【摘要】：目的: 比較檸檬酸酸蝕后的牙釉質(zhì)經(jīng)過不同再礦化時間，刷牙對其表面磨損深度的影響，為口腔保健行為提供理論指導(dǎo)。 材料和方法: 1、經(jīng)倫理委員會批準(zhǔn)，選擇10個志愿者，簽署知情同意書。2、收集新鮮拔除、健康無齲的正畸減數(shù)的前磨牙80顆，制成5mm×5mm×2mm大小的牙釉質(zhì)塊，打磨，拋光后，用顯微硬度計測量各個牙釉質(zhì)的表面顯微硬度，并挑選出60個顯微硬度值最接近計算平均值的釉質(zhì)塊。3、為志愿者制作腭基托，隨機(jī)分配釉質(zhì)塊，用蜂蠟固定在腭基托中，釉質(zhì)近遠(yuǎn)中邊緣分別用復(fù)合樹脂覆蓋2mm（釉質(zhì)表面和基托邊緣各1mm）。每個腭基托6個釉質(zhì)塊，分別為A-F組，每組10個樣本。4、實驗第一天：志愿者除進(jìn)食時間和口腔清潔時間將腭基托取下，其余時間均需將腭基托置于口腔內(nèi)，以便釉質(zhì)塊表面形成唾液獲得性膜。實驗第二至四天，志愿者每天進(jìn)行兩次刷牙實驗（上午8：00和下午8:00），第四天下午刷牙實驗結(jié)束后志愿者將不再需要佩戴腭基托，處理如下:首先用蜂蠟將F組釉質(zhì)塊覆蓋，然后每個腭基托浸入50ml檸檬酸（pH3.2）中2分鐘，最后將F組蜂蠟去除。A-D組進(jìn)行不同的再礦化時間后進(jìn)行刷牙（從腭基托邊緣方向向中心方向統(tǒng)一力度磨刷40次）。A組：0分鐘；B組：20分鐘；C組：40分鐘；D組：60分鐘。E組：酸蝕并且再礦化，但不進(jìn)行刷牙。F組：不酸蝕，再礦化，刷牙。5、實驗結(jié)束后用輪廓儀測量各個牙釉質(zhì)塊的磨損深度，每個釉質(zhì)塊記錄三個讀數(shù)，取其平均值，六組間比較采用秩和檢驗的統(tǒng)計學(xué)方法；組間兩兩比較采用LSD方法；檢驗水準(zhǔn)P0.05為差異有統(tǒng)計學(xué)意義。用電子掃描顯微鏡觀察各組釉質(zhì)塊的表面形態(tài)。 結(jié)果: 1.牙釉質(zhì)隨著酸蝕后再礦化時間的增加，刷牙對其表面造成的磨損深度逐漸減小，組間差異具有統(tǒng)計學(xué)意義（P＜0.05）。 2.刷牙會對酸蝕后的牙釉質(zhì)表面造成磨損，實驗組A、B、C、D組釉質(zhì)表面磨損深度與對照組E組比較，差異明顯且有統(tǒng)計學(xué)意義（P＜0.05） 3.酸蝕對牙釉質(zhì)表面磨損有影響，實驗組A、B、C、D組與對照組F組比較，磨損深度增加，差異有統(tǒng)計學(xué)意義（P＜0.05） 4.牙釉質(zhì)被酸蝕后再礦化時間越短，在電鏡下顯示其表面凹陷越大越深越多，表面形態(tài)越粗糙。 結(jié)論: 1.牙釉質(zhì)被酸蝕后，立即刷牙會對牙釉質(zhì)表面形成較大的磨損，，而隨著酸蝕后牙釉質(zhì)在唾液中的再礦化時間增加，刷牙對其造成的磨損深度減小。 2.進(jìn)食酸性飲料后，即使使用含氟牙膏，間隔60分鐘刷牙仍然對牙釉質(zhì)有損害。
[Abstract]:Objective: to compare the effect of tooth brushing on the wear depth of enamel after citric acid etching after different remineralization time, and to provide theoretical guidance for oral health care. Materials and methods: 1. With the approval of the Ethics Committee, 10 volunteers were selected to sign the informed consent form. 80 premolars with fresh extraction and no caries were collected and made into enamel blocks of the size of 5mm 脳 5mm 脳 2mm, which were polished and polished. The surface microhardness of each tooth enamel was measured by microhardness meter, and 60 enamel blocks, which were closest to the calculated average value, were selected. The palatal base was made for volunteers, and the enamel mass was randomly allocated and fixed in the palatine base with beeswax. 2mm (enamel surface and base edge 1mm) were covered with composite resin at the distal edge of enamel. There were 6 enamel masses in each palatine base, each group with 10 samples. 4. The first day of the experiment: except for feeding time and oral cleaning time to remove the palatine base, the rest of the time should be placed in the mouth. In order to form a salivary acquired membrane on the enamel mass surface. From the second to the fourth day, the volunteers brushed their teeth twice a day (8:00 and 8:00). After the fourth day of brushing the teeth, the volunteers would no longer need to wear a palatine base. The treatment was as follows: first, the enamel of group F was covered with beeswax. Then each palatal base was immersed in 50ml citric acid (pH3.2) for 2 minutes, then the beeswax of group F was removed from beeswax for different remineralization time and then brushed (40 times from the palatine base edge to the center). Group A: 0 minutes; Group B: 20 minutes; group C: 40 minutes; group D: 60 minutes; group E: acid erosion and re-mineralization, but not brushing teeth. Group F: no acid erosion, remineralization, brushing teeth .5.After the experiment, the wear depth of each enamel mass was measured by profilometer. Each enamel block recorded three readings, take its average, six groups of comparison using rank sum test statistical method; two groups of comparison using LSD method; test level P0.05 for the difference was statistically significant. The surface morphology of each group of enamel was observed by electron scanning microscope. Results: 1. With the increase of remineralization time of enamel after etching, the wear depth caused by tooth brushing on its surface decreased gradually, and the difference between groups was statistically significant (P < 0.05). 2. Tooth brushing will cause wear on enamel surface after acid etching. The wear depth of enamel surface in group A BX CnD is significantly different from that in group E (P < 0.05). 3. The effect of brushing teeth on the surface of enamel in the experimental group was significantly higher than that in the control group (P < 0.05). Acid etching had an effect on the surface wear of enamel. Compared with the control group F, the wear depth of the experimental group was higher than that of the control group (P < 0.05). 4. The shorter the remineralization time of enamel is, the larger the surface depression is, the deeper the surface is, and the rougher the surface morphology is. Conclusion: 1. After the enamel was etched by acid, the enamel surface was worn by brushing immediately, but the wear depth decreased with the increase of the remineralization time of enamel in saliva. 2. Even if fluoride toothpaste is used, brushing teeth at intervals of 60 minutes will still damage enamel.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R780.1

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