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目的 探讨酪蛋白磷酸肽-无定形磷酸钙(casein phosphopeptide-amorphous calcium phosphate,CPP-ACP)与不同浓度氟离子联合应用促进脱矿牙釉质再矿化的效果及机制,为正畸后釉质脱矿提供新的治疗方法.方法 取正畸拔除的健康前磨牙30颗(西安交通大学口腔医学院口颌颌面外科提供),乳酸凝胶法制备牙釉质早期脱矿标本,按随机数字表法分为3组(每组10颗):CPP-ACP对照组再矿化液为5%CPP-ACP+去离子水;加氟A组再矿化液为5%CPP-ACP+500 mg/L F-;加氟B组再矿化液为5%CPP-ACP+900 mg/L F-.各组标本在再矿化液中浸泡4 d.用电子探针仪测量再矿化前后牙釉质CaO、P2O5和F的质量百分比,计算再矿化前后变化量.结果 CPP-ACP对照组F质量百分比的再矿化前后差异无统计学意义(P=0.06),其他两组F质量百分比的再矿化前后差异均有统计学意义(P<0.05);3组CaO和P2O5质量百分比的再矿化前后差异均有统计学意义(P<0.05).加氟B组F质量百分比的再矿化前后变化量[(0.107±0.035)%]显著大于加氟A组[(0.057± 0.038)%](P<0.05),加氟A组显著大于CPP-ACP对照组[(0.013±0.019)%](P<0.05).加氟A、B组CaO和P2O5质量百分比的再矿化前后变化量均显著大于CPP-ACP对照组(P<0.05),而加氟A、B组间差异无统计学意义(P>0.05).结论 在CPP-ACP中加入氟可增加钙、磷、氟在牙釉质表面的运载和渗透.

Objective To evaluate the remineralization effect and mechanism of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) with different concentrations of fluorine on demineralized enamel using electronic probe. Methods Extracted premolar teeth for orthodontic purpose were immersed into lactic acid gel to prepare artificial white spot lesions (10 teeth in each group). Then the specimens were randomly assigned to three groups: Control group, with 5% of the CPP-ACP+deionized water;Group A with 5% CPP-ACP+500 mg/L F-and Group B with 5% CPP-ACP+900 mg/L F-. The teeth in each group were soaked in different solutions for 4 days and then were measured using electron probe tester. The changes of contents among the three groups were compared. Results No statistically significant difference in the percentage of fluorine was found in the control group before and after treatment (P=0.06), and the difference in the percentage of fluorine quality in the other two groups was statistically significant (P<0.05). Statistically significant difference was found between calcium oxide and phosphorus peroxide in the three groups before and after mineralization (P<0.05). The percentage change of fluorine mass in group B [(0.107± 0.035)%] was significantly greater than that in group A [(0.057±0.038)%] (P<0.05), while fluorine mass in group A was significantly greater than that in control group [(0.013 ± 0.019)% ] (P<0.05). In group A and group B, the change in quality of calcium oxide and phosphorus peroxide was significantly greater than that in control group (P<0.05), while no significant difference was found between group A and group B (P>0.05). Conclusions The addition of fluorine in CPP-ACP increased the transport and penetration of calcium, phosphorus and fluorine on enamel surface.