대한소아치과학회지 (Journal of the korean academy of Pediatric Dentistry)

  • 제35권4호
  • /
  • Pages.684-691
  • /
  • 2008
  • /
  • 1226-8496(pISSN)
  • /
  • 2288-3819(eISSN)
대한소아치과학회 (Korean Academy of Pediatric Dentistry)
권호 표지

법랑질 인공우식병소에서 APF gel과 CPP-ACP 제제의 재광화 효과

REMINERALIZATION EFFECTS BY APF GEL AND CPP-ACP PASTE ON INCIPIENT ARTIFICIAL CARIES OF ENAMEL

  • 강지선 (조선대학교 치과대학 소아치과학교실) ;
  • 이난영 (조선대학교 치과대학 소아치과학교실) ;
  • 이상호 (조선대학교 치과대학 소아치과학교실)
  • Kang, Ji-Sun (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Nan-Young (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Sang-Ho (Department of Pediatric Dentistry, College of Dentistry, Chosun University)
  • 발행 : 2008.11.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

많은 연구에서 불소 이온을 이용한 치아우식증의 예방 및 재광화 효과에 대해 밝힌 바 있다. 불소는 치아우식을 예방하고 재광화를 촉진하는 대표적인 성분이다. 하지만 불소를 이용한 재광화는 하부의 탈회 병소를 충분히 광화시키지 못하며 다공성으로 인해 불완전한 광화를 보인다. 또한 그 적용 과정에서 과량이 섭취되었을 경우에 발생할 수 있는 독성도 고려해야 한다. 한편 CPP-ACP(Casein Phosphopeptides-Amorphous Calcium Phosphate)는 초기의 우식병소를 재광화 시키며 우유 단백질인 casein으로부터 추출한 성분으로 섭취되어도 인체에 무해하다. 본 연구의 목적은 APF gel과 CPP-ACP 제제의 재광화 효과를 비교해 보고자 하는 것이다. 본 실험에서는 법랑질 인공우식 병소에 Acidulated Phosphate Fluoride(APF) gel과 CPP-ACP 제제를 각 도포 방법에 따라 적용하였다. 14일 후, 표면미세경도를 측정하고 편광 현미경 하에서 재광화 병소를 관찰하여 다음과 같은 결과를 얻었다. 1. 실험 전후 표면미세경도를 측정하여 비교한 결과, 모든 군에서 실험 후에 표면미세경도가 증가하였다(P<0.05). 2. CPP-ACP 제제를 도포한 군에서 불소를 도포한 군에 비해 표면미세경도 증가 폭이 유의하게 컸다(P<0.05). 3. 편광현미경 하에서 관찰한 결과 불소도포 군은 불규칙하고 얇은 재광화 층을, CPP-ACP 제제를 도포한 군은 균일하고 두터운 재광화 층을 보였다.

Many operations have been carried out using the fluoride ion to prevent and reverse dental caries. It certainly encourages remineralization and also prevents dental caries. However, the remineralization developed by these means is superficial only leaving lower levels of demineralized lesion with a degree of porosity and incomplete mineralization. We must consider its toxic effects when it is ingested for overdose. The CPP-ACP paste is able to remineralize the incipient lesion and has no harmful effects when it is ingested, because it was made form casein which is from the protein of milk. The purpose of this article is to compare the remineralization effects between APF gel and the CPP-ACP paste. we applicated the APF gel and CPP-ACP paste on the artificial enamel carious lesion. After 14 days, we measured the surface microhardness and observed the remineralized lesion under polarized light microscope. The results were as follows : 1. The surface microhardness of group III was the highest, followed by group II, and I(p<0.05). 2. The surface microhardness of group III was significantly higher than those of group I, and II(p<0.05). 3. We could observe thin and irregular remineralization layer of group II, and regular and moderate remineralization layer of group III under polirized light microscope.

키워드

참고문헌

  1. Oshiro M, Yamaguchi K, Takamizawa T, et al. : Effect of CPP-ACP paste on tooth mineralization: an FE-SEM study. J Oral Sci, 49:115-120, 2007. https://doi.org/10.2334/josnusd.49.115
  2. Yamaguchi K, Miyazaki M, Takamizawa T : Effect of CPP-ACP paste on mechanical properties of bovine enamel as determined by an ultrasonic device. J Dent, 34:230-236, 2006. https://doi.org/10.1016/j.jdent.2005.06.005
  3. Norman OH, Franklin GG : Primary Preventive Dentistry. Pearson Education, Inc, 2004.
  4. Silverstone LM. : Remineralization phenomena. Caries Res. 11 Suppl 1:59-84, 1977. https://doi.org/10.1159/000260296
  5. Graham JM, Hume WR : Preservation and Restoration Tooth Structure, Knowledge Books and Software, Queensland, p21-118, 2004.
  6. ten Cate JM : In vitro studies on the effects of fluoride on de- and remineralization. J Dent Res, 69 Spec No:614-619; discussion 634-636, 1990.
  7. Reynolds EC : The prevention of sub-surface demineralization of bovine enamel and change in plaque composition by casein in an intra-oral model. J Dent Res, 66:1120-1127, 1987. https://doi.org/10.1177/00220345870660060601
  8. Reynolds EC : Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res, 76:1587-1595, 1997. https://doi.org/10.1177/00220345970760091101
  9. Dunipace AJ, Hall AF, Kelly SA, et al. : An in situ interproximal model for studying the effect of fluoride on enamel. Caries Res, 31:60-70, 1997. https://doi.org/10.1159/000262376
  10. Katz S, Park KK, Stookey GK, et al. : Development and initial testing of a model for in vitro formation of pit and fissure caries. Caries Res, 20:424-428, 1986. https://doi.org/10.1159/000260968
  11. Yamaguchi K, Miyazaki M, Takamizawa T, et al. : Effect of CPP-ACP paste on mechanical properties of bovine enamel as determined by an ultrasonic device. J Dent, 34:230-236, 2006. https://doi.org/10.1016/j.jdent.2005.06.005
  12. Oshiro M, Yamaguchi K, Takamizawa T, et al. : Effect of CPP-ACP paste on tooth mineralization: an FE-SEM study. J Oral Sci, 49:115-120, 2007. https://doi.org/10.2334/josnusd.49.115
  13. 정희민, 김용기, 김종수 등 : 컴포머의 재석회화 효과에 관한 비교 연구. 대한소아치과학회지, 29:498-508, 2002.
  14. ten Cate JM : Remineralization of caries lesions extending into dentin. J Dent Res, 80:1407-1411, 2001. https://doi.org/10.1177/00220345010800050401
  15. ten Cate JM, Arends J : Remineralization of artificial enamel lesions in vitro. Caries Res, 11:277-286, 1977. https://doi.org/10.1159/000260279
  16. Lammers PC, Borggreven JM, Driessens FC : Influence of fluoride and pH on in vitro remineralization of bovine enamel. Caries Res, 26:8-13, 1992. https://doi.org/10.1159/000261418
  17. Lammers PC, Borggreven JM, Driessens FC : Influence of fluoride on in vitro remineralization of artificial subsurface lesions determined with a sandwich technique. Caries Res, 24:81-85, 1990. https://doi.org/10.1159/000261244
  18. Amjad Z, Nancollas GH : Effect of fluoride on the growth of hydroxyapatite and human dental enamel. Caries Res, 13:250-258, 1979. https://doi.org/10.1159/000260408
  19. Cobb BH, Rozier GR, Bawden JW : A clinical study of the caries preventive effects of an APF solution and APF thixotropic gel. Pediatr Dent, 2:263-166, 1980.
  20. Clark DC, Hanley JA, Stamm JW et al. : An empirically based system to estimate the effectiveness of caries-preventive agents. A comparison of the effectiveness estimates of APF gels and solutions, and fluoride varnishes. Caries Res, 19:83-95, 1985. https://doi.org/10.1159/000260833
  21. Ekstrand J, Koch G : Systemic fluoride absorption following fluoride gel application. J Dent Res, 59:1067, 1980. https://doi.org/10.1177/00220345800590061101
  22. Ekstrand J, Koch G, Lindgren LE et al. : Pharmacokinetics of fluoride gels in children and adults. Caries Res, 15:213-220, 1981. https://doi.org/10.1159/000260517
  23. McCall DR, Watkins TR, Stephen KW : Fluoride ingestion following APF gel application. Br Dent J, 19;155:333-336, 1983. https://doi.org/10.1038/sj.bdj.4805229
  24. Fejerskov O : Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res, 38:182-191, 2004. https://doi.org/10.1159/000077753
  25. Harper DS, Osborn JC, Hefferren JJ, et al. : Cariostatic evaluation of cheeses with diverse physical and compositional characteristics. Caries Res, 20:123-130, 1986. https://doi.org/10.1159/000260931
  26. Reynolds EC : The prevention of sub-surface demineralization of bovine enamel and change in plaque composition by casein in an intra-oral model. J Dent Res, 66:1120-1127, 1987. https://doi.org/10.1177/00220345870660060601
  27. Reynolds EC : Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Spec Care Dentist, 18:8-16, 1998. https://doi.org/10.1111/j.1754-4505.1998.tb01353.x
  28. Reynolds EC, Cai F, Shen P, et al. : Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugarfree chewing gum. J Dent Res, 82:206-211, 2003. https://doi.org/10.1177/154405910308200311
  29. Featherstone JD, ten Cate JM, Shariati M, et al. : Comparison of artificial caries-like lesions by quantitative microradiography and microhardness profiles. Caries Res. 17:385-391, 1983. https://doi.org/10.1159/000260692
  30. Wefel JS : Effects of fluoride on caries development and progression using intra-oral models. J Dent Res, 69 Spec No:626-633; discussion 634-636, 1990.
  31. Edmunds DH, Whittaker DK, Green RM : Suitability of human, bovine, equine, and ovine tooth enamel for studies of artificial bacterial carious lesions. Caries Res, 22:327-336, 1988. https://doi.org/10.1159/000261132
  32. White DJ : Reactivity of fluoride dentifrices with artificial caries. I. Effects on early lesions: F uptake, surface hardening and remineralization. Caries Res, 21:126-140, 1987. https://doi.org/10.1159/000261013
  33. Arends J, ten Bosch JJ : Demineralization and remineralization evaluation techniques. J Dent Res, 71 Spec No:924-928, 1992.
  34. Amaechi BT, Higham SM : in vitro remineralisation of eroded enamel lesions by saliva. J Dent, 29:371-376, 2001. https://doi.org/10.1016/S0300-5712(01)00026-4
  35. Aoba T, Okazaki M, Takahashi J, et al. : X-ray diffraction study on remineralization using synthetic hydroxyapatite pellets. Caries Res, 12:223-230, 1978. https://doi.org/10.1159/000260336