无髓变色牙内漂白术后1年临床效果观察

doi:10.7518/hxkq.2023.2022349

摘要/Abstract

摘要：

目的探讨无髓变色牙内漂白临床效果及术后1年内颜色反弹情况，以期指导临床和提示预后。方法对20例无髓变色牙进行内漂白治疗，分别于漂白前、漂白后即刻、漂白后第1、3、6、9、12月使用电脑比色仪对变色牙进行颜色测量，获得不同时间点牙体颈、中、切各部位颜色的L*、a*、b*值，计算出漂白前后颜色变化量ΔE*、ΔL*、Δa*、Δb*，并观察ΔE*、ΔL*、Δa*、Δb*在颈、中、切部随时间的变化情况，分析颜色反弹速度（V*）以及反弹率（P*）。结果 20例无髓变色牙内漂白后即刻颜色改变平均ΔE*为14.99。漂白后牙体颈部和中部ΔE*、ΔL*在1、3、6、9、12月减小，差异有统计学意义，自漂白后第9个月起，牙体中部及颈部颜色的反弹速度较第1个月时降低，差异存在统计学意义（P<0.05）。牙体切端ΔE*、ΔL*在第6、9、12月减小，差异有统计学意义，但牙体切端颜色的反弹速度各时间点间差异无统计学意义。20例牙齿在漂白后第9月颜色反弹达到稳定时的平均反弹率为30.11%。结论内漂白能使无髓变色牙获得显著的颜色改变。漂白后主要影响颜色反弹的依然主要是明度L*，与a*、b*关系不大。内漂白后的牙齿颜色在1年内会出现一定程度反弹，但从第9个月起颜色反弹速度趋于稳定，临床上可在此时根据患牙与邻牙颜色是否协调以及患者需求来决定是否进行二次内漂白。

关键词: 牙齿内漂白, 无髓变色牙, 颜色, 反弹

Abstract:

Objective This study aimed to observe the color rebound and rebound rates of non-pulp discolored teeth within 1 year after routine internal bleaching to guide clinical practice and prompt prognosis. Methods In this work, the efficacy of bleaching was observed in 20 patients. The color of discolored teeth was measured by using a computerized colorimeter before bleaching; immediately after bleaching; and at the 1st, 3rd, 6th, 9th, and 12th months after bleaching. The L*, a*, and b* values of the color of cervical, mesial, and incisal parts of the teeth were obtained, and the color change amounts ΔE*, ΔL*, Δa*, and Δb* were calculated. The overall rebound rate (P*) and the color rebound velocity (V*) were also analyzed over time. Results In 20 patients following treatment, the average ΔE* of tooth color change was 14.99. After bleaching, the neck and middle of the teeth ΔE* and ΔL* decreased in the 1st, 3rd, 6th, 9th, and 12th months, and the differences were statistically significant. Meanwhile, from the 9th month after bleaching, the rebound speed was lower than that in the 1st month, and the difference was statistically significant. The incisal end of the tooth ΔE* and ΔL* decreased in the 6th, 9th, and 12th months after bleaching, and the differences were statistically significant. No significant difference was found in the rebound speed between time points. However, this rate settled after the 9th month, with an average color rebound rate of 30.11% in 20 patients. Conclusion The results indicated that internal bleaching could cause a noticeable color change on pulpless teeth. The color rebound after bleaching was mainly caused by lightness (L*), which gradually decreased with time, and it was slightly related to a* and b*. The color of the teeth after internal bleaching rebounded to a certain extent with time, but the color rebound speed became stable from the 9th month. Clinically, secondary internal bleaching can be considered at this time according to whether the colors of the affected tooth and the adjacent tooth are coordinated and depending on the patient’s needs.

Key words: internal tooth bleaching, pulpless discolored teeth, color, teeth rebound

中图分类号:

R 781.05

彭碧博, 黄佳琳, 王剑. 无髓变色牙内漂白术后1年临床效果观察[J]. 华西口腔医学杂志, 2023, 41(2): 190-196.

Peng Bibo, Huang Jialin, Wang Jian.. One-year clinical observation of the effect of internal bleaching on pulpless discolored teeth[J]. West China Journal of Stomatology, 2023, 41(2): 190-196.

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时间	颈部				中部				切端
时间	ΔE*	ΔL*	Δa*	Δb*	ΔE*	ΔL*	Δa*	Δb*	ΔE*	ΔL*	Δa*	Δb*
漂白前	0	0	0	0	0	0	0	0	0	0	0	0
漂白后
0月	16.95±1.29	15.51±1.26	-3.57±0.91	-1.12±0.99	17.03±1.20	15.53±1.14	-3.63±0.85	-2.89±0.94	10.98±0.98	8.83±1.04	-2.35±0.79	-1.42±1.04
1月	15.56±130	13.83±1.19	-4.05±0.82	-2.60±1.04	15.67±1.34	13.88±1.32	-4.07±0.70	-3.58±0.83	10.45±0.99	8.20±1.08	-2.24±0.73	-2.22±0.98
3月	14.48±1.23	12.31±1.32	-4.25±0.69	-2.60±1.04	14.56±1.25	12.25±1.29	-4.31±0.65	-4.07±0.94	9.88±0.96	6.41±1.34	-2.60±0.72	-2.21±0.98
6月	12.82±1.22	10.63±1.29	-4.09±0.77	-2.25±0.88	12.79±1.13	10.46±1.07	-4.21±0.68	-3.79±0.91	8.88±1.03	5.76±1.16	-2.60±0.75	-1.97±1.00
9月	11.81±1.26	9.29±1.34	-4.09±0.77	-2.45±0.90	11.67±1.07	9.17±1.08	-4.17±0.67	-3.43±0.86	8.35±1.04	5.59±1.22	-2.65±0.65	-1.47±0.85
12月	10.69±1.25	8.29±1.26	-3.87±0.79	-1.83±0.89	10.63±1.03	7.94±1.10	-3.98±0.65	-3.14±0.84	7.63±0.98	4.47±1.18	-2.70±0.54	-1.51±0.90

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