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目的:探讨渗透树脂对漂白后牙釉质表面结构、显微硬度及颜色的影响，为渗透树脂的临床应用提供参考。方法:选择128颗因正畸需要而拔除的前磨牙（郑州大学第一附属医院口腔颌面外科提供），通过随机排列表法随机分为A、B、C 3部分，每部分再通过随机排列表法随机均分为对照组、树脂组、漂白组和联合组；对照组不做任何处理；漂白组和联合组行冷光美白处理；树脂组和联合组行渗透树脂处理。A部分在处理后即刻及处理后2周进行扫描电镜观察；B部分在处理前、处理后即刻及处理后2周进行显微硬度测量（每组每个时间点样本量为8）；C部分在处理前、处理后即刻及处理后1、2周进行色度测量，并计算各组处理后各时间点与处理前的色差（ΔE值）（每组每个时间点样本量为10）。结果:扫描电镜显示，处理后即刻树脂组、联合组牙釉质表面平整光滑，除可见树脂覆盖外，其余与对照组基本一致；漂白组表面可见微孔状缺损和矿物质沉积；处理后2周各组牙釉质表面平整光滑无明显差别。处理后即刻对照组、树脂组、漂白组、联合组显微硬度分别为（354±33）、（364±21）、（411±30）、（350±17） HV（n F=9.39，n P0.05）。处理后即刻对照组、树脂组、漂白组、联合组ΔE值分别为0.00±0.00、2.29±1.86、7.20±1.94、8.00±0.88（n F=74.21，n P0.05）外，其余组间差异均有统计学意义（n P0.05）。联合组处理后即刻ΔE值显著大于处理后1、2周（n F=10.97，n P0.05）。n 结论:对健康牙釉质进行美白时，单纯的冷光美白或冷光美白联合渗透树脂均能达到美白效果。“,”Objective:To investigate the effect of permeable resin on the surface structure, microhardness and color of tooth enamel after bleaching.Methods:One hundred and twenty-eight premolars extracted for orthodontic needs were selected (provided by the Department of Oral and Maxillofacial surgery of the first affiliated Hospital of Zhengzhou University) and randomly divided into A, B and C 3 groups. Each group was randomly divided into control subgroup, resin subgroup, bleaching subgroup and combined subgroup. Samples in the control subgroup did not receive any treatment. Those in the bleaching subgroup and combined subgroup were treated with cold light whitening. Those in the resin group and combined group were treated with permeable resin. Samples in the group A were observed by scanning electron microscope immediately after treatment and 2 weeks after treatment, and the microhardness of samples in the group B was measured before treatment, immediately after treatment and 2 weeks after treatment (the sample size of each time point was 8 in each subgroup). In group C, chromaticity was measured and chromatic aberration (ΔE value) was calculated before treatment, immediately after treatment and 1 and 2 weeks after treatment (10 samples in each subgroup).Results:Scanning electron microscope showed that the enamel surface of the resin subgroup and the combined group was smooth immediately after treatment, which was basically the same as that of the control subgroup, but covered with resin, and microporous defects and mineral deposits could be seen on the surface of the bleaching subgroup. Two weeks after treatment, the enamel surface of each subgroup was smooth, there was no obvious difference. Immediately after treatment, the microhardness of the control subgroup, resin subgroup, bleaching subgroup and combined subgroup were (354±33), (364±21), (411±30) and (350±17) HV, respectively (n F=9.39,n P<0.05). The microhardness of the bleaching subgroup was significantly higher than that of the other subgroups (n P0.05). Immediately after treatment, the ΔE values of the control subgroup, resin subgroup, bleaching subgroup and combined subgroup were 0.00±0.00, 2.29±1.86, 7.20±1.94 and 8.00±0.88, respectively (n F=74.21,n P0.05), there were significant differences among the other subgroups (n P0.05). The difference in the combined subgroup immediately after treatment was significantly higher than that at 1 and 2 weeks after treatment (n F=10.97,n P0.05), and the color tended to be stable.n Conclusion:When whitening healthy enamel, simple cold light whitening or cold light whitening combined with permeation resin can achieve whitening effect.