次氯酸钠与酒精消毒对酸蚀过程中牙釉质影响的比较

doi:10.13481/j.1671-587x.20190227

摘要/Abstract

摘要： 目的：探讨次氯酸钠与酒精消毒对酸蚀过程中牙釉质的影响，为正畸治疗提供参考。方法：收集离体恒牙60颗，随机分为2组（A和B组），每组各30颗，A组采用5.25%次氯酸钠预处理，B组采用75%酒精预处理；经分组处理后，A和B组再分别随机分为3组（A₀、A₁、A₂和B₀、B₁、B₂组），每组各10颗，分别采用37%磷酸酸蚀0、15和30s。取离体乳牙40颗，随机分为2组（C和D组），每组各20颗，C组采用5.25%次氯酸钠预处理，D组采用75%酒精预处理；经分组处理后，C和D组再分别随机分为2组（C₀、C₁组和D₀、D₁组），每组各10颗，分别采用37%磷酸酸蚀0和30 s。超声清洗离体牙，扫描电镜（SEM）观察釉质微观形态，检测各组釉质表面孔隙直径，测量各组样品抗剪切力强度，并进行组间比较。结果：各组釉质表面孔隙直径比较差异均有统计学意义（P<0.01）。恒牙实验组中A₂组牙釉质孔隙直径最大（P<0.01），表面蛋白残留较少，釉质暴露充分，且抗剪切力强度最大（P<0.01）；B₁组孔隙直径最小（P<0.01），且表面蛋白残留较多，抗剪切力强度最小（P<0.01）。乳牙实验组中C₁组釉质孔隙直径最大（P<0.01），且表面残留蛋白较少，抗剪切力强度最大（P<0.01）；D₁组釉质孔隙直径最小（P<0.01），且表面蛋白残留较多，抗剪切力强度最小（P<0.01）。结论：与常用酒精消毒方法比较，采用5.25%次氯酸钠预处理牙釉质30s可明显增加釉质表面粗糙度和清洁度，并增强正畸托槽粘结强度。

关键词: 次氯酸钠, 酸蚀, 牙釉质, 扫描电子显微镜

Abstract: Objective: To investigate the influence of sodium hypochlorite and alcohol disinfection in the enamel during acid etching, and to provide reference for the orthodontic treatment.Methods: Sixty extracted permanent teeth were selected and randomly divided into two groups (group A and group B), with 30 teeth in each group.The teeth in group A were pretreated with 5.25% sodium hypochlorite and the teeth in group B were pretreated with 75% alcohol. After pretreatment, group A and group B were randomly divided into three groups (groups A₀, A₁, A₂, B₀, B₁,and B₂), with 10 teeth in each group and the teeth were etched with 37% phosphoric acid for 0,15 and 30 s. Forty extracted deciduous teeth were selected and randomly divided into 2 groups (group C and D), with 20 teeth in each group. In group C, the teeth were pretreated with 5.25% sodium hypochlorite; in group D, the teeth were pretreated with 75% alcohol.After pretreatment, group C and group D were randomly divided into two groups (groups C₀,C₁,D₀,and D₁) with 10 teeth in each group, and the teeth were etched with 37% phosphoric acid for 0 and 30 s.The morphology of enamel was observed by scanning electron microscope(SEM) after the extracted teeth were cleaned with ultrasound; the pore diameters of enamel surface were detected and the shear strength of samples in each group was detected.Results: The differences in pore diameters between various groups were statistically significant (P<0.01).In the permanent teeth test group, the pore diameter in group A₂ was the maximum (P<0.01), the surface protein residues were less, and the enamel was fully exposed, and the shear strength was the highest(P<0.01).The pore diameter in group B₁ was the minimum (P<0.01), the surface protein residues were more, and the shear strength was the lowest(P<0.01).In the deciduous teeth test group, the pore diameter in group C1 was the maximum (P<0.01), the surface protein residues were less, and the shear strength was the highest(P<0.01).The pore diameter in group D₁ was the minimum, and the surface protein residues were more, and the shear strength was the lowest(P<0.01).Conclusion: Compared with the traditional alcohol disinfection method, pretreatment of 5.25% sodium hypochlorite in tooth enamel for 30 s can significantly increase the surface roughness and cleanliness of enamel, and enhance the shear strength of orthodontic bracket.

Key words: sodium hypochlorite, acid etching, enamel, scanning electron microscope

中图分类号:

R783.5

公柏娟, 罗淞元. 次氯酸钠与酒精消毒对酸蚀过程中牙釉质影响的比较[J]. 吉林大学学报(医学版), 2019, 45(02): 370-375.

GONG Baijuan, LUO Songyuan. Comparison of influence in enamel during acid etching etching between sodium hypochlorite and alcohol disinfection[J]. Journal of Jilin University(Medicine Edition), 2019, 45(02): 370-375.

参考文献

[1] 孙静,冯云霞.次氯酸钠对正畸黏接效果影响的研究[J].中国当代医药,2011,18(5):7-8.
[2] 高杨,张明,宫春梅,等.两种不同处理方法对牙釉质结构及正畸托槽粘接强度的影响[J].中国组织工程研究,2015,19(38):6087-6091.
[3] 牟胤赫,杨陆一,吴嫣然,等.不同条件下3种正畸粘接剂粘结强度的比较及其意义[J].吉林大学学报:医学版,2016,42(3):512-516.
[4] SATO T,TAKAGAKI T,MATSUI N,et al.Morphological evaluation of the adhesive/enamel interfaces of two-step self-etching adhesives and multimode one-bottle self-etching adhesives[J].J Adhes Dent,2016,18(3):223-229.
[5] 孙静.次氯酸钠对正畸粘接效果影响的研究[D].太原:山西医科大学,2011.
[6] 后岷红,陈敏,李蕾,等.次氯酸钠冲洗方式、温度和冲洗时间影响根管玷污层的清除效果[J].中国组织工程研究,2015,19(43):6918-6923.
[7] 程绘,杨健.次氯酸钠在根管冲洗中的应用进展[J].南昌大学学报:医学版,2014,54(9):102-104.
[8] RIVERA-PRADO H,MOYAHO-BERNAL Á,ANDRADE-TORRES A,et al.Efficiency in bracket bonding with the use of pretreatment methods to tooth enamel before acid etching:sodium hypochlorite vs.hydrogen peroxide techniques[J].Acta Odontol Latinoam,2015,28(1):79-82.
[9] CHAY P L,MANTON D J,PALAMARA J E.The effect of resin infiltration and oxidative pre-treatment on microshear bond strength of resin composite to hypomineralised enamel[J].Int J Paediatr Dent,2014,24(4):252-267.
[10] ROELOFS T,MERKENS N,ROELOFS J,et al.A retrospective survey of the causes of bracket-and tube-bonding failures[J].Angle Orthod,2017,87(1):111-117.
[11] HELLER D,HELMERHORST E J,OPPENHEIM F G.Saliva and serum protein exchange at the tooth enamel surface[J].J Dent Res,2017,96(4):437-443.
[12] GENTILE E, DI STASIO D, SANTORO R, et al.In vivo microstructural analysis of enamel in permanent and deciduous teeth[J].Ultrastruct Pathol,2015,39(2):131-134.
[13] GÓMEZ S,BRAVO P,MORALES R,et al.Resin penetration in artificial enamel carious lesions after using sodium hypochlorite as a deproteinization agent[J].J Clin Pediatr Dent,2014,39(1):51-56.
[14] PUGACH M K,OZER F,MULMADGI R,et al.Shear bond strength of dentin and deproteinized enamel of amelogenesis imperfecta mouse incisors[J].Pediatr Dent,2014, 36(5):130-136.
[15] HASIJA P,SACHDEV V,MATHUR S,et al.Deproteinizing agents as an effective enamel bond enhancer-An in vitro study[J].J Clin Pediatr Dent,2017,41(4):280-283.
[16] CHRISTOPHER A,KRISHNAKUMAR R,REDDY NV,et al.Effect of Enamel deproteinization in primary teeth[J].J Clin Pediatr Dent,2018,42(1):45-49.
[17] 张晓芳,董培,康洪英,等.不同年龄离体牙牙釉质酸蚀后超微结构研究[J].中国实用口腔科杂志,2014,7(7):423-425.
[18] 王宁,付传芸,杨瑞,等.底板形态和粘结时间对托槽粘结强度的影响[J].山东大学学报:医学版,2013,51(10):38-41.
[19] 王守东,杨陆一,宁磊,等.3种金属底板托槽喷砂处理前后粘结强度的比较及其意义[J].吉林大学学报:医学版,2018,44(5):949-954.
[20] 张昊,马俊青,李强,等.不同酸蚀时间处理后年轻及成年恒牙釉质表面微观形貌及性质的变化[J].南京医科大学学报:自然科学版,2014,34(1):48-52.