新式水溶性磷酸鈣塗劑於牙齒去敏感之應用

牙齒敏感是臨床上常見的問題，在臺灣有近30%的民眾遭遇此類酸痛問題，然而目前的治療方式，皆無法提供立即且持久的去敏感效果。運用新式水溶性磷酸鈣(CLP)製作牙齒再礦化貼片時，發現新式水溶性磷酸鈣對於牙本質小管亦有良好的封閉性。因此本研究目的之一為體外試驗，以15顆人類之牙齒分為3組(N=5)，經取樣、包埋及分別塗布去離子水，Pro-ReliefR產品及新式水溶性磷酸鈣塗劑(CLP paste)；運用光學顯微鏡照片，比較使用前後，以及可口可樂酸蝕兩分鐘牙本質小管之面積變化，以評估其封閉性效果差異。研究目的之二則是要進行新式水溶性磷酸鈣塗劑之牙齒去敏感臨床有效性評估。利用視覺類比疼痛評分(VAS, visual analog scale)，評估比較使用Pro-ReliefR產品及水溶性磷酸鈣塗劑後之敏感情況變化，並分別於第4週、8週、12週後請患者回診，再度對原敏感牙齒進行評估以檢測其復發程度，追蹤長期效能。(通過臺北醫學大學暨附屬醫院聯合人體研究倫理委員會JIRB編號201104014)體外實驗結果，使用Pro-ReliefR產品與新式水溶性磷酸鈣塗劑的切片與使用去離子水的切片相比，明顯可見牙本質小管有封閉的現象。牙本質小管在使用Pro-ReliefR paste 和水溶性磷酸鈣塗劑CLP paste處理後和經過可口可樂酸蝕兩分鐘後直徑變小，統計上有顯著差異(p<0.0001 by paired t-test)。而使用Pro-ReliefR paste 和CLP paste處理後之牙本質樣品，兩組間牙本質小管的直徑相同 (p=0.0707by paired t-test)，證實新式水溶性磷酸鈣塗劑與Pro-ReliefR產品具有相同的牙本質小管封閉性。體內試驗方面，在台北市立萬芳醫院進行七位患者，共計二十顆敏感牙齒之水溶性磷酸鈣塗劑去敏感臨床評估。受試者中，男性有三位(42.86%)，女性有四位(57.14%)。受試者為年齡大於三十歲之健康成年人。敏感牙齒最常發生於小臼齒，之後依序為臼齒、門齒及犬齒。使用Pro-ReliefR paste與CLP paste，疼痛指數皆立即顯著下降(p<0.05 by Wilcoxon signed rank test)，而在使用後一個月、兩個月及三個月的觀察，去敏感效果可以持續維持(p<0.05 by Wilcoxon signed rank test)且兩組無差別(p>0.05 by Wilcoxon signed rank test)。研究結果證實新式水溶性磷酸鈣塗劑CLP paste可以提供敏感性牙齒立即且持久有效的舒緩效果。

關鍵字

水溶性磷酸鈣；牙本質敏感；去敏感

並列摘要

Dentin hypersensitivity is a common clinical problem. The purpose of this study was to evaluate the efficacy of calcium lactate phosphate (CLP) for dentin desensitization. The in vitro study utilized 15 human teeth treated with distilled water, Colgate Pro-ReliefR paste, and CLP paste, respectively. The samples were embedded with acrylic resin, and the sealing capacity of each material was evaluate with upright metallurgical microscope and ImageJ software. Significant dentinal tubule occlusion was seen for the Pro-Relief group and CLP group after material application and after Coca Cola acid-etching. The in vivo study was performed at Taipei Medical University- Wanfang Hospital (Taipei Medical University - Joint Institutional Review Board, TMU-JIRB 201104014). We used visual analog scale (VAS) to evaluate the changes of dentin sensitivity for each treatment interval. Seven patients with 20 sensitive teeth were enrolled in the study. Colgate Pro-ReliefR paste and CLP paste polished onto the sensitive teeth. One-second air blast was applied to test the severity level of sensitivity. For Pro-ReliefR paste and CLP paste groups, VAS decreased significantly about 40%.(p<0.05 by Wilcoxon signed rank test)For 4-week, 8-week, and 12-week follow-up, the desensitization effect persisted (p<0.05 by Wilcoxon signed rank test)for both groups. (p>0.05 by Wilcoxon signed rank test)The calcium lactate phosphate paste can provide instant and long-lasting results for dentin desensitization.

並列關鍵字

soluble calcium phosphate ； dentin hypersensitivity, desensitization

參考文獻

2 Chappell, H., Duer, M., Groom, N., Pickard, C. & Bristowe, P. Probing the surface structure of hydroxyapatite using NMR spectroscopy and first principles calculations. Physical chemistry chemical physics : PCCP10, 600-606, doi:10.1039/b714512h (2008).

3 Nanci, A. Ten Cate's oral histology : development, structure, and function.

7 Orchardson, R. & Gillam, D. G. Managing dentin hypersensitivity. J Am Dent Assoc137, 990-998; quiz 1028-1029 (2006).

8 Brannstrom, M. Dentin sensitivity and aspiration of odontoblasts. J Am Dent Assoc66, 366-370 (1963).

9 Absi, E. G., Addy, M. & Adams, D. Dentine hypersensitivity. A study of the patency of dentinal tubules in sensitive and non-sensitive cervical dentine. Journal of clinical periodontology14, 280-284 (1987).

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新式水溶性磷酸鈣塗劑於牙齒去敏感之應用

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