成膜基质对氟化物涂膜提高釉质抗脱矿性能的影响

目的:评价成膜基质材料对氟化物涂膜提高釉质体外抗脱矿性能的影响。方法:在制备的5组牛牙釉质试样表面分别涂布以5种成膜基质(渗透型丙烯酸树脂、珂巴树脂、聚合松香、聚乙烯醇缩丁醛、甲基丙烯酸共聚树脂)配制的5种氟涂膜材料,另有一组不做处理,为对照组。在保湿12 h后,除去涂膜,然后对所有试样进行脱矿-再矿化循环处理7 d,之后纵向剖切试样,测定纵剖面显微硬度(HK),并用扫描电镜观察釉质处理面。结果:在釉质表面下90μm深度范围内的相同深度,所有涂膜组釉质的显微硬度均明显高于对照组(P<0.05);在釉质表面下50μm深度范围内的相同深度,渗透型丙烯酸树脂组的釉质硬度大于其它4组(P<0.05);各组釉质表面在扫描电镜下呈现不同特点的脱矿形式。结论:成膜基质材料对氟化物涂膜提高釉质体外抗脱矿性能有明显影响,含渗透型丙烯酸树脂的氟涂膜对抗釉质脱矿效果更佳。     

氟化物涂膜对乳牙防龋疗效观察

目的:观察氟化物涂膜 Duraphat 对儿童乳牙的防龋效果.方法:选择同一社区的 3-4 岁儿童 348 名,随机分为2组,氟化物涂膜组 175 人,每半年使用一次氟化物涂膜 Duraphat 进行防龋;对照组 173 人不作任何处理;3 年后进行患龋状况检查.结果:实验前涂膜组与对照组龋患率,龋均都较低,差异无显著性(p>0.05).3年后涂膜组龋患率和龋均上升幅度均显著低于对照组(P<0.01).新生龋龋均对照组显著高于涂膜组(P<0.01).结论:氟化涂膜对乳牙有显著的防龋作用.     

红色荧光定量分析法评价釉质早期龋的临床研究

目的采用定量光导荧光（QLF）技术的红色荧光分析法检测釉质早期龋,并监测含氟牙膏促进早期龋再矿化的效果,评价该技术诊断早期龋的能力。方法选择有上颌前牙光滑面釉质早期龋的96名小学生为研究对象,指导其在6个月的时间内使用含氟牙膏（氟离子质量分数为0.145%）刷牙。分析基线和6个月后的上颌前牙光滑面荧光图像,获得红色荧光变量（包括荧光面积Ar、平均荧光量△R、荧光总量R）,将其与绿色荧光变量（包括荧光面积Aw、平均荧光损失量△F、荧光损失总量△Q）进行比较,并通过配对t检验评价使用含氟牙膏后龋损的变化情况。结果红色荧光变量Ar、△R、lgR与对应的绿色荧光变量Aw、△F、lg△Q的Pearson相关系数分别为0.89、0.54、0.72（P<0.05）,具有高度相关性。使用含氟牙膏6个月后,红色和绿色荧光变量均较基线明显降低,其差异有统计学意义（P<0.05）。结论采用QLF技术的红色荧光分析法能够评价釉质早期龋的严重程度,并纵向监测病变,适用于评价龋损防治措施的效果。     

釉质表层特征与早期釉质龋形成的关系

釉质表层是在早期龋时釉质表面相对完整的一层结构，其出现与表面釉质的晶体排列和化学组成有关，早期釉质龋不单是矿物质的溶解和丢失，还包括溶解的矿物质在釉质表层的选择性再矿化，釉质表层和再矿化在早期龋损过程中有重要作用。对釉质表层和早期釉的研究是指导早期龋预防和治疗的关键。本文就釉质表层结构特点，化学组成特点及近6年来众学者对早期龋的形成和预防方面的研究作一综述。     

正畸不同用氟方法预防釉质粘接面早期龋的超微结构观察

目的;测定应用氟化物的不同方法对釉质吸收氟离子的影响。方法：采用因固定正畸需要而拔除的双尖牙１２颗,随机分成对照组,酸蚀中用氟组和酸蚀后用氟组,每组牙釉质经酸蚀和不同用氟方法处理后,做扫描电镜检查。结果;酸蚀后用氟组釉质表面的反应产物最多,釉质吸收的氟离子最多。     

早期釉质龋表层形成的化学机制

早期釉质龋表层相对完善，表层脱矿比表层下轻是其典型的病理特征，也是龋损机制的难点和关键。本文介绍了对早期釉质龋表层形成机制的研究历程，各种学说及氟等抑龋因子在早期龋表层形成中所发挥的作用。     

早期釉质龋表层形成的化学机理

典型的牙釉质龋损均有一脱矿程度较深层组织轻的表层,再矿化可能是该表层形成最主要的化学机理,正常釉质表层固有的结构特点和特殊理化性质也起一定作用。研究早期釉质龋损表层形成的化学机理不仅是了解龋病发生动力学的重要内容,而且为临床防龋和治疗早期龋提供理论依据。     

早期釉质龋表层形成的化学机理

典型的牙釉质龋损均有一脱矿程度较深层组织轻的表层,再矿化可能是该表层形成最主要的比学机理,正常釉质表层固有的结构特点和特殊理化性质也起一定作用。研究早期釉质龋损表层形成的化学机理不仅是了解龋病发生动力学的重要内容,而且为临床防龋和治疗早期龋提供理论依据。     

氟化物凝胶局部应用预防放射性龋的效果观察

鼻咽癌患者经钴~(60)放疗后短期内继发猛性放射性龋。本文采取局部应用氟化物凝胶和挡板保护腮腺观察防龋效果。两年随防结果表明局部应用氟化物凝胶具有明显的防龋效果,并推广应用于头颈部癌瘤放疗患者。挡板保护腮腺的措施未能获得显著的统计学效果。     

光学相干断层成像术对人牙窝沟釉质早期龋变深度的测量

目的 探讨光学相下断层成像技术(OCT)检测离体牙(牙合)面窝沟釉质早期人工龋变深度的准确性和可行性.方法 将7颗因正畸治疗需要拔除的人前磨牙随机分成脱矿及脱矿-再矿化2组,(牙合)面开窗3 mm×4 mm.将脱矿组放入脱矿液中制备人工脱矿模型:将脱矿-再矿化组交替放入脱矿液和再矿化液制备人工龋模型.分别对上述2组牙齿样本进行OCT扫描,测得龋变深度;在牙齿样本OCT扫描的相应部位制备磨片,测量偏光显微镜下龋变的深度.结果 除了脱矿7天的样本外,其余样本2种检测方法测得的龋变深度差异无统计学意义(P>0.05),OCT检测的龋变深度与偏光显微镜检测结果基本相符.结论 OCT作为一种无创的检测方法,可以对釉质窝沟早期人工龋清晰成像,并可进行龋变深度的量化分析,提示其在窝沟早期龋的临床诊断中具有应用潜能.     

A 2-year report on caries prevention by fluoride varnishes in a community with fluoridated water

Abstract – The benefit of semi-annual applications of sodium fluoride varnish (Duraphat®) and silanc fluoride varnish (Fluor Protector®) was studied in 11-13-year-old children with life-long exposure to fluoridated drinking water (1–1.2 parts/ 10⁶). Annual clinical and radiograpic examinations were made on 67 children in the Duraphat group and 71 children in the Fluor Protcctor group. Floride varnish was applied semi-annually using the half-mouth tecnique. At the end of 2 years, the mean overall DMFS- increments on te control side and test side of the Duraphat group were 5.0 and 3.8 ( P 0.01), respectively, and of te Fluor Protector group 3.7 and 3.3 (NS). The caries redutions were 24%and 12%, respectively. Since there were no differences between initial mean DMFS scores of te groups, it was assumed that lower increments in the Fluor Protector group were due to fluoride ions crossing the midline and providing protectioon on the control side as well. When increments in the Duraphat control side and the Fluor Protector test side were compared, the caries reducation of Fluor Protector was 35% ( P <0.01). Fluoride varnishes provide additional benefit even when fluoride intake from drinking water is optimal.     

The use of fluoride varnishes in the prevention of dental caries: a short review

OBJECTIVES: To review the current literature regarding the anti-caries efficacy of fluoride varnishes. To analyse a series of studies designed to detect the caries preventive efficacy of fluoride varnishes by means of meta-analysis. MATERIALS AND METHODS: Current literature on fluoride varnishes has been reviewed. An evaluation of the results of the available in vitro, animal and human studies on the anti-caries efficacy of these preventive agents was performed. A systematic literature search and a meta-analysis were also performed to assess the caries preventive effects of fluoride varnishes. The purpose of this analysis was to calculate the overall preventive efficacy of clinical fluoride varnishes treatment studies, based on defined methodological criteria. RESULTS: The efficacy of fluoride varnishes in caries prevention is clearly demonstrated in several experimental studies. Clinical trials show caries incidence reduction ranging approximately from 18% to 70%. Nevertheless, available studies show a high degree of heterogeneity and only three were found to meet a series of defined methodological criteria. All the three studies were based on a comparison between 0.2% NaF rinses and a fluoride varnish. The meta-analysis showed no significant differences between the two treatments. CONCLUSIONS: Available data suggest that fluoride varnishes are a useful tool in caries prevention. One may conclude that fluoride varnishes, when applied regularly, demonstrate good caries preventive properties.     

定量光导荧光技术评价含氟牙膏抑制早期龋损效果的临床研究

目的评价定量光导荧光技术（QLF）用于纵向监测光滑面早期龋损矿物质含量变化的能力及用于评价不同氟化物抑制早期龋损效果差异的可能性。方法选取305名11～14岁上颌前牙有早期光滑面龋的中小学生,随机分为NaF组、MFP组和不含氟组,分别采用含NaF的牙膏、含Na2PO3F的牙膏（氟浓度均为1 450 mg/L）和不含氟的牙膏刷牙。拍摄受检者上颌前牙光滑面早期龋损基线、刷牙后3个月和6个月时的QLF照片并保存。使用软件QLF2.00g对病损进行分析,界定病损范围,得出每次检查的△F（荧光损失）、Area（病损面积）和△Q（总荧光损失量）。结果296名（97.05%）受检者完成了整个研究。QLF检查结果显示,3个月时,296名受检者上颌前牙光滑面早期龋损均出现不同程度的好转,3组光滑面早期龋损Area、△F和lg△Q的变化均无统计学差异（P>0.05）;6个月时,296名受检者上颌前牙光滑面早期龋损均较基线时出现明显的好转,NaF组、MFP组光滑面早期龋损Area、△F和lg△Q的变化有统计学差异（P<0.05）,而NaF组与MFP组之间无统计学差异（P>0.05）。结论QLF作为一种定量诊断方法,能够用于纵向病变跟踪监测和评价不同龋病干预措施效果。     

氟保护漆预防儿童乳牙龋齿的临床效果评价

目的对氟保护漆预防儿童乳牙龋齿的临床效果进行评价。方法将重庆市一所幼儿园的150名3岁儿童随机分为4组,0.5%氟保护漆组、0.1%氟保护漆组、0.5%氟化钠组和空白对照组,分别采用质量分数为0.5%氟保护漆、0.1%氟保护漆、0.5%氟化钠和去离子水作为涂擦药物,每6个月涂擦1次,为期2年,记录试验前后患龋情况,对4组药物的防龋效果进行比较分析。结果0.5%氟保护漆组的龋均和龋面均显著低于0.1%氟保护漆组、0.5%氟化钠组和空白对照组（P<0.05）。结论质量分数为0.5%的氟保护漆具有明显的预防乳牙龋齿的作用。     

Remineralising effects of fluoride varnishes containing calcium phosphate on artificial root caries lesions with adjunctive application of proanthocyanidin

ObjectivesTo evaluate the remineralising effects of fluoride (F) varnishes containing bioavailable calcium-phosphate compound (Ca-P) based remineralisation systems and 5000 ppm F toothpaste (FTP) on root caries lesions (RCLs) and the potential effects of proanthocyanidin (PA) for the treatments of RCLs when used as an adjunct to F regimens.MethodsDemineralised root dentine and a pH-cycling model were used to mimic RCLs and the oral environment. Remineralising effects of MI Varnish^TM (MIV) containing casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) and Clinpro? White Varnish (CPWV) containing tri-calcium phosphate (TCP) along with FTP and PA were evaluated regarding the birefringence, elemental composition, mechanical properties and mineral density of remineralised dentine with Duraphat^TM as a comparison.ResultsMIV, CPWV and Duraphat^TM promoted the incorporation of F into RCLs and increased mineral density but did not change microhardness of root dentine significantly. Surface microhardness increased significantly when MIV or CPWV was used with 5000 ppm FTP. Application of PA with F regimens significantly increased subsurface mineral density. When PA was applied with MIV or CPWV along with FTP, the highest ion uptake and relative mineral gain (%ΔZ) was achieved, and significant increase of microhardness was up to 30 μm depth. Generally, MIV was associated with a higher mineral content gain than CPWV.SignificanceTreatment of carious root surfaces remains challenging due to the complex pathological processes and difficulty in restoring the highly organised structure of root dentine. Treatment strategies targeting both remineralisation and preservation of the dentinal organic matrix have the potential to improve the fluoride-mediated remineralisation approaches.     

含氟涂料与含氟泡沫对儿童龋病预防效果的对比研究

目的比较含氟涂料和含氟泡沫对儿童乳牙龋病的预防效果,为在我国开展乳牙龋病防治工作提供理论依据。方法随机整群抽样的方法抽取2所幼儿园的3~4岁儿童共220名,进行口腔检查,记录患龋情况。随机将这些儿童分为含氟泡沫组和含氟涂料组,分别用氟泡沫和氟保护漆进行龋齿预防,每半年1次,2年共干预4次,每年进行口腔检查,比较2组基线后1年和2年的乳牙新生龋均、新生龋面均及龋齿发病率。结果含氟泡沫组干预1年及2年后新生龋面均分别为2.58±4.36、3.85±5.15;含氟涂料组干预1年及2年后新生龋面均分别为0.95±2.28、1.94±3.32,均显著低于含氟泡沫组(P<0.01)。结论含氟涂料对儿童龋病的预防效果优于含氟泡沫。     

Review on fluoride, with special emphasis on calcium fluoride mechanisms in caries prevention

Low concentrations of fluoride have a beneficial effect on enamel and dentin de- and remineralization. After fluoride treatments, such as topical applications, rinses or dentifrices, salivary fluoride concentrations decrease exponentially in a biphasic manner to very low concentrations within a few hours. For treatments to be effective over periods longer than the brushing and the following salivary clearance, fluoride needs to be deposited and slowly released. Calcium fluoride (or like) deposits act in such a way. owing to a surface covering of phosphate and/or proteins, which makes the CaF₂ Jess soluble under in vivo conditions than in a pure form in inorganic solutions. Moreover, due to the phosphate groups on the surface of the calcium fluoride globules, fluoride is assumed to be released with decreasing pH when the phosphate groups are protonated in the dental plaque.