應用生醫玻璃製劑與雷射治療牙本質過敏症

Application of Bioglass Paste and Laser on the Treatment of Dentin Hypersensitivity

蔡心儀(Hstn-Yi Tsai) ； 李苑玲(Yuan-Ling Lee) ； 林峰輝(Feng-Huie Lin) ； 藍萬烘(Wan-Hong Lan) ； 王若鬆(Juo-Song Wang) ； 林俊彬(Chun-Pin Lin)

《中華牙醫學雜誌》 23卷3期 (2004/06) Pp. 175-181

https://doi.org/10.7105/CDJ.200406.0175

摘要

牙本質過敏症(dentin hypersensitivity)為牙科臨床上常遭遇的問題，至今仍缺乏有效的治療方式。而關於牙本質過敏症的致病機轉目前則仍處於眾說紛紜的局面，在諸多研究和實驗的驗證下，流體動力學理論(hydrodynamic theory)是現今較為可信的說法。生醫玻璃因具有良好生物相容性與可調整性質的特點，使其在應用上具有相當的發展潛力。本研究之目的為研發生醫玻璃製劑用以治療牙本質過敏症，以流體動力學理論為基礎，希望藉向封閉牙本質小管的方式來達到治療的效果。實驗採用8.4% Na2O-40.6% CaO-39.0% SiO2-12.0% P2O5成分之DP-生醫玻璃(DP-bioglass)，與磷酸混合調拌製成生醫玻璃製劑(DP-bioglass paste), 並利用二氣化嫂雷射將其熔融於牙本質表面，藉此封閉牙本質小管以降低敏感度。使用電子顯微鏡、X光燒射分析儀及溫度計量偶等儀器分別進行樣本的顯微結構觀察、產物結晶相的鑑定以及檢測二氧化碳雷射處理後的髓腔昇溫效應。研究結果顯示： (l)生醫玻璃製劑可藉向二氧化碳雷射熔融於牙本質表面，並於其表面形成一厚度為105µm 的融熔阻隔層，使牙本質小管的閉口完全被封閉；(2)熔融的生醫玻璃製劑之主要成分為 CaHPO4•2H2O；(3)二氧化碳雷射於本實驗中所造成的平均髓腔昇溫為4.86℃。由此可知生醫玻璃製劑合併二氧化砍雷射的使用，似乎可為牙本質過敏症的治療提供另一種治療模式，並且值得進一步發展。

關鍵字

牙本質過敏症 ； 生醫玻璃 ； 磷酸 ； 二氧化碳雷射

並列摘要

Dentin hypersensitivity is one of the common problems in dental practice. Nevertheless, there has, thus far, been a lack of effective solutions for this problem. Bioglass is a potential material for treating dentin hypersensitivity due to its good biocompatibility and usage adjustability. Although elucidation of the etiology of dentin hypersensitivity has been controversial so far, one of the most acceptable explanations is the hydrodynamic theory. Based on the hydrodynamic theory, this study attempted to clarify the role of a paste composed of bioglass and phosphoric acid in the treatment of dentin hypersensitivity. A continuous-wave CO2 laser was used to melt the bioglass paste onto the dentin surfaces and seal the orifices of the dentinal tubules. The microstructure, phase transformation, and thermal behavior of the bioglass paste in the dentin were analyzed by using scanning electronic microscopy (SEM), X-ray diffractometry (XRD), and J-type thermal couple when subjected to CO2 laser irradiation. The results indicated the following. (1)The bioglass paste could be melted onto the dentin surface, producing a melted layer similar to a barrier measuring approximately 105μm thick. As a result, the orifices of the dentinal tubules were completely sealed. (2)The main crystalline phase of this melted bioglass paste was CaHPO4-2H2O. (3)The average thermal change in the pulp chamber induced by the laser effect was 4.86℃. From the results of this study, we concluded that the use of bioglass paste in conjunction with a CO2 laser may offer an alternative way to treat dentin hypersensitivity.

並列關鍵字

dentin hypersensitivity ； bioglass ； phosphoric acid ； CO2 laser