中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (18): 2842-2846.doi: 10.3969/j.issn.2095-4344.1727

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

不同非含氟护牙剂对牙釉质酸蚀后再矿化效果影响的体内试验

伍廷芸1，王德堂1，朱友家2，阮  琼3，伍爱民1，何尚群1，曾小芳1
  

  1. 1荆楚理工学院医学院，湖北省荆门市  448000；2武汉大学中南医院口腔医学中心，湖北省武汉市  430079；3荆门市康复医院口腔科，湖北省荆门市  448000
  • 收稿日期:2019-01-22 出版日期:2019-06-28 发布日期:2019-06-28
  • 通讯作者: 朱友家，武汉大学中南医院口腔医学中心，湖北省武汉市 430079
  • 作者简介:伍廷芸，男，1981年生，贵州省安顺市人，2008年武汉大学毕业，硕士，讲师，主治医师，主要从事釉质脱矿后的再矿化及大学生心理学研究。
  • 基金资助:

    2016年荆楚理工学院校级科研基金项目(QN201609)，项目负责人：伍廷芸

Effects of different types of fluoride-free toothpaste on the remineralization of enamel after acid erosion: an in vivo study

Wu Tingyun1, Wang Detang1, Zhu Youjia2, Ruan Qiong3, Wu Aimin1, He Shangqun1, Zeng Xiaofang1
  

  1. 1Medical College, Jingchu University of Technology, Jingmen 448000, Hubei Province, China; 2Center of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan 430079, Hubei Province, China; 3Department of Stomatology, Jingmen Rehabilitation Hospital, Jingmen 448000, Hubei Province, China
  • Received:2019-01-22 Online:2019-06-28 Published:2019-06-28
  • Contact: Zhu Youjia, Center of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan 430079, Hubei Province, China
  • About author:Wu Tingyun, Master, Lecturer, Attending physician, Medical College, Jingchu University of Technology, Jingmen 448000, Hubei Province, China

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摘要：

文章快速阅读：

 

文题释义：
生物活性玻璃：是一类能对机体组织进行修复、替代与再生，具有能使组织和材料之间形成键合作用的材料，其主要成分为SiO2、Na2O、CaO和P2O5等组成的硅酸盐玻璃，具有良好的生物相容性和生物安全性，在接触到水或者唾液时释放出钙和磷酸盐离子，构成羟磷灰石矿物质的基本元素。   
酪蛋白磷酸肽-无定形磷酸钙：酪蛋白磷酸多肽是动物奶酪中的一种多肽，为色氨酸片段，是运送钙、磷、氟到达牙齿的良好载体，其与无定形磷酸钙结合形成酪蛋白磷酸多肽-无定形磷酸钙，可将具有生物活性的钙离子和磷酸盐离子运送到牙齿表面，起到磷酸钙储存库的作用。
 
 
背景：低龄儿童吞咽反射发育尚未健全，使用含氟牙膏存在氟中毒危险，而无氟护齿剂因不含氟元素而具备非常优良的安全性能。
目的：比较奥乐V护牙剂、GC护牙素和无氟牙膏在家庭自我口腔保健中对于脱矿牙釉质的再矿化效果。
方法：纳入荆门市康复医院口腔科因正畸需要拟拔除健康第一前磨牙的患者15例，共60颗牙，年龄12-18岁。将每例患者左侧的上下颌第一前磨牙作为对照组，颊面酸蚀后即刻拔除；无氟牙膏组随机选择5例患者，右侧上下颌第一前磨牙颊面酸蚀后，早晚以无氟牙膏刷牙，10 d后拔除；奥乐V护牙剂组随机选择5例患者，右侧上下颌第一前磨牙颊面酸蚀后，早晚以奥乐V护牙剂刷牙，10 d后拔除；GC护牙素组的5例患者，右侧上下颌第一前磨牙颊面酸蚀后，早晚使用含摩擦剂和发泡剂的普通牙膏刷牙后，将GC护牙素均匀涂于酸蚀牙颊面3 min，10 d后拔除。制备离体牙颊面牙釉质标本，进行扫描电镜观察与X射线能谱分析。
结果与结论：①扫描电镜显示，对照组牙釉质表面不规则，多孔隙，呈蜂窝状改变，釉柱中心溶解，大部分出现孔隙样凹陷；无氟牙膏组牙釉质表面可见散在的少量矿物质沉积，奥乐V护牙剂组和GC护牙素组牙釉质表面仍有大量蜂窝状空隙，同时有大量矿物质沉积，孔隙变小，矿化物颗粒细小，沉积不均匀，GC护牙素组沉积量较多；②X射线能谱分析显示，对照组与无氟牙膏组钙、磷含量无差异(P > 0.05)，奥乐V护牙剂组和GC护牙素组钙、磷含量无差异(P > 0.05)，奥乐V护牙剂组、GC护牙素组钙、磷含量高于对照组、无氟牙膏组(P < 0.05)；③结果表明，奥乐V护牙剂、GC护牙素均可显著促进脱矿牙釉质的再矿化，以GC护牙素的再矿化效果更优。

关键词: 护牙剂, 生物活性玻璃, 酪蛋白磷酸肽, 无定形磷酸钙, 奥乐V护牙剂, GC护牙素, 无氟牙膏, 再矿化

Abstract:

BACKGROUND: The development of the swallowing reflex in young children is incomplete, and there is a risk of fluorosis when using fluoride toothpaste. By contrast, fluoride-free toothpaste is much safer for children.
OBJECTIVE: To compare the effects of OHOLV toothpaste, GC MI paste and fluoride-free toothpaste on the remineralization of demineralized enamel in family oral care.
METHODS: Fifteen patients, aged 12-18 years, who were prepared to receive extractions of healthy first premolars (60 teeth in total) due to orthodontic needs in the Department of Stomatology of Jingmen Rehabilitation Hospital, were included. Left maxillary and mandibular first premolars as controls were extracted immediately after acid eroding on the buccal surface. Five patients were randomly selected and included into fluoride-free toothpaste group. After their right maxillary and mandibular first premolars were eroded, fluoride-free toothpaste was applied every morning and evening, and after 10 days, these teeth were extracted. Five patients were randomly selected and included into OHOLV toothpaste group. After their right maxillary and mandibular first premolars were eroded, OHOLV toothpaste was applied every morning and evening, and after 10 days, these teeth were extracted. Similarly, for the five patients in the GC MI paste group, the same erosion was performed before the application of GC MI paste for 3 minutes every morning and evening, and after 10 days, these teeth were also extracted. Buccal enamel specimens were isolated, observed and analyzed by scanning electron microscopy and energy-dispersive X-ray spectroscopy.
RESULTS AND CONCLUSION: (1) Scanning electron microscope showed that the enamel surface in the control group was irregular, porous and honeycomb-shaped, the center of the enamel rod dissolved, and many porous defects appeared. A few scattered mineral deposits could be seen on the enamel surface in the fluoride-free toothpaste group. There were still a lot of honeycomb-shaped pores on the enamel surface in the OHOLV toothpaste and GC MI paste groups. Meanwhile, there were also a large number of mineral deposits and the pores became smaller. The mineralized particles were small and the deposits were uneven. The GC MI paste group had a larger amount of deposits. (2) Energy-dispersive X-ray spectroscope showed no difference in calcium and phosphorus levels between control and fluoride-free toothpaste groups (P > 0.05). No difference was observed in the calcium and phosphorus levels between OHOLV toothpaste and GC MI paste groups (P > 0.05). The OHOLV toothpaste and the GC MI paste groups had higher calcium and phosphorus levels than the control and fluoride-free toothpaste groups (P < 0.05). (3) These results suggest that OHOLV toothpaste and GC MI paste can significantly promote the remineralization of demineralized enamel, especially GC.

Key words: toothpaste, bioactive glass, casein phosphopeptides, amorphous calcium phosphate, OHOLV toothpaste, fluoride-free toothpaste, remineralization

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