不同生物活性钙磷基材料联合应用于树脂渗透对牙釉质白斑的疗效：一项体外研究。

The effect of combined use of resin infiltration with different bioactive calcium phosphate-based approaches on enamel white spot lesions: An in vitro study.

机构信息

Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China; Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China.

College of Stomatology, Bengbu Medical College, Bengbu, China.

出版信息

J Dent. 2024 Apr;143:104909. doi: 10.1016/j.jdent.2024.104909. Epub 2024 Feb 28.

DOI:10.1016/j.jdent.2024.104909

PMID:38428717

Abstract

OBJECTIVES

This in vitro study aimed to evaluate the effect of resin infiltration combined with casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) or bioactive glass (BAG) on the stability of enamel white spot lesions (WSLs) treatment.

MATERIALS AND METHODS

Eighty-four enamel blocks were prepared from the buccal surfaces of sound human premolars. All enamel blocks were placed in a demineralisation solution for 3 days to establish the artificial enamel WSLs. Enamel blocks with WSLs were randomly divided into three groups (n = 28 each group): RI/B: one-off resin infiltration followed by twice daily BAG treatment; RI/C: one-off resin infiltration followed by twice daily CPP-ACPF treatment; RI: one-off resin infiltration treatment only (as control) and subjected to pH cycling for 7 days. Surface morphology, elemental analysis, crystal characteristics, surface roughness and microhardness of enamel surfaces were investigated by scanning electron microscopy and energy-dispersive spectrometry observation, X-ray diffraction (XRD), atomic force microscope and Vickers' hardness testing, respectively.

RESULTS

Mean values of the surface roughness (mean±standard deviation (nm)) were 24.52±5.07, 27.39±5.87 and 34.36±4.55 for groups RI/B, RI/C and RI respectively (p = 0.003). The calcium to phosphate ratios were 1.32±0.16, 1.22±0.26 and 0.69±0.24 for groups RI/B, RI/C and RI respectively (p < 0.001). XRD revealed apatite formation in all three groups. The mean enamel surface microhardness (kg/mm) of the groups were 353.93±28.49, 339.00±27.32 and 330.38±22.55 for groups RI/B, RI/C and RI respectively (p = 0.216).

CONCLUSIONS

Resin infiltration combined with CPP-ACPF or BAG remineralisation appears to improve the surface properties of WSLs.

CLINICAL SIGNIFICANCE

The combination of resin infiltration and CPP-ACPF/BAG remineralisation may be a potential treatment for the management of the WSLs.

摘要

目的

本体外研究旨在评估树脂渗透联合酪蛋白磷酸肽-无定形磷酸钙氟化物（CPP-ACPF）或生物活性玻璃（BAG）对釉质白斑（WSL）稳定性的影响。

材料和方法

从健康人前磨牙的颊面制备 84 个釉质块。所有釉质块均置于脱矿溶液中 3 天，以建立人工釉质 WSL。WSL 釉质块随机分为三组（每组 n = 28）：RI/B：一次性树脂渗透，随后每日两次 BAG 处理；RI/C：一次性树脂渗透，随后每日两次 CPP-ACPF 处理；RI：仅一次性树脂渗透处理（作为对照），并进行 7 天 pH 循环。通过扫描电子显微镜和能谱观察、X 射线衍射（XRD）、原子力显微镜和维氏硬度测试分别研究釉质表面的形貌、元素分析、晶体特征、表面粗糙度和显微硬度。

结果

RI/B、RI/C 和 RI 组的表面粗糙度（平均值±标准偏差（nm））分别为 24.52±5.07、27.39±5.87 和 34.36±4.55（p = 0.003）。RI/B、RI/C 和 RI 组的钙磷比分别为 1.32±0.16、1.22±0.26 和 0.69±0.24（p < 0.001）。XRD 显示所有三组均有磷灰石形成。RI/B、RI/C 和 RI 组的釉质表面平均显微硬度（kg/mm）分别为 353.93±28.49、339.00±27.32 和 330.38±22.55（p = 0.216）。