酪蛋白磷酸多肽钙磷复合体对牙釉质脱矿和再矿化作用的实验研究

Effect of the complex of casein phosphopeptide and amorphous calcium phosphate on reducing enamel demineralization and promoting remineralization

目的评价10％酪蛋白磷酸多肽钙磷复合体（complex of casein phosphopeptide and amorphous calcium phosphate。cPP．ACP）对抑制离体牙牙釉质脱矿及促进再矿化的功效，以期为临床防龋提供实验依据。方法将因正畸需要拔除的离体前磨牙18颗从冠根向一分为二，制成36个实验样本，用自凝材料包埋于塑料圈内，根据扫描电镜样品的要求打磨抛光后牙釉质面积为3mm×3mm。用随机数字表法将实验样本随机分为6组，每组6个，分别为不酸蚀组、酸蚀组及实验A、B、C、D组，不酸蚀组不进行酸蚀及CPP．ACP浸泡，酸蚀组仅用37．5％磷酸酸蚀浸泡牙釉质2min，实验组用37．5％磷酸酸蚀浸泡牙釉质2min后分别用CPP—ACP涂搽牙面3min，置于蒸馏水中浸泡24h，待第2天在同一时间涂搽CPP．ACP3rain并进行蒸馏水浸泡24h，实验A、B、c、D组分别应用cPP—ACP浸泡7、14、21、28d。扫描电镜观察并用能谱检测钙的质量分数，统计分析各组釉柱再矿化与浸泡时间的关系。结果扫描电镜观察结果显示，CPP—ACP浸泡后实验A、B、C、D组釉质表面有大量的矿物质沉积，填补了釉质表面局限性的小凹陷；实验D组的釉质表面矿物质沉积较实验A、B、C组致密。实验A、B、C、D组釉质表面钙质量分数[分别为（66．53±0．63）、（67．00±0．49）、（67．07±0．24）、（67．18±0．50）]与酸蚀组（65．74±0．68）相比差异均有统计学意义（P〈0．05）；实验A、B、C、D组间两两比较差异均无统计学意义（P〉0．05）。结论CPP—ACP在体外实验7d能使离体牙牙釉质在蒸馏水环境中抑制脱矿和促进再矿化，28d可以加强牙釉质再矿化的功效。

Objective To investigate the effect of the complex of casein phosphopeptide and amorphous calcium phosphate（CPP-ACP） on the demineralization and remineralization of dental enamel in vitro. Methods Premolars extracted from patients receiving orthodontic treatment were cut into two slabs, which were embedded and polished. The slabs were randomly divided into non-acid etching group, acid etching group（ immersed in 37. 5% phosphoric acid for 2 minutes） , experimental group A （ immersed in 37.5% phosphoric acid for 2 minutes and wiped by CPP-ACP for 3 minutes, then immersed in distilled water for 7 days ） ,experimental group B（immersed in 37. 5% Phosphoric acid for 2 minutes and wiped by CPP-ACP for 3 minutes, then immersed in distilled water for 14 days） , experimental group C （immersed in 37.5% phosphoric acid for 2 minutes and wiped by CPP-ACP for 3 minutes, then immersed in distilled water for 21 days）,experimental group D（immersed in 37.5% phosphoric acid for 2 minutes and wiped by CPP-ACP for 3 minutes, then immersed in distilled water for 28 days） , with 6 slabs in each group. The mineral content was determined by scanning electron microscope. Results There was a large amount of mineral deposited on enamel surface in experimental group A, B, C, D. The calcium content of experimental group D was higher than those of other 3 experimental groups. The calcium content of experimental group A, B, C, D（66. 53 ± 0. 63,67.00 ± 0. 49,67. 07 ±0. 24,67.18 ±0. 50 ） was higher than that of acid etching group（ 65.74± 0. 68 ） （ P 〈 0. 05 ）. There was no significant difference of the calcium content amongexperimental group A, B, C, D （P 〉 0.05 ）. Conclusions CPP-ACP can reduce enamel demineralization and promote remineralization in vitro.