Maintaining the integrity of the enamel surface -: The role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization
Maintaining the integrity of the enamel surface -: The role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization
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DOI：
10.14219/jada.archive.2008.0352
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发表时间：
2008-05-01
影响因子：
3.9
通讯作者：
Hicks, M. John
中科院分区：
文献类型：
--
作者：
Garcia-Godoy, Franklin;Hicks, M. John
背景资料。龋齿是一种传染病，在美国，90%的青少年和年轻人都会患上龋齿。它是一种复杂的疾病，发生在牙齿生物膜和釉质表面之间的界面上。唾液中的许多成分被牙齿生物膜吸收，保护牙釉质表面。另一方面，新萌出的牙齿依靠釉质膜来替代酸敏感的羟基磷灰石。变形链球菌定植牙科生物膜时，依赖于垂直传播、水平传播或两者兼而有之。这些产酸、耐酸细菌被认为是导致釉质龋齿的主要微生物。生物膜从唾液和口腔外的来源中隔离钙、磷和氟化物的能力使牙釉质在脱矿后可以进行再矿化。最佳的再矿化取决于牙釉质表面长期暴露在低浓度的钙、磷和氟化物中。生物可利用的钙、磷和氟化物的外部来源可以改变牙齿生物膜的龋齿形成。临床意义。糖醇、聚维酮碘、地尔莫松醇、三氯生和洗必泰的使用可能会调节龋齿的过程。此外，涉及益生菌和分子遗传学的研究提供的结果表明，这些方法可以用非致龋菌取代致龋菌，同时保持正常的口腔内环境平衡。
Background. Dental caries is an infectious disease, and it affects 90 percent of late adolescents and young adults in the United States. It is a complex disease that occurs along the interface between the dental biofilm and the enamel surface.Results. Many components in saliva are taken up by dental biofilm and protect the enamel surface. On the other hand, newly erupted teeth depend on the enamel pellicle for posteruption maturation of acid-susceptible substituted hydroxyapatite. When Streptococcus mutans colonizes dental biofilm, it depends on vertical transmission, horizontal transmission or both. These acidogenic, aciduric bacteria are considered to be the primary organisms responsible for enamel caries. The ability of the biofilm to sequester calcium, phosphate and fluoride from the saliva, as well as from sources outside the oral cavity allows enamel to undergo remineralization after demineralization. Optimal remineralization depends on the enamel surface's being exposed to low concentrations of calcium, phosphate and fluoride for prolonged periods. Outside sources of bioavailable calcium, phosphate and fluoride can alter dental biofilm's cariogenicity.Clinical Implications. The use of sugar alcohols, povidone-iodine, delmopinol, triclosan and chlorhexidine may modulate the caries process. In addition, studies involving probiotics and molecular genetics have provided results showing that these methods can replace and displace cariogenic bacteria with noncariogenic bacteria, while maintaining normal oral homeostasis.