Train T E, McWhorter A G, Seale N S, Wilson C F, Guo I Y
Department of Pediatric Dentistry, Baylor College of Dentistry, Dallas, Texas, USA.
Pediatr Dent. 1996 Sep-Oct;18(5):353-62.
Improvement of appearance and alteration in surface enamel was evaluated following microabrasion of teeth with differing degrees of fluorosis stain in vivo. Eighty-two fluorotic permanent maxillary central incisors from 41 patients were divided into categories of mild (32), moderate (30), and severe (20). Teeth received 30-sec applications of PREMA until no stain remained or for a maximum of 10 min of treatment. Ten teeth needed only 5 min of treatment. All others received the maximum. Standardized intraoral photographs and duplicate polysiloxane impressions were taken prior to treatment, after 5 and 10 min of treatment, and at least 4 days after treatment. Slides were randomized and viewed independently by two standardized observers and rated for area of white spot lesions (WS), stain amount (SA), and stain intensity (SI). The Wilcoxon's signed rank test indicated a significant difference in the area of WS (P < 0.05) and SA and SI (P < 0.005) from pretreatment to successive ratings. Kruskal-Wallis analysis revealed significant differences among the three severity groups for amount of WS, SA, and SI (P < 0.005). Mildly stained teeth had the best esthetic result, moderately stained teeth improved but continued to demonstrate WS and staining, and severely stained teeth showed some improvement, but more than 50% of the surface had WS and > 25% of the surface was stained. SEMs at 10X magnification were made of the models and randomly rated for type, depth, description, and area of surface defects by the two observers. Mild teeth showed no significant changes from pretreatment to 10 min of treatment. Moderate and severe teeth showed no significant change in type and depth of defects from pretreatment to 10 min of treatment but were significantly worse in description and area of defects. Despite esthetic improvement in all groups, moderate and severe teeth showed more defective surfaces following microabrasion. This technique can only be recommended as definitive treatment for teeth with mild fluorosis.
在体内对不同程度氟斑牙染色的牙齿进行微研磨后，评估其外观改善情况和表面釉质的变化。来自41名患者的82颗氟斑恒上颌中切牙被分为轻度（32颗）、中度（30颗）和重度（20颗）三类。牙齿接受PREMA处理30秒，直到污渍消失或最长处理10分钟。10颗牙齿仅需5分钟处理。其他所有牙齿均接受最长处理时间。在处理前、处理5分钟和10分钟后以及处理后至少4天拍摄标准化口腔内照片和复制的聚硅氧烷印模。幻灯片随机分组，由两名标准化观察者独立查看，并对白斑病变面积（WS）、污渍量（SA）和污渍强度（SI）进行评分。Wilcoxon符号秩检验表明，从预处理到连续评分，WS面积（P < 0.05）以及SA和SI（P < 0.005）存在显著差异。Kruskal-Wallis分析显示，三个严重程度组在WS量、SA和SI方面存在显著差异（P < 0.005）。轻度染色的牙齿美学效果最佳，中度染色的牙齿有所改善，但仍有WS和染色，重度染色的牙齿有一定改善，但超过50%的表面有WS且超过25%的表面有染色。对模型制作10倍放大的扫描电子显微镜图像，并由两名观察者对表面缺陷的类型、深度、描述和面积进行随机评分。轻度牙齿从预处理到处理10分钟无显著变化。中度和重度牙齿从预处理到处理10分钟，缺陷类型和深度无显著变化，但在缺陷描述和面积方面明显更差。尽管所有组的美学效果都有改善，但中度和重度牙齿在微研磨后显示出更多有缺陷的表面。该技术仅可推荐用于轻度氟斑牙的确定性治疗。
