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为什么龈上牙石更易在6颗下前牙的舌面形成?

Why does supragingival calculus form preferentially on the lingual surface of the 6 lower anterior teeth?

作者信息

Dawes Colin

机构信息

Department of Oral Biology, Faculty of Dentistry, University of Manitoba, 780 Bannatyne Avenue, Winnipeg MB, Canada. Colin_Dawes@ umanitoba.ca <Colin_Dawes@ umanitoba.ca>

出版信息

J Can Dent Assoc. 2006 Dec;72(10):923-6.

Abstract

Many authors have assumed that the reason supragingival calculus tends to form preferentially on the lingual surface of the 6 lower anterior teeth is because saliva from the adjacent submandibular ducts is a source of calcium and phosphate ions and because loss of CO2 as the saliva enters the mouth increases the local pH. However, the fluid phase of plaque in all locations is supersaturated with respect to the calcium phosphates in calculus and there is always a tendency for calculus to deposit, except after sugar consumption, when plaque pH may fall below the critical level and the plaque fluid becomes unsaturated. pH is least likely to fall below the critical level in plaque lingual to the lower anterior teeth, as this plaque is very thin, sugar concentration after sugar intake is lowest in that area and its clearance rate is fastest, and the high salivary film velocity there promotes loss of any acid formed in plaque. A high salivary film velocity also brings more salivary urea to the site, which facilitates plaque alkalinization. These factors all contribute to the development of shallow Stephan curves of short duration and together provide a more reasonable explanation for the fact that supragingival calculus deposition progresses most easily on the lingual surface of the lower anterior teeth.

摘要

许多作者认为,龈上牙石倾向于优先在6颗下前牙的舌面形成,原因在于来自相邻下颌下腺导管的唾液是钙和磷酸根离子的来源,并且当唾液进入口腔时二氧化碳的流失会使局部pH值升高。然而,所有部位菌斑的液相相对于牙石中的磷酸钙都是过饱和的,并且总是存在牙石沉积的趋势,除了在摄入糖之后,此时菌斑pH值可能会降至临界水平以下,菌斑液变得不饱和。在下前牙舌侧的菌斑中,pH值最不可能降至临界水平以下,因为该部位的菌斑非常薄,摄入糖后该区域的糖浓度最低且清除率最快,而且那里较高的唾液膜流速会促使菌斑中形成的任何酸流失。较高的唾液膜流速还会将更多的唾液尿素带到该部位,这有助于菌斑碱化。这些因素都有助于形成持续时间短的浅斯氏曲线,共同为龈上牙石沉积最容易在下前牙舌面进展这一事实提供了更合理的解释。

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