Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan..
Oral Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan..
J Dent. 2023 Apr;131:104452. doi: 10.1016/j.jdent.2023.104452. Epub 2023 Feb 16.
This study aimed to evaluate the change of mineral content in dentine lesions over time and examine the effectiveness of the combined treatment with silver diammine fluoride (SDF) and glass ionomer cement (GIC).
Sixty bovine dentine specimens were divided into 4 groups: cont, Fuji, Safo, and Safo+Fuji. The specimens were imaged and measured using microcomputed tomography (microCT) at 7 time points: pre-demineralisation, after demineralisation for two weeks, immediately after treatment, 1 week, 2 weeks, 1 month, and 3 months after treatment. The 3-month group was evaluated with a light microscope, attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, and scanning electron microscope (SEM)/energy-dispersive X-ray spectroscopy (EDS). Data were analysed by Dunn's test and Wilcoxon signed rank test with Bonferroni correction for microCT, and Kruskal-Wallis test and two-way analysis of variance for EDS characterisation.
MicroCT images showed high mineral density beneath dentine lesions in Safo+Fuji. The mineral density at 600 μm in Safo+Fuji increased significantly over time, while Safo showed an opposite trend (adjusted p<0.005). In Safo+Fuji, EDS revealed significantly high energy of fluorine (p<0.05, at 300 μm) and a tendency towards high energy of calcium (p>0.05). However, Safo+Fuji showed lower energy of silver compared to Safo (p<0.001). ATR-FTIR revealed that phosphate groups had the highest peak at a depth between 300 and 400 μm in Safo+Fuji.
Safo+Fuji was effective in remineralising the deep lesion in dentine after one and three months, and a hypermineralisation zone generated beneath the lesion demonstrated additional benefit in this study.
This long-term in vitro study showed that SDF+GIC treatment could strengthen the structure of decayed teeth when applied in the treatment of patients with advanced rampant caries.
本研究旨在评估牙本质病变中矿物质含量随时间的变化，并研究同时使用银胺氟化物（SDF）和玻璃离子水门汀（GIC）联合治疗的效果。
将 60 个牛牙本质标本分为 4 组：对照组、富士玻璃离子组、SDF 组和 SDF+富士玻璃离子组。使用微计算机断层扫描（microCT）在 7 个时间点对标本进行成像和测量：去矿化前、去矿化两周后、治疗后即刻、1 周、2 周、1 个月和 3 个月。3 个月组进行光镜观察、衰减全反射傅里叶变换红外光谱（ATR-FTIR）分析和扫描电子显微镜（SEM）/能谱（EDS）分析。采用 Dunn 检验和 Wilcoxon 符号秩检验（Bonferroni 校正）对 microCT 数据进行分析，采用 Kruskal-Wallis 检验和双向方差分析对 EDS 特征进行分析。
microCT 图像显示 SDF+富士玻璃离子组牙本质病变下有较高的矿物质密度。SDF+富士玻璃离子组在 600 μm 处的矿物质密度随时间显著增加，而 SDF 组则呈现相反的趋势（调整后 p<0.005）。在 SDF+富士玻璃离子组中，EDS 显示氟的能量显著升高（p<0.05，在 300 μm 处），且钙的能量有升高的趋势（p>0.05）。然而，SDF+富士玻璃离子组的银能量低于 SDF 组（p<0.001）。ATR-FTIR 显示，磷酸基团在 SDF+富士玻璃离子组的 300-400 μm 深度处有最高的峰。
SDF+富士玻璃离子在 1 个月和 3 个月后对牙本质深层病变具有再矿化作用，病变下形成的高矿化区在本研究中显示出额外的益处。
本长期体外研究表明，当应用于治疗猖獗性龋患者时，SDF+GIC 治疗可以增强患牙的结构。
