定量光导荧光技术评价CPP-ACP联合多乐氟对釉质抗酸性影响的实验研究

Effects of CPP-ACP combined with Duraphat on acid resistance of enamel evaluated by quantitative light-induced fluorescence

目的利用定量光导荧光技术,研究酪蛋白磷酸肽-无定形磷酸钙(CPP-ACP)联合多乐氟对釉质抗酸性的影响及作用。方法收集在右江民族医学院附属医院口腔科就诊正畸减数前磨牙32颗,随机分为4组,分别为去离子水组、CPP-ACP组、多乐氟组及联合组,每组8颗牙,术前使用定量光导荧光系统检测各组基线处的荧光损失量(△F)、脱矿面积(Area)、病变体积(△Q)值,去离子水组未作特殊处理,CPP-ACP组、多乐氟组、CPP-ACP联合多乐氟组实验分别进行CPP-ACP涂布、多乐氟涂布、CPP-ACP联合多乐氟涂布,将所有标本放入脱矿液中72 h,72 h后停止实验,定量光导荧光系统拍摄每组标本的荧光图像,对数据进行统计学分析。结果①脱矿前QLF值:4组各QLF变量基线值间差异无统计学意义(P>0.05),具有可比性;②QLF荧光图片结果:4个不同处理组表现病损区荧光强度的损失,但病损的严重程度不一,其中联合组颊侧面形成的病损面积最少,荧光损失最轻;③脱矿后QLF值:与去离子水组比较,CPP-ACP组、多乐氟组以及联合组的早期龋病损较轻,其中联合组△F、Area、△Q最少。各组脱矿后△F、Area、△Q差异比较具有统计学意义(P<0.05);组间两两比较,各组组间△F、Area、△Q差异均具有统计学意义(P<0.05);④扫描电镜结果:原样标本釉质表面平整,无釉柱晶体溶解及孔隙结构;去离子水组呈典型酸蚀样外观;CPP-ACP组、多乐氟组、联合组釉质表面地貌均有一定程度的破坏,联合组破坏最轻。结论QLF可以作为一种对釉质早期龋矿物质含量动态变化进行定量的诊断方法;CPP-ACP、多乐氟均能抑制釉质脱矿,其中两者联合使用时抗酸效果最佳,多乐氟次之,CPP-ACP抗酸作用最弱。

Objective To study the effects of casein phosphopeptide-amorphous calcium phosphate(CPP-ACP)combined with Duraphat on acid resistance of enamel by quantitative light-induced fluorescence(QLF).Methods A total of 32 orthodontic extracted premolars were collected from the Department of Stomatology,the Affiliated Hospital of Youjiang Medical University for Nationalities,and randomly divided into 4 groups:deionized water group,CPP-ACP group,Duraphat group,and combination group of Duraphat and CPP-ACP,with 8 teeth in each group.The fluorescence loss(△F),demineralization Area(Area),and lesion volume(△Q)values at baseline of each groups were detected by quantitative light-induced fluorescence system before operation.The deionized water group received no special treatment,while the CPP-ACP group,Duraphat group,and the combination group were conducted with CPP-ACP coating,Duraphat coating,and CPP-ACP combined with Duraphat coating,respectively.All samples were placed in demineralization solution for 72 hours before the experiment was stopped.Fluorescence images of samples in each group were captured by quantitative light-induced fluorescence system,and the data were analyzed statistically.Results①QLF values before demineralization:There was no statistical difference in QLF baseline values among the 4 groups(P>0.05),indicating there is comparability;②Results of QLF fluorescence pictures:The 4 different treatment groups showed a loss of fluorescence intensity in the caries lesion area,but the severity of the lesion varied.Among them,the area of lesions formed on the buccal surface in the combination group was the smallest and the fluorescence loss was the least;③QLF values after demineralization:Compared with the deionized water group,the CPP-ACP group,Duraphat group and combination group had milder early dental caries lesions,with the combination group having the lowest△F,Area,and△Q.There were statistical differences inΔF,Area,andΔQ between groups after demineralization(P<0.05);Pairwise comparison among groups showed statistical differences in△F,Area and△Q(P<0.05);④Results of scanning electron microscope:The enamel surface of the original sample was smooth,without dissolution of enamel prism crystals or pore structures;the deionized water group showed a typical acid-etched appearance;the enamel surface topography in the CPP-ACP group,Duraphat group and the combination group all had a certain degree of damage,with the combination group having the least damage.Conclusion QLF can be used as a diagnostic method to quantify the dynamic changes of mineral content of early dental caries;both CPP-ACP and Duraphat can inhibit enamel demineralization,with the combined use of both having the strongest acid resistance effects,followed by Duraphat,and CPP-ACP having the weakest acid resistance effects.