鲁颖娟　宇文婷　廖隽琨

[摘要]目的：研究牙齿漂白对正畸托槽粘结强度的影响。方法：选取于中山大学孙逸仙纪念医院口腔正畸科就诊的患者60例，将患者分为未漂白组、漂白后即刻粘结组及漂白24h后粘结组，6个月后对三组的脱落率进行比较，结果：三组间差异具有统计学意义（P<0.05）。未漂白组的脱落率明显低于另外两组（P<0.05），即刻粘结组的脱落率明显高于其他两组（P<0.05）。结论：漂白对托槽的粘结有不利影响，其中以即刻粘结最为显著。

[关键词]牙齿漂白；金属托槽；粘结强度

[中图分类号]R783 [文献标识码]A [文章编号]1008-6455（2014）20-1738-02

The influence of bleaching on orthodontic bracket adhesion

LU Ying-juan，YU Wen-ting，LIAO Jun-kun

（Department of Orthodontics，Sun Yat-sen Memorial Hospital，Sun Yat-sen University，Guangzhou 510120，Guangdong，China）

Abstract： Objective The purpose of this research was to investigate the influence of bleaching on orthodontic bracket adhesion. Methods A total of 60 patients （ tooth） underwent fixed orthodontics in the orthodontic department of SUN YAT-SEN Memorial Hospital.All patients were divided into three groups according to the bleaching，after six months， we compared the loss rate. Results Statistically significant differences were observed between all the groups （P<0.05）. The teeth of Non-bleaching group had lower loss rate than the other two groups，the different was significant （P<0.05）.The risk of loss was significantly lower when the bracket was bonded immediately and return quickly after 24 hours（P<0.05）. Conclusion The bleaching treatments did significantly reduce the bond strengths of orthodontic brackets，which had the worst effect when bonding immediately.

Key words：bleaching；bracket；adhesion

随着生活水平的提高，人们对美观的要求日益提高。为了拥有一口洁白整齐的牙齿，越来越多的患者开始选择牙齿正畸和牙齿漂白治疗，其中有不少正畸患者曾接受过牙齿漂白治疗。目前较公认的观点是漂白剂对牙釉质的表面形态有一定的影响，而正畸托槽则是直接与牙釉质表面粘结的，所以研究牙齿漂白对托槽粘结强度的影响具有临床意义[1]。

1 资料和方法

1.1一般资料：收集于中山大学孙逸仙纪念医院口腔正畸科就诊的患者共60例，年龄12～18岁。入选条件如下：①上下颌恒牙列；②牙齿颊面皆光滑且未经过任何治疗；③无牙漂白史；④所有患者皆明白试验目的并同意配合。将患者分成3组，每组20例。

1.2试验过程：第1组为对照组：未进行牙齿美白治疗的正畸患者；第2组为即刻粘结组：选用Beyond Technology Crop生产的Beyond冷光牙齿美白仪及其配套的冷光美白剂，按厂家说明的漂白程序进行漂白治疗，即刻进行托槽的粘结；第3组未24h后粘结组，牙齿漂白治疗同第2组，24h后进行托槽的粘结。本实验采用美国3M公司的Victory Series托槽，用35%磷酸溶液酸蚀（Scotchbond 3M）酸蚀30s后冲洗吹干，运用粘结剂与光固化复合树脂（Transbond XT，3M）进行粘结。……