多功能天然抗氧化剂在口腔治疗中的研究进展

Research progress on multifunctional natural antioxidants in oral therapies

氧化应激与龋病、牙周炎、牙髓炎等口腔疾病的发生发展有密切关系,炎症过程中伴随的氧化应激会加重组织损伤。然而,大量研究表明部分牙科材料如复合树脂、漂白剂、根管冲洗剂和种植体会引起自由基水平升高,不利于口腔疾病的治疗和周围组织的健康,因此有必要应用外源性抗氧化剂降低自由基水平。植物来源的天然抗氧化剂因易于提取、安全性高而在生物医学领域受到广泛关注。本文主要关注口腔中氧化应激现象,对天然抗氧化剂在各种口腔疾病治疗及牙科材料改性中的研究进展进行综述。目前研究表明,构建基于多酚的金属有机纳米酶,或将维生素、多酚添加到仿生水凝胶等方式可提高抗氧化剂的安全性和利用率,但这些高分子递送系统存在降解性差、肝肾毒性等问题,目前研究仍处于起步阶段。在材料改性方面,选择天然抗氧化剂与原材料的种类和配比,以及选择合适的改性方式至关重要。抗氧化剂与原材料间形成的化学键过强可能导致抗氧化小分子无法从改性后的复合材料中释放,从而影响抗氧化效果。同时,选择富含邻苯三酚官能团的多酚可以在化学改性后保留更多游离酚羟基,有利于赋予植体材料更强的抗氧化性。尽管天然抗氧化剂在口腔治疗中的研究取得了进展,但仍缺乏临床实验及长期应用效果的数据支持,未来还有待进一步的研究。

Oxidative stress is closely associated with the development of oral diseases such as caries,periodontitis and endodontitis.The accompanying oxidative stress during inflammation could aggravate tissue damage.However,nu-merous studies have shown that some dental materials,such as composite resins,bleach,drugs for root canal irrigation and dental implants,can give rise to abundant free radicals,which have adverse effects on peripheral tissues.Therefore,it is essential to supplement with extra antioxidants against free radicals.Plant-derived natural antioxidants have attracted great attention in biomedicine because of their excellent biocompatibility and easy access.This paper focused on the redox imbalance in the oral cavity and the application of natural antioxidants to oral therapy and their modification of dental materials.Current research shows that by constructing polyphenol-based metal organic nanoenzymes or adding vitamins and polyphenols to bionic hydrogels,the safety and utilization rate of antioxidants can be significantly improved.However,these polymer delivery systems have problems such as poor degradability,hepatotoxicity and nephrotoxicity,and the research is still in its infancy.In terms of material modification,it is crucial to choose the type and ratio of natural antioxidants and raw materials,as well as appropriate modification methods.A strong chemical bond between the an-tioxidant and the raw material may lead to the failure of antioxidant release from the modified composite,lowering the antioxidant activity.At the same time,the selection of polyphenols rich in pyrogallol functional groups can retain more free phenolic hydroxyl groups after chemical modification,which is conducive to greater antioxidant activity by the im-plant materials.Although research on natural antioxidants in oral therapy has made progress,there is a lack of data supporting clinical trials and longterm application effects,and further research is still needed.