Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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REMINERALIZATION OF INCIPIENT ENAMEL CARIES LESION BY CPP-ACP PASTE

CPP-ACP제제를 이용한 법랑질 초기 우식증의 재광화 치험례

  • Kang, Ji-Sun (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Sang-Ho (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Nan-Young (Department of Pediatric Dentistry, College of Dentistry, Chosun University)
  • 강지선 (조선대학교 치과대학 소아치과학교실) ;
  • 이상호 (조선대학교 치과대학 소아치과학교실) ;
  • 이난영 (조선대학교 치과대학 소아치과학교실)
  • Published : 2008.02.29
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Abstract

The dental caries can be recovered or worse depending on the velocity of de- and remineralization of tooth. It is possible to remineralize the lesions by fluoride agent, but the results can be distinguished according to one's salivary flow rate, quantity of ion contents, and pH of the saliva. This article presents good results after applying the CPP-ACP paste for the patients who have incipient enamel caries. We instructed the patients to apply the paste everyday in the customed tray. We observed the white spot lesions without getting worse and reducing the size of lesions. After applying the CPP-ACP paste for 6 weeks, we concluded that; 1. It was possible to remineralize the incipient caries without preparation of the teeth. 2. CPP-ACP paste was successful for recovery of the demineralized lesions, especially for mild and moderate caries lesions, not for the severe developemental defects or chronic lesions. 3. CPP-ACP paste was efficient for pediatric patients, and the custumed tray was very useful for patients to apply the paste. 4. The ability of the patients for caring their oral hygiene was improved by routine check up and instructions.

치아우식증은 치아의 탈회와 재광화가 반복하여 일어나는 동적인 과정으로, 탈회 및 재광화의 속도에 따라 우식이 정지되거나 악화된다. 재광화를 유도하기 위해 불소 제제가 흔히 사용되고 있으나, 개인마다 salivary flow rate이나 타액내 이온 함량 및 타액의 pH 등에 따라 그 효과가 제한될 수 있다. 또한 소아 환자의 경우 과량 섭취로 인한 독성 우려도 배제할 수 없다. 최근 CPP-ACP(Casein Phosphopeptides-Amorphous Calcium Phosphate) 제제를 이용하여 탈회된 법랑질의 재광화를 유도하는 술식이 보고되고 있는 바, 본 증례에서는 법랑질 초기 우식증을 가진 환아에게 국내에서 시판중인 CPP-ACP 제제인 Tooth Mousse를 적용하였다. 제제의 효과를 높이기 위하여 치아미백술 시행시와 동일한 방법으로 제작된 customed tray를 사용하여 매일 도포하도록 하였다. 주기적인 관찰 결과 추가적인 우식의 진행 없이 시술 전과 비교하여 법랑질 병소의 크기가 감소한 양상이 관찰되었다. 발육 장애 증례나 만성적 우식증의 경우에는 그 효과가 크지 않았으나 경도 및 중등도의 초기 우식증을 가진 소아 환자에게 CPP-ACP 제제를 6주간 적용한 결과 치아 삭제 등의 시술 없이 본래 법랑질 밀도를 회복할 수 있었으며 주기적인 점검과 구강위생 교육을 통해 구강 관리 능력을 향상시킬 수 있었다.

Keywords

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