Shellis R Peter, Featherstone John D B, Lussi Adrian
School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
Monogr Oral Sci. 2014;25:163-79. doi: 10.1159/000359943. Epub 2014 Jun 26.
Dental erosion is caused by repeated short episodes of exposure to acids. Dental minerals are calcium-deficient, carbonated hydroxyapatites containing impurity ions such as Na(+), Mg(2+) and Cl(-). The rate of dissolution, which is crucial to the progression of erosion, is influenced by solubility and also by other factors. After outlining principles of solubility and acid dissolution, this chapter describes the factors related to the dental tissues on the one hand and to the erosive solution on the other. The impurities in the dental mineral introduce crystal strain and increase solubility, so dentine mineral is more soluble than enamel mineral and both are more soluble than hydroxyapatite. The considerable differences in structure and porosity between dentine and enamel influence interactions of the tissues with acid solutions, so the relative rates of dissolution do not necessarily reflect the respective solubilities. The rate of dissolution is further influenced strongly by physical factors (temperature, flow rate) and chemical factors (degree of saturation, presence of inhibitors, buffering, pH, fluoride). Temperature and flow rate, as determined by the method of consumption of a product, strongly influence erosion in vivo. The net effect of the solution factors determines the overall erosive potential of different products. Prospects for remineralization of erosive lesions are evaluated.
牙齿酸蚀症是由反复短时间接触酸引起的。牙齿矿物质是缺钙的、含碳酸根的羟基磷灰石，含有诸如Na(+)、Mg(2+)和Cl(-)等杂质离子。溶解速率对酸蚀进展至关重要，它受溶解度以及其他因素影响。在概述溶解度和酸溶解原理后，本章一方面描述与牙齿组织相关的因素，另一方面描述与酸蚀溶液相关的因素。牙齿矿物质中的杂质会引入晶体应变并增加溶解度，因此牙本质矿物质比釉质矿物质更易溶解，且两者都比羟基磷灰石更易溶解。牙本质和釉质在结构和孔隙率上的显著差异会影响组织与酸溶液的相互作用，所以相对溶解速率不一定反映各自的溶解度。溶解速率还会受到物理因素（温度、流速）和化学因素（饱和度、抑制剂的存在、缓冲作用、pH值、氟化物）的强烈影响。由产品使用方式决定的温度和流速会强烈影响体内酸蚀情况。溶液因素的综合作用决定了不同产品的总体酸蚀潜力。本文还评估了酸蚀病变再矿化的前景。
