Maciel Pires Paula, Ionescu Andrei Cristian, Pérez-Gracia Maria Teresa, Vezzoli Elena, Soares Igor Paulino Mendes, Brambilla Eugenio, de Almeida Neves Aline, Sauro Salvatore
Department of Pediatric Dentistry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil.
Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain.
Clin Oral Investig. 2022 Oct;26(10):6195-6207. doi: 10.1007/s00784-022-04569-9. Epub 2022 Jun 7.
Evaluate the ability of current ion-releasing materials to remineralise bacteria-driven artificial caries lesions.
Standardised class I cavities were obtained in 60 extracted human molars. Specimens underwent a microbiological cariogenic protocol (28 days) to generate artificial caries lesions and then were randomly divided into four restorative groups: adhesive + composite (negative control); glass ionomer cement (GIC); calcium silicate cement (MTA); and resin-modified calcium silicate cement (RMTA). Microhardness analysis (ΔKHN) was performed on 40 specimens (10/group, t = 30 days, 45 days, 60 days in artificial saliva, AS). Micro-CT scans were acquired (3/group, t = 0 days, 30 days, and 90 days in AS). Confocal microscopy was employed for interfacial ultra-morphology analysis (2/group, t = 0 days and 60 days in AS). Additional specimens were prepared and processed for scanning electron microscopy (SEM) and FTIR (n = 3/group + control) to analyse the ability of the tested materials to induce apatite formation on totally demineralised dentine discs (60 days in AS). Statistical analyses were performed with a significance level of 5%.
Adhesive + composite specimens showed the lowest ΔKHN values and the presence of gaps at the interface when assessed through micro-CT even after storage in AS. Conversely, all the tested ion-releasing materials presented an increase in ΔKHN after storage (p < 0.05), while MTA best reduced the demineralised artificial carious lesions gap at the interface. MTA and RMTA also showed apatite deposition on totally demineralised dentine surfaces (SEM and FTIR).
All tested ion-releasing materials expressed mineral precipitation in demineralised dentine. Additionally, calcium silicate-based materials induced apatite precipitation and hardness recovery of artificial carious dentine lesions over time.
Current ion-releasing materials can induce remineralisation of carious dentine. MTA shows enhanced ability of nucleation/precipitation of hydroxyapatite compared to RMTA and GIC, which may be more appropriate to recover severe mineral-depleted dentine.
评估当前的离子释放材料对细菌驱动的人工龋损进行再矿化的能力。
在60颗拔除的人类磨牙上制备标准化的I类洞。标本经过微生物致龋方案（28天）以产生人工龋损，然后随机分为四个修复组：粘结剂+复合树脂（阴性对照）；玻璃离子水门汀（GIC）；硅酸钙水门汀（MTA）；树脂改性硅酸钙水门汀（RMTA）。对40个标本（每组10个，在人工唾液（AS）中t = 30天、45天、60天）进行显微硬度分析（ΔKHN）。进行显微CT扫描（每组3个，在AS中t = 0天、30天和90天）。采用共聚焦显微镜进行界面超微形态分析（每组2个，在AS中t = 0天和60天）。制备额外的标本并进行扫描电子显微镜（SEM）和傅里叶变换红外光谱（FTIR）分析（每组n = 3 +对照），以分析测试材料在完全脱矿的牙本质圆盘上诱导磷灰石形成的能力（在AS中60天）。进行显著性水平为5%的统计分析。
即使在AS中储存后通过显微CT评估，粘结剂+复合树脂标本显示出最低的ΔKHN值且界面处存在间隙。相反，所有测试的离子释放材料在储存后ΔKHN均增加（p < 0.05），而MTA在界面处对脱矿的人工龋损间隙减少效果最佳。MTA和RMTA在完全脱矿的牙本质表面也显示出磷灰石沉积（SEM和FTIR）。
所有测试的离子释放材料在脱矿牙本质中均表现出矿物质沉淀。此外，随着时间的推移，硅酸钙基材料诱导人工龋损牙本质病变的磷灰石沉淀和硬度恢复。
当前的离子释放材料可诱导龋损牙本质再矿化。与RMTA和GIC相比，MTA显示出更强的羟基磷灰石成核/沉淀能力，可能更适合修复严重矿物质缺失的牙本质。
