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研究生:林育朋
研究生(外文):Yu-Peng Lin
論文名稱:含氟漂白劑對牙釉質表面性質的影響
論文名稱(外文):Manifestation and characterization of enamel surface changes after fluoride-containing bleaching treatments
指導教授:莊淑芬莊淑芬引用關係張志涵張志涵引用關係
指導教授(外文):Shu-Fen ChuangChih-Han Chang
學位類別:碩士
校院名稱:國立成功大學
系所名稱:口腔醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:71
中文關鍵詞:檸檬酸漂白劑
外文關鍵詞:bleaching agentfluoridecitric acid
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現今居家美白的治療中,普遍使用含有過氧化物的漂白劑去除牙齒染色。其中,較常被使用的是碳醯胺過氧化物(Carbamide peroxide, CP)氧化劑,它是一種由過氧化氫與尿素結合的化合物。研究指出牙齒的硬組織經美白後會有表面軟化、脫鈣、增加腐蝕和增加齲齒發生率、較容易發生斷裂或減低抗磨耗的能力等現象,但最常發生的是敏感問題。所以為了改善其負面效應,目前發展含氟漂白劑以改善上述缺點,而含氟漂白劑的系統也被證實會增加牙齒的再礦化。
雖然含氟漂白劑已在臨床上普遍使用,而氟添加物雖被認為可保護牙齒,但真正造成負面性質改善的原因為何,或氟與牙齒表面的反應機制,此效應卻尚未被評估。
本實驗研究目的為評估含不同氟濃度的漂白劑,及不同濃度CP/含相同氟濃度的漂白劑對牙釉質表面性質的影響。研究方向為使用小牛門牙當材料,以模擬口腔環境的方式進行去礦化/再礦化,評估含氟漂白劑對牙齒鈣化的影響。分析使用微硬度機、掃瞄式電子顯微鏡、表面輪廓儀、顯微拉曼光譜儀、化學分析電子光譜儀和感應耦合電漿發射光譜分析儀。
結果顯示以高氟濃度漂白劑去礦化後的微硬度較高,表面型態受到腐蝕較輕微,粗糙度前兩週較低;且磷灰石結構沒有破壞,鈣離子析出有較少的情形,且表面生成沈積。高CP濃度漂白劑去礦化後的微硬度較低,表面型態受到腐蝕,但鈣離子析出與低CP濃度者相比差異不大。
結果與其他進行去礦化研究相比,發現由於檸檬酸pH值太低,實驗結果相似於脫鈣嚴重牙齒之處理。但是各組的分析結果仍呈現出明顯差異,可以提供給臨床上應用資訊,如進行漂白療程的患者,有喝軟性飲料的習慣,或是有牙齒酸蝕現象的患者,牙醫師在漂白劑的選擇上,可以挑選最適當的含氟濃度,以減低漂白後的去礦化。
External tooth bleaching by peroxide-based home bleaching agents is a popular method to whiten discolored teeth. Carbamide peroxide (CP) is an oxidizing agent, consisting of hydrogen peroxide-urea compounds. Some studies found surface softening, mineral loss, increased susceptibility to erosion or caries, reduced fracture stability or a decrease in abrasion resistance on bleached dental hard tissues. Moreover, tooth sensitivity often occurs during the bleaching treatments. Therefore, investigations have been addressed on fluoride–containing CP that improved these disadvantages. It provoked the argument that adding fluoride to whitening systems may aid tooth remineralization.
Although fluoride-containing CP bleaching gels are often used in the clinic. Additional fluoride is thought that it can protect tooth. The reason of improve negative effect are not clear. It may be fluoride compound form on tooth surface. The efficacy has not been thoroughly evaluated.
The purpose of the present study was to evaluate the effects of fluoride concentration and CP concentration on the manifestations of surface enamel. In the present study, bovine incisors were treated by the fluoride-free bleaching gels and bleaching gels containing different concentrations of fluoride. These incisors were placed in a de-/ remineralization cycle to simulate conditions in oral cavity. Microhardness, Scanning Electron Microscope, Electron Spectroscopy for Chemical Analysis, Inductively Coupled Plasma-Optical Emission Spectrometry, Microscopes Raman Spectrometer and Profilemeter, were used.
The result showed that teeth treated with bleaching gels containing high concentrations of fluoride exhibited higher microhardness, less erosion morphology and apatite destruction, less Ca-leaching, and potential surface deposition on enamel surface. Treating with the higher concentration CP with the same fluoride concentration generated lower microhardness, more erosion morphology but Ca-leaching were similar to the lower CP concentration ones.
The present results were similar to other study using the citric acid for demineralization. However, these results showed the correlations between the fluoride concentration and the enamel surface changes. The clinic information provided by this study suggests that dentist should choose bleaching agents with suitable fluoride concentration to reduce demineralization after bleaching treatment, or avoid severe erosion and in patients with soft drinks habits.
中文摘要………………………………………….…………………….Ⅰ
Abstract……………………………………………….…………………Ⅲ
致謝……………………………………………………………………..Ⅴ
目錄……………………….……………………………….…….....…...Ⅶ
表目錄…………………………………………………………………..Ⅹ
圖目錄………………………………………………………………..ⅩⅠ
第一章 導論..............................................................................................1
1-1 前言………………………………………………………………….1
1-2 臨床化學藥劑漂白的分類…………………………………….……1
1-3 含碳醯胺過氧化物的漂白劑及漂白作用原理…………………….2
1-4 漂白劑對牙齒的影響……………………………………………….5
1-5 漂白劑添加氟化物對牙齒的效應………………………………….6
1-6 研究動機與目的…………………………………………………….7
第二章 材料與方法……………………………………………………..8
2-1 樣品製備…………………………………………………………….8
2-2 漂白及去/再礦化步驟……………………………………………..10
2-3 微硬度量測………………………………………………………...15
2-4 掃瞄式電子顯微鏡觀察…………………………………………...16
2-5 表面粗糙度量測…………………………………………………...17
2-6 表面結構破壞分析……………………………………………...…18
2-7 化學分析電子光譜儀分析………………………………………...20
2-8 感應耦合電漿發射光譜分析儀量測……………………………...21
第三章 結果……………………………………………………………23
3-1 表面微硬度………………………………………………………...23
3-1.1 漂白劑含不同氟濃度的結果……………………………………23
3-1.2 不同濃度的漂白劑但含相同氟濃度的結果……………………23
3-2 表面型態…………………………………………………………...39
3-3 表面粗糙度………………………………………………………...36
3-3.1 漂白劑含不同氟濃度的結果……………………………………36
3-3.2 不同濃度漂白劑/含相同氟濃度的結果………………………...36
3-4 表面結構破壞……………………………………………………...39
3-5 表面生成氟化物結構……………………………………………...42
3-6 鈣離子析出………………………………………………………...51
3-6.1 漂白劑含不同氟濃度的結果……………………………………51
3-6.2 不同濃度漂白劑/含相同氟濃度的結果………………………...51
第四章 討論……………………………………………………………54
第五章 結論……………………………………………………………61
參考文獻………………………………………………………………..62
自述……………………………………………………………………..71
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