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深层釉质牙本质龋损的再矿化

Remineralization of deep enamel dentine caries lesions.

作者信息

ten Cate J M

机构信息

Department of Cariology Endodontology Pedodontology, Academic Center for Dentistry Amsterdam , Amsterdam, The Netherlands.

出版信息

Aust Dent J. 2008 Sep;53(3):281-5. doi: 10.1111/j.1834-7819.2008.00063.x.

Abstract

Enamel remineralization is generally studied in superficial (up to 100 mum) lesions, but in vivo caries lesions may be tenfold deeper. This article addresses the question whether deep lesions, and extending into dentine, can be remineralized under optimal conditions and if this process is influenced by agents affecting calcium phosphate precipitation and dissolution. Lesions through enamel into dentine were first formed in thin sections and then continuously remineralized for periods up to 200 days. With longitudinal assessment by transversal microradiography it was showed that remineralization throughout the depth of the lesion and into the dentine was possible, although this process is very slow. Fluoride and bisphosphonate treatments affected mainly the deposition in the outer enamel. Although it was assumed that this would affect the diffusion of ions to deeper layers, the treatments had no impact on remineralization in the inner enamel or dentinal parts of the lesions. These findings are discussed with relevant theoretical considerations, and in their possible clinical implications.

摘要

牙釉质再矿化通常是在浅表(达100微米)病变中进行研究的,但体内龋齿病变可能要深达十倍。本文探讨了深入牙本质的深层病变在最佳条件下是否能够再矿化,以及这一过程是否会受到影响磷酸钙沉淀和溶解的因素的影响。首先在薄片中形成贯穿牙釉质进入牙本质的病变,然后连续再矿化长达200天。通过横向显微放射照相术进行纵向评估表明,尽管这个过程非常缓慢,但在病变的整个深度以及进入牙本质的部位实现再矿化是可能的。氟化物和双膦酸盐处理主要影响外层牙釉质中的沉积。尽管曾认为这会影响离子向更深层的扩散,但这些处理对病变内层牙釉质或牙本质部分的再矿化没有影响。结合相关理论考量及其可能具有的临床意义对这些发现进行了讨论。

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