钙磷再矿化及其系统  

Calcium and phosphorus remineralization and its system

作　　者：许鹏程[1] 徐欣[1] 周学东[1] 

机构地区：[1]口腔疾病研究国家重点实验室 华西口腔医院牙体牙髓病科(四川大学),成都610041

出　　处：《国际口腔医学杂志》2014年第3期347-350,共4页International Journal of Stomatology

基　　金："十二五"国家科技支撑计划(2012BAI07B03);四川省科技厅口腔转化医学共用平台项目(JCPT2011-9)

摘　　要：龋病是一种釉质脱矿与再矿化作用失衡,牙体硬组织向脱矿方向持续发展的疾病。当口腔内钙和磷酸根离子饱和度下降时,釉质脱矿;反之,釉质再矿化;因此,钙和磷酸根离子是再矿化的物质基础,钙磷离子浓度越高,越有利于釉质再矿化的发生。无定形钙磷(ACP)能与氟离子结合生成无定形钙磷氟(ACPF),ACP和ACPF能向口腔环境提供可利用的钙磷和氟离子,促进釉质的再矿化;但亦降低可利用的钙、磷酸根和氟离子浓度,降低其促再矿化能力。酪蛋白磷酸肽(CPP)与钙和磷酸根以一种微弱的化学力结合,使得CPP-ACP复合体中的钙、磷酸根离子与口腔环境中的游离钙、磷酸根离子间保持一种动态平衡。当pH值较高时,大量钙、磷离子以CPP-ACP形式存在;随着pH值降低,CPP-ACP释放出钙、磷酸根离子促进釉质再矿化。CPP-ACP有效定位于龋损表层及表层下并释放钙和磷酸根离子,具有良好的促再矿化效果。氟具有良好的再矿化防龋效果,可通过与CPPACP中的氢氧根离子置换生成CPP-ACPF。CPP-ACPF通过附着于牙体表面或顺CPP-ACPF浓度梯度渗透进入釉质龋坏表层下,持续释放钙、磷酸根和氟离子,促进釉质表层和表层下再矿化。Dental caries is a highly prevalent disease that progresses from initial demineralization to eventual cavitation on the dental hard tissue. Calcium and phosphate ions are the material basis of remineralization. Enamel remineralization easily occurs when calcium and phosphate ions increase. Amorphous calcium phosphate（ACP） can be combined with fluoride to produce calcium phosphate fluoride（ACPF）. ACP and ACPF can provide available calcium phosphate and fluoride ions to the oral environment to promote enamel remineralization. However, the ability of ACP and ACPF to promote remineralization is reduced because of the rapid deposition. Casein phosphopeptide-amorphous calcium phosphate complexes（CPP-ACP） conserve calcium. Phosphate ions can provide a continuous supply of calcium phosphate to the oral environment. CPP-ACP can be combined with fluoride to produce CPP-ACPF, which can constantly release calcium, phosphate, and fluoride ions to promote enamel remineralization.

关 键 词：龋病 再矿化 氟 无定形磷酸钙 酪蛋白磷酸肽 

分 类 号：R781.1[医药卫生—口腔医学]