酪蛋白磷酸多肽钙磷复合体的应用顺序对乳牙牙本质粘结强度的影响

目的探讨酪蛋白磷酸多肽钙磷复合体(casein phosphopetide-amorphic calcium phosphat, CPP-ACP)应用顺序对乳牙牙本质粘结强度及对乳牙牙本质小管封闭作用的影响。方法选取人56颗无龋乳磨牙,磨除牙合面釉质,制备牙本质平面。将其中48颗乳磨牙随机分3大组(n=16)。A组:仅酸蚀15 s。B组:涂CPP-ACP后酸蚀15 s。C组:酸蚀15 s后涂CPP-ACP。各组分为2小组(n=8),其中AN,BN,CN组使用Prime&Bond NT(NT)全酸蚀粘结剂,AS,BS,CS组使用Single bond 2(SB2)全酸蚀粘结剂。制作树脂粘结试件,电子万能试验机测定剪切强度(SBS值)。其余8个乳磨牙随机分成4组(n=2),分别为空白组(S1组)、酸蚀组(S2组)、酸蚀后涂CPP-ACP组(S3组)、涂CPP-ACP后酸蚀组(S4组)分别用扫描电镜观察粘结前牙本质小管封闭情况。结果剪切实验结果为AN组、BN组、CN组剪切强度无统计学差异(P>0.05);AS组,BS组,CS组剪切强度也无统计学差异(P>0.05);AN组>AS组,BN组>BS组,CN组>CS组差异有统计学意义(P<0.05)。扫描电镜结果为S3组中牙本质小管封闭数目最多。结论在酸蚀后应用CPP-ACP处理乳牙牙本质不影响NT和SB2两种全酸蚀粘结剂的粘结强度;可以达到有效的牙本质小管封闭;Prime&Bond NT(NT)全酸蚀粘结系统的粘结强度高于Single bond 2(SB2)。     

含氟涂漆与CPP-ACP或生物活性玻璃对根龋的作用评价

目的：体外研究含氟涂漆与酪蛋白磷酸肽-非结晶型磷酸钙(casein phosphopeptide-amorphous calcium phosphate,CPP-ACP)或生物玻璃对根龋的作用。方法：选择2017年4月—2018年10月北京大学人民医院口腔科收集的84颗活动性根龋牙,随机分为A、B、C、D组,每组均21颗牙,4组均给予含氟牙膏刷牙,B组增加含5%氟化钠的涂漆,C组增加含5%氟化钠+CPP-ACP的涂漆,D组增加含5%氟化钠+生物活性玻璃的涂漆。观察涂漆前、后各组根龋严重程度、表面粗糙度、矿物质浓度。采用SPSS 23.0软件包分析根龋严重程度与表面粗糙度的相关性。结果：B、C、D组涂漆50 d后硬度显著高于涂漆前及A组（P<0.05）;C、D组涂漆50 d后硬度显著高于B组（P<0.05）;D组涂漆50 d后硬度显著高于C组（P<0.05）。涂漆7 d后,B、C组表面粗糙度评分均显著高于A、D组（P<0.05）;涂漆14 d后,B组表面粗糙度评分均显著高于A、C、D组（P<0.05）;涂漆50 d后,D组表面粗糙度评分显著高于B、C组（P<0.05）。A组根龋严重程度评分与表面粗糙度呈负相关（P<0.05）。各组涂漆50 d后矿物质浓度均显著高于涂漆前（P<0.05）。结论：含氟化物+CPP-ACP或生物活性玻璃涂漆均具有显著阻止根龋的作用,生物活性玻璃较CPP-ACP更稳定,提高牙表面矿物质浓度效果更好。     

GC护牙素在固定正畸中预防釉质脱矿的临床研究

目的观察固定正畸矫治中GC护牙素预防牙釉质脱矿的临床效果。方法选择固定矫治器治疗的患者64名,随机分为2组,护牙素组32例,657颗牙;对照组32例,678颗牙。矫治结束后对牙面脱矿情况进行临床观察,用SPSS13.0统计软件进行数据处理分析。结果矫治前二组患者被观察牙齿牙釉质脱矿率和脱矿程度均无明显差异(P>0.05)。矫治后护牙素组牙釉质脱矿率为5.78%,对照组为15.78%。护牙素处理组牙釉质脱矿率和脱矿程度明显低于对照组,有显著性差异(P<0.01)。结论在固定正畸治疗中配合使用GC护牙素处理牙面,可预防牙釉质脱矿的发生。     

Esthetic comparison of white-spot lesion treatment modalities using spectrometry and fluorescence

Objective:To compare the esthetic improvements of white-spot lesions (WSLs) treated by fluoride, casein phosphopeptide amorphous calcium phosphate (CPP-ACP), or resin infiltration.Materials and Methods:WSLs were created on human enamel and randomly assigned to four groups: NaF (500 ppm), CPP-ACP, resin infiltration (Icon), or distilled deionized water (DDW; control group). The color change (ΔE) of each specimen was measured with a Crystaleye spectrophotometer, and fluorescence loss (ΔQ) was measured by quantitative light-induced fluorescence (QLF), at different time points after treatment: baseline (0 weeks), 2 weeks, 4 weeks, and 6 weeks.Results:The ΔE and ΔQ baseline values for the four groups before the treatments did not differ significantly. Icon treatment improved the WSL color significantly and gave the lowest ΔE (2.9 ± 1.2 on average) compared with other treatments (P < .01). The Icon treatment also resulted in a significant change in the ΔQ of WSLs compared with baseline (P < .01). In the NaF and CPP-ACP treatment groups, ΔQ showed significant recovery compared with the baseline values only after 4 weeks after treatment (P < .05).Conclusions:Resin infiltration is more effective than NaF or CPP-ACP in providing esthetic improvement of WSLs.     

Calcium-Based Caries Preventive Agents: A Meta-evaluation of Systematic Reviews and Meta-analysis

Objective

This article aims to assess systematic reviews and/or meta-analyses on calcium-based caries preventive agents, evaluating reported evidence, thereby summarizing a critical appraisal on the subject.

Biocompatibility and Osteogenic/Calcification Potential of Casein Phosphopeptide-amorphous Calcium Phosphate Fluoride

Introduction

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and CPP-ACP with fluoride (CPP-ACFP) have been shown to provide bioavailable ions to promote mineralization. Hence, the aim of this study was to evaluate the materials’ biocompatibility and osteogenic/calcification potential for endodontic applications.

Aesthetic management of severely fluorosed incisors in an adolescent female

BACKGROUND: Dental fluorosis is a condition of enamel hypomineralization due to the effects of excessive fluoride on ameloblasts during enamel formation. Delayed degradation of enamel matrix proteins or inhibited protein removal results in impaired and incomplete crystal growth, producing hypomineralized and porous enamel. Severely fluorosed teeth may undergo post-eruptive surface breakdown and post-eruptive dark brown to black staining. METHODS: A 13 year old girl presented with severely discoloured maxillary central incisors. Initial aesthetic management of these teeth was conservative, including in-office tooth whitening, microabrasion and take-home whitening. RESULTS: Dark brown to black staining of the teeth was reduced successfully without the need for gross mechanical preparation of the enamel. Further improvement of aesthetics was achieved with composite veneers. CONCLUSIONS: Conservative treatment options such as tooth whitening and microabrasion can dramatically improve severely discoloured fluorosed teeth. This can provide a satisfactory interim outcome or minimize the removal of discoloured enamel and dentine prior to the provision of composite veneers. The use of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) may enhance remineralization and decrease postoperative sensitivity following tooth whitening and microabrasion procedures in hypomineralized teeth.     

酪蛋白磷酸肽钙磷复合体对粘性放线菌产酸影响的实验研究

[目的]研究酪蛋白磷酸肽钙磷复合体(Casein phosphopeptide- Amorphic Calcium Phosphate,CPP-ACP)对粘性放线菌产酸的影响,探讨CPP-ACP作为一种生物防龋制剂的可行性. [方法]将粘性放线菌加入含不同浓度CPP-ACP的蔗糖培养基中,厌氧培养48 h,用精密pH计检测培养基上清液的pH值,计算pH的变化值△pH(初始pH值-终末pH值). [结果]随CPP-ACP浓度的升高,培养基上清液的pH值升高,△pH降低,即粘性放线菌的产酸量降低(P＜0.01). [结论] CPP-ACP对粘性放线菌产酸具有抑制作用,且随CPP-ACP浓度的升高抑制作用增强.     

The incorporation of casein phosphopeptide-amorphous calcium phosphate into a glass ionomer cement

Objectives

The aim of this study was to measure the effect of incorporating CPP-ACP into an autocure GIC on physical and mechanical properties, ion release and enamel demineralization inhibition.

Methods

Physical and mechanical properties were evaluated using tests specified by the International Organization for Standardization (ISO). Concentrations of fluoride, calcium and inorganic phosphate in deionized water (pH 6.9) and lactic acid (pH 4.8) were measured up to five months. Cavities on human extracted molars were prepared, restored with GIC (control), CPP-ACP modified GIC or resin composite, then stored in 50 mM lactic acid solution at pH 4.8 for 4 days. Sections of demineralized enamel were examined using polarized light microscopy followed by lesion area measurement.

Results

The incorporation of up to 5% CPP-ACP into Fuji VII decreased the cements’ strength and prolonged setting time. However, values remained within ISO limits. The incorporation of 3 or 5% CPP-ACP significantly decreased fluoride release, while higher calcium and inorganic phosphate release occurred. The demineralized enamel area adjacent to GIC with 3 or 5% CPP-ACP was significantly smaller compared to GIC control.

Significance

The incorporation of 3% CPP-ACP into GIC has the potential to improve its anticariogenic ability without adversely affecting its mechanical properties.