杯状牙磨损缺陷：不仅仅是侵蚀性挑战？
Cup-Shaped Tooth Wear Defects: More than Erosive Challenges?
机构信息
Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands,
Department of Dental Materials, Academic Center for Dentistry (ACTA), Amsterdam, The Netherlands.
出版信息
Caries Res. 2019;53(4):467-474. doi: 10.1159/000496983. Epub 2019 Mar 6.
BACKGROUND/AIM: The underlying mechanism of the development of cups and grooves on occlusal tooth surfaces is still unclear. The aim of this study was to evaluate factors contributing to in vitro cup formation, in order to elucidate the clinical process.
METHODS
A total of 48 extracted human molar teeth were exposed to acidic aqueous solutions at pH of 4.8 and 5.5 in constant motion, in combination with different loading conditions: no load (0N group, control), 30 N (30N group) or 50 N (50N group) (n = 8 per group). Before and after 3 months of exposure (1,422,000 loading cycles), the samples were scanned using a non-contact profilometer. Pre- and post-exposure scans were subtracted and height loss and volume tissue loss were calculated. Representative samples with wear and cupping lesions were imaged using scanning electron microscopy, light microscopy and micro-computed tomography.
RESULTS
Average height and volume tissue loss at pH 5.5 was 54 µm and 3.4 mm3 (0N), 52 µm and 3.4 mm3 (30N) and 58 µm and 3.7 mm3 (50N), respectively, with no statistically significant differences. Average height and volume loss at pH 4.8 were 135 µm and 8.7 mm3 (0N), 172 µm and 12.6 mm3 (30N) and 266 µm and 17.8 mm3 (50N), respectively, with a statistically significant difference between 0N and 50N (p < 0.002). Cup-shaped lesions had formed only at pH of 4.8, in the 30N and 50N groups.
CONCLUSION
The study showed that a cup can arise fully in enamel and that mechanical loading in addition to erosive challenges are required.
背景/目的：牙合面窝沟的形成机制尚不清楚。本研究旨在评估导致体外杯状形成的因素，以阐明临床过程。
方法
共 48 颗人离体磨牙在 pH 值为 4.8 和 5.5 的酸性水溶液中以恒定的运动速度暴露，结合不同的加载条件：无载（0N 组，对照组）、30N（30N 组）或 50N（50N 组）（每组 8 个）。暴露 3 个月（1422000 次加载循环）前后，使用非接触式轮廓仪对样本进行扫描。将暴露前后的扫描相减，计算高度损失和体积组织损失。使用扫描电子显微镜、光学显微镜和微计算机断层扫描对具有磨损和杯状病变的代表性样本进行成像。
结果
在 pH 值为 5.5 时，平均高度和体积组织损失分别为 54µm 和 3.4mm3（0N）、52µm 和 3.4mm3（30N）和 58µm 和 3.7mm3（50N），差异无统计学意义。在 pH 值为 4.8 时，平均高度和体积损失分别为 135µm 和 8.7mm3（0N）、172µm 和 12.6mm3（30N）和 266µm 和 17.8mm3（50N），0N 和 50N 之间差异有统计学意义（p < 0.002）。仅在 pH 值为 4.8 时，30N 和 50N 组出现杯状病变。
结论
研究表明，牙釉质中可以完全形成杯状，并且需要机械加载除了侵蚀性挑战。
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