儿童时期恒牙釉质显微硬度及微观结构研究

doi:10.7518/hxkq.2025.2025161

摘要/Abstract

摘要：

目的通过研究儿童时期不同萌出阶段的恒牙釉质显微硬度及微观结构，为儿童龋病早期预防提供参考。方法收集并筛选出因正畸拔除的前磨牙45颗，按照萌出时间将前磨牙分为A（萌出0~1年）、B（萌出1~3年）、C（萌出3~5年）组；另外筛选出因阻生拔除且未萌出的第三磨牙为对照组；每组15颗。制备样本，分别采用维氏显微硬度仪、扫描电镜及电子探针测定釉质表面显微硬度、微观结构及微量元素成分。结果与对照组相比，随萌出时间增加，A、B、C组釉质显微硬度增强，表面孔状结构明显减少，表层钠、镁元素含量减少，氟元素含量增加（P<0.05）。结论萌出不同阶段恒牙的釉质显微硬度、微观结构存在差别；萌出1年内牙齿存在明显的龋易感风险，应做好早期预防。

关键词: 儿童, 年轻恒牙, 釉质, 萌出后成熟, 微观结构

Abstract:

Objective Through the investigation of the microhardness and microstructure of permanent tooth enamel at various eruption stages during childhood, this research offers references for the early prevention of childhood dental caries. Methods Forty-five premolars extracted due to orthodontic reasons were collected and screened. These premolars were divided into three experimental groups according to the time since eruption: Group A (erupted for 0-1 year), Group B (erupted for 1-3 years), and Group C (erupted for 3-5 years). Additionally, the third molars that were extracted due to impaction and had not erupted were selected as the control group, with 15 teeth in each group. Samples were prepared, and the surface microhardness, microstructure, and elemental composition of the enamel were measured using Vickers microhardness tester, scanning electron microscope, and electron probe, respectively. Results Compared with that in the control group, the microhardness of enamel in groups A, B, and C increased with prolonged eruption time, the surface porosity structure decreased considerably, the contents of Na and Mg on the surface decreased, and that of F increased (P<0.05). Conclusion The microhardness and microstructure of enamel in permanent teeth at different stages vary. Permanent teeth are at a substantially higher risk of caries within one year after eruption, and early prevention should be emphasized.

Key words: children, immature permanent teeth, enamel, post-eruptive maturation, microstructure

中图分类号:

R788

顾起弘, 姜文敬, 刘一静, 刘玲, 高黎. 儿童时期恒牙釉质显微硬度及微观结构研究[J]. 华西口腔医学杂志, 2025, 43(4): 518-524.

Gu Qihong, Jiang Wenjing, Liu Yijing, Liu Ling, Gao Li. Research on the microhardness and microstructure of permanent tooth enamel in childhood[J]. West China Journal of Stomatology, 2025, 43(4): 518-524.

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深度	钙	磷	钠	镁	氟
P值	0.572	0.444	0.001^*	0.024^*	0.315
表层	64.87±0.26	30.98±0.19	1.31±0.10	0.39±0.06	2.38±0.19
50 μm	64.66±0.24	31.11±0.18	0.89±0.09	0.35±0.06	2.53±0.17
100 μm	64.88±0.27	30.90±0.20	0.77±0.10	0.34±0.06	2.28±0.19

深度	钙	磷	钠	镁	氟
P值	0.580	0.077	0.052	0.354	0.007^*
表层	65.37±0.83	30.79±0.63	0.67±0.32	0.23±0.20	2.73±0.56
50 μm	66.10±0.73	31.17±0.57	0.59±0.26	0.17±0.02	1.83±0.47
100 μm	63.48±0.69	32.13±0.58	1.29±0.30	0.37±0.19	0.56±0.54

深度	钙	磷	钠	镁	氟
P值	0.075	0.131	1.000	0.248	0.014^*
表层	68.21±0.73	29.53±0.59	0.59±0.25	0.17±0.17	2.65±0.41
50 μm	65.82±0.69	31.41±0.55	0.72±0.25	0.42±0.17	1.24±0.42
100 μm	64.98±0.70	30.84±0.58	1.14±0.30	0.40±0.20	1.22±0.55

深度	钙	磷	钠	镁	氟
P值	0.051	0.216	0.040^*	0.046^*	0.232
表层	62.62±0.99	33.66±0.77	0.96±0.39	0.68±0.26	2.03±0.70
50 μm	61.09±0.91	33.87±0.71	0.62±0.37	0.53±0.24	2.28±0.66
100 μm	59.76±0.99	34.82±0.79	0.68±0.41	0.32±0.26	3.08±0.74