Buzalaf Marília Afonso Rabelo, Magalhães Ana Carolina, Wiegand Annette
Department of Biological Sciences, Bauru Dental School, University of São Paulo, Bauru, Brazil.
Monogr Oral Sci. 2014;25:244-52. doi: 10.1159/000360557. Epub 2014 Jun 26.
In recent years, different agents have been discussed as potential alternatives to fluoride in the prevention of dental erosion. These agents are intended to form acid-resistant layers on the surface, to induce repair of eroded lesions by mineral precipitation or to prevent the enzymatic degradation of demineralised collagen. The application of adhesives and/or fissure sealants is considered to be an effective alternative to fluoride, but requires professional application and, depending on the product used, a re-sealing of the surface every several months. Studies testing film-forming products, such as polymers, have suggested the potential effectiveness of some of these approaches, such as chitosan, although further studies are needed to confirm the effectiveness of this approach. Other studies have demonstrated that products designed to deliver calcium and/or phosphate have not been successful at providing a significant anti-erosive effect. In advanced erosive lesions, the demineralised collagenous dentine matrix can be degraded by host enzymes such as matrix metalloproteinases (MMPs). As well as fluorides, epigallocatechin gallate and chlorhexidine have been identified as effective MMP inhibitors, with the potential to reduce the progression of dentine erosion. While fluoride compounds have been shown to have an anti-erosive potential, particularly those containing tin, alternative approaches that provide even greater protective capacity still need to be developed and proven to be effective.
近年来，人们讨论了不同的药剂作为氟化物在预防牙侵蚀方面的潜在替代品。这些药剂旨在在表面形成耐酸层，通过矿物质沉淀诱导侵蚀病变的修复，或防止脱矿质胶原蛋白的酶促降解。应用粘合剂和/或窝沟封闭剂被认为是氟化物的有效替代品，但需要专业应用，并且根据所使用的产品，每隔几个月需要重新封闭表面。测试成膜产品（如聚合物）的研究表明，其中一些方法（如壳聚糖）具有潜在的有效性，尽管需要进一步研究来证实这种方法的有效性。其他研究表明，旨在输送钙和/或磷酸盐的产品在提供显著的抗侵蚀效果方面并不成功。在晚期侵蚀性病变中，脱矿质的胶原牙本质基质可被宿主酶（如基质金属蛋白酶（MMPs））降解。除了氟化物，表没食子儿茶素没食子酸酯和氯己定已被确定为有效的MMP抑制剂，有可能减少牙本质侵蚀的进展。虽然已表明氟化物化合物具有抗侵蚀潜力，特别是那些含锡的化合物，但仍需要开发并证明提供更大保护能力的替代方法是有效的。
