掺钕钇铝钙钛晶体激光结合两种再矿化制剂与早期釉质龋的再矿化  

Effect of neodymium-doped:yttrium aluminum perovskite laser combined with two kinds of remineralizers on remineralization of early enamel caries

作　　者：许颖华 刘婧 尤权 文志豪 高璐[2] Xu Yinghua;Liu Jing;You Quan;Wen Zhihao;Gao Lu(Pudong New Area Eye Disease and Dental Disease Prevention&Treatment Center,Shanghai 200011,China;School of Stomatology,Dalian Medical University,Dalian 116044,Liaoning Province,China)

机构地区：[1]上海市浦东新区眼病牙病防治所,上海市200011 [2]大连医科大学口腔医学院,辽宁省大连市116044

出　　处：《中国组织工程研究》2024年第3期360-365,共6页Chinese Journal of Tissue Engineering Research

基　　金：浦东新区卫生和计划生育委员会卫生计生科研项目(PW2019A-21),项目负责人:许颖华;中国高等教育学会专项课题(2020SZYB23),项目负责人:高璐;辽宁省自然科学基金项目(2021-MS-293),项目负者人,高璐;辽宁省教育厅教改项目(2021-535),项目负者人:高璐。

摘　　要：背景:近年来,多种激光被广泛应用于口腔医学相关的各种疾病,包括龋病的预防及治疗。目的:探讨掺钕铝酸钇晶体(neodymium-doped:yttrium aluminum perovskite,Nd:YAP)激光联合两种再矿化制剂对早期釉质龋再矿化的作用。方法:将60颗牙釉质块体外建立人工龋模型后,随机分为6组(n=10):A组不进行任何处理,行体外pH循环;B组进行护牙素(主要成分为酪蛋白磷酸钙复合体)再矿化处理,行体外pH循环;C组进行舒适达牙膏(主要成分为生物活性玻璃)再矿化处理,行体外pH循环;D组进行Nd:YAP激光照射,行体外pH循环;E组进行Nd:YAP激光照射,然后进行护牙素再矿化处理,行体外pH循环;F组进行Nd:YAP激光照射,然后舒适达牙膏再矿化处理,行体外pH循环;再矿化处理2次/d,实验周期20 d。G组为正常对照,未致龋,未进行再矿化处理,仅行体外pH循环。实验结束后,检测各组牙釉质表面的显微硬度、形貌与Ca/P比值。结果与结论:①B、C、D组牙釉质表面的硬度值高于A组(P<0.0001),E、F组牙釉质表面的硬度值明显高于B、C、D组(P<0.0001),F组牙釉质表面的硬度值明显高于E组(P<0.0001);②扫描电镜下可见,A组牙釉质表面存在大量的脱矿孔隙;B组牙釉质表面有矿物质沉积,沉积不均匀且较为疏松;C组牙釉质表面有大量矿物质沉积,且钙化团块间可见脱矿孔隙;D组牙釉质表面较为平整,脱矿孔隙较A组明显变小,釉柱间质有破坏;E组牙釉质表面矿物质沉积较厚,脱矿孔隙明显减少;F组牙釉质表面沉积的矿化物最为致密且均匀,脱矿孔隙细小;③B、C组牙釉质表面Ca/P比值明显高于A组(P<0.0001),E组牙釉质表面Ca/P比值明显高于B、C、D组(P<0.0001),F组牙釉质表面Ca/P比值高于E组(P<0.001);③结果显示,生物活性玻璃、酪蛋白磷酸钙复合体、Nd:YAP激光在牙釉质脱矿后均具有促进牙釉质表面再矿化的作用,Nd:YAP激光联合生物活性玻璃或酪蛋白磷酸钙�BACKGROUND:In recent years,a variety of lasers have been widely used in various diseases related to stomatology,including the prevention and treatment of dental caries.OBJECTIVE:To investigate the effect of neodymium-doped:yttrium aluminum perovskite(Nd:YAP)laser combined with two remineralizers on early enamel caries in vitro.METHODS:Early enamel caries models in vitro were artificially established by 60 enamel blocks and randomly divided into 6 groups(n=10).Group A did not undergo any treatment but underwent extracorporeal pH circulation.Group B underwent remineralization of dentin(the main component of casein phosphopeptide-amorphous calcium phosphate composite)and extracorporeal pH circulation.Group C underwent remineralization treatment of Sensodyne toothpaste(the main component of bioactive glass)and then underwent extracorporeal pH circulation.Group D received Nd:YAP laser irradiation and extracorporeal pH circulation.Group E was treated with Nd:YAP laser irradiation,with remineralization of dentin,and then with extracorporeal pH circulation.In group F,Nd:YAP laser irradiation was performed,and then Sensodyne toothpaste was used for remineralization,and the extracorporeal pH circulation was performed;the remineralization treatment was conducted twice a day,and the experimental period was 20 days.Group G was a normal control group,without caries or remineralization,but only underwent extracorporeal pH circulation.After the experiment,the microhardness,morphology and Ca/P ratio of the dental enamel surface were measured in each group.RESULTS AND CONCLUSION:(1)The surface microhardness value of dental enamel in groups B,C and D was higher than that in group A(P<0.0001);the surface microhardness value of dental enamel in groups E and F was significantly higher than that in groups B,C and D(P<0.0001),and the surface microhardness value of dental enamel in group F was significantly higher than that in group E(P<0.0001).(2)Scanning electron microscopy showed that there were a lot of demineralized pores on the ena

关 键 词：牙釉质龋 再矿化 酪蛋白磷酸钙复合体 生物活性玻璃 掺钕钇铝钙钛晶体(Nd:YAP)激光 显微硬度 钙磷比 联合治疗 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] R781.1