磨牙切牙釉质矿化不全的临床治疗研究
Comparative study on the treatment of molar-incisor hypomineralization
作者：单小霞, 杨巧韵, 杨兴花, 杨雨欣, 马亚楠, 赵子昂, 李睿敏
Author：Shan Xiaoxia, Yang Qiaoyun, Yang Xinghua, Yang Yuxin, Ma Ya’nan, Zhao Ziang, Li Ruimin
收稿日期：2025-04-01 年卷（期）页码：2026,44(1):137-137-143
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：磨牙切牙釉质矿化不全,切牙局部斑块病损,渗透树脂,第一恒磨牙,窝沟封闭,
Key words：molar-incisor hypomineralisation,local plaque lesions of incisors,infiltrative resin,first permanent molar,pit and fissure sealant,
基金项目：中国牙病防治基金(A2021-135);宁夏自然科学基金(2024AAC02076)
中文摘要
目的 评价不同治疗方法对轻度磨牙切牙釉质矿化不全患者切牙局部斑块病损及第一恒磨牙窝沟封闭的疗效。 方法 选取临床确诊为轻度磨牙切牙釉质矿化不全患者为研究对象，对切牙局部斑块病损和第一恒磨牙窝沟进行前瞻性临床治疗对比研究。切牙局部斑块病损采用渗透树脂与含氟涂料2种方法进行治疗，术前及术后1、3、6月测量切牙局部斑块病损面积和病损区域的明度（L）、红绿色相（a）、黄蓝色相（b），计算色差值（ΔE）及牙齿白度指数（WID）。第一恒磨牙窝沟采用磷酸酸蚀窝沟封闭与免酸蚀窝沟封闭2种方法进行治疗，术后1、3、6月计算2种方法的患龋率、封闭剂保留率、窝沟封闭成功率等指标。 结果 轻度磨牙切牙釉质矿化不全患者切牙局部斑块病损，与术前相比，术后1、3、6月渗透树脂组斑块病损面积减小（P<0.05），L、ΔE值呈降低趋势（P<0.05），而涂氟组斑块病损面积、L值差异无统计学意义（P>0.05）。轻度磨牙切牙釉质矿化不全患者第一恒磨牙窝沟，磷酸酸蚀窝沟封闭术后6月的窝沟封闭成功率、窝沟封闭剂保留率高于免酸蚀窝沟封闭（P<0.05），窝沟封闭剂脱落率低于免酸蚀窝沟封闭（P<0.05）。 结论 渗透树脂治疗能减小轻度磨牙切牙釉质矿化不全患者切牙局部斑块病损L、ΔE值，渗透树脂治疗对斑块病损面积的改善更显著，且在6个月内效果较稳定。轻度磨牙切牙釉质矿化不全患者第一恒磨牙窝沟封闭建议采用磷酸酸蚀。
英文摘要
ObjectiveThis study aimed to evaluate the efficacy of different treatment methods on local plaque lesions of incisors and the sealing of pits and fissures in first permanent molars in patients with mild molar-incisor hypomineralization (MIH).MethodsPatients clinically diagnosed with mild MIH were selected as research subjects for a prospective clinical comparative study on the treatment of local plaque lesions in incisors and the pits and fissures of first permanent molars. Infiltrative resin and fluoride varnish were used to treat local plaque lesions on incisors. The area of local plaque lesions on incisors and lightness (L), red-green hue (a), and yellow-blue hue (b) of the lesion area were measured before treatment and at 1, 3, and 6 months after treatment. The color difference value (ΔE) and tooth whiteness index (WID) were then calculated. Two methods, phosphoric acid etching pit and fissure sealing and self-etching pit and fissure sealing, were used for the treatment of pits and fissures of first permanent molars. The incidence rate of caries, sealant retention rate, and success rate of pit and fissure sealing for the two methods were calculated at 1, 3, and 6 months after treatment.ResultsIn patients with mild MIH, local plaque lesions on incisors exhibited a significant reduction in area at 1, 3, and 6 months post-treatment in the infiltrative resin group (P<0 .05), whereas no significant change was observed in the fluoride application group (P>0.05). After infiltrative resin treatment, the L value and ΔE value showed a decreasing trend (P<0 .05), whereas the l value in the fluoride application group did not change significantly (P>0.05). In patients with first permanent molars, the phosphoric acid etching pit and fissure sealing group exhibited superior success and retention rates at 6 months post-treatment compared with the self-etching pit and fissure sealing group (P<0 .05) and a lower loss rate than the self-etching pit and fissure sealing group (P<0 .05).ConclusionInfiltrative resin treatment can reduce the L value and ΔE value of local plaque lesions on incisors in patients with mild MIH. It demonstrates a significant improvement in plaque lesion area, with relatively stable effects within 6 months. Phosphoric acid etching is recommended for the pit and fissure sealing of first permanent molars in patients with mild MIH.
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