氟钼酸铵溶液治疗牙本质过敏症的临床初步研究

牙本质过敏症是口腔科临床常见病和多发病,十九世纪中叶以来,国内外学者采用多种药物及方法治疗该症,但疗效多不理想或不持续.寻求较为理想的脱敏药物,一直成为我们口腔工作者不懈努力的目标. 我院马茹苓等应用38%氟化氨银溶液治疗牙本质过敏症,取得了较好的临床疗效.但氟化氨银对皮肤及器皿可染成褐色,对粘膜牙龈有轻度白色损害现象.为克服这一缺点,近年来,我们将10%氟钼酸铵溶液应用于临床,并以氟化氨银作对照,观察其临床疗效和应用特点,现报告如下:     

氟化所银抑制牙本质龋机制的探讨

氟化氨银具有抑制牙本质龋和治疗牙本质过敏等良好效果。本文在以往研究的基础上，应用ｘ线衍射技术分析氟化氨银与牙本质粉作用后的生成物质，进一步探讨氟化氨银抑制牙本质龋和治疗牙本质过敏的可能机制。结果表明，牙本质粉在氟化氨银溶液中浸泡１小时至７天小，羟基磷其钙逐步分解；生成氟化钙和磷酸银，随时间延长，磷酸银生成的量也增加。氟化钙和磷酸银的生成能够增强牙本质抗龋作用。     

氟化氨银抑制牙本质龋机制的探讨

氟化氨银具有抑制牙本质龋和治疗牙本质过敏等良好效果。本文在以往研究的基础上 ,应用 x线衍射技术分析氟化氨银与牙本质粉作用后的生成物质 ,进一步探讨氟化氨银抑制牙本质龋和治疗牙本质过敏的可能机制。结果表明 ,牙本质粉在氟化氨银溶液中浸泡 1小时至 7天后 ,羟基磷酸钙逐步分解 ;生成氟化钙和磷酸银 ,随时间延长 ,磷酸银生成的量也增加。氟化钙和磷酸银的生成能够增强牙本质抗龋作用。     

氟化氨银溶液治疗牙本质过敏症的即刻疗效观察

70年代日本首先使用氟化氨银溶液用于防龋,继而用于治疗牙本质过敏.我们使用本院配制的38%氟化氨银溶液应用于临床,并在治疗前后通过临床检查和电活力测试的方法来检测治疗的效果.结果表明:氟化氨银溶液的单次即刻有效率为62.5%,是目前较理想的牙本质脱敏药物,现报道如下.材料和方法一、材料:1.38%氟化氨银溶液.2.美国 ANALYTIC TECHNOLOGY800—1型电活力分析仪.     

羟磷灰石同质间吸附效果及对牙本质小管封闭效果的研究

目的:观察羟磷灰石同质间的吸附和羟磷灰石微粒子对牙本质小管的封闭效果。方法:1)羟磷灰石颗粒放入羟磷灰石微粒子溶液中进行机械反应与羟磷灰石颗粒放入B rush ite(CaHPO4.2H2O)微粒子溶液中进行机械反应,对比两种溶液中微粒子附着在羟磷灰石颗粒表面的量。2)用羟磷灰石微粒子涂布牙本质表面观察裸露的牙本质小管封闭情况。结果:在相同时间内羟磷灰石颗粒与羟磷灰石微粒子的附着量明显高于羟磷灰石颗粒与B rush ite微粒子的附着量,并随时间的延长附着量而增加。羟磷灰石微粒子有明显的封闭牙本质小管的作用。结论:羟磷灰石同质间有吸附性;羟磷灰石微粒子可以封闭裸露的牙本质小管。     

氟化氨银溶液用于根管消毒的实验与临床应用

采用3.8%氟化氨银溶液对离体牙标本进行根管封药,置于恒温生理盐水中3—7天.结果在电镜下可见牙本质小管内深1/4—1/2处有大小不等黑色银颗粒沉积,阻塞牙本质小管.另外对患根尖周炎的感染根管进行细菌培养.实验结果3.8%氟化氨银溶液对感染根管内的厌氧菌、产黑色素类杆菌有杀菌,抑菌作用.临床应用3.8%氟化氨银溶液进行根管消毒,封药5—7天疗效达92.3%、使用安全、对根尖无刺激性是行之有效的根管消毒药.     

氟钼酸铵溶液提高根部牙本质抗酸性机理探讨

目的：探讨氟钼酸铵溶液提高根部牙本质抗酸性的机理。方法：用X光衍射、等离子发射光谱、光量法对10%氟钼酸铵溶液、2.86%氟钼酸铵溶液、2%氟化钠溶液、7.26%钼酸铵溶液及去离子水处理过的根部等量牙本质粉进行产物分析；并用氟电极测定产物中氟的含量；钙电极测定用乳酸溶解出的产物中钙的含量。结果：氟钼酸铵溶液处理过的牙本质粉中有氟化钙、钼酸钙生成，其中碳酸磷灰石的含量有所减少，牙本质抗酸溶液性得到提高。结论：氟钼酸铵溶液可能通过促进根表面对氟吸收生成难溶性的盐类；降低易溶解的碳酸磷灰石的含量等作用提高根表面的抗酸溶解性。     

氟钼酸铵溶液抑制人工根面龋作用的研究

目的 :观察 10 0g/L氟钼酸铵溶液对体外形成的人工根面龋的抑制作用。方法 :3 2个正畸减数前磨牙根面开窗 ,置于致龋菌液中 48h形成初期人工龋损后随机分为 4组 ,各组从开窗区中央分为 2部分 ,一半为龋损基线 ,另一半开窗区 ,分别用 10 0 g/L氟钼酸铵、3 80g/L氟化氨银、2 0g/L氟化钠溶液及去离子水处理 2min× 3 ,再次放入新鲜菌液中 48h。标本磨片拍摄显微放射照片并测定龋损深度及脱矿量。结果 :氟钼酸铵组形成的人工龋损深度浅 ,脱矿量变化小 ,与氟化钠组和对照组存在显著性差异 (P <0 .0 5) ,与氟化氨银组无差异 (P >0 .0 5) ;氟钼酸铵和氟化氨银处理组龋损深度及脱矿量前后无显著性差异 (P >0 .0 5)。而氟化钠溶液及去离子水处理组处理前后有差异 (P <0 .0 5)。结论 :10 0g/L氟钼酸铵有抑制根面龋损作用 ,其作用与 3 80 g/L氟化氨银相似 ,优于 2 0 g/L氟化钠     

牙髓病及根尖周病

氟钼酸铵溶液对牙本质小管封闭作用的观察;根管超声冲洗效果的扫描电镜研究;牙病治疗后产生折裂的原因分析;不同扩根器械拆除根管充填物的比较研究;替硝唑碘仿地塞米松糊剂根管消毒的临床疗效评价     

六氟硅酸铵溶液封闭牙本质小管的扫描电镜观察

目的:研究不同浓度六氟硅酸铵(SiF)溶液封闭牙本质小管的即刻效果.方法:将32个新鲜拔除的人第三磨牙,分别制备4mm ×4mm ×2mm的牙本质盘,经0.5 mol/L EDTA溶液酸蚀2min后,随机分A、B、C、D、E、F、G7组,A组为空白对照组,B～G组分别使用10、20、30、40、50、100 mg/L的六氟硅酸铵溶液涂抹3 min,扫描电镜观察牙本质小管的封闭效果及小管内堵塞深度,并用Image-pro PLUS,v6.0图像分析软件量化分析.结果:各处理组牙本质小管均有不同程度的封闭,其中50 mg/L为即刻最佳最低有效浓度,并且可渗入牙本质小管内达一定深度;计算各组开放牙本质总面积进行量化分析显示,10 ～ 100 mg/L各浓度SiF各处理组的开放牙本质小管总面积均低于空白对照组(P＜0.05);各处理组开放牙本质小管总面积随着SiF浓度增高而越来越低,其中50 mg/L和100 mg/L牙本质小管封闭效果最好,与其他各组相比均有统计学差异(P＜0.05).结论:50 mg/L以上六氟硅酸铵溶液对牙本质小管有良好的封闭作用.     

Effects of dentin tubule occlusion by dentifrice containing a PVM/MA bioadhesive copolymer in a silica base

Objective

To study the effectiveness of a dentifrice containing polymethyl vinyl ether-maleic acid (PVM/MA) copolymer in a silica base in occluding dentin tubules for treatment of dentin sensitivity.

Methods

Thirty-two human dentin discs were divided into two groups and brushed in the morning for 30 s each to study the dentifrices with and without PVM/MA copolymer. Dentin tubule occlusion and dentin permeability were evaluated with a focus variation three dimensional vertical scanning microscope (IFM) and electrochemical impedance spectroscopy (EIS). After second brushing for 30 s in the afternoon the dentin discs were immersed in saliva for 16 h and then subjected to erosion using orange juice for 10 min. The effects of saliva and orange juice on tubule occlusion used in the study of dentifrices were further evaluated with IFM.

Results

On average 97.7% of the dentin tubules were occluded after brushing in the PVM/MA group, as compared to 13.3% in the control group (p < 0.0001). EIS showed that the impedance of the dentin disc increased after treatment with PVM/MA but not in the control group (p < 0.05). After 16 h of storage in saliva and 10 min of erosion by orange juice, 86% of the dentin tubules remained occluded in the PVM/MA treated dentifrice. The sizes of the tubule openings were increased after orange juice erosion in the control group but not in the PVM/MA group.

Conclusion

Dentifrice containing PVM/MA copolymer in a silica base effectively occluded dentin tubules. The intra-tubular plugs were resistant to saliva and orange juice challenges.     

五倍子水提取物对正常釉质及去有机质釉质脱矿影响的实验研究

目的：探讨五倍子水提取物影响牙釉质脱矿的机理。方法：建立去有机质釉质模型,分别以30mg／ml五倍子水提取物、2％氟化钠、38％氟化氨银、10％硝酸银及去离子水处理去有机质釉质及正常釉质,采用化学法制备釉质人工龋。分别收集各组脱矿液,以原子光谱法检测脱矿液中钙、磷含量。脱矿后釉质进行显微放射照相分析,比较其脱矿量及龋损深度。结果：与氟化氨银及硝酸银组相同,五倍子水提取物对正常釉质抑制脱矿的效果显著优于去有机质釉质。氟化钠及去离子水对正常釉质及去有机质釉质抑制脱矿效果无显著性差异。结论：有机质在一定条件下可抑制釉质脱矿;五倍子通过作用于釉质有机质达到抑制釉质脱矿的作用。     

Effect of propolis gel on the in vitro reduction of dentin permeability

Objective

The aim of this study was to evaluate the capacity of potassium oxalate, fluoride gel and two kinds of propolis gel to reduce the hydraulic conductance of dentin, in vitro.

Material and Methods

The methodology used for the measurement of hydraulic conductance of dentin in the present study was based on a model proposed in literature. Thirty-six 1-mm-thick dentin discs, obtained from extracted human third molars were divided into 4 groups (n=9). The groups corresponded to the following experimental materials: GI-10% propolis gel, pH 4.1; GII-30% propolis gel; GIII-3% potassium oxalate gel, pH 4,1; and GIV-1.23% fluoride gel, pH 4.1, applied to the dentin under the following surface conditions: after 37% phosphoric acid and before 6% citric acid application. The occluding capacity of the dentin tubules was evaluated using scanning electron microscopy (SEM) at ×500, ×1,000 and ×2,000 magnifications. Data were analyzed statistically by two-way ANOVA and Tukey''s test at 5% significance level.

Results

Groups I, II, III, IV did not differ significantly from the others in any conditions by reducing in hydraulic conductance. The active agents reduced dentin permeability; however they produced the smallest reduction in hydraulic conductance when compared to the presence of smear layer (P<0.05). The effectiveness in reducing dentin permeability did not differ significantly from 10% or 30% propolis gels. SEM micrographs revealed that dentin tubules were partially occluded after treatment with propolis.

Conclusions

Under the conditions of this study, the application of 10% and 30% propolis gels did not seem to reduce the hydraulic conductance of dentin in vitro, but it showed capacity of partially obliterating the dentin tubules. Propolis is used in the treatment of different oral problems without causing significant great collateral effects, and can be a good option in the treatment of patients with dentin sensitivity.     

Systemp脱敏剂治疗牙本质过敏症的研究

目的观察Systemp脱敏剂治疗牙本质过敏症的效果.方法牙本质过敏症患牙240颗,实验组120颗,使用Systemp脱敏剂,对照组120颗使用30%草酸钾溶液.离体牙30颗,磨除牙冠颈1/3区牙釉质,暴露牙本质,分3组,第1组涂布Systemp,第2组涂布草酸钾溶液,第3组不作任何处理,进行扫描电镜观察.结果实验组与对照组的疗效存在显著性差异,各组内随着时间的推移,疗效出现下降且存在显著性差异.电镜下可见,经Systemp处理后牙本质表面的牙本质小管基本被封闭,开口不显现,并有"树脂突"样结构深入牙本质小管约50μm.结论Systemp能有效地封闭牙本质小管,治疗牙本质过敏症效果明显,持续性较佳,是一种较为理想的牙本质脱敏剂.     

氟化微量元素制剂对牙釉质显微硬度变化影响的实验研究

目的：比较氟化微量元素制剂对酸蚀下牙釉质显微硬度降低的抑制作用,为找到低毒高效的防龋制剂提供依据。方法：牙釉质样本分别经含相同氟浓度的5种氟化微量元素制剂（氟化锌、氟化镧、氟化亚锡、氟化锶、氟钼酸铵）及氟化钠处理后酸蚀,MH-5型显微硬度计测量牙釉质酸蚀前后显微硬度,观察牙釉质显微硬度的变化。结果：氟化钠、氟化锌、氟化锶、氟化亚锡、氟化镧、氟钼酸铵均有抑制酸蚀下釉质显微硬度降低的作用,其中氟化亚锡对酸蚀下牙釉质显微硬度降低的抑制作用明显强于氟化钠（P〈0．05）。结论：含锡氟化物可显著提高牙釉质的抗酸能力,在抑龋防龋方面,氟化微量元素拥有广泛的应用前景。     

氟化微量元素制剂对变形链球菌产酸影响的实验研究

目的比较氟化微量元素制剂对变形链球菌产酸及乳酸脱氢酶活性的抑制作用。方法含相同氟浓度的5种氟化微量元素制剂(氟化锌、氟化镧、氟化亚锡、氟化锶、氟钼酸铵)和氟化钠分别加入到含变形链球菌菌悬液的BHI培养基中,采用二硝基苯肼法并利用720A型离子仪,观察变形链球菌乳酸脱氢酶活性及培养液pH的变化。结果氟化锌、氟化亚锡对变形链球菌乳酸脱氢酶活性的抑制作用强于氟化钠(P<0.01);氟化锌、氟化亚锡抑制变形链球菌产酸的作用亦强于氟化钠(P<0.05)。结论锡、锌等微量元素可提高氟化物的防龋生物活性。     

8DSS peptide induced effective dentinal tubule occlusion in vitro

Objective

Eight repetitive nucleotide sequences of aspartate–serine–serine (8DSS) derived from dentin phosphoprotein (DPP) has been proved to be a good remineralization agency. In this study, 8DSS peptide was employed to induce dentinal tubule occlusion.

三种新型钙盐脱敏剂封闭牙本质小管的体外研究

目的 体外比较3种新型钙盐脱敏剂封闭牙本质小管的效果,以期为临床应用提供参考.方法 新鲜离体第三磨牙25颗,制备成1.00 mm厚的牙本质薄片,6%柠檬酸处理后,按随机数字表法分为5组(n=5),分别用蒸馏水(A组)、NovaMin(B组)、Pro-Argin(C组)、酪蛋白磷酸肽-无定形非晶体磷酸钙(D组)、75%NaF甘油(E组)处理样本冠面2 min,纵向劈开,扫描电镜观察牙本质表面和剖面后,测量牙本质小管封闭数目比及封闭深度,X射线能谱分析表面元素组成和剖面钙磷元素变化趋势.结果 A组牙本质小管完全开放,B、C、D、E组牙本质小管封闭数目比分别为(81.6±6.1)%、(71.5±6.3)%、(43.2±2.6)%、(39.9±4.1)%;剖面封闭深度分别为(30.33±2.26)、(24.55±2.58)、(16.10±4.65)、(8.90±1.51)μm;表面封闭数目比和剖面封闭深度4组间差异有统计学意义(P＜0.01),但B、C组间差异无统计学意义(P＞0.05);5组钙磷比差异无统计学意义(P=0.342).结论 体外牙本质小管即刻封闭效果比较,NovaMin处理组在牙本质表面和剖面均显示出较好的封闭性能,可形成类牙本质样物质.

Abstract：

Objective To evaluate the occluding effects of three new calcium desensitizers on dentinal tubules in vitro. Methods Twenty-five dentin specimens of 1.00 mm thick from freshly extracted third molars were divided into five groups randomly. After treatment with 6% citric acid, group A was treated with distilled water, and group B-E were treated with NovaMin, Pro-Argin, casein phosphopeptide-amorphous calcium phosphate( CPP-ACP), and 75% NaF glycerin for 2 min respectively. Then the teeth were vertically cleaved into two sections. The surfaces and cross sections were observed by the scanning electron microscope(SEM) and energy dispersive X-ray (EDX), which were analyzed by the Image-Pro Plus software. Results The percentage of dentin tubules sealed were ( 81.6 ± 6. 1 ) %, ( 71.5 ± 6. 3 ) %, (43.2 ± 2. 6) %, ( 39. 9 ± 4. 1 ) %for groups B, C, D and E respectively, and the occluding depth were ( 30. 33 ± 2. 26 ), ( 24. 55 ± 2. 58 ),(16. 10 ±4. 65) and (8. 90 ± 1.51 ) μm respectively. The differences between these groups were statistically significant (P＜0. 01) except for group B and C (P ＞0.05). However, there was no significant difference between all the groups for the Ca/P ratios ( P = 0. 342). Conclusions NovaMin may have better immediate occluding effects than other desensitizers and could deposit a dentin-like mineral.     

纳米羟基磷灰石的制备及其对牙本质小管封闭效果的初步观察

目的 通过合成纳米羟基磷灰石(hydroxyapatite,HA)以及体外实验观察其对牙本质小管的封闭效果,为纳米HA的临床应用提供依据.方法 采用磷酸氢二铵[(NH4)2HPO4]和硝酸钙[Ca(NO3)2]合成纳米HA,扫描电子显微镜(scanning electron microscope,SEM)、透射电子显微镜(transmission electron microscope,TEM)、傅里叶变换红外光谱计(Fourier transform infrared spectrometer,FTIR)和X射线衍射仪(X-ray diffractometer,XRD)检测纳米HA.选取8颗健康第三磨牙制备24片牙本质薄片,按随机数字表分为酪蛋白磷酸肽钙磷复合体(casein phosphopeptideamorphous calcium phosphate,CPP-ACP)组、纳米HA组及空白对照组,每组8片;空白对照组不做处理,CPP-ACP组和纳米HA组每天分别用CPP-ACP和纳米HA处理牙本质薄片2次,7d后SEM观察牙本质表面.结果 经SEM、TEM、FTIR和XRD检测,证实本项实验制备的HA为纳米HA;SEM观察纳米HA对牙本质小管的封闭效果明显高于CPP-ACP组和窄白对照组.结论 在体外条件下,与CPP-ACP相比,纳米HA可更有效地封闭暴露的牙本质小管.     

Influence of ascorbic acid on bonding of peroxide-affected dentin and 4-META/MMA-TBB resin

The purpose of this study was to evaluate the tensile bond strength (TBS) to peroxide-exposed dentin. Furthermore, the effect of ascorbic acid (AA) on the bond strength of peroxide-exposed dentin was investigated. Extracted bovine dentin was exposed to 10% carbamide peroxide, 30% hydrogen peroxide, or distilled water for 30 min, then treated with 10% AA (0, 30, 90, and 180 min), and conditioned with 10% citric acid/3% ferric chloride. The polymethyl-methacrylate (PMMA) rod was bonded to the treated bovine dentin with 4-META/MMA-TBB resin. A minidumbbell-shaped bonded specimen was prepared from these bonded assemblies and the TBS was tested. The fractured surfaces were also observed with a scanning electron microscope. Exposure to peroxide before bonding significantly reduced bond strength. The application of AA to the peroxide-exposed dentin increased bond strength. On the other hand, an adverse effect of AA was found in distilled water-affected dentin. Extended resin fibers were partially seen in the peroxide-exposed dentin. In conclusion, peroxide reduced the bond strength, and the stronger the oxidation, the weaker the obtained bond. Antioxidation with AA recovered the bond strength, and this effect increased the longer the AA was applied.K. Yazaki was formerly affiliated with Department of Pharmacology, Tokyo Dental College, 1-2-2, Masago, Mihama-ku, Chiba 261-8502, Japan. He is now in private practice.