渗透树脂在自然形成的早期龋损中渗透能力的研究
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[摘要] 目的 比较渗透树脂和粘接剂在自然形成的早期龋损中的渗透能力。方法 选取36颗邻面有白垩色早期龋损的离体恒磨牙和前磨牙，垂直于龋损表面将牙齿一切为二。两半病损用15%的盐酸酸蚀2 min，随后一半病损用渗透树脂处理，另一半病损用粘接剂处理。用激光扫描共聚焦显微镜（CLSM）在双荧光模式下进行观察，测量树脂的渗透深度（PD）和病损深度（LD），并且计算渗透百分数（PP）。结果 在相同的病损组织学分级中渗透树脂组和粘接剂组间LD的差异无统计学意义（P＞0.05），但是两组PD和PP间差异有统计学意义（P＜0.01）, 渗透树脂组明显高于粘接剂组。结论 粘接剂和渗透树脂对早期龋损均有渗透作用，但是渗透树脂渗透更深，甚至能完全地渗入到病损内。
[关键词] 龋病； 渗透树脂； 粘接剂； 激光扫描共聚焦显微镜
[中图分类号] R 781.05 [文献标志码] A [doi] 10.3969/j.issn.1000-1182.2012.05.008
A study on the penetration abilities of natural initial caries lesions with resin infiltration Liu Yonghong1, Ge Lihong2, Chen Huizhen1, Chi Xueqian1. （1. Dept. of Oral Medicine, The Second Hospital of Hebei Medical Univer-sity, Shijiazhuang 050000, China; 2. Dept. of Pediatric Dentistry, Peking University Stomatological Hospital, Beijing 100081, China）
[Abstract] Objective To compare the penetration abilities of resin infiltration into natural initial caries lesions with those of adhesive in vitro. Methods Thirty-six extracted human molars and premolars showing proximal white spot lesions were selected. Teeth roots were removed, and the crowns were cut across the caries lesions perpendicular to the surface. Corresponding lesion halves were etched for 2 min with 15% hydrochloric acid gel and were subse-quently treated with either adhesive or resin infiltration. Specimens were observed with confocal laser scanning mi-croscopy（CLSM） in dual fluorescence mode. In confocal microscopic images, penetration depth（PD） and lesion depth
（LD） were defined as the distance from the surface to the deepest point of red and green fluorescence, respectively. The penetration percentages（PP） were calculated. Results At the same level of caries, mean maximum lesion LD were comparable for both lesion halves（P＞0.05）. But mean maximum PD and PP of the resin infiltration were significantly higher than those of the adhesive（P＜0.01）. Conclusion Penetration of enamel caries lesions is observed in the ad-
hesive and the resin infiltration. But the resin infiltration is capable of penetrating almost completely into enamel parts of natural caries lesions.
[Key words] caries； resin infiltration； adhesive； confocal laser scanning microscopy
早期釉质龋在临床上表现为白垩色斑块，其典型的病理损害是釉质表层相对完整而表层下严重脱矿。目前，临床上对于这类病损的治疗方案是利用氟化物促进再矿化、口腔卫生宣教和合理的饮食控制等。但是，对于依从性较差的患者，在龋病进展期及邻面的病损，治疗效果不佳。
早期釉质龋存在着釉质结构的破坏，其微观结构是多孔的，从表到内有许多微小通道，它有利于有机酸的扩散和矿物质的进出。龋损渗透技术就是利用低黏度的渗透树脂进入这些微孔，堵塞、封闭这些通道，阻止龋损的进展[1]。渗透树脂是一种新型
的材料，可永久性地堵塞早期龋表层的微孔[2]。有报