牙本质的仿生再矿化  

Biomimetic remineralization of dentin

作　　者：宋群 刘啸晨 马雨轩 王晨语 焦凯 牛丽娜 SONG Qun;LIU Xiaochen;MA Yuxuan;WANG Chenyu;JIAO Kai;NIU Lina(State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shanxi Key Laboratory of Oral Diseases,Department of Prosthodontics,School of Stomatology,The Fourth Military Medi⁃cal University,Xi′an 710032,China;Department of Prosthodontics,Affiliated Stomatological Hospital,School of Medicine,Zhejiang University,Hangzhou 310058,China;State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Key Laboratory of Oral Diseases,Department of Oral Anatomy and Physiology and TMD,School of Stomatology,The Fourth Military Medical University,Xi′an 710032,China)

机构地区：[1]军事口腔医学国家重点实验室,口腔疾病国家临床医学研究中心,陕西省口腔疾病重点实验室,第四军医大学口腔医院修复科,陕西西安710032 [2]浙江大学医学院附属口腔医院修复科,浙江杭州310058 [3]军事口腔医学国家重点实验室,口腔疾病国家临床医学研究中心,陕西省口腔疾病重点实验室,第四军医大学口腔医院解剖生理教研室,陕西西安710032

出　　处：《口腔疾病防治》2020年第6期383-389,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金优秀青年基金项目(81722015);国家自然科学基金面上项目(81870805);浙江省青年基金项目(LQ14H140005)。

摘　　要：近年来,在修复由龋病等原因引起的牙本质脱矿的研究中,牙本质仿生再矿化技术以其精确控制无定形矿物质前体在脱矿牙本质胶原纤维内有序沉积、形成的磷灰石晶体与天然矿化牙本质相似、自下而上的再矿化方式不依赖于籽晶存在等优点,逐渐成为这一领域的研究热点。本文回顾了脱矿牙本质再矿化的理念和实践的进展,并着重对牙本质仿生再矿化策略的相关研究进行综述,文献复习结果表明,传统的牙本质再矿化方法通常是脱矿牙本质与矿物质晶体的无序混合,这样矿化后的牙本质在形态特征和机械性能上均无法与天然矿化牙本质相媲美;而近年逐渐兴起的牙本质仿生再矿化技术则复现了天然矿化牙本质中矿物质在牙本质胶原纤维内迭序排列的结构特点,其微观结构、理化性能均得到极大提高,有望在树脂⁃牙本质粘结混合层和龋坏牙本质脱矿层的再矿化研究领域实现新的突破。目前牙本质仿生再矿化在临床应用上需要克服的技术障碍在于如何在再矿化过程中持续补充矿化所需的各种有效成份,并在缓慢释放各成份的同时保持母体材料的机械性能不变,研究者们已相继提出了三步法输送仿生再矿化原材料,以及预先制备聚合物稳定的矿化前体、再使用介孔硅纳米材料作为输送矿化成份的系统的构想,为牙本质仿生再矿化策略向临床应用的转化提供了初步体外实验基础。In recent years,due to precise control of the amorphous mineral precursor in the demineralization of den⁃tine collagen fibers in orderly deposition,forming apatite crystals similar to the natural mineralized dentin,the bottom⁃up remineralization approach which does not depend on the existence of seed crystallites,dentin biomimetic mineralization techniques gradually become a hotspot in the research field of restoration of demineralized dentin caused by dental caries.This paper reviews the changing concepts and practices of the remineralization of demineralized dentin,empha⁃sizing biomimetic remineralization studies.The results of the literature review show that the traditional dentin remineral⁃ization method is usually a disordered mixture of demineralized dentin and minerals,so mineralized dentin is not compa⁃rable to natural mineralized dentin in terms of the morphological characteristics and mechanical properties.With its gradual increase in recent years,dentine biomimetic mineralization technology perfectly resembles the minerals in the dentin overlapping sequence arranged with the dentine collagen fiber structure characteristics,leading to greatly im⁃proved microstructural,physical and chemical properties.As a result,dentine biomimetic mineralization technology is expected to achieve new breakthroughs in the fields of resin⁃dentin bonding mixing layers and the decay of dentin.At present,the technical obstacles that need to be overcome in the clinical application of the biomimetic remineralization of dentin are how to continuously supplement all the active ingredients needed for mineralization in the process of rem⁃ineralization and how to keep the mechanical properties of the parent material unchanged while slowly releasing all in⁃gredients.Researchers have successively proposed three⁃step transportation of the biomimetic remineralization of raw materials,as well as the preparation of mineralization precursors stabilized by polymers in advance and the reuse of mes⁃oporous silicon nanoma

关 键 词：牙本质 仿生再矿化 引导组织再矿化 羟基磷灰石 胶原纤维 非胶原蛋白 聚丙烯酸 无定形磷酸钙 

分 类 号：R78[医药卫生—口腔医学]