预防和治疗蛀牙:除氟化物外。

Monographs in oral science Pub Date : 2025-01-01 Epub Date: 2025-05-28 DOI:10.1159/000543569
Marília Afonso Rabelo Buzalaf, Ana Carolina Magalhães, Daniela Rios, Annette Wiegand
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引用次数: 0

摘要

人们已经讨论了不同的药物作为氟化物的潜在替代品,以预防和治疗侵蚀性牙齿磨损。这些试剂可以通过(1)在牙齿表面形成一层酸保护层来起作用,例如通过使用密封剂、聚合物或修饰获得的牙膜;(2)(矿物)降水增强机制;和/或(3)保存牙本质的有机基质。使用粘合剂、密封剂或流动剂被认为是氟化物的有效替代品,但需要根据所使用的产品每隔几个月重新密封一次表面。测试成膜产品的研究,如人工聚合物和获得性膜的工程,已经表明其中一些方法的潜在有效性,如壳聚糖和一些唾液或唾液来源的蛋白质。设计用于输送钙和/或磷酸盐的产品尚未成功地提供显著的抗腐蚀效果。在晚期ETW中,脱矿的胶原牙本质基质可以被宿主酶降解,如基质金属蛋白酶(MMPs)。表没食子儿茶素没食子酸酯和氯己定以及氟化物已被确定为有效的MMP抑制剂,具有减少牙本质侵蚀进展的潜力。虽然氟化物化合物,特别是含锡化合物,已明确显示具有抗腐蚀潜力,但仍需要开发提供更大保护能力的替代方法,并在临床上证明是有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevention and Treatment of Dental Erosion: Beyond Fluorides.

Different agents have been discussed as potential alternatives to fluoride in the prevention and treatment of erosive tooth wear (ETW). These agents may act by (1) forming an acid-protective layer on the tooth surface, such as through the use of sealants, polymers or the modification of the acquired pellicle; (2) enhancing mechanisms of (mineral) precipitation; and/or (3) preserving the organic matrix of dentine. The application of adhesives, sealants or flowables is considered to be an effective alternative to fluoride, but requires a re-sealing of the surface every several months depending on the products used. Studies testing film-forming products, such as artificial polymers as well as engineering of acquired pellicle, have suggested the potential effectiveness of some of these approaches, such as chitosan and some salivary or saliva-derived proteins. Products designed to deliver calcium and/or phosphate have not been successful at providing a significant anti-erosive effect. In advanced ETW, the demineralised collagenous dentine matrix can be degraded by host enzymes, such as matrix metalloproteinases (MMPs). Epigallocatechin gallate and chlorhexidine as well as fluorides have been identified as effective MMP inhibitors, with the potential to reduce the progression of dentine erosion. While fluoride compounds have clearly been shown to have an anti-erosive potential, particularly those containing tin, alternative approaches that provide even greater protective capacity still need to be developed and proven to be effective clinically.

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