Zero Domenick T, Lussi Adrian
Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis 46202, USA.
Int Dent J. 2005;55(4 Suppl 1):285-90. doi: 10.1111/j.1875-595x.2005.tb00066.x.
The intrinsic and extrinsic aetiology factors responsible for dental erosion are well understood as are the chemical events leading the initial mineral dissolution, softening and eventual loss of the dental surface. Of greatest importance are the pH, titratable acidity, phosphate and calcium concentration, fluoride content of the erosive challenge which determines the degree of saturation with respect to the tooth mineral, and thus the driving force for its dissolution. Of the biological modifying factors affecting the erosion process, the protective properties of saliva and its contribution to pellicle formation are considered of greatest importance. Unstimulated salivary flow rate and buffering capacity have been directly associated with dental erosion. The acquired pellicle has been shown to have a protective effect against acid erosion by acting as a diffusion barrier. There is considerable overlap between the aetiology of dental erosion and that of dentinal hypersensitivity. Patient education on the causes and prevention of dental erosion are essential to prevent progression. In addition to reducing or eliminating exposure to acidic soft drinks and juices, modified acid beverages with reduced potential to cause erosion can be recommended to patients. Frequent application of high concentration topical fluoride may be of some benefit in preventing further demineralisation and increase the abrasion resistance of erosion lesions.
导致牙侵蚀的内在和外在病因因素已为人熟知，引发牙齿表面初始矿物质溶解、软化及最终丧失的化学过程同样如此。侵蚀性刺激的pH值、可滴定酸度、磷酸盐和钙浓度、氟含量最为重要，它们决定了相对于牙齿矿物质的饱和度，进而决定了其溶解的驱动力。在影响侵蚀过程的生物调节因素中，唾液的保护特性及其对获得性膜形成的作用被认为最为重要。非刺激性唾液流速和缓冲能力与牙侵蚀直接相关。已证明获得性膜可作为扩散屏障，对酸侵蚀起到保护作用。牙侵蚀的病因与牙本质过敏的病因有相当大的重叠。对患者进行牙侵蚀病因及预防的教育对于防止病情进展至关重要。除了减少或消除接触酸性软饮料和果汁外，还可向患者推荐侵蚀潜力降低的改良酸性饮料。频繁应用高浓度局部用氟化物可能有助于防止进一步脱矿，并增加侵蚀性病变的耐磨性。
