4种再矿化制剂对酸蚀牙釉质磨损的影响

Effect of four remineralization agents on abration of acid eroded enamel

摘要:

目的：比较酪蛋白磷酸肽-无定形磷酸钙复合物（casein phosphopeptide-amorphous calcium phosphate，CPP-ACP）、含氟酪蛋白磷酸肽-无定形磷酸钙复合物（casein phosphopeptide-amorphous calcium phosphate fluoride，CPP-ACPF）、含氟磷酸三钙（tri-calcium phosphate fluoride，TCP+F）、Duraphat 保护漆4种再矿化制剂对酸蚀牙釉质刷牙磨损后表面硬度和表面形态的影响。方法：选择因阻生拔除的下颌第三磨牙制成釉质块，选择硬度值介于280～330 HV的釉质块50个，随机分为5组。将5组样本进行可口可乐酸蚀处理，5次/d，5 min/次，共5 d。采用电动牙刷对酸蚀后的5组釉质块进行刷牙磨损，刷牙所用的压力为2 N，2次/d，3 min/次，共5 d。刷牙间隔期5组样本分别涂布去离子水、CPP-ACP、CPP-ACPF、TCP+F、Duraphat，继续磨损-再矿化-酸蚀处理5 d。采用显微硬度法测量处理前后牙釉质表面硬度，采用扫描电镜（scanning electron microscope，SEM）观察牙釉质表面形态的变化。结果：CPP-ACP组、CPP-ACPF组显微硬度值继续降低，与去离子水组无统计学差异（P ＞0.05）；TCP+F组、Duraphat组显微硬度值出现增加，明显高于去离子水组（P＜0.05）。SEM显示除去离子水组以外，其余4组釉质样本表面均变得平整。结论：Duraphat和TCP+F可以防止持续酸蚀牙釉质的磨损。

Abstract:

Objective：To compare the effect of casein phosphopeptide-amorphous calcium phosphate（CPP-ACP），casein phosphopep－tide-amorphous calcium phosphate fluoride（CPP-ACPF），tri-calcium phosphate fluoride（TCP+F） and Duraphat fluoride var－nish on surface microhardness and surface morphology after toothbrushing abrasion of eroded enamel. Methods：Impacted mandibular third molars were collected at clinic and 50 sam－ples with hardness between 280-330 HV were selected. The samples were processed into enamel slabs and then were randomly divided into five groups. The samples were first immersed into Co－ca-Cola for 5 min，5 times a day for 5 days. Then erosive enamel samples were subjected to brushing abrasion with an electric tooth－brush 2 N brushing load for 3 min，2 times a day for 5 days. Distilled water，CPP-ACP，CPP-ACPF，TCP+F and Duraphat were re－spectively applied during brushing interval and abrasion-remineralization-erosion treatment was provided for ５ days. Microhardness of enamel surface before and after the treatment was measured by microhardness tester and morphology changes of enamel surface was observed by scanning electron microscope（SEM）. Results：Microhardness in CPP-ACP and CPP-ACPF group was decreased，having no significant difference compared with that of distilled water group（P ＞0.05）. Microhardness in TCP+F and Duraphat group was significantly higher than that of distilled water group（P<0.05）. Smooth enamel surface was observed with SEM in other four groups except in distilled water group. Conclusion：Duraphat and TCP+F can prevent the abrasion of constant acid eroded enamel.