[摘要]目的：探讨渗透树脂应用于正畸治疗后牙面白斑样病损患者的修复美学效果及预后随访。方法：选择笔者医院口腔科2017年1月-2019年12月正畸术后84例牙面白斑样病损患者为研究对象，共84颗患牙。按照随机数表法将其分为观察组（n=43）和对照组（n=41），对照组予以氟化物治疗，观察组予以渗透树脂治疗。对比两组病损面积比、有效率、患牙表面显微硬度（SMH）及L*值、患牙白垩斑评分、美观效果及不良反应情况。结果：治疗后，觀察组患者患牙病损面积比明显低于对照组，而有效率明显高于对照组[（5.84±0.65 vs 13.25±2.73）、（88.37 vs 65.85）]% （P<0.05）;观察组患者患牙SMH及L*值均明显高于对照组[（196.31±21.71 vs 131.64±15.84）、（82.67±9.12 vs 78.25±8.62）]（P<0.05）;观察组患者患牙计算机评分及专业医生评分均明显高于对照组[（44.82±5.82 vs 39.27±4.93）、（39.27±4.93 vs 40.76±5.14）]分（P>0.05）;观察组患者前牙覆盖与覆牙合良好、后牙咬合状况良好及牙齿排列整齐明显高于对照组[（95.35 vs 78.05）、（90.02 vs 73.17）、（100.00 vs 75.61）]%（P<0.05）;观察组患者患牙不良反应率明显低于对照组（6.98 vs 24.39）%（P<0.05）。对患者进行为期1年随访，牙面仍旧自然美观，无明显变色和着色，未见龋洞形成，龈色正常。结论：渗透树脂应用于正畸术后牙面白斑样病损患者不仅可减少病损面积，还可提高临床效果及美学效果，不良反应小，安全性较高，值得在临床上推广应用。

[关键词]渗透树脂;口腔正畸;美学效果;牙面白斑样病损;预后

[中图分类号]R783.5    [文献标志码]A    [文章编号]1008-6455（2021）05-0133-04

Esthetic Effect and Prognosis Follow-up of Infiltrating Resin Applied to Patients with Tooth White Spot after Orthodontics

LU Li-rong

（Suzhou Medical District，the 94th Hospital of the Joint Service Support Force of the People's Liberation Army，Suzhou 215007，Jiangsu，China）

Abstract： Objective Study on the aesthetic effect and prognosis of the application of osmotic resin in the patients with white spot lesions after orthodontic surgery. Methods  A total of 84 patients with leukoid lesions after orthodontic surgery in the department of stomatology of our hospital from January 2017 to December 2019 were selected as the research subjects， and a total of 84 teeth were affected. According to the random number table method， they were divided into observation group （n=43） and control group （n=41）. The control group was treated with fluoride， and the observation group was treated with permeable resin.The lesion area ratio，the effective rate， the surface microhardness （SMH） and the value of L*， the chalky plaque score， the aesthetic effect and the adverse reactions were compared between the two groups. Results  After treatment， the lesion area ratio of patients in the observation group was significantly lower than that of the control group， while the effective rate was significantly higher than that of the control group [（5.84±0.65 vs 13.25±2.73）， （88.37 vs 65.85）]% （P<0.05）. The SMH and L* values of the observed group were significantly higher than those of the control group [（196.31±21.71 vs 131.64±15.84） and （82.67±9.12 vs 78.25±8.62）] （P<0.05）. The computer score and professional doctor's score of the observation group were significantly higher than those of the control group [（44.82±5.82 vs 39.27±4.93） and （39.27±4.93 vs 40.76±5.14）] （P>0.05）. In the observation group， patients with good anterior tooth coverage and overbite， good posterior teeth bite condition and orderly teeth arrangement were significantly higher than those in the control group [（95.35 vs 78.05）， （90.02 vs 73.17）， （100.00 vs 75.61）]% （P<0.05）. The rate of adverse tooth reactions in the observation group was significantly lower than that in the control group （6.98 vs 24.39） % （P<0.05）.After a 1-year follow-up， the tooth surface was still natural and beautiful， with no obvious discoloration and coloring， no caries formation， and normal gum color. Conclusion  The application of osmotic resin in the patients with white spot lesions after orthodontic surgery can not only reduce the lesion area， but also improve the clinical and aesthetic effects.

Key words： permeable resin; orthodontic technique; aesthetic effect; white spot on tooth surface; prognosis

正畸治疗过程中患者易发生白垩斑并发症，是由于安置固定矫正器会腐蚀牙齿，且佩戴时间过长，易发生牙面细菌感染，从而导致牙釉质脱矿，由此形成牙面白斑样病损[1]。相关研究证明[2]，随着人们生活水平的提高，越来越多的人注重微笑美学，白垩斑严重影响面部美观。临床治疗白垩斑有两大目标：①改善白垩斑的颜色，使患者牙齿表面恢复光泽;②阻止牙釉质脱矿的发展，预防龋洞[3-4]。吴云兵等[5]研究显示，再矿化及牙齿漂白等是临床治疗正畸引起的白垩斑常用方式，但矿化治疗和牙齿漂白均对患者有一定损伤，况且白垩斑仍会显示，美学效果还不理想。渗透树脂是一种新型材料，具有渗透力强等优点，可有效阻止牙齿发生细菌及龋齿，牙釉质密度高，折光率低，对牙齿的美学效果具有一定作用[6]。……