Knight N N, Lie T, Clark S M, Adams D F
Department of Periodontology, School of Denstistry, University of Bergen, Norway.
J Periodontol. 1993 May;64(5):366-73. doi: 10.1902/jop.1993.64.5.366.
This study examined by scanning electron microscopy the effect of various mechanical and chemical procedures in obliterating dentinal tubuli. Dentin blocks containing open, cross-sectioned dentinal tubuli were separated into one experimental and one control area. The mechanical treatments consisted of 20 seconds of continuous instrumentation with sharp and dull curets, finely textured inserts for the EVA reciprocating handpiece, metal and plastic inserts for a sonic scaler, and metal inserts for an ultrasonic scaler. Chemical treatments included a light-cured dental resin and active obliterating agents including sodium, stannous and hydrogen fluorides, potassium oxalate, glycerin, ferric oxalate, and potassium nitrate. These substances were applied to the test surfaces for 2 minutes and allowed to dry. One half of the chemically treated specimens were then sprayed with water in order to evaluate the retention of the obliterating agents. The results revealed that among the mechanical treatments, the sharp curet gave the most consistent and complete obliteration of the tubuli. The plastic inserts had no tubular occluding effects. Among the chemical procedures, the light-cured resin resulted in the most complete obliteration of the tubuli, while the fluoride agents and glycerin had no effect. It can be hypothesized that combining instrumentation with a sharp curet causing a heavy smear layer and occlusion of tubuli apertures, followed by application of a light body resin, may prove to be a rational method of desensitizing hypersensitive dentin surfaces. However, this combined treatment should be evaluated in clinical trials.
本研究通过扫描电子显微镜检查了各种机械和化学方法对封闭牙本质小管的效果。将含有开放、横截面牙本质小管的牙本质块分为一个实验区域和一个对照区域。机械处理包括用尖锐和钝的刮匙连续操作20秒、用于EVA往复式手机的细纹插入物、用于声波洁治器的金属和塑料插入物以及用于超声洁治器的金属插入物。化学处理包括光固化牙科树脂和活性封闭剂，包括氟化钠、氟化亚锡、氟化氢、草酸钾、甘油、草酸铁和硝酸钾。将这些物质应用于测试表面2分钟，然后使其干燥。然后，对一半经过化学处理的标本喷水，以评估封闭剂的保留情况。结果显示，在机械处理中，尖锐刮匙对小管的封闭最为一致和彻底。塑料插入物没有封闭小管的作用。在化学方法中，光固化树脂对小管的封闭最为彻底，而氟化物和甘油则没有效果。可以推测，先用尖锐刮匙进行操作，形成厚厚的玷污层并封闭小管开口，然后再应用轻质树脂，可能是一种使过敏牙本质表面脱敏的合理方法。然而，这种联合治疗方法应在临床试验中进行评估。
