Robinson C, Brookes S J, Kirkham J, Wood S R, Shore R C
Division of Oral Biology, Leeds Dental Institute, Leeds, UK.
Caries Res. 2001 Mar-Apr;35(2):136-41. doi: 10.1159/000047445.
Instead of removing the porous carious tissue at a relatively late stage in the disease process, attempts have been made to 'fill' the microporosities of lesions at a much earlier stage of lesion development. This would not only reduce the porosity and therefore access of acid and egress of dissolved material, but also afford some mechanical support to the tissue and perhaps inhibit further attack. Successful infiltration of materials into lesions has been demonstrated previously using resorcinol-formaldehyde which, however, was clinically unacceptable. The advent of dental adhesives with potentially suitable properties has prompted a re-examination of this concept. Artificial lesions of enamel were generated in extracted human teeth using acidified gels. A range of currently available adhesive materials was then used to infiltrate the porosities. The extent of occlusion of the lesion porosities was determined both qualitatively using light microscopy and quantitatively using a chloronaphthalene imbibition technique. The effect of such treatment upon subsequent exposure to acid gels was also investigated. Results showed that up to 60% of the lesion pore volume had been occluded following infiltration with some of the materials and that this treatment was capable of reducing further acid demineralization. The development of such treatment strategies could offer potential noninvasive means of treating early enamel lesions.
在疾病进程相对较晚阶段去除多孔的龋损组织的同时,人们也尝试在病损发展的更早阶段“填充”病损的微孔。这不仅会降低孔隙率,从而减少酸的进入和溶解物质的流出,还能为组织提供一些机械支撑,并可能抑制进一步的侵蚀。先前已证明使用间苯二酚 - 甲醛可成功将材料渗入病损,但该材料在临床上无法接受。具有潜在合适特性的牙科粘合剂的出现促使人们重新审视这一概念。使用酸化凝胶在拔除的人牙上制造釉质人工病损。然后使用一系列目前可用的粘合剂材料渗入孔隙。使用光学显微镜定性和使用氯萘吸液技术定量确定病损孔隙的封闭程度。还研究了这种处理对随后暴露于酸性凝胶的影响。结果表明,用一些材料渗入后,高达60%的病损孔隙体积已被封闭,并且这种处理能够减少进一步的酸脱矿。这种治疗策略的发展可能提供治疗早期釉质病损的潜在非侵入性方法。