Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AD, United Kingdom.
Dental Physical Science, Francis Bancroft Building, Queen Mary University of London, Mile End Rd, London, E1 4NS, United Kingdom.
J Dent. 2018 Jun;73:91-96. doi: 10.1016/j.jdent.2018.04.009. Epub 2018 Apr 16.
To compare the efficacy of fluoride varnishes either casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) or bioglass particles on the severity index of root caries.
Visual-tactile assessments including lesion hardness was carried out to categorise the severity index of 80 extracted teeth with primary root caries. These teeth were randomly divided into four groups; CPP-ACP and fluoride, bioglass and fluoride, fluoride only, and no treatment. Standardised toothbrushing using a dentifrice containing 1450 ppm fluoride was carried out twice a day for all groups. All samples were stored in remineralising solution at 37°C for 45 days. Visual-tactile assessments were carried out at baseline, and after 45 days. Surface roughness measurements (Ra) were performed at baseline and after 7, 14, 30 and 45 days. X-ray Microtomography was performed at the baseline and after 45 days for three samples from each group to quantify the change in mineral contents in the lesion area.
The Visual-tactile assessment results showed a reduction in the severity index of root caries, being 20% in CPP-ACP and fluoride, 100% in bioglass and fluoride, 80% in fluoride only, and 60% in non-varnish (toothbrushing only). Non-significant change in surface roughness was observed in all groups. X-ray Microtomography assessment showed a highly significant increase in the mineral deposition in all cases (p > .001).
The combination of bioglass with fluoride has a potentially superior effect than either CPP-ACP with fluoride or fluoride only to reverse and arrest the root caries in a laboratory setting.
The combination of bioglass particles and fluoride formulation is likely to have a significant impact in reversing and arresting root caries in a minimally invasive approach. However, randomised controlled double-blinded clinical trials are required to translate these results into clinical practice.
比较氟化物涂料（CPP-ACP 或生物玻璃颗粒）在根龋严重指数方面的疗效。
对 80 颗有原发性根龋的离体牙进行视诊和触诊评估，包括病变硬度，以对严重指数进行分类。这些牙齿被随机分为四组：CPP-ACP 和氟化物组、生物玻璃和氟化物组、氟化物组和空白对照组。所有组均使用含有 1450ppm 氟化物的牙膏进行标准的刷牙，每天两次。所有样本均在 37°C 的再矿化溶液中储存 45 天。在基线、第 45 天对所有样本进行视诊和触诊评估。在基线、第 7、14、30 和 45 天对表面粗糙度（Ra）进行测量。对每组的三个样本进行 X 射线微断层扫描，以定量测量病变区域的矿物质含量变化。
视诊和触诊评估结果显示根龋严重指数降低，CPP-ACP 和氟化物组降低 20%，生物玻璃和氟化物组降低 100%，氟化物组降低 80%，空白对照组降低 60%。所有组的表面粗糙度均无显著变化。X 射线微断层扫描评估显示所有病例的矿物质沉积均有显著增加（p>.001）。
与 CPP-ACP 氟化物或单纯氟化物相比，生物玻璃与氟化物联合应用可能具有更好的逆转和阻止根龋进展的效果。
生物玻璃颗粒和氟化物配方的联合应用可能会对微创方法逆转和阻止根龋产生显著影响。然而，需要进行随机对照双盲临床试验，将这些结果转化为临床实践。
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