北京大学学报(医学版) ›› 2019, Vol. 51 ›› Issue (2): 340-344. doi: 10.19723/j.issn.1671-167X.2019.02.026

• 论著 • 上一篇    下一篇

抗敏牙膏缓解诊室美白产生的牙齿敏感的临床效果评价

罗志强,张一,唐琳,刘玉华()   

  1. 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081
  • 收稿日期:2017-03-23 出版日期:2019-04-18 发布日期:2019-04-26
  • 通讯作者: 刘玉华 E-mail:liuyuhua@hsc.pku.edu.cn

Clinical evaluation of the effect of reducing tooth sensitivity caused by in office bleaching using dentifrices

Zhi-qiang LUO,Yi ZHANG,Lin TANG,Yu-hua LIU()   

  1. Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2017-03-23 Online:2019-04-18 Published:2019-04-26
  • Contact: Yu-hua LIU E-mail:liuyuhua@hsc.pku.edu.cn

摘要:

目的: 评估含有不同类型脱敏成分的抗敏牙膏缓解冷光美白术中及术后产生的牙齿敏感的效果。方法: 本试验总共招募150个符合条件的受试者,通过计算机生成区组随机序列将150个病例随机分成3组(每组各50例):硝酸钾组(牙膏中的脱敏成分为硝酸钾,n=50)、氟化亚锡组(牙膏中的脱敏成分为氟化亚锡,n=50),安慰剂组(普通含氟牙膏,不含脱敏成分,n=50),试验要求受试者在诊室美白术前15 d开始使用含有相应成分的牙膏刷牙,并且延续到整个试验随访结束。每个受试者均接受一个治疗周期的诊室美白,美白剂的主要有效成分为35%的过氧化氢凝胶。一个美白治疗周期包括3次美白操作,每次操作持续15 min,总计45 min。诊室美白产生的牙齿敏感采用100 mm长的数字化疼痛评判法(visual analogue scale, VAS) 来进行评估,观察时间点为术后即刻0 d、术后1、2、7、14、30 d。最后,硝酸钾组、氟化亚锡组、安慰剂组分别有48(96%),45(90%),46(92%)例受试者完成了整个试验随访。数据的统计学方法采用了方差分析(ANOVA)。结果: 对于诊室美白产生的牙齿敏感,对3组的VAS均值进行分析,在术后即刻0 d,硝酸钾组的VAS均值为39.22±15.08,低于氟化亚锡组(47.18±12.59)和安慰剂组(52.53±14.05),差异具有统计学意义(P<0.05),而氟化亚锡组和安慰剂组结果相似,差异无统计学意义(P>0.05)。在术后1 d,硝酸钾组的VAS均值为38.27±16.52,低于氟化亚锡组(44.69±14.92)和安慰剂组(44.45±13.54),差异具有统计学意义(P<0.05),而氟化亚锡组和安慰剂组结果相似,差异无统计学意义(P>0.05)。在术后2、7、14、30 d,3组VAS均值相似,差异无统计学意义(P>0.05)。结论: 与氟化亚锡组和安慰剂组相比,术前15 d使用硝酸钾脱敏牙膏能够有效缓解诊室美白术中和术后的牙齿敏感程度。

关键词: 牙齿敏感, 过氧化氢, 硝酸钾, 氟化亚锡

Abstract:

Objective: To evaluate tooth sensitivity and the efficacy of in-office bleaching when using different desensitizing dentifrices.Methods: In total, 150 eligible individuals were recruited and randomized by computer-generated block randomization into three groups: potassium nitrate group (n=50), stannous fluoride group (n=50), and placebo group (n=50). Participants were asked to use a desensitizing dentifrice and toothbrush 15 days prior to and after the in-office bleaching. Each patient received a one-session in-office bleaching with 35% hydrogen peroxide whitening gel. The in-office bleaching included three 15 min operations, totally 45 min. Tooth sensitivity was evaluated by 100 mm visual analog scale (VAS) scores immediately 0 d and 1 d, 2 d, 7 d, 14 d, and 30 d after in-office bleaching. In total, 48 (96%), 45 (90%), and 46 (92%) individuals in the potassium nitrate, stannous fluoride, and placebo groups, respectively, completed the follow-up observations.Results: Data were analyzed using analysis of covariance (ANOVA). For tooth sensitivity produced by in-office bleaching, the mean VAS values of the three groups were analyzed. At 0 d immediately after surgery, the mean VAS of the potassium nitrate group was 39.22±15.08, which was lower than that of the stannous fluoride group (47.18±12.59) and the placebo group (52.53±14.05), and the difference was statistically significant (P<0.05). The results of the stannous fluoride group and the placebo group were similar, and the difference was not statistically significant (P>0.05). On 1 day postoperatively, the mean VAS of the potassium nitrate group was 38.27±16.52, which was lower than that of the stannous fluoride group (44.69±14.92) and the placebo group (44.45±13.54), P<0.05. The results of the stannous fluo-ride group and the placebo group were similar, and the difference was not statistically significant (P>0.05). The mean values of VAS were similar 2 d, 7 d, 14 d and 30 d after operation, and the difference was not statistically significant (P>0.05).Conclusion: Compared with the stannous fluoride group and the placebo group, the use of potassium nitrate desensitizing toothpaste 15 days before surgery can effectively alleviate the tooth sensitivity during and after in-office bleaching.

Key words: Tooth sensitivity, Hydrogen peroxide, Potassium nitrate, Stannous fluoride

中图分类号: 

  • R783.9

表1

受试者基线时的基本情况(x?±s)"

Items Potassium nitrate group(n=48) Stannous fluoride group(n=45) Placebo group(n=46) P
Age/yearsa 26.51±5.43 28.14±4.22 24.53±4.87 0.64
Male,n(%)b 13(27.08) 16(35.56) 10(21.74) 0.34
VAS valuesa 1.35±0.56 2.10±0.25 1.78±0.34 0.75

表2

3个治疗组各随访时间点VAS(mm)多重比较Post hoc分析"

Comparison VAS 0 d VAS 1 d VAS 2 d VAS 7 d VAS 14 d VAS 30 d
Difference
of means
P value Difference
of means
P value Difference
of means
P value Difference
of means
P value Difference
of means
P value Difference
of means
P value
Potassium nitrate
group vs.stannous
fluoride group
-7.96 0.007* -6.42 0.041* -4.80 0.054 0.55 0.744 0.90 0.609 -0.18 0.919
Potassium nitrate
group vs.placebo
group
-13.31 <0.001* -8.18 0.010* -0.82 0.742 0.24 0.886 0.18 0.918 -1.21 0.497
Stannous fluoride
group vs.placebo
group
-5.35 0.070 -1.77 0.577 3.99 0.115 -0.31 0.857 -0.72 0.688 -1.03 0.567

图1

3个治疗组在不同时间点上VAS均值的变化"

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