氟化物对牙本质漂白深度影响的实验研究

目的通过实验观察氟化物对过氧化脲类漂白剂渗透性及漂白效果的影响。方法 36颗离体牙样本使用标准茶溶液染色、VITA比色板比色后,12颗样本使用35%过氧化脲漂白,12颗样本NaF处理后再行漂白,12颗样本放入去离子水中作为空白对照。治疗时间均为30 min。比色后分别从近远中向和唇舌向剖开,使用图像分析软件测量、比较其剩余染色面积。结果两组离体牙漂白后牙齿色阶改变无显著性差异;对比NaF漂白组和漂白组之间的近远中向剖面染色面积和唇舌向两剖面剩余染色面积,漂白组和NaF漂白组对牙本质的漂白深度无显著性差异。结论着色牙漂白术前局部应用氟化物并不影响漂白效果和漂白深度。     

无髓变色牙漂白治疗30例临床分析

目的:评价无髓变色牙漂白治疗的效果。方法:对30例33颗无髓变色、牙冠完整的前牙使用15%过氧化脲进行诊间和夜间漂白相结合、冠内和冠外联合漂白治疗,并与以30%过氧化氢冠内漂白组作为对照;同时,对实验组有效病例在治疗后1a复查,应用SPSS17.0软件包对所得数据进行统计学分析。结果:15%过氧化脲联合漂白组疗效显著高于30%过氧化氢冠内漂白组,2组差异有统计学意义。1a后复查牙颜色的色阶数值变化,无统计学意义。结论:15%过氧化脲进行诊间和夜间漂白相结合、冠内和冠外联合漂白,能有效治疗无髓变色牙。     

家用过氧化脲凝胶对氟斑牙着色斑漂白作用的临床评价

目的:评价家用过氧化脲凝胶对氟斑牙着色斑漂白的临床效果.方法:将24例氟斑牙患者的108颗着色氟斑牙,根据着色区着色深浅分为轻、中、重度3组.用过氧化脲凝胶进行家庭漂白.在治疗前、治疗结束时及治疗结束1年后,采用CMYK色值表对氟斑牙着色斑进行比色,记录漂白前、后的色阶变化及疗程,计算漂白有效率并评价疗效稳定性;用数字化疼痛评判法记录受试者术中牙的敏感度.采用SPSS13.0软件包对结果进行x2检验.结果:(1)轻度氟斑牙着色斑脱色效果显著,1个疗程内漂白有效率达100%;中、重度氟斑牙着色斑脱色效果稍差,有效率分别为94.29%和86.21%,3组间无统计学差异(P＞0.05).(2)治疗结束1年后复查,3组漂白有效率与治疗结束时比较均无统计学差异(P＞0.05).(3)用药时,部分患者有不同程度的牙酸痛症状,敏感率为56.52%,停止用药2～3h后,敏感症状消失.结论:家用过氧化脲凝胶治疗氟斑牙着色斑效果显著,具有一定的安全性和稳定性.     

10%过氧化脲漂白无髓牙的临床研究

目的 :评价 10 %过氧化脲对变色无髓牙的漂白效果。方法 :对 8例患者的 8颗变色无髓牙 ,制作含储药池的扇形个别托盘 ,并开放舌侧髓室口 ,去除根充牙胶至釉牙骨质界下 2～ 3mm ,然后用玻璃离子覆盖 2～ 3mm。治疗中 ,患者临睡前将 10 %过氧化脲注入髓室及个别托盘的储药池内 ,从而同时从内外两侧对无髓牙进行漂白。患者晨起后 ,清洁牙齿 ,用无菌棉球充填髓室。治疗结束后 ,暂时充填髓腔 ,两周后改行光固化充填。结果 :8颗变色无髓牙在 3周内均获得满意效果。无髓牙漂白所用时间与着色时间成正比。结论 :10 %过氧化脲能有效地治疗变色无髓牙。     

10％过氧化脲漂白无髓牙的临床研究

目的：评价10％过氧化脲对变色无髓牙的漂白效果。方法：对8例患者的8颗变色无髓牙，制作含储药池的扇形个别托盘，并开放舌侧髓室口，去除根充牙胶至釉牙骨质界下2－3nm，然后用玻璃离子覆盖2－3mm，治疗中，患者临睡前将10％过氧化脲注入髓主个别托盘的储药池内，从而同时从内外两侧对无髓牙进行漂白，患者晨起后，清洁牙齿，用无菌棉球充填髓室，治疗结束后，暂时充填髓腔，暂时充填髓腔，两击后改行光固化充填，结果：8颗变色无髓牙在3周内均获得满意效果，无髓牙漂白所用时间与着色时间成正比，结论：10％过氧化脲能有效地治疗变色无髓牙。     

10%过氧化脲个体托盘漂白变色牙的临床观察

目的 评价10％过氧化脲对各种变色牙的临床漂白效果。方法 对23例变色牙患者的178颗牙制作含贮药池的马蹄形上下颌个体托盘，采用10％过氧化脲进行4周家庭漂白治疗。分别于漂白前后对照Vitalesence比色板，记录比较漂白牙色的改变。结果 178颗变色牙经漂白治疗，效果良好151颗，改善15颗，总有效率达93．3％。结论 10％过氧化脲是一种使用简便、安全、有效的牙齿漂白剂。     

过氧化氢活髓牙漂白对牙体修复的影响

过氧化氢活髓牙漂白不仅影响修复的粘结强度 ,而且影响多种修复材料的性能和应用。1　过氧化氢活髓牙漂白对修复粘结强度的影响许多研究显示 ,活髓牙采用 350ｍｌ/Ｌ过氧化氢液行诊室内漂白或 10 0ｇ/Ｌ过氧化脲凝胶作家庭漂白时可使复合树脂对釉质的粘结强度降低[1～ 5] 。Ｓｔｏｋｅｓ等[5] 报告采有 350ｍｌ/Ｌ过氧化氢液作釉质漂白 2ｈ ,使复合树脂粘结强度从 16 .2ＭＰａ降至8.4ＭＰａ ,而用 10 0ｇ/Ｌ过氧化脲凝胶作釉质漂白14ｄ ,粘结强度可降至 9.4ＭＰａ ,以上结果均在漂白结束后 4 8ｈ检测得出。而Ｍｕｒｃｈｉｓｏｎ等[6 ] 、Ｊ…     

冷光牙齿漂白技术对活髓牙牙髓影响的病理观察

目的 探讨冷光牙齿漂白技术对活髓牙牙髓的影响.方法 选择因正畸需要拔除的40颗活髓牙,对照组(10颗)不做任何处理拔除,其余30颗牙采用冷光漂白后分别即刻拔除(15颗)和漂白7 d后拔除(15颗).40颗牙齿均制作病理切片,镜下观察牙髓组织形态.结果 所有活髓牙漂白前后均未发现有任何临床症状.漂白后即刻拔除组、7 d后拔除组以及对照组在镜下均表现为正常的牙髓组织结构,与对照组相比漂白后即刻拔除组及7 d后拔除组牙髓组织均无明显改变.结论 冷光牙齿漂白技术对活髓牙牙髓无明显不良影响,是一项安全可靠的漂白技术.     

活髓牙漂白技术研究和应用现状

活髓牙漂白已经有100多年的历史,近10多年来发展尤为迅速,新技术、新产品不断出现。本文就目前常用的活髓牙漂白方法、效果、安全性和评价方法,以及活髓牙的着色、漂白机理作一综述。     

活髓牙冷光美白临床效果评价

目的    探讨活髓牙冷光美白的临床效果。方法    选择2011年8月至2014年8月在上海交通大学医学院附属第九人民医院口腔修复科接受Beyond冷光美白治疗的患者206例,按着色原因分为氟斑牙、四环素牙、外源性着色及其他原因4组。用视觉评价法和比色仪法评价漂白对牙色的影响,并追踪漂白后24 h、1周及3个月的牙色反弹情况。用视觉模拟评分法评价漂白完成即刻、漂白后24 h和1周牙敏感度的变化。结果    牙色评价中除四环素牙效果略差外,其他类型的着色牙漂白均有显著效果,且在追踪的3个月内未发现明显的反弹现象。牙漂白后的敏感多出现在漂白后24 h内。除氟斑牙外,其余类型着色牙的敏感程度在漂白24 h后即与漂白前差异无统计学意义（P > 0.05）;氟斑牙在漂白后1周可恢复至漂白前敏感程度。结论    冷光美白用于临床活髓牙漂白可取得基本稳定、满意的效果。     

Beyond冷光美白与过氧化脲漂白四环素牙的疗效比较

目的评价Beyond冷光美白法漂白四环素牙的疗效及安全性。方法用Beyond冷光美白仪及配套的冷光美白剂,对试验组50例患者712颗四环素牙进行脱色。对照组50例患者717颗四环素牙用奥伦增白剂漂白作对照。用VITA比色板作脱色前、后比色,比较脱色效果,观察牙齿敏感情况。结果试验组脱色总显效率为86.5%,对照组为58.7%,两者差异有显著性(P<0.05)。试验组有6例(12.0%)患者出现牙齿轻度酸痛不适感,对照组有11例(22.0%)患者出现不同程度的牙齿酸痛感,两者差异有显著性(P<0.05)。结论Beyond冷光美白法脱色四环素牙有效、安全、快速。     

Intracoronal bleaching of discolored non-vital teeth

This clinical study compared the effectiveness of bleaching non-vital teeth with an open pulp chamber during bleaching using 10% carbamide peroxide compared to the modified walking bleach technique and extracoronal bleaching. Sixty discolored, non-vital teeth were treated. They were divided into three groups. Each group was treated with one of the bleaching materials and methods: extracoronally using 10% carbamide peroxide for two weeks as negative control (Group A), intracoronally using sodium perborate mixed with 3% hydrogen peroxide (modified walking bleach technique) (Rotstein, Mor & Friedman, 1993) for four weeks (Group B) and intracoronally and extracoronally using 10% carbamide peroxide for two weeks (Group C) (Liebenberg, 1997). Tooth color was measured at baseline, (BL), immediately post-bleaching (IP) and six months post-bleaching (SP) with a colorimeter (Castor, Sigma, Germany) using a tooth-positioning jig. The color was determined according to the CIELAB system, which records lightness as L* and chromaticity coordinates as a* and b*. The difference in L* and b* among the three groups was significant between BL and IP examination. The post-bleaching, whitening effect in Group C was significantly better, but after six months, in Group C, it was as effective as in Group B.     

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目的评价Beyond冷光美白法漂白生理性黄牙的疗效及安全性。方法2006年5月至2008年5月于沈阳市口腔医院用Beyond冷光美白仪及配套的冷光美白剂对试验组30例患者428颗生理性黄牙进行脱色;用奥伦增白剂漂白的30例患者464颗生理性黄牙作对照;用VITA比色板作脱色前、后比色,比较脱色效果,观察牙齿敏感情况。结果试验组轻、中、重度生理性黄牙的显效率分别为94.44%、92.59%、74.04%,而对照组相应着色程度生理性黄牙的显效率分别为70.92%、66.16%、32.00%,两者差异有统计学意义(P<0.01)。试验组有7例(13.33%)患者出现牙齿轻度酸痛不适感,对照组有15例(50%)患者出现酸痛感,二者差异有统计学意义(P<0.05)。结论Beyond冷光美白法脱色生理性黄牙有效、安全、快速。     

Efficacy of a novel at-home bleaching technique with carbamide peroxides modified by CPP-ACP and its effect on the microhardness of bleached enamel

This study was designed to evaluate in vitro the efficacy of a novel at-home bleaching technique using 10% or 16% carbamide peroxide modified by casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and its influence on the microhardness of bleached enamel. A total of 40 bovine incisors were divided into four groups (n=10) according to the bleaching agent used: 10% carbamide peroxide only; a blend of 10% carbamide peroxide and a CPP-ACP paste; 16% carbamide peroxide only; and a blend of 16% carbamide peroxide and a CPP-ACP paste. During the 14-day bleaching regimen, the samples were stored in artificial saliva. The Vickers microhardness and color of the teeth were assessed at baseline (T0) and immediately after the bleaching regimen (T14) using a microhardness tester and a spectrophotometer, respectively. The degree of color change was determined by the Commission Internationale de l'Eclariage (CIE) L*a*b* system (ΔE, ΔL*, Δa*, and Δb*) and Vita shade guide parameters. The data were analyzed by analysis of variance and the Tukey test (p<0.05). The teeth that were bleached with a blend of peroxide (10% or 16%) and the CPP-ACP paste presented increased microhardness values at T14 compared with T0, whereas the samples that were bleached with peroxide only did not show any differences in their microhardness values. All of the bleaching agents were effective at whitening the teeth and did not show a statistically significant difference using the CIEL*a*b* system (ΔE, ΔL*, Δa*, and Δb*) or the Vita shade guide parameters. The use of a CPP-ACP paste with carbamide peroxide bleaching agents increased the bleached enamel's microhardness and did not have an influence on whitening efficacy.     

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目的评价家庭夜间美白法与冷光美白技术用于着色牙漂白的临床效果。方法收集广州市东升医院口腔科2007--2010年的96例着色牙病例,分别用家庭夜间美白法（50例）与冷光美白技术（46例）进行牙齿漂白,以VITA比色板分析脱色效果,用数字化疼痛评判法（VAS）记录受试者术中牙齿敏感程度。术后及2年后复查评价疗效。结果术后家庭夜间美白组总有效率为98．0％,冷光美白组为100．0％,两组总有效率差异无统计学意义（P〉0．05）。四环素牙治疗显效率、总有效率方面：家庭夜间美白组为72．2％、94．4％,冷光美白纽为90．0％、100．0％,差异均有统计学意义（均P〈0．05）。术中VAS评判：家庭夜间美白组敏感率为84．0％,冷光美白组为80．4％,两组敏感率差异无统计学意义（P〉0．05）。所有敏感者停止用药后6～24h均能缓解。2年后复查：两组牙齿颜色均出现反色。家庭夜间美白组总有效率为32．0％,冷光美白组为28-3％,两组差异无统计学意义（P〉0．05）;与治疗结束时的总有效率差异有统计学意义（P〈0．05）。2年后检查两组牙髓活力均正常。结论家庭夜间美白法与冷光美白技术治疗着色牙效果显著,在四环素牙上冷光美白技术优于家庭夜间美白法。2年后两组牙颜色均出现反色。两种漂白方法均具有临床安全性。     

Comparison of 10% carbamide peroxide and sodium perborate for intracoronal bleaching

The purpose of this study was to compare 10% carbamide peroxide to the combination of sodium perborate and water as intracoronal bleaching agents. Forty-four extracted teeth were discolored in vitro. Bleaching agents were placed intracoronally to the level of the cemento-enamel junction for 12 days; solutions were replaced after four and eight days. Standardized slides were used to rank color changes; a colorimeter was used to quantify color change. After 12 days, 65% of the discolored teeth in the 10% carbamide peroxide group and 67% of the discolored teeth in the sodium perborate group had lightened to their original shade or lighter. While there was no statistical difference between the two treatments, sodium perborate was easier to use.     

Extended at-home bleaching of tetracycline-stained teeth with different concentrations of carbamide peroxide.

OBJECTIVE: The degree of color change and the dental sensitivity associated with the use of different concentrations (10%, 15%, and 20%) of carbamide peroxide every night for 6 months was evaluated in tetracycline-stained teeth. METHOD AND MATERIALS: Fifty-nine subjects were shown how to place two different concentrations of carbamide peroxide in the custom trays with reservoirs. For a period of 6 months, the patients were to insert the tray every evening before retiring. Patients returned in 1 and 2 weeks and at 1, 2, 3, 4, 5, 6, 7, 8, and 9 months for evaluation of the degree of color change by subjective shade matching and by photographic means. Sensitivity of hard or soft tissues was self-reported. RESULTS: Fifty-two subjects attended more than 90% of the recalls. A colorimeter was used to convert shade guide tabs to Commission Internationale de l'Eclairage color spaces (CIELAB). The most rapid whitening occurred in the first month. At 3 and 9 months, 91% and 85% of the subjects, respectively, were at least "a little pleased" with the results of the bleaching. In the professional evaluation, 90% of the teeth were deemed to have an excellent or satisfactory esthetic result. The higher the concentration of carbamide peroxide, the more rapidly the lightness value and color difference changed. There was no difference among the three concentrations in resulting gingival sensitivity. Patients experienced less tooth sensitivity with 10% gel than they did with 15% and 20% gels. CONCLUSION: Bleaching with 10%, 15%, and 20% carbamide peroxide is effective for removing tooth staining caused by tetracycline. The 10% concentration has the most advantages and the fewest disadvantages.     

A clinical study comparing the efficacy and sensitivity of home vs combined whitening

This randomized clinical study assessed efficacy in terms of color change and production of sensitivity after home whitening alone and home whitening supplemented with in-office bleaching. Thirty-six subjects (aged 19 to 58 years) were randomly assigned to one of three different treatment groups: (A) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays; (B) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 9% hydrogen peroxide (in the same trays); or (C) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 27% hydrogen peroxide (in the same trays). The efficacy of tooth whitening was assessed by determining the color change associated with the six upper anterior teeth using a value-ordered shade guide. Sensitivity was self-assessed with the use of a visual analog scale (VAS). Tooth shade and sensitivity were assessed at the following points: pretreatment; immediately after the home whitening phase; immediately after the in-office phase (groups B and C); and one week post active treatment. At the one week follow-up visit, subjects in group A had a mean (SD) color change of 5.9 (1.83) (teeth were lighter) immediately after cessation of treatment (p<0.01). Subjects in groups B and C experienced a greater change in mean (SD) shade immediately following their respective in-office treatments of 5.1 (1.53) and 5.4 (1.55). However, within one week, the shade of these teeth regressed to a similar degree to that achieved by subjects treated in group A. Overall, no significant difference in shade change or sensitivity was produced between the three groups. Investigators concluded that the in-office element of combined whitening produced no significant difference in tooth color or sensitivity when compared with home whitening alone.