中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (15): 2445-2451.doi: 10.12307/2024.246

• 生物材料综述 biomaterial review • 上一篇    下一篇

铈及铈基材料在口腔疾病领域中的应用

张滨婧，王  剑   

  1. 口腔疾病研究国家重点实验室，国家口腔疾病临床医学研究中心，四川大学华西口腔医院修复科，四川省成都市  610041
  • 收稿日期:2023-02-28 接受日期:2023-03-03 出版日期:2024-05-28 发布日期:2023-09-23
  • 通讯作者: 王剑，博士，教授，口腔疾病研究国家重点实验室，国家口腔疾病临床医学研究中心，四川大学华西口腔医院修复科，四川省成都市 610041
  • 作者简介:张滨婧，女，2000年生，重庆市人，汉族。
  • 基金资助:
    国家自然科学基金(82271034，81970985)，项目负责人：王剑

Cerium and cerium-based materials in dental applications

Zhang Binjing, Wang Jian   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2023-02-28 Accepted:2023-03-03 Online:2024-05-28 Published:2023-09-23
  • Contact: Wang Jian, MD, Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
  • About author:Zhang Binjing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 82271034, No. 81970985 (to WJ)

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摘要：


文题释义：

铈：铈在1803年被首次发现，原子序数为58，属于稀土元素，第六周期系第ⅢB族镧系元素，在地壳中的含量约0.004 6%，排名第25位，是丰度最高的稀土元素。铈多以氧化铈的形式存在，具有氧化还原酶模拟活性，具有抗菌、抗炎、成骨和成血管等多种功能。
活性氧：是氧得到单电子的活性小分子，主要包括过氧化物、超氧化物及羟基自由基等。活性氧是氧正常代谢的副产物，在细胞信号传导、氧化应激和增殖分化中起重要作用。但在病理条件下，过量的活性氧会对DNA和RNA造成损伤，影响细胞的正常生理功能，与多种疾病的发生发展具有密切联系。


背景：铈(cerium，Ce)是含量最丰富的镧系元素，主要以氧化铈的形式存在。Ce3+和Ce4+两种价态之间快速转化使铈兼具氧化剂和还原剂的作用，具有抗菌、抗炎、促进组织再生和抗肿瘤等多种生物学活性，在口腔医学领域具有广泛的应用。

目的：概述铈在抗菌、抗炎、促进组织再生及抗肿瘤中的作用和机制，综述近年来铈和铈基材料在口腔材料改性和口腔疾病诊疗中的研究现状和应用前景。
方法：以“cerium，ceria，prosthodontics，prosthesis，restorative dentistry，denture，dental implant，caries，endodontics，pulpitis，periodontitis，periodontal diseases，oral cancer”为英文检索词，以“铈，氧化铈，修复，种植，龋齿，龋病，牙髓，牙周炎，牙周疾病，口腔癌”为中文检索词，分别在Web of Science、PubMed、中国知网及万方数据库进行文献检索，检索时限为各数据库建库至2023年。通过分析和阅读文献进行筛选，按照排除筛选标准纳入文献，最终纳入73篇文献进行综述。

结果与结论：①铈主要通过直接接触细菌、氧化应激和破坏细菌生物膜发挥抗菌作用，同时依赖氧化还原酶模拟活性清除活性氧而发挥抗炎功能，铈的成骨和成血管活性涉及ERK和Wnt等一系列信号通路。②铈的抗菌、抗炎、成骨和成血管活性使其在治疗口腔感染性疾病和促进口腔软硬组织再生中具有广阔的应用前景，但铈的抗肿瘤特性在口腔领域的应用仍存在一定空白。③作为口腔陶瓷材料，氧化铈稳定的氧化锆具有优异的机械物理性能，但透光性较低，适用于制作基底瓷、义齿支架和种植体。④依托铈的生物学活性，铈基材料能够有效促进种植体骨和软组织整合，抑制牙齿脱矿和致龋菌生长，促进牙本质牙髓复合体再生，减轻牙周炎炎症反应并促进牙周组织再生，在种植体表面改性、龋病预防、牙髓炎、牙周疾病和口腔癌的诊疗中均有较大的应用潜力。⑤铈在高浓度和长时间给药的情况下存在潜在的毒性，为进一步扩大铈在口腔临床实际中的应用，铈的生物安全性以及铈基材料适应口腔环境的优化在未来仍需更详尽的研究。

http://orcid.org/0000-0002-5489-8923(张滨婧)

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: 铈, 氧化铈, 口腔医学, 口腔修复, 口腔种植, 龋病, 牙髓炎, 牙周疾病, 口腔癌, 临床应用

Abstract: BACKGROUND: Cerium (Ce) is the most abundant element among lanthanides, which is mostly in the form of ceria. The reversible transformation between Ce3+ and Ce4+ ions contributes to the high redox activity of cerium. Because of its antibacterial, anti-inflammatory, osteogenic, angiogenic and anti-tumor properties, cerium has been widely used in stomatology. 
OBJECTIVE: To summarize the antibacterial, anti-inflammatory, osteogenic, angiogenic and anti-tumor mechanism of cerium, and to review the research status and application prospects of cerium and cerium-based materials in the modification of oral materials and the diagnosis and treatment of oral diseases in recent years. 
METHODS: The articles published from database inception to 2023 were retrieved from Web of Science, PubMed, CNKI and WanFang databases with the search terms “cerium, ceria, prosthodontics, prosthesis, restorative dentistry, denture, dental implant, caries, endodontics, pulpitis, periodontitis, periodontal diseases, oral cancer” in English and “cerium, ceria, prosthodontics, implant, dental caries, dental pulp, periodontitis, periodontal disease, oral cancer” in Chinese. By analyzing and reading literature for screening, according to the inclusion and exclusion criteria, 73 articles were finally included in this review.
RESULTS AND CONCLUSION: (1) Cerium exerts an antibacterial effect through direct contact with bacteria, oxidative stress and destroying bacterial biofilm, and exerts an anti-inflammatory function based on mimetic enzyme activity. The osteogenic and angiogenic activities of cerium involve a series of signaling pathways including ERK and Wnt signaling pathways. (2) Antibacterial, anti-inflammatory, osteogenic, and angiogenic activities allow cerium significant potential in the treatment of oral infectious diseases and regeneration of oral soft and hard tissues. However, there is still a certain gap in the application of cerium’s anti-tumor properties in the oral field. (3) Due to excellent mechanical properties and a low light-transmitting property, ceria-stabilized zirconia as a dental ceramic material can be used for core ceramics, the frameworks of dental prostheses and dental implants. (4) Benefited from its biological properties, cerium-based materials have the ability to promote osseointegration and soft tissue integration, inhibit demineralization and cariogenic bacteria, facilitate regeneration of the dentin-pulp complex, lessen inflammatory response and enhance periodontal tissue regeneration. There are wide applications of cerium in surface modifications of implants and treatments of caries, pulpitis, periodontitis and oral cancers. (5) Cerium shows certain toxicity under conditions of high concentration and long-term administration. To further expand clinical applications of cerium in dentistry, biosafety and optimization of cerium-based materials need to be further explored in the future.

Key words: cerium, ceria, stomatology, restorative dentistry, dental implant, caries, pulpitis, periodontitis, oral cancer, clinical application

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