Buzalaf M A R, Kato M T, Hannas A R
Bauru Dental School, University of São Paulo, Brazil.
Adv Dent Res. 2012 Sep;24(2):72-6. doi: 10.1177/0022034512455029.
This review discusses the role of matrix metalloproteinases (MMPs) in the development of dentin erosion and the protective effects of MMP inhibitors, based on recent evidence from in vitro and in situ studies. MMPs are present in both dentin and saliva and play an important role in dentin erosion progression. Enzymatic removal of the organic matrix by MMPs increases the demineralization process, since the demineralized organic matrix has been shown to hamper ionic diffusion after an acidic challenge. Recent evidence from in vitro and in situ studies has shown a protective role of MMP inhibitors against dentin erosion and erosion plus abrasion. The inhibitors tested were green tea and its active epigallocatechin-gallate (EGCG), ferrous sulfate, and chlorhexidine. They have been tested in dentifrices, solutions, and gels. The latter led to a more pronounced protective effect against dentin erosion and erosion plus abrasion. The protection was long-lasting and could be observed after up to 10 days of severe erosive and erosive-plus-abrasive challenges in situ. Thus, the use of MMP inhibitors has emerged as an important preventive tool against dentin erosion. Clinical studies should be conducted to confirm the results obtained and to give support to the establishment of clinical protocols of use.
本综述基于近期体外和原位研究的证据，探讨了基质金属蛋白酶（MMPs）在牙本质侵蚀发展中的作用以及MMP抑制剂的保护作用。MMPs存在于牙本质和唾液中，在牙本质侵蚀进展中起重要作用。MMPs对有机基质的酶解作用会增加脱矿过程，因为已表明脱矿后的有机基质在酸性刺激后会阻碍离子扩散。近期体外和原位研究的证据表明，MMP抑制剂对牙本质侵蚀以及侵蚀加磨损具有保护作用。所测试的抑制剂有绿茶及其活性成分表没食子儿茶素没食子酸酯（EGCG）、硫酸亚铁和氯己定。它们已在牙膏、溶液和凝胶中进行了测试。后者对牙本质侵蚀以及侵蚀加磨损具有更显著的保护作用。这种保护作用持久，在原位进行长达10天的严重侵蚀和侵蚀加磨损挑战后仍可观察到。因此，使用MMP抑制剂已成为预防牙本质侵蚀的重要工具。应开展临床研究以证实所得结果，并为临床使用方案的制定提供支持。
