酪蛋白磷酸肽-无定形磷酸钙防治早期釉质龋的体外研究

Effect of casein phosphopeptide-amorphous calcium phosphate on prevention of enamel subsurface lesion in vitro

目的 探讨酪蛋白磷酸肽-无定形磷酸钙（CPP-ACP）抑制牛牙釉质脱矿和促进早期釉质龋再矿化的作用,评价CPP-ACP防治早期釉质龋的效果.方法 抑制脱矿实验制备40颗牛牙釉质块,随机分5组,每组8颗,分别应用0.5％、1.0％和2.0％的CPP-ACP溶液、0.22％ NaF溶液和去离子水处理牛牙釉质表面,经人工龋实验形成釉质龋损.再矿化实验制备48颗牛牙釉质块,随机分6组,每组8颗,经人工龋实验在各组标本上形成釉质龋损后,分别采用0.5％、1.0％和2.0％的CPP-ACP、0.22％ NaF、常规再矿化液和去离子水进行pH循环再矿化实验.2个实验均采用横断显微放射照相技术检测各组釉质表面的人工龋损矿物质含量.结果 抑制脱矿实验各CPP-ACP溶液组标本脱矿深度和脱矿量均低于去离子水组（P＜0.01）;各CPP-ACP组随着其浓度逐渐增加,脱矿深度和脱矿量逐渐降低（P ＜0.05）;0.22％ NaF组脱矿量和脱矿深度最低（P＜0.05）.再矿化实验各CPP-ACP溶液组标本的脱矿深度和脱矿量均低于去离子水组（P＜0.01）;各CPP-ACP组随其浓度逐渐增加,脱矿深度和脱矿量逐渐降低（P＜0.05）,0.22％ NaF组脱矿量和脱矿深度最低（P＜0.05）.结论 0.5％～2.0％ CPP-ACP溶液均有抑制釉质脱矿和促进再矿化的作用,该作用随着浓度增加而增强.2.0％ CPP-ACP抑制脱矿和促进再矿化效果不及0.22％ NaF溶液.

Objective To determine the ability of casein phosphopeptide-amorphous calcium phosphate （CPP- ACP） in inhibiting enamel demineralization and promoting enamel remineralization. Methods In the experiment of inhibition of enamel demineralization, forty bovine enamel specimens were randomly divided into five groups of eight. The specimens of each group were assigned to different solution respectively ,0. 5% CPP-ACP, 1.0% CPP-ACP ,2.0% CPP-ACP, 0. 22% NaF and deionized water （control）. Then the specimens were subjected to cariogenic solution to produce artificial enamel lesions. In the experiment of promoting remineralization, forty-eight bovine enamel specimens were randomly divided into six groups. The specimens were immersed in cariogenic solution continuously for 2 days to produce initial lesion. Then all specimens were subjected to a pH cycling regime with the solution respectively, 0. 5% CPP-ACP, I. 0% CPP-ACP,2.0% CPP-ACP,0. 22% NaF,classical remineralization solution and deionized water. The pH cycling regime was performed three times per day for ten days. The depth and mineral loss of the lesions of each specimen in above two expertments were determined by mieroradiography and image analysis. Results In the experiment of inhibition of enamel demineralization, the lesion depth and mineral loss in all the experimental groups were significantly smaller than those in the control group （ P 〈 0. 01 ） and increased with the increasing concentration （ P 〈 0, 05 ）. In the experiment of promoting remineralization, the lesion depth and mineral loss in all the experimental groups were significantly smaller than those in the control group （P 〈 0. 01 ） and decreased as CPP-ACP concentration increased （ P 〈 0. 05 ）. Conclusion CPP-ACP may inhibit enamel demineralization and promote remineralization.