利用数码相机早期检测白斑病变及再矿化治疗。

Department of Oral Health, Unit of Social Medical Science, Nagasaki University, Japan.

Aust Dent J. 2008 Sep;53(3):274-80. doi: 10.1111/j.1834-7819.2008.00062.x.

BACKGROUND

In this paper, the characteristics of the early stage of dental caries are discussed and the methods we used to treat the early stage of dental caries to increase the number of caries-free patients are presented. Studies from in vitro to in situ experiments and a clinical study were carried out to support clinical remineralization therapy.

METHODS AND RESULTS

To clarify the effect of time for remineralization, the degree of remineralization was assessed at 2 days, 6 days, and 10 days after 2-day demineralization in 0.01 M/L lactic acid buffer (pH 4.0 at 37 degrees ). The remineralization solution contained 3.0 mM/L Ca, 1.8 mM/L P, and 3 ppm fluoride adjusted to pH 7.0. A 10-day continuous remineralization with a 3 ppm fluoride resulted in a high fluoride concentration. To evaluate mineral loss from sound tooth structure and white spot lesions, thin sections (about 90 microm) including white spots (WS) were prepared and exposed to oral conditions for 2 weeks continuously. The mineral loss from sound tooth structure was found to be twice that from WS. In another experiment during the remineralization period, enamel samples were immersed in three different bicarbonate solutions; 0.5, 5.0 and 50 mM/L for 30 minutes, two times per day. Both the bicarbonate and fluoride applied groups showed higher improvement in acid resistance and the amount of remaining mineral was almost two times higher than the controls (p < 0.01). In a clinical study we demonstrated remineralization in patients who followed professional mechanical tooth cleaning and fluoride prophylaxis paste. Using this regime, in patients with deciduous caries present at baseline, over 80 per cent of permanent teeth were caries free at the age of 12 years. In these studies the digital camera with CasMaTCH and an image analysis system showed several advantages for monitoring in de- and remineralization.

CONCLUSIONS

White spot lesions, rather than intact tooth surfaces, can be mineralized through the daily clinical procedures described in this paper.

背景

本文讨论了龋齿早期的特征，并介绍了我们用于治疗龋齿早期以增加无龋患者数量的方法。开展了从体外到原位实验以及一项临床研究，以支持临床再矿化治疗。

方法与结果

为阐明再矿化时间的影响，在0.01 M/L乳酸缓冲液（37℃时pH 4.0）中进行2天脱矿后，于第2天、第6天和第10天评估再矿化程度。再矿化溶液含有3.0 mM/L钙、1.8 mM/L磷和3 ppm氟，pH值调至7.0。含3 ppm氟的10天连续再矿化导致高氟浓度。为评估健康牙体结构和白斑病变的矿物质流失，制备了包括白斑（WS）的薄片（约90微米），并使其连续暴露于口腔环境2周。发现健康牙体结构的矿物质流失是白斑的两倍。在再矿化期间的另一项实验中，将釉质样本浸入三种不同浓度的碳酸氢盐溶液中；0.5、5.0和50 mM/L，每次30分钟，每天两次。应用碳酸氢盐和氟的组在耐酸性方面均有更高改善，剩余矿物质含量几乎比对照组高两倍（p < 0.01）。在一项临床研究中，我们证明了接受专业机械牙齿清洁和含氟防龋牙膏的患者出现了再矿化。采用这种方案，基线时有乳牙龋齿的患者中，超过80%的恒牙在12岁时无龋。在这些研究中，配备CasMaTCH的数码相机和图像分析系统在监测脱矿和再矿化方面显示出若干优势。