- 期刊
使用不同性質牙膏對加氟牙本質小管堵塞劑的影響－體久實驗
The Influence of Various Dentifrices to the Efficacy of the Fluoridated Dentinal Tubule Occluding Agent-An in Vitro Study
摘要
已有許多研究顯示，治療牙本質知覺敏感的方法中，仍以牙本質小管堵塞法最為適宜，而其中又以產生磷灰石礦物質堵塞牙本質小管為最符合自然之道，因其所產生物質為牙齒無機成分中最主要的成份。本研究的目的在體外以牙本質試片評估含氟去敏感試劑加氟牙本質小管堵塞劑之作用機縛，並探討刷牙的機械破壞及不同性質的牙膏研磨作用對2日氟牙本質小管堵塞劑之影響。本實驗主要包含4個實驗組，第一個為控制組，主要觀察加氟牙本質小管堵塞劑堵塞牙本質小管的形態。第二個為不使用任何種牙膏的刷牙實驗組；第三個為使用去敏感牙膏的刷牙實驗組；第四個為使用不合氟牙膏的刷牙實驗組。第二至第四實驗組各分爲兩小組，包括控制組、塗抹加氣牙本質小管堵塞劑組，分別不沾牙膏及沾取去敏感牙膏、不含氟牙膏刷牙1200次及3600次，並以掃描式電子顯微鏡觀察其表面及縱切面之影像。在電子顯微鏡下，塗抹加氟牙本質小管堵塞劑覆蓋牙本質試片表面，並深入到牙本質小管內，將牙本質小管堵塞或封閉，達到去敏感的效果。無論有無使用牙膏，刷牙的動作會將塗抹在牙本質表面的加氟加氟牙本質小管堵塞劑刷除。若配合使用去敏感牙膏，雖然表面的去敏感試劑會被刷除，但刷牙次數增多，牙膏內的硝酸鉀鹽、研磨劑及刷牙產生的塗抹層，會將牙本質小管開口再度緻密的堵塞。使用不合氣的牙膏刷牙，牙本質表面會有結晶顆粒沉積，隨著刷牙次數的增多，沉澱顆粒會將牙本質小管完全堵塞或部份堵塞，但堵塞的程度不似使用去敏感牙膏般的緻密。自以上結果我們可以得到結論，塗抹加氟牙本質小管塞劑後均會深入到牙本質小管內，將牙本質小管堵塞，達到去牙本質敏感效果。刷牙的機械性破壞會移除覆蓋於牙本質表面的加氟牙本質小管堵塞劑。長期使用去敏感牙膏，應可治療牙本質小管敏感症，若將加氟牙本質小管堵塞劑或氟化鈉製劑配合去敏感牙膏之日常刷牙使用，不但可立即解除敏感症狀，長期並可維持症狀的不再復發。
並列摘要
Many studies have reported that dentinal tubule occlusion was the most effective method in treating dentin hypersensitivity. And the production of apatitic minerals to occlude the dentinal tubules was the most bionomic way, because the production was the main composition of the inorganic matrix of tooth. The purpose of the present study was to evaluate not only the mechanisms of the fluoridated dentinal tubule occluding agent (FDTOA), but also the influence of tooth brushing to the effect of this agent in vitro. Four groups were included in this study. The first group is control group to observe: 1) the morphology of the prepared dentin disc; 2) the prepared dentin disc with the application of the FDTOA; The second group, all samples have been brushed without dentifrices; the third group, all samples have been brushed with the application of desensitizing dentifrices; and the fourth group, all samples have been brushed with application of non-fluoridated dentifrices. the 2nd, 3rd and 4th group were divided into 2 subgroups: 1) the control group, 2) the group applied with the FDTOA. The samples were divided to two parts and were brushed 1200 times and 3600 time separately. The surfaces and the longitudinal section images were then observed under SEM. The granular product of the FDTOA covered on the surface of dentin disc and extended into dentina1 tubules. Toothbrushing with or without dentifrices would remove the product of the FDTOA from the surface of dentin disc. When toothbrushing combined with desensitizing dentifrices， the FDTOA on the surface was brushed off. However, the potassium nitrate and abrasives in the dentifrices and smear layer produced by toothbrushing could re-occ1ude the orifices of dentinal tubules if toothbrushing reached 3600 times. As for samples toothbrushing with non-fluoridated dentifrices, the crystallite deposition on the surface could be found and the extent of deposition in the dentinal tubules increased with the times of toothbrushing. However, the extent of deposition was not as dense as desensitizing dentifrices. Based on the above results, it was concluded that FDTOA could extend deeply into the dentinal tubules which occluded the tubules and therefore desensitized the hypersensitivity dentin. The product of the FDTOA covered on the dentin surface could be removed by toothbrushing. The long-term application of desensitizing dentifrices may cure dentin hypersensitivity. After applying the FDTOA, the dentin hypersensitivity could be relived immediately, and toothbrushing combined with desensitizing dentifrices could maintain the desensitizing effect without recurrence.