Schmidlin Patrick, Zobrist Katja, Attin Thomas, Wegehaupt Florian
Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
J Appl Oral Sci. 2016 Jan-Feb;24(1):31-6. doi: 10.1590/1678-775720150352.
To assess the re-hardening potential of enamel matrix derivatives (EMD) and self-assembling peptides in vitro, hypothesizing that these materials may increase the mineralization of artificial carious lesions and improve hardness profiles.
Forty-eight enamel samples were prepared from extracted bovine lower central incisors. After embedding and polishing, nail varnish was applied, leaving a defined test area. One third of this area was covered with a flowable composite (non-demineralized control). The remaining area was demineralized in an acidic buffer solution for 18 d to simulate a carious lesion. Half the demineralized area was then covered with composite (demineralized control), while the last third was left open for three test and one control treatments: (A) Application of enamel-matrix proteins (EMD - lyophilized protein fractions dissolved in acetic acid, Straumann), (B) self-assembling peptides (SAP, Curodont), or (C) amine fluoride solution (Am-F, GABA) for 5 min each. Untreated samples (D) served as control. After treatment, samples were immersed in artificial saliva for four weeks (remineralization phase) and microhardness (Knoop) depth profiles (25-300 µm) were obtained at sections. Two-way ANOVA was calculated to determine differences between the areas (re-hardening or softening).
Decalcification resulted in significant softening of the subsurface enamel in all groups (A-D). A significant re-hardening up to 125 µm was observed in the EMD and SAP groups.
This study showed that EMD and SAP were able to improve the hardness profiles when applied to deep demineralized artificial lesions. However, further research is needed to verify and improve this observed effect.
在体外评估釉基质衍生物（EMD）和自组装肽的再硬化潜力，假设这些材料可能增加人工龋损的矿化并改善硬度分布。
从拔除的牛下颌中切牙制备48个釉质样本。包埋和抛光后，涂抹指甲油，留出确定的测试区域。该区域的三分之一覆盖可流动复合树脂（非脱矿对照）。其余区域在酸性缓冲溶液中脱矿18天以模拟龋损。然后将脱矿区域的一半覆盖复合树脂（脱矿对照），而最后三分之一留作三种测试和一种对照处理：（A）应用釉基质蛋白（EMD - 冻干蛋白组分溶解于乙酸中，Straumann公司），（B）自组装肽（SAP，Curodont），或（C）氟化胺溶液（Am - F，GABA），每种处理5分钟。未处理的样本（D）作为对照。处理后，样本在人工唾液中浸泡四周（再矿化阶段），并在切片上获得显微硬度（努氏硬度）深度分布（25 - 300μm）。计算双向方差分析以确定各区域之间的差异（再硬化或软化）。
脱钙导致所有组（A - D）的釉质表层下显著软化。在EMD组和SAP组中观察到高达125μm的显著再硬化。
本研究表明，EMD和SAP应用于深层脱矿的人工龋损时能够改善硬度分布。然而，需要进一步研究来验证和改善这种观察到的效果。
