酪蛋白磷酸多肽-无定形磷酸钙在正畸治疗中预防牙釉质脱矿的体外研究  

The preventive effect of casein phosphopeptide-amorphous calcium phosphate on enamel demineralization in orthodontic treatment in vitro

作　　者：廖福琴[1] 厉松[2] 盛敏[2] 韩志峰[1] 张丽军[1] 吴燕丽[1] 

机构地区：[1]北京市和平里医院,100013 [2]首都医科大学附属北京口腔医院

出　　处：《现代口腔医学杂志》2008年第5期524-527,共4页Journal of Modern Stomatology

摘　　要：目的通过体外实验研究酪蛋白磷酸多肽-无定形磷酸钙(CPP-ACP,商品名护牙素)对固定矫治中托槽周围牙釉质脱矿的预防作用。方法将60颗因正畸治疗而拔除的前磨牙随机分成四组:①护牙素组;②0.2%NaF组;③0.2%NaF+护牙素组;④空白对照组。在牙齿颊面粘结正畸托槽,体外pH循环35天后,每组取10个样本经切片、磨片至厚度100μm^110μm,采用软X线投照技术及高清晰度数码显微图像分析系统测量釉质脱矿深度和灰度。另外,每组取5个样本用扫描电镜观察釉质表面超微结构的改变。用SPSS13.0统计软件进行数据处理分析。结果形态学表现:软X线照片显示护牙素组、0.2%NaF组、0.2%NaF+护牙素组都没有出现明显脱矿,对照组出现了19.34±6.8μm深的脱矿。扫描电镜显示前三组的牙釉质表面有矿物质沉积,孔隙变小,对照组的牙釉质表面有程度不等蜂窝状孔隙。灰度值比较结果显示:①护牙素组、0.2%NaF组之间脱矿量没有统计学差异(P>0.05);②护牙素组、0.2%NaF组、0.2%NaF+护牙素组的脱矿量与空白对照组之间有显著的统计学差异(P<0.05);③护牙素组及0.2%NaF组与0.2%NaF+护牙素组之间均有显著的统计学差异(P<0.05)。结论护牙素在正畸治疗中具有预防牙釉质脱矿作用;护牙素和氟化物有协同作用,可增强牙齿的防龋能力。Objective To evaluate the preventive effect of casein phosphopeptide - amorphous calcium phosphate （CPP-ACP） on enamel demlneralization in fixed appliance orthodontic treatment in vitro. Methods Sixty premolars / extracted before orthodontic treatment which were sound. The 60 samples were randomly assigned to four groups ：①CPP- ACP;②0. 2% NaF;③0. 2% NaF＋ CPP - ACP;④control. All teeth bonded with bracket and a pH - cycling regime for 35 days. Ten teeth of each group were sectioned , microradiographied and the mineral content were determined by microdensitometry. The other 5 teeth of each group ultrastructures were observed with SEM. Results There was no significant clecalcification in the experimental groups, but the decalcification depth of the control group was about 20taan. The enamel remineralizing was demonstrated in the experimental groups but none in the control group by SEM. There was no significant difference of decalcification between group CPP - ACP and group 0.2% NaF （ P 〉 0.05 ）, but the decalcification of experimental group was lower significantly than that of the control group （ P 〈 0.05）. The decalcification of group 0.2% NaF ＋ CPP - ACP was the slightest among the all groups （ P 〈 0.05 ） .Condusion CPP - ACP solution can prevent the enamel demineralization in fixed appliance orthodontic treatment in vitro. Synergy is found in the combination of 0.2% NaF with CPP - ACP.

关 键 词：正畸 牙釉质脱矿 酪蛋白磷酸多肽-无定形磷酸钙(护牙素)0.2%氟化钠 

分 类 号：R783.5[医药卫生—口腔医学]