酪蛋白磷酸肽-无定形磷酸钙促进牙再矿化的机制

Mechanism of casein phosphopeptide-amorphous calcium phosphate on tooth remineralization

牙体在正常生理状态下处于脱矿和再矿化的动力平衡之中,当环境改变后,平衡被打破,脱矿和再矿化会向某一方向持续进行。脱矿不仅导致牙体形态学发生改变,也是龋病的开端,所以应该采取有力措施阻断这一过程,使其平衡向再矿化方向发展。以往以氟化物防龋并取得了较好的效果,却因不良反应使其应用受到了一定的限制。研究显示,牛奶和奶酪等奶制品也可发挥防龋效应,且此种效应主要与牛奶中所含的酪蛋白有关。酪蛋白经过酶消化后所得到的酪蛋白磷酸肽(CPP)结合无定形磷酸钙(ACP),应用于牙体表面可持续提供钙和磷酸根离子,促进牙体再矿化并抑制牙体脱矿。本文就CPP的来源和结构、CPP与ACP结合、CPP-ACP的抑制脱矿和促进再矿化作用、CPP-ACP作用的试验支撑、CPP-ACP与氟化物的相互作用、CPP-ACP对树脂粘接力的影响等研究进展作一综述。

In the physiological states,demineralization and remineralization of enamel is in the dynamic balance. When the environment changes,the balance can be broken.Demineralization not only led to morphological changes（such as opaque spot）,but also the initial of caries.We should take effective measures to block this process, so that the direction of balance toword the remineralization.In the last decades,fluoride are widely used as an effective topical agent for the prevention of caries by promoting enamel remineralization.But the side-effects of fluoride can limiting its application.Recently,it has been founded that milk and cheese have the properties of anticariogenic,which attributed to the casein.Its tryptic digestion product of phosphopeptides（CPP） have the ability to bind amorphous calcium phosphate（ACP）.When the phosphopeptides appling to the surface of teeth,this candelivering the calcium and phosphate ions,and enhances remineralization,prevents demineralization and reduces caries development.In this review,the structure and the source of CPP,the blend of CPP and ACP,the properties of enhances remineralization and prevents demineralization,the current evidence supporting of CPP-ACP, the interaction of CPP-ACP with fluoride,and the influence of the subsequent resin adhesion are in details.