酪蛋白磷酸肽-磷酸钙溶液对牙釉质再矿化的影响**

背景：酪蛋白磷酸肽-磷酸钙的作用时间和效力均强于普通只含钙磷的再矿化液，实验室及人体研究证明其能使牙釉质缺损再矿化，但研究多集中于釉质表面的微脱矿。 目的：拟通过酸蚀剂处理形成不同深度的釉质表面脱矿形态，观察酪蛋白磷酸肽-磷酸钙溶液对牙釉质再矿化的影响。 设计、时间及地点：对照观察实验，于2008-05/07在兰州大学口腔医院完成。 材料：离体牙釉质块收集于兰州大学口腔医院外科门诊需拔除的正畸上颌第一前磨牙20个。 方法：选取需拔除的正畸上颌第一前磨牙20个，随机分为2组，每组10个，分别用35%磷酸凝胶、20%磷酸凝胶对牙冠颊、腭面酸蚀处理60 s，每颗牙牙冠沿近远中向纵剖，一半置于酪蛋白磷酸肽-磷酸钙再矿化液中矿化10 d，另一半作为对照置于去离子水中。比较两种材料酸蚀及再矿化后的形态改变。 主要观察指标：扫描电镜观察牙釉质表面在酸蚀后和酪蛋白磷酸肽-磷酸钙液再矿化后的表面形态改变。 结果：采用35%磷酸凝胶、20%磷酸凝胶酸蚀后形成深、浅两种不同釉质酸蚀表面结构，呈鱼鳞状,经酪蛋白磷酸肽-磷酸钙再矿化液处理后酸蚀釉质表面都有大量的矿化物沉积，颗粒细小，沉积不均匀，逐渐变平，两种结构间无明显区别。 结论：实验表明酪蛋白磷酸肽-磷酸钙可促进脱矿釉质再矿化，再矿化程度与釉质表面形态无关。

Effects of casein phosphopeptide-stabilized amorphous calcium phosphate solution on enamel remineralization

BACKGROUND: The durability and efficacy of casein phosphopeptide-stabilized amorphous calcium phosphate solution (CPP-ACP) on remineralization of enamel lesions are greater than calcium phosphate-based solution. However, the majority of studies focus on demineralization at enamel surface. OBJECTIVE: To investigate the efficacy of CPP-ACP on remineralization of different surface of enamel etched. DESIGN, TIME AND SETTING: A randomized control experiment was performed in Stomatology Hospital, Lanzhou University from May to July 2008. MATERIALS: A total of 20 first premolar in maxillary extracted for orthodontic reasons were collected in Stomatology Hospital, Lanzhou University. METHODS: The samples were randomly divided into two groups with 10 teeth in each group. Buccal and palatal surface of teeth were separately etched by 35% or 20% phosphoric acid gel in 20% for 60 seconds. Teeth were cut vertically along mesto-distal surface, the half etched of teeth were placed in the CPP-ACP solution to be remineralized for 10 days, and the other half were placed in deionized water as controls. Morphology of teeth was compared. MAIN OUTCOME MEASURES: Morphological changes of teeth etched and re-mineralized in the CPP-ACP solution were observed by scanning electron microscopy (SEM). RESULTS: SEM observation indicated that enamel surface became different fish scaled structures when they were etched by 35% and 20% phosphoric acid gel. On the surface of the enamel treated with phosphoric acid gel, a large amount of minerals deposited after remineralization in the CPP-ACP solution. The minerals were exiguous and the aggradation was uneven. There was not significant difference between the two structures. CONCLUSION: CPP-ACP can promote remineralization on the surface of teeth enamel, and the extent of mineralization has no relation to the morphology of teeth enamel.