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微创牙科治疗具有无痛、牙体组织损失小和操作简单等优点,得到越来越多牙体修复医师的关注。渗透树脂治疗早期龋损是近年来应用于临床的微创治疗新疗法。其作用原理是在龋病的早期阶段,脱矿区扩大的晶体间隙和釉质表层的微孔是酸和溶解的无机物扩散通道,同时也可对外环境中低粘度液体发生虹吸作用,低粘度、高渗透性流动树脂可由此渗透到脱矿牙体组织中,填充微孔,封闭酸和细菌进入牙体组织的路径,阻断龋病进展;理论上可为牙体组织提供机械性的支持,阻止釉质表层塌陷、龋洞形成。渗透治疗可被理解成一种微观的充填治疗。树脂渗透治疗适用于尚未形成龋洞的、病损范围局限于釉质表层至牙本质浅层1/3的邻面及光滑面早期龋。操作步骤大致分为酸蚀、干燥、渗透、固化四步。全部治疗须在严格隔湿的条件下完成,最好使用橡皮障。树脂渗透技术为治疗早期龋提供有效的新方法,具体优点:①增加脱矿区的稳固性;②更多的保存健康牙体组织,维持生理形态;③永久阻塞微孔和空腔结构;④阻断龋病进展;⑤更久的延迟充填治疗,使继发龋发生风险最小化;⑥改善白垩色斑块区的美观;⑦微创、无痛,患者易于接受。但也存在一些局限性,如适应证范围相对较窄,只适用于平滑面、邻面早期龋,而不适用于早期窝沟龋,以及对釉质矿化不良形成的白垩色斑块美观改善效果并不理想。
Minimally invasive dental treatment has the advantages of painless, small loss of tooth tissue and simple operation, more and more dental restoration physicians attention. Infiltration of resin in the treatment of early carious lesions in recent years, clinical application of minimally invasive treatment of new therapies. The principle of action is that in the early stage of dental caries, the enlarged crystal gap in the demineralized zone and the pores in the enamel surface are the diffusion channels of acid and dissolved inorganic substance, but also the siphon effect of low viscosity liquid in the external environment, low viscosity and high Permeable flow resins can thus penetrate into the demineralized tooth tissue, fill micropores, enclose acids and bacteria into the tooth tissue pathways and block the progression of dental caries; theoretically provide mechanical support to the tooth tissue and prevent Enamel surface collapse, cavities formed. Infiltration therapy can be understood as a micro-filling treatment. Resin infiltration treatment is not applied to the formation of cavities, the scope of the lesion is limited to the enamel surface to the shallow 1/3 of the dentine and smooth early caries. The steps are roughly divided into etching, drying, infiltration, curing four steps. All treatment should be done under strict wet conditions, the best use of rubber dam. Resin infiltration technology for the treatment of early caries provide an effective new method, the specific advantages: ① increase the stability of the demineralization zone; ② more to save healthy tooth tissue, maintaining physiological morphology; ③ permanent blocking micropores and cavity structure; ④ resistance ⑤ more delayed filling treatment, so that the risk of secondary caries is minimized; ⑥ improve the appearance of the chalky plaque area; ⑦ minimally invasive, painless, the patient is easy to accept. But there are also some limitations, such as the scope of indications is relatively narrow, only applies to the smooth surface, adjacent to the early caries, and not suitable for early pit and caries, and enamel formation of chalky plaque appearance of aesthetically pleasing to improve Not ideal.