摘要
牙齒的美觀學對於很多病人來說是至關重要的事。牙齒的顏色可能因外在的染色或內因性染色而有所改變。對於牙齒的美白，目前已經有很多的方法，目前常見的方法有兩種，第一種是居家美白，第二種是診所內強力美白。居家美白是將低濃度的美白藥劑裝在牙托上讓患者於夜間佩戴，佩戴時間持續約兩個禮拜。診所內強力美白則是利用高濃度的美白藥劑，例如25% 或35% 的過氧化氫塗布在患者的牙齒上，在加以光源或熱催化整個美白的化學反應，一次診療即可達到明顯美白牙齒的效果。如果患者需要更進一步的美白可以追加幾次診療。很多臨床的實驗報告提到利用美白藥劑和光照達成美白的效果。牙齒的美白是由美白藥劑所產生的自由基開啟一連串複雜的氧化反應，自由基將有機的有色大分子氧化，使其斷鍵去環，變成顏色較淡的小分子，這些有機的有色大分子是造成牙齒染色的主因。牙齒美白的效果可能因為一些因素受到影響，例如牙齒初始的顏色，牙釉質的厚度，患者本身是否有抽煙的習慣，患者的口腔衛生…等等。自然牙的顏色每個人都不見得一樣，年齡也可能是其中一個影響因素。除此之外，每顆牙齒從切緣端到齒頸部都有顏色的變化，也因此比色的位置不同也可能導致結果評估上造成差異。 本實驗的目的是為了分析牙齒初始的色相、受測者性別以及年齡和牙齒接受強力雷射美白前後色階進步量是否相關。試著從實驗的結果建立一些依據供臨床的醫師進行參考。 材料與方法:利用二極體雷射活化35% 過氧化氫，於每個象限進行15次照射，以松風比色機進行比色 結果: 樣本數91人 所有的資料都以t-test，One-way ANOVA和Tukey HSD作統計分析 美白前初始色階與美白後進步色階量與性別無顯著相關。 美白前初始色階與美白後進步色階量和年齡有顯著相關，大於30歲的組別美白前平均色階較深，美白後平均色階進步量較少。 美白前初始色階與美白後進步色階量和色相有顯著相關，色相C的組別美白前平均色階最深，A次之，D最淺;美白後平均色階進步量A最大，C次之，D最少。 關鍵字: 二極體雷射;美白;色階
並列摘要
Esthetics of the teeth is very important to patients. The color of the teeth is influenced by intrinsic color and extrinsic stains that form on the tooth surface. There are a number of methods for the external teeth whitening. Dentist supervised two fundamental bleaching approaches, nightguard bleaching and in-office or power bleaching. Nightguard bleaching typically uses low level whitening agent applied to the teeth with a custom fabricated mouth guard. Patients wear at night for at least 2weeks. In-office bleaching uses relatively high levels of whitening agents, for example 25–35% hydrogen peroxide containing products, for shorter time periods. The peroxide may be further activated by heat or light. The in-office treatment can result in significant whitening after only one treatment visit but may require multiple treatment appointments for optimum whitening. Numerous clinical studies have documented the effectiveness of bleaching in changing tooth color through whitening and lightening. The bleaching of teeth is believed to result from a complex oxidation process of free radicals generated by the bleaching agent. The bleaching effect is a result of the degradation of complex organic molecules that are responsible for the color of teeth to less complex molecules, resulting in a reduction or elimination of discoloration. The degree of effectiveness of tooth bleaching is influenced by numerous factors related to the individual tooth prior to bleaching such as the original tooth color, tooth thickness, tobacco usage, and dental hygiene. Natural tooth color differs from individual to individual based on factors including age. Furthermore, each tooth has a color gradation from its incisal to its cervical region. Therefore, the regions of the tooth where color measurements are performed as well as the original tooth color prior to bleaching would appear to be primarily responsible for the varied results. The purpose of this study was to analyze that whether the hue of the original tooth color(A,B,C,D)，gender and the years of patients have any correlation with the shade difference before and after bleaching by utilizing 35% hydrogen peroxide and diode laser. Try to establish an objective guidelines to predict effectiveness of tooth whitening, creating assistance to clinician to make tooth whitening a more reliable dental treatment. 91 subjects were enrolls in the study，each subject were bleached with 35% bleaching agent and activate with diode laser Color changes were measured with Vita shade guide and ShadeEye NCC Dental Chroma Meter. All data of clinical test were analysis with t-test, One-way ANOVA and Tukey HSD static analysis method. Male and female don’t have significant difference on shade change. There are significant difference on shade change between >30 y/o group and <30 y/o group . Older patients tend to have darker initial tooth shade and less shade improvement. There are significant difference on shade change between hue A，C and D group . Hue A group tends to have most shade improvement than hue C group and hue D group. Key words: Diode Laser;tooth whitening;shade
參考文獻
延伸閱讀
- 黃瓊芳、鄭信忠、林光勳（2004）。患者對於雷射美白之自我滿意度及術後牙齒敏感度之評估。中華牙醫學雜誌，23(2)，124-129。https://doi.org/10.7105/CDJ.200404.0124
- 李惠娜（2020）。雷射都卜勒微流影像儀診斷外傷牙髓活性之效能分析〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2001202021545700
- 黃瓊芳、林伶紅、鄭信忠、歐耿良、洪景明、李勝揚（2005）。牙齒強力美白後塗佈表面處理劑之體外測試評估。中華牙醫學雜誌（中文版），1(3)，174-184。https://doi.org/10.7106/CJD.200509.0174
- 陳忠正、劉謙美、林保瑩、藍萬烘（1996）。Nd：YAG雷射和洗牙 牙根整平在牙周病治療效果之比較。中華民國牙周病醫學會雜誌，1(2)，108-108。https://www.airitilibrary.com/Article/Detail?DocID=a0000071-199612-201301020005-201301020005-108
- 黃明霞、陳恆理、賴玉玲、凌莉珍（2004）。Laser Applications in Periodontal Treatments。中華民國牙周病醫學會雜誌，9(1)，55-62。https://www.airitilibrary.com/Article/Detail?DocID=a0000071-200403-9-1-55-62-a