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放疗后牙齿硬组织的损伤与再矿化策略

The damage and remineralization strategies of dental hard tissues following radiotherapy.

作者信息

Yao Lin, Li Yanyao, Fu Di, Wang Ye, Hua Chengge, Zou Ling, Jiang Li

机构信息

State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.

State Key Laboratory of Oral Diseases, Department of General Dentistry, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.

出版信息

BMC Oral Health. 2024 Jul 16;24(1):805. doi: 10.1186/s12903-024-04561-7.

Abstract

OBJECTIVES

This study pursued two main purposes. The first aim was to expound on the microscopic factors of radiation-related caries (RRC). Further, it aimed to compare the remineralization effect of different remineralizing agents on demineralized teeth after radiotherapy.

METHODS

The enamel and dentin samples of bovine teeth were irradiated with different doses of radiation. After analysis of scanning electron microscope (SEM), X-Ray diffraction (XRD), and energy dispersive spectrometer (EDS), the samples irradiated with 50 Gy radiation were selected and divided into the demineralization group, the double distilled water (DDW) group, the Sodium fluoride (NaF) group, the Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group, the NaF + CPP-ACP group, and the Titanium tetrafluoride (TiF) group. After demineralization, remineralizing agents treatment, and remineralization, the samples were evaluated using SEM, atomic force microscope (AFM), EDS, and transverse microradiography (TMR).

RESULTS

A radiation dose of 30 Gy was sufficient to cause damage to the dentinal tubules, but 70 Gy radiation had little effect on the microstructure of enamel. Additionally, the NaF + CPP-ACP group and the TiF group significantly promoted deposit formation, decreased surface roughness, and reduced mineral loss and lesion depth of demineralized enamel and dentin samples after radiation.

CONCLUSIONS

Radiation causes more significant damage to dentin compared to enamel. NaF + CPP-ACP and TiF had a promising ability to promote remineralization of irradiated dental hard tissues.

ADVANCES IN KNOWLEDGE

This in vitro study contributes to determining a safer radiation dose range for teeth and identifying the most effective remineralization approach for RRC.

摘要

目的

本研究有两个主要目的。第一个目的是阐述放射性龋齿(RRC)的微观因素。此外,其旨在比较不同再矿化剂对放疗后脱矿牙齿的再矿化效果。

方法

用不同剂量的辐射照射牛牙的釉质和牙本质样本。在进行扫描电子显微镜(SEM)、X射线衍射(XRD)和能量色散谱仪(EDS)分析后,选择接受50 Gy辐射的样本并分为脱矿组、双蒸水(DDW)组、氟化钠(NaF)组、酪蛋白磷酸肽 - 无定形磷酸钙(CPP - ACP)组、NaF + CPP - ACP组和四氟化钛(TiF)组。在脱矿、再矿化剂处理和再矿化后,使用SEM、原子力显微镜(AFM)、EDS和横向显微放射照相术(TMR)对样本进行评估。

结果

30 Gy的辐射剂量足以对牙本质小管造成损伤,但70 Gy的辐射对釉质微观结构影响较小。此外,NaF + CPP - ACP组和TiF组显著促进了沉积物形成,降低了表面粗糙度,并减少了放疗后脱矿釉质和牙本质样本的矿物质流失和病变深度。

结论

与釉质相比,辐射对牙本质造成的损伤更显著。NaF + CPP - ACP和TiF在促进受辐射牙齿硬组织再矿化方面具有良好的能力。

知识进展

这项体外研究有助于确定牙齿更安全的辐射剂量范围,并确定RRC最有效的再矿化方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33b8/11253375/ee6f01ac35a0/12903_2024_4561_Fig1_HTML.jpg

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