Multi-scale characterization of Developmental Defects of Enamel and their clinical significance for diagnosis and treatment
Multi-scale characterization of Developmental Defects of Enamel and their clinical significance for diagnosis and treatment
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DOI：
10.1016/j.actbio.2023.08.011
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发表时间：
2023-09-13
影响因子：
9.7
通讯作者：
Babajko, Sylvie
中科院分区：
文献类型：
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作者：
Houari, Sophia;Derocher, Karen;Babajko, Sylvie
牙釉质发育缺陷(DDE)如氟斑牙(DF)和磨牙切牙矿化不足(MIH)是一个主要的公共卫生问题。他们的临床方面是非常多变的，挑战他们的早期和特异性的诊断，并阻碍恢复性治疗的进展。在这里，结合宏观、微观和纳米尺度的结构和化学方法，包括最近应用于牙釉质的原子探针断层扫描，对89名患者的MIH、DF和健康牙齿进行了研究和比较。从整体上看，DF的特征是矿物含量和结晶度的均匀损失，主要是破坏牙釉质的外层，而MIH与牙釉质深度的局部缺陷有关，在那里晶体矿物颗粒嵌入到有机相中。在纳米尺度上只能检测到矿物相元素组成的微小差异，如在两种严重的DDE中都增加了F和Fe含量。我们证明，改进的临床相关性数字颜色测量可以区分轻度和重度的DF和MIH损害。从釉质的组成和结构，特别是其显微结构、有机物的存在和金属含量(Fe、Zn)等方面对这种鉴别能力进行了讨论。我们的结果为DDE的特征和发病机制提供了更多的见解，突出了比色测量在临床诊断中的潜力，并为改善微渗透修复策略的性能提供了指导。声明重要性釉质发育缺陷(DDE)与龋病和牙齿松动有关，影响全球数十亿人。他们的精确特征，适应微创护理与优化的材料是高度期望的。在这项研究中，我们首先建议使用分光光度计测量的颜色参数作为鉴别临床诊断的一种手段。其次，我们使用最先进的技术系统地表征了受两种主要DDE影响的釉质牙齿的结构、化学成分和机械光学性能，这两种DDE分别是牙齿氟中毒(DF)或磨牙切牙矿化不足(MIH)。我们证明了DF和MIH特殊的釉质结构和光学特征，而矿物纳米晶体的化学修饰主要与病变的严重程度相关。我们的结果为个性化牙科的概念铺平了道路。根据我们的结果，我们提出了一种新的临床诊断方法，适用于这些患者的适应和改进的修复方案。(C)2023由爱思唯尔有限公司出版。保留所有权利。
Developmental Defects of Enamel (DDE) such as Dental Fluorosis (DF) and Molar Incisor Hypomineralization (MIH) are a major public health problem. Their clinical aspects are extremely variable, challenging their early and specific diagnosis and hindering progresses in restorative treatments. Here, a combination of macro-, micro-and nano-scale structural and chemical methods, including, among others, Atom Probe Tomography recently applied on tooth enamel, were used to study and compare MIH, DF and healthy teeth from 89 patients. Globally, we show that DF is characterized by an homogenous loss of mineral content and crystallinity mainly disrupting outside layer of enamel, whereas MIH is associated with localized defects in the depth of enamel where crystalline mineral particles are embedded in an organic phase. Only minor differences in elemental composition of the mineral phase could be detected at the nanoscale such as increased F and Fe content in both severe DDE. We demonstrate that an improved digital color measurement of clinical relevance can discriminate between DF and MIH lesions, both in mild and severe forms. Such discriminating ability was discussed in the light of enamel composition and structure, especially its microstructure, organics presence and metal content (Fe, Zn). Our results offer additional insights on DDE characterization and pathogenesis, highlight the potentiality of colorimetric measurements in their clinical diagnosis and provide leads to improve the performance of minimally in-vasive restorative strategies.Statement of significance Developmental Defects of Enamel (DDE) are associated to caries and tooth loose affecting billions of people worldwide. Their precise characterization for adapted minimally invasive care with optimized materials is highly expected. Here In this study, first we propose the use of color parameters measured by a spectrophotometer as a means of differential clinical diagnosis. Second, we have used state-of-the-art techniques to systematically characterize the structure, chemical composition and mechanical optical properties of dental enamel teeth affected by two major DDE, Dental Fluorosis (DF) or Molar Incisor Hypomineralization (MIH). We evidence specific enamel structural and optical features for DF and MIH while chemical modifications of the mineral nanocrystals were mostly correlated with lesion severity. Our results pave the way of the concept of personalized dentistry. In the light of our results, we propose a new means of clinical diagnosis for an adapted and improved restoration protocol for these patients.(c) 2023 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.