Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지

COMPARATIVE STUDY OF THE REMINERALIZATION EFFECTS USING CPP-ACP AND FLUORIDE ON THE ARTIFICIAL ENAMEL LESION

CPP-ACP 함유 크림과 불소가 초기 인공우식 법랑질에 미치는 재광화 효과에 대한 비교 연구

  • Kim, Ki-Baek (Department of Pediatric Dentistry, Chonnam National University School of Dentistry, Dental Research Institute and Second stage of BK21) ;
  • Choi, Nam-Ki (Department of Pediatric Dentistry, Chonnam National University School of Dentistry, Dental Research Institute and Second stage of BK21) ;
  • Kim, Seon-Mi (Department of Pediatric Dentistry, Chonnam National University School of Dentistry, Dental Research Institute and Second stage of BK21) ;
  • Yang, Kyu-Ho (Department of Pediatric Dentistry, Chonnam National University School of Dentistry, Dental Research Institute and Second stage of BK21)
  • 김기백 (전남대학교 치의학전문대학원 소아치과학교실 및 치의학연구소 및 2단계 BK21) ;
  • 최남기 (전남대학교 치의학전문대학원 소아치과학교실 및 치의학연구소 및 2단계 BK21) ;
  • 김선미 (전남대학교 치의학전문대학원 소아치과학교실 및 치의학연구소 및 2단계 BK21) ;
  • 양규호 (전남대학교 치의학전문대학원 소아치과학교실 및 치의학연구소 및 2단계 BK21)
  • Published : 2009.02.27
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Abstract

The aim of this study was to examine efficacy of the commercially available 10% CPP-ACP cream (Tooth mousse, GC Co., Japan) and/or 0.05% NaF solution on the remineralization of artifical caries-like lesion in the bovine teeth enamel. Sixty bovine teeth were embedded in orthodontic resin and flattened. The enamel surface in 3 mm diameter was exposed with nail varnish. Specimens were stored in demineralizing solution and divided 5 groups; Group 1 (No treatment), 2 (0.05% NaF solution 1 min), 3 (Tooth mousse 3 min), 4 (After 0.05% NaF solution, Tooth mousse treatment), and 5 (After Tooth mousse treatment, soaking in 0.05% NaF solution during 1 min). After treatment by groups, all specimens was stored in artificial saliva for 30 min. After the process described as above was performed during 10 days without pH cycling, surface hardness (Vickers Hardness Number, VHN) was tested and analyzed by paired t-test and one-way ANOVA test with SPSS 14.0. In intragroup comparison between surface hardness of pre and post-treatment, group 3, 4, 5 showed statistically significant increase (P < 0.05). In intergroup comparison among surface hardness increase of all groups, difference of group 5 between pre and post-treatment ($15.80{\pm}12.21$) was the highest, and followed by group 4 ($14.27{\pm}11.73$), 3 ($4.05{\pm}5.18$), 2 ($1.15{\pm}6.83$), 1 ($0.78{\pm}6.21$). Tooth mousse can be a good alternative agent for the fluoride, and the combination use with fluoride might have the additional anticariogenic effect.

본 연구는 상품화된 10% CPP-ACP 크림 (Tooth mousse, GC Co., Japan)이 0.05 % NaF 불소 용액 매일 양치법을 대체할 수 있는지 알아보기 위하여, 인공 탈회 병소를 가진 우치 법랑질에 대해 10일간 위 두 가지 방법 단독 혹은 복합 사용의 재광화 효과를 비교하였다. 0.1% thymol 용액에 냉장 보관한 소의 치아를 교정용 레진 (Orthodotic resin, Dentsply international Inc., USA)에매몰한 후 탈회 용액에 96시간 보관하였고, 총 60개의 시편을 5개의 군으로 나누었다; 비처치군 (1군), 0.05% NaF 용액 1분 (2군), Tooth mousse 3분 (3군), 0.05% NaF 용액 1분 처리 후 Tooth mousse 3분 (4군), Tooth mousse 3분 처리 후 0.05% NaF 용액 1분(5군). 재광화 정도는 10일간의 시편 처리 전 후의 Vickers hardness number를 측정하여 비교하였으며, 연구 결과는 다음과 같다. 1. 각 군에서 시편 처리 전후의 표면경도를 paired t-test를 이용하여 비교분석한 결과, 3, 4, 5 군에서만 유의할만한 표면 경도 증가가 나타났다(P < 0.05). 2. 각 군별로 평균 표면 경도 증가량은 5 > 4 > 3 > 2 > 1 군 순이었고, 각 군의 표면경도 증가량을 one-way ANOVA test로 비교분석한 후 Duncan test로 사후 검정한 결과, 4, 5 군은 1, 2, 3 군과 유의할만한 표면경도 증가를 보였으며 (P < 0.05), 다른 군들 간에는 유의할만한 차이를 보이지 않았다. 3. Tooth mousse를 우치에 10일간 적용시킨 결과 0.05% NaF 용액보다 더 많은 표면경도 변화량을 나타냈지만, 통계학적으로 유의할만한 차이는 없었다. 이상의 결과에서 Tooth mousse 사용은 불소 양치가 용이하지 않은 환자들에게 양호한 대체 방안이 될 것으로 사료되며, 또한 불소 적용시 Tooth mousse를 복합 사용하는 것이 추천될 수 있으리라 사료된다.

Keywords

References

  1. Roberson TM, Heymann HD, Swift EJ Jr. : Sturdevant's art & science of Operative Dentistry. 4th ed. Mosby Co., St. Louis, 64-132, 2002.
  2. Mandel ID : Caries prevention: current strategies, new directions. J Am Dent Assoc, 127:1477-1488, 1996.
  3. Centers for Disease Control and Prevention: Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis - UnitedStates, 17-24, 1988-1994 and 1999-2002. In:Surveillance Summaries, August 26, 2005. MMWR 2005:54(No. SS-3)
  4. 보건복지부 : 2006 국민구강건강실태조사. 서울:보건복지부, 17-25, 2007.
  5. 보건복지부 : 2003 국민구강건강실태조사. 서울:보건복지부, 12-14, 2004.
  6. 박기철 등 : 미래지향적인 예방치과학, 1판. 정문각, 서울, 241-256, 1997.
  7. Roberts AJ : Role of models in assessing new agents for caries prevention - non-fluoride systems. Adv Dent Res, 9:304-311, 1995.
  8. 대한소아치과학회 : 소아, 청소년 치과학. 4판. 신흥인터내셔날, 서울, 160-174, 2007.
  9. Rose RK : Effects of an anticariogenic casein phosphopeptide on calcium diffusion in streptococcal model dental plaques. Arch Oral Biol, 45:569-575,2000. https://doi.org/10.1016/S0003-9969(00)00017-0
  10. Rose RK : Binding characteristics of Streptococcus mutans for calcium and casein phosphopeptide. Caries Res, 34:427-431, 2000. https://doi.org/10.1159/000016618
  11. Reynolds EC : Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: A review. Spec Care Dent, 18:8-16, 1998. https://doi.org/10.1111/j.1754-4505.1998.tb01353.x
  12. Lennon AM, Pfeffer M, Buchalla W, et al. : Effect of a casein/calcium phosphate-containing tooth cream and fluoride on enamel erosion in vitro. Caries Res, 40:154-157, 2006. https://doi.org/10.1159/000091063
  13. Rosen S, Min DB, Harper DS, et al. : Effect of cheese, with and without sucrose, on dental caries and recovery of Streptococcus mutans in rats. J Dent Res, 63:894-896, 1984. https://doi.org/10.1177/00220345840630061601
  14. Silva MF, Burgess RC, Sandham HJ, et al. : Effects of water-soluable components of cheese on experimental caries in humans. J Dent Res, 66:38-41,1987. https://doi.org/10.1177/00220345870660010801
  15. Krovicka A, Bowen WH, Pearson S, et al. : The effects of cheese snacks on caries in desalivated rats. J Dent Res, 66:1116-1119, 1987. https://doi.org/10.1177/00220345870660060501
  16. 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
  17. 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
  18. Reynolds EC, Webber FL, Black CL, et al. : Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res, 74:1272-1279, 1995. https://doi.org/10.1177/00220345950740060601
  19. Reynolds EC : Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilzed calcium phosphate solution. J Dent Res, 76: 1587-1595, 1997. https://doi.org/10.1177/00220345970760091101
  20. Cross KJ, Huq NL, Palamara JE, et al. : Physicochemical characteri -zation of casein phosphopeptide-amorphous calcium phosphate nanocomplexes. J Biol Chem, 280:15362-15369, 2005. https://doi.org/10.1074/jbc.M413504200
  21. Schupbach P, Neesser JR, Golliard M, et al. : Incorporation of caseinoglycomacropeptide and caseinophosphopeptide into the salivary pellicle inhibits adherence of mutans streptococci. J Dent Res, 75:1779-1788, 1996. https://doi.org/10.1177/00220345960750101101
  22. Ramalingam L, Messer LB, Reynolds EC : Adding Casein Phospho-peptide-amorphous Calcium Phosphate to Sports Drinks to Eliminate In Vitro Erosion. Pediat Dent, 27:61-67, 2004.
  23. Shen P, Cai F, Nowicki A, et al. : Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide -amorphous calcium phosphate. J Dent Res, 80:2066- 2070, 2001. https://doi.org/10.1177/00220345010800120801
  24. 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
  25. Iijima Y, Cai F, Shen P, et al. : Acid resistance of enamel subsurface lesions remineralized by a sugarfree chewing gum containing casein phophopeptideamorphous calcium phosphate. Caries Res, 38:551-556, 2004. https://doi.org/10.1159/000080585
  26. Itthagarun A, King NM, Yiu C, et al. : The effect of chewing gums containing calcium phosphates on the remineralization of artificial caries-like lesions insitu. Caries Res, 39:251-254, 2005. https://doi.org/10.1159/000084806
  27. Cai F, Manton DJ, Shen P, et al. : Effect of addition of citric acid and casein phosphopeptide-amorphous calcium phosphate to a sugar-free chewing gum onenamel remineralization in situ. Caries Res, 41:377-383, 2007. https://doi.org/10.1159/000104796
  28. Schirrmeister JF, Seger RK, Altenburger MJ, et al. : Effects of various forms of calcium added to chewing gum on initial enamel carious lesions in situ. Caries Res, 41:108-114, 2007. https://doi.org/10.1159/000098043
  29. Mazzaoui SA, Burrow MF, Tyas MJ, et al. : Incorporation of casein phosphopeptide-amorphous calcium phosphate into a glass-ionomer cement. JDent Res, 82:914-918, 2003. https://doi.org/10.1177/154405910308201113
  30. Cross KJ, Huq NL, Stanton DP, et al. : NMR studies of a novel calcium, phosphate and fluoride delivery vehicle-$\alpha$S1-casein(59-79) by stabilized amorphous calcium fuoride phosphate nanocomplexes. Biomaterials, 25:5061 -5069, 2004. https://doi.org/10.1016/j.biomaterials.2004.01.045
  31. Groeneveld A, Arends J : Influence of pH and demineralization time on mineral content, thickness of surface layer and depth of artificial caries lesions. Caries Res, 9:36-44, 1975. https://doi.org/10.1159/000260140
  32. ten Cate JM, Duijsters PPE : Influence of fluoride in solution on tooth demineralization. I. Chemical data. Caries Res, 17:193-199, 1983. https://doi.org/10.1159/000260667
  33. ten Cate JM, Duijsters PPE : Influence of fluoride in solution on tooth demineralization. II. Microradiographic data. Caries Res, 17:513-519, 1983. https://doi.org/10.1159/000260711
  34. 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
  35. White DJ : Reactivity of fluoride dentifrices with artificial caries. II. Effects on subsuface lesions: F uptake, F distribution, surface hardening and remineralization. Caries Res, 22:27-36, 1988. https://doi.org/10.1159/000261079
  36. 손재범, 김동기, 홍석진 : 수종 생약추출물 함유치약이 초기 인공우식법랑질에 미치는 효과. 대한구강보건학회지, 28:304-314, 2004.
  37. 송근배, 김동운, 이영은 등 : 크세논 광을 이용한 법랑질의 재광화 탐지 가능성. 대한보건학회지, 31:1-10, 2007.
  38. 김권수, 최충호, 김경남 등 : 인공탈회된 법랑질 표면에 대한 우유와 0.05% 불화나트륨용액의 재광화효과. 대한구강보건학회지, 26:405-415, 2002.
  39. 홍석진, 이상대, 정성숙 : 국민학교 불소용액 양치사업 연구. 대한구강보건학회지, 18:95-102, 1994.
  40. 치과보존학회 : 치과보존학. 1st ed. 신흥인터내셔날. 서울, 28-58, 2001.
  41. Schwitz RH, Ismail AI, Pitts NB : Dental caries. Lancet, 369:51-59, 2007. https://doi.org/10.1016/S0140-6736(07)60031-2
  42. 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
  43. Koch G, Bergmann-Arnadottir I, Bjarnason S, et al. : Caries- preventive effect of fluoride dentifrices with and without anticalculus agents: a 3-year controlled clinical trial. Caries Res, 24:72-79, 1990.
  44. 홍석진, 박기철, Stookey GK : 인공우식 법랑질에 대한 불소함유치약의 효과. 대한국강보건학회지, 20:1-10, 1996.
  45. 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
  46. Yamaguchi K, Miyazaki M, Takamizawa T, et al. : Ultrasonic determination of the effect of casein phosphopeptide-amorphous calcium phosphate paste on the demineralization of bovine dentin. Caries Res, 41:204-207, 2007. https://doi.org/10.1159/000099319
  47. Arends J, ten Bosch JJ : Demineralization and remineralization evaluation techniques. J Dent Res, 71:924-928, 1992.
  48. Featherstone JDB, ten Cate JM, Shariate M, et al. : Comparison of artificial caries-like lesions by quantitative microradiography and microhardness profile.Caries Res, 17:385-391, 1983. https://doi.org/10.1159/000260692
  49. Arends J, Schuthof J, Jongebloed WG, et al. : Caries Res, 14:190-195, 1980. https://doi.org/10.1159/000260453
  50. Featherstone JDB, Cutress TW, Rodgers BE, et al. : Remineralization of artificial caries-like lesions in vivo by a self-administered mouthrinse or paste. Caries Res, 16:235-242, 1982. https://doi.org/10.1159/000260603
  51. 김진희, 정성숙, 최충호, 등 : 국내 시판중인 수종 치약의 불소함량과 인공우식법랑질에 미치는 영향. 대한구강보건학회지, 30:56-66, 2006.
  52. Meyer-luechel H, Hopfenmuller W, von Klinggraff D, et al. : Microradiographic study on the effects of mucin-based solutions used as saliva substitutes ondemineralised bovine enamel in vitro. Arch Oral Bio, 51:541-547, 2006. https://doi.org/10.1016/j.archoralbio.2006.01.006