Cheung A, Zid Z, Hunt D, McIntyre J
School of Dentistry, The University of Adelaide, South Australia.
Aust Dent J. 2005 Dec;50(4):228-34. doi: 10.1111/j.1834-7819.2005.tb00365.x.
Tooth erosion is a problem for professional wine tasters (exogenous erosion from frequent exposure to wine acids) and for people with gastro oesophageal reflux disease (GORD) and bulimia who experience frequent reflux of gastric contents into the mouth (endogenous erosion from mainly HCl). The objective in this study was to determine whether plaque/pellicle could provide teeth with any protection from two common erosive acids, using an in vivo-in vitro technique.
Tiles of human tooth enamel and root surfaces were prepared from six extracted, unerupted third molar teeth and sterilized. Mandibular stents were prepared for six volunteer subjects and the tiles bonded to the buccal flanges of these stents. They were worn initially for three days to permit a layer of pellicle and plaque to form over the tile surfaces, and for a further 10 days of experimentation. Following cleaning of the plaque/ pellicle layer from the tiles on the right side flange, all the tiles were submerged in either 0.06M HCl or white wine for an accumulated time of 600 and 1500 minutes, respectively. Depths of erosion were determined using light microscopy of sections of the enamel and root tiles. SEM of the lesion surfaces was carried out to investigate the nature of erosive damage and of plaque/pellicle remnants.
Retained plaque was found to significantly inhibit dental erosion on enamel, from contact with both HCl and wine, compared with that resulting following its removal. However, it was found to provide no significant protection on root surfaces. SEM analysis of the tile surfaces revealed marked etching of enamel on the cleaned surfaces, and considerable alteration to the appearance of remaining plaque and pellicle on most surfaces.
Within the limitations of numbers of specimens, dental plaque/pellicle provided a significant level of protection to tooth enamel against dental erosion from simulated gastric acids and from white wine, using an in vivo-in vitro model. It was unable to provide any significant protection to root surfaces from these erosive agents. Possible reasons for this difference are explored.
牙齿侵蚀是职业品酒师面临的一个问题（因频繁接触葡萄酒酸导致外源性侵蚀），也是患有胃食管反流病（GORD）和贪食症的人面临的问题，他们经常出现胃内容物反流至口腔的情况（主要由盐酸导致内源性侵蚀）。本研究的目的是使用体内 - 体外技术，确定菌斑/薄膜是否能为牙齿提供抵御两种常见侵蚀性酸的保护。
从六颗拔除的未萌出第三磨牙制备人牙釉质和牙根表面的切片，并进行灭菌处理。为六名志愿者受试者制作下颌支架，将切片粘贴到这些支架的颊侧翼上。最初佩戴三天，以使切片表面形成一层薄膜和菌斑，然后再进行10天的实验。在清洁右侧翼上切片的菌斑/薄膜层后，将所有切片分别浸泡在0.06M盐酸或白葡萄酒中，累计时间分别为600分钟和1500分钟。使用牙釉质和牙根切片的光学显微镜确定侵蚀深度。对病变表面进行扫描电子显微镜检查，以研究侵蚀损伤的性质以及菌斑/薄膜残余物的情况。
与去除菌斑后相比，发现保留的菌斑能显著抑制牙釉质因接触盐酸和葡萄酒而受到的侵蚀。然而，发现它对牙根表面没有显著的保护作用。对切片表面的扫描电子显微镜分析显示，清洁表面的牙釉质有明显蚀刻，大多数表面上剩余的菌斑和薄膜外观有相当大的改变。
在样本数量有限的情况下，使用体内 - 体外模型，牙菌斑/薄膜为牙釉质提供了显著水平的保护，使其免受模拟胃酸和白葡萄酒导致的牙齿侵蚀。它无法为牙根表面提供抵御这些侵蚀剂的显著保护。探讨了这种差异的可能原因。
