Miani C M, Marigo L, Boari A, Sigismondi M
Facoltà di Medicina e Chirurgia A. Gemelli, Università Cattolica del Sacro Cuore, Roma.
Minerva Stomatol. 2000 Apr;49(4):139-47.
Early caries lesions present a greater porosity in the deep layers than in the superficial layer of the enamel. The "white spot" lesion is a dynamic lesion which is subjected to the changes occurring in the oral cavity; it can regress, stabilize or progress. The aim of this study is to show if there are considerable morphological differences in the superficial ultrastructural aspect of early caries lesions, active or stabilized, in persons of different age.
To carry out this SEM observation, 15 patients aged from 12 to 50 presenting early caries lesions have been selected. Some of them had been recently subjected to orthodontic treatment, others several years ago. Five of these patients have been called back to examine again the demineralized area by microscope in the very same place of the first observation. The replica technique was used utilizing a silicon-based impression material, an epoxy resin for replicas casting, little steel nets to fix the silicon material.
At the level of white spot lesions it is evident a tissural structure scattered with small overlappings and micropits with a diameter of 0.5-2 mu. The patients who removed orthodontic bands more than 10 years before show a shining white aspect, corresponding to the nearly complete loss of enamel perikymata with well defined abrasions, but without any micropits at SEM examination.
The replica technique has shown to be useful to record the defects of active and stabilized caries lesions. However this technique can't be utilized as a diagnostic instrument because it would be too expensive, but it is certainly a valid support for in vivo research.
早期龋损在牙釉质深层的孔隙率比表层更大。“白斑”病变是一种动态病变,会受到口腔内发生的变化影响;它可能会消退、稳定或进展。本研究的目的是表明不同年龄人群中,活跃或稳定的早期龋损在表面超微结构方面是否存在显著的形态学差异。
为进行扫描电子显微镜(SEM)观察,选取了15名年龄在12至50岁之间有早期龋损的患者。其中一些患者近期接受了正畸治疗,另一些则是几年前接受的治疗。召回了5名患者,在首次观察的同一位置通过显微镜再次检查脱矿区域。使用复制技术,采用硅基印模材料、用于复制铸造的环氧树脂以及用于固定硅材料的小钢网。
在白斑病变处,明显可见一种组织结构,散布着小的重叠部分和直径为0.5 - 2微米的微孔。那些在10多年前拆除正畸带的患者表现出亮白色外观,对应釉质嵴几乎完全丧失,有明确的磨损,但在扫描电子显微镜检查中没有任何微孔。
复制技术已证明对记录活跃和稳定龋损的缺陷有用处。然而,该技术不能用作诊断工具,因为成本过高,但它无疑是体内研究的有效辅助手段。