Seong J, Virani A, Parkinson C, Claydon N, Hellin N, Newcombe R G, West N
Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK.
Oral Care Medical Affairs Consumer Healthcare R&D, GlaxoSmithKine, Weybridge, UK.
J Dent. 2015 Aug;43(8):1013-20. doi: 10.1016/j.jdent.2015.04.002. Epub 2015 Apr 11.
Investigation of early enamel erosion using replica impressions to compare changes in enamel surface topography in vivo prior to and over a 24 h period following acid challenge.
A single treatment, blinded, enamel replica clinical study was undertaken in 20 healthy subjects. Replica tooth impressions were taken at baseline, following acid challenge and 2, 4, 7 and 24 h post challenge. Subjects consumed 500 ml of acidic soft drink over 30 min. Scanning electron microscopy of surface tomography was characterised with a descriptive 5 point scale by four judges. Duplicate impressions were taken to assess reproducibility.
18 subjects had scorable sequences. Descriptive analyses showed erosive changes following acid consumption and reparative changes in the subsequent 24 h period. Comparing baseline replica to the 24 h replica, there were no significant differences (p=0.26) in tooth surface characteristics. Comparing the replica taken immediately following acidic challenge with the subsequent replicas at 2, 4, 7 and 24 h, showed clear reduction of erosive effects on the enamel surface at 2 h (p=0.02) and a highly significant reduction at 4, 7 and 24 h (p<0.001).
This methodology demonstrated the ability to follow the progression and recovery of early erosive enamel lesions over 24 h being accurate and reproducible. This study suggests enamel repair commences within 2 h following a substantial acidic challenge and is completed 4-24 h later. After 24 h, the tooth surface appeared visibly indistinguishable from the original tooth surface, suggestive of a recovery process occurring.
Healthy erosive lifestyles often culminate in tooth wear. The time taken for enamel remineralisation following acidic challenge is unknown however, this study suggests the repair process is relatively slow following a substantial acidic challenge, and at least 4-24 h should elapse prior to further acidic consumption to allow for recovery.
使用复制印模研究早期釉质侵蚀情况，以比较酸蚀刺激前及刺激后24小时内体内釉质表面形貌的变化。
对20名健康受试者进行了一项单治疗、盲法的釉质复制临床研究。在基线、酸蚀刺激后以及刺激后2、4、7和24小时采集复制牙齿印模。受试者在30分钟内饮用500毫升酸性软饮料。由四名评判员使用描述性五点量表对表面断层扫描的扫描电子显微镜图像进行表征。采集重复印模以评估可重复性。
18名受试者有可评分序列。描述性分析显示，饮用酸后出现侵蚀性变化，随后24小时内出现修复性变化。将基线复制印模与24小时复制印模进行比较，牙齿表面特征无显著差异（p = 0.26）。将酸蚀刺激后立即采集的复制印模与随后2、4、7和24小时的复制印模进行比较，结果显示在2小时时釉质表面的侵蚀作用明显减轻（p = 0.02），在4、7和24小时时侵蚀作用显著减轻（p < 0.001）。
该方法证明了能够在24小时内追踪早期侵蚀性釉质病变的进展和恢复情况，具有准确性和可重复性。本研究表明，在受到大量酸蚀刺激后2小时内釉质修复开始，并在4 - 24小时后完成。24小时后，牙齿表面在视觉上与原始牙齿表面难以区分，提示恢复过程正在发生。
健康的侵蚀性生活方式常常导致牙齿磨损。然而，酸蚀刺激后釉质再矿化所需的时间尚不清楚，本研究表明，在受到大量酸蚀刺激后，修复过程相对缓慢，在进一步摄入酸性物质之前至少应经过4 - 24小时以实现恢复。
