Keyes Paul H, Rams Thomas E
Formerly National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA; presently retired, Washington, DC, USA.
Department of Periodontology and Oral Implantology, and Oral Microbiology Testing Service Laboratory, School of Dentistry, Department of Microbiology and Immunology, School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
J Oral Biol (Northborough). 2016;3(1). doi: 10.13188/2377-987x.1000017. Epub 2016 Feb 12.
An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms.
A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification.
Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin.
These observations further document the potential protective effects of dental calculus mineralization against dental caries.
一些研究已经注意到牙齿上牙结石矿化与龋齿脱矿之间存在负相关关系。牙结石甚至可能在现有的龋齿上形成表层并阻止其进展,但这种现象在龋病学领域仅有很少的记录且很少被考虑。为了进一步评估牙结石阻止龋齿进展的情况,本研究对大量拔除的人类牙齿进行了评估,以确定龋齿、牙结石和牙菌斑生物膜的存在及位置。
总共1200颗牙齿保存在10%的缓冲甲醛生理盐水中,由一位经验丰富的检查者在牙齿湿润时使用研究体视显微镜以15 - 25倍放大倍数进行观察。选取代表性牙齿进行切片和拍照,并对其牙菌斑生物膜进行革兰氏染色检查,在光学显微镜下以100倍放大倍数观察。
在1200颗拔除的人类牙齿中,有1140颗(95%)观察到有牙结石,其中1139颗牙齿在牙结石覆盖的表面下未发现龋齿病变。然而,在187颗评估的有未修复的近中釉质龋的牙齿中,有一颗(0.54%)发现有牙结石阻止龋齿进展的情况。在上颌前磨牙的远中面,牙结石矿化填充了早期龋齿病变的外表面空洞。被牙结石覆盖的龋损仅轻微延伸至釉质,并呈现出非活性或静止龋齿的褐色色素沉着特征。相比之下,该牙齿的近中面没有牙结石表层,有一个大的龋损穿过釉质并深入牙本质。
这些观察结果进一步证明了牙结石矿化对龋齿的潜在保护作用。