中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (22): 3522-3526.doi: 10.3969/j.issn.2095-4344.3097

• 组织工程口腔材料 tissue-engineered oral materials • 上一篇    下一篇

渗透树脂联合生物活性玻璃修复脱矿牙釉质的效果及稳定性

程亚楠,吴毓聪,毛秋华,陈  灵,陆丽英,徐  普   

  1. 中南大学湘雅医学院附属海口医院·海南省口腔医学中心,海南省海口市   570208
  • 收稿日期:2020-04-16 修回日期:2020-04-22 接受日期:2020-05-23 出版日期:2021-08-08 发布日期:2021-01-20
  • 通讯作者: 徐普,主任医师,中南大学湘雅医学院附属海口医院·海南省口腔医学中心,海南省海口市 570208
  • 作者简介:程亚楠,女,1986年生,山东省菏泽市人,汉族,2018年中南大学毕业,博士,主治医师,主要从事骨组织工程、牙周组织改建方面的研究。
  • 基金资助:
    海南省重点研发项目(ZDYF2016018),项目负责人:徐普

Restoration effect and stability of resin infiltration combined with bioactive glass on demineralized tooth enamel

Cheng Yanan, Wu Yucong, Mao Qiuhua, Chen Ling, Lu Liying, Xu Pu   

  1. Affiliated Haikou Hospital, Xiangya Medical School, Central South University, Hainan Provincial Stomatology Center, Haikou 570208, Hainan Province, China
  • Received:2020-04-16 Revised:2020-04-22 Accepted:2020-05-23 Online:2021-08-08 Published:2021-01-20
  • Contact: Xu Pu, Chief physician, Affiliated Haikou Hospital, Xiangya Medical School, Central South University, Hainan Provincial Stomatology Center, Haikou 570208, Hainan Province, China
  • About author:Cheng Yanan, MD, Attending physician, Affiliated Haikou Hospital, Xiangya Medical School, Central South University, Hainan Provincial Stomatology Center, Haikou 570208, Hainan Province, China
  • Supported by:
    key research and development project of hainan province, No. ZDYF2016018 (to XP)

摘要:

文题释义:
生物活性玻璃:为一种硅钙磷无机非金属生物活性材料,是一种新兴的牙修复材料,体外具有良好的生物相容性和生物活性。生物活性玻璃改性后的树脂粘接剂能够释放钙磷等矿物离子,具有抑制脱矿牙本质胶原水解、促进脱矿牙本质再矿化的作用。生物活性玻璃可应用于龋齿修复、体内成骨、生物黏合剂等方面。
渗透树脂:是一种广泛应用于牙科的高分子材料,能够有效防止脱矿的牙釉质进一步发展,也可以阻止釉质表层塌陷、龋洞形成,并填充通道,有效阻断脱矿继续。牙体组织树脂浸渗后矿物含量及力学性能等方面也有改善。渗透树脂可应用于釉质龋、釉质白斑、釉质矿化不全。

背景:渗透树脂是一种修复釉质初期龋的有效方式,但近期研究发现其存在抗脱矿能力不足、聚集收缩、易老化、颜色稳定性较差等缺陷。
目的:观察渗透树脂联合生物活性玻璃修复脱矿牙釉质的效果及稳定性。
方法:收集临床因正畸治疗拔除的磨牙100颗,建立人工牙釉质脱矿模型后随机分4组进行再矿化处理:A组浸于人工唾液中;B组进行渗透树脂处理后浸于人工唾液中;C组进行渗透树脂处理后以氟化钠(2次/d)处理,最后浸于人工唾液中;D组进行渗透树脂处理后以生物活性玻璃(2次/d)处理,最后浸于人工唾液中,4组再矿化处理时间为4周。再矿化处理后,将4组进行再脱矿处理,72 h后取出。于处理前、脱矿后、再矿化处理后及再脱矿处理后分别进行光学相干断层成像扫描、牙釉质表面粗糙度及牙釉质显微硬度检测。
结果与结论:①光学相干断层成像扫描显示,处理前,各组牙釉质表面平滑,信号最强,组间无差异;初次脱矿后,各组牙釉质表面略不平,信号增强区域向表面以下延伸,且组间无差异;再矿化后和再脱矿处理后,信号增强区域向表面以下延伸更加明显,且D组牙釉质表面信号增强区域减弱较其他各组更显著;②处理前与初次脱矿处理后,4组间牙釉质表面粗糙度比较差异无显著性意义(P﹥0.05);再矿化处理后,粗糙度值大小为:A组>B组>C组>D组,组间比较差异均有显著性意义(P < 0.01);再脱矿处理后,A组粗糙度值高于初次脱矿后(P < 0.01),B、C、D组低于初次脱矿后(P < 0.01);③处理前与初次脱矿处理后,4组间牙釉质显微硬度比较差异无显著性意义(P﹥0.05);再矿化处理后,显微硬度值大小为:A组<B组<C组<D组,组间比较差异均有显著性意义(P < 0.01);再脱矿处理后,A组显微硬度值低于初次脱矿后(P < 0.01),B、C、D组高于初次脱矿后(P < 0.01);④结果表明,渗透树脂联合生物活性玻璃修复牙釉质脱矿的效果及抗脱矿稳定性优于单纯使用渗透树脂及渗透树脂与氟化物联合。
https://orcid.org/0000-0002-4470-4224 (程亚楠) 

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程

关键词: 材料, 渗透树脂, 生物活性玻璃, 再矿化, 再脱矿, 表面粗糙度, 显微硬度

Abstract: BACKGROUND: Resin infiltration is an effective way to repair the initial caries of enamel, but recent studies have found that it has defects such as insufficient anti-mineralization ability, aggregation shrinkage, easy aging and poor color stability. 
OBJECTIVE: To observe the restoration effect and stability of resin infiltration combined with bioactive glass on demineralized tooth enamel. 
METHODS: 100 isolated human tooth specimens were selected to establish an artificial enamel demineralization model, which were randomly divided into four groups and received remineralization treatment. In the group A, models were immersed in artificial saliva. In the group B, the models were immersed in artificial saliva after resin infiltration treatment. In the group C, the models were treated with resin infiltration and then treated with sodium fluoride (twice a day), and finally immersed in artificial saliva. In the group D, the models were treated with resin infiltration and treated with bioactive glass (twice a day), and finally immersed in artificial saliva. The remineralization time of the four groups was 4 weeks. After remineralization, the four groups were re-demineralized and removed after 72 hours. Optical coherence tomography, enamel surface roughness and enamel microhardness were measured before treatment, after demineralization, after remineralization and after re-demineralization. 
RESULTS AND CONCLUSION: (1) Optical coherence tomography scan showed that the enamel surface of each group was smooth before treatment; the signal was strongest; and there was no difference between the groups. After the initial demineralization, the surface of each group was slightly uneven; the signal enhancement region extended below the surface; and there was no difference between the groups. After remineralization and re-demineralization, the signal enhancement region extended more obviously below the surface, and the signal enhancement region of group D enamel surface was weakened more significantly than other groups. (2) Before treatment and after initial demineralization, there was no significant difference in enamel surface roughness between four groups (P > 0.05). After remineralization, the roughness values were: group A > group B > group C > group D, and the difference was significant among groups (P < 0.01). After re-demineralization, the roughness value of group A was higher than that after the initial demineralization (P < 0.01); the roughness values of groups B, C, and D were lower than those after the initial demineralization (P < 0.01). (3) Compared with the initial demineralization, there was no significant difference in microhardness between the four groups (P ﹥ 0.05). After remineralization, the microhardness values were: group A < group B < group C < group D, and the difference was significant among groups (P < 0.01). After re-demineralization, the microhardness value of group A was lower than that after the initial demineralization (P < 0.01); the microhardness values of groups B, C, and D were higher than those after the initial demineralization (P < 0.01). (4) The results showed that the effect and anti-demineralization stability of porous resin combined with bioactive glass were better than that of using only permeable resin combined with fluoride.

Key words: material, resin infiltration, bioactive glass, remineralization, re-demineralization, surface roughness, microhardness

中图分类号: