque index (API) and the Lobene stain index. Adverse events and any changes in general health conditions of the patients were monitored. Comparisons of indices at baseline and post-intervention yielded statistically significant differences. In non-smokers, the median API (IQR) at baseline was 32.5 (19.0, 63.0) which decreased to 16.5 (7.0, 42.0) after the intervention ( < 0.001). The median Lobene stain index (extension) at baseline and after the intervention was 0.9 (0.5, 1.3) and 0.3 (0.2, 0.7), respectively ( < 0.001). In smokers, the median API at baseline (IQR) was 46.0 (30.0, 86.0), which decreased to 23.0 (7.0, 43.0) ( < 0.001) post-intervention. Lobene stain indices were lower after intervention in all groups than at baseline (all, < 0.001), and the magnitude of reduction was more prominent in the smoker group. This study demonstrates that 2-week use of a toothpaste containing HAP can effectively reduce extrinsic tooth stains in smokers and non-smokers.
吸烟是多种口腔疾病的主要风险因素。特别是，吸烟导致的牙齿污渍已被证明比不吸烟者的更难去除。羟基磷灰石（HAP）是一种仿生材料，已被证明在许多口腔健康应用中都有帮助；然而，其在吸烟者和非吸烟者中去除污渍的效果尚不确定。为了比较HAP牙膏对吸烟者和非吸烟者外在牙齿变色的去除/控制效果。次要目标是比较吸烟者和非吸烟者在染色程度和对HAP的反应方面的差异。共有100名符合纳入和排除标准的成年人（50名吸烟者，50名非吸烟者）被邀请参加该研究。在基线和干预后2周，由同一名检查者进行临床观察，包括使用邻面菌斑指数（API）和洛贝内染色指数测量前牙污渍。监测患者的不良事件和一般健康状况的任何变化。基线和干预后指数的比较产生了统计学上的显著差异。在非吸烟者中，基线时API的中位数（IQR）为32.5（19.0，63.0），干预后降至16.5（7.0，42.0）（<0.001）。基线和干预后洛贝内染色指数（扩展）的中位数分别为0.9（0.5，1.3）和0.3（0.2，0.7）（<0.001）。在吸烟者中，基线时API的中位数（IQR）为46.0（30.0，86.0），干预后降至23.0（7.0，43.0）（<0.001）。所有组干预后的洛贝内染色指数均低于基线（均<0.001），且吸烟者组的降低幅度更为显著。这项研究表明，使用含HAP的牙膏2周可有效减少吸烟者和非吸烟者的外在牙齿污渍。
