Comprehensive studies on the establishment of clinical cariology for systematic

本研究的目的是建立临床龋齿学，以系统地管理龋齿。主要结果如下：1。(1)激光仪器是一种有效的龋病诊断方法。(2)采用免疫组织化学方法评价龋治疗后抗原提呈细胞的定位变化。结果表明，经治疗后，它们仍能维持较长时间。(1)龋病是一种传染性疾病。(1)龋病牙本质中常见的溶乳酸假分枝杆菌具有遗传多样性。(2)为了阐明细菌生物膜的结构和功能，在体外制备了人工生物膜。该模型有助于阐明细菌在生物膜中的功能，也有助于估计抗菌药物在生物膜中的杀菌效果。(1)通过观察牙体硬组织的形态变化和牙髓反应，评价Er:YAG激光在除龋和造腔中的应用。(2)采用免疫组织化学方法观察直接盖髓和移植牙髓内牙本质/牙髓复合体的修复和再生机制。结果表明非胶原蛋白参与了硬组织的形成。(3)丙二醇作为根管内药物载体在治疗难治性根管中的应用效果。对治疗后再感染（继发性龋齿）的预防效果进行了评价。结果表明，含氟材料对牙齿结构的耐酸性能有重要的增强作用，具有一定的临床应用价值。患者教育、定期召回检查和风险评估对一种新型老年依赖口腔刷进行细菌学评价，显示其清除菌斑的效果和临床应用价值。

The aim of this study was to establish the clinical cariology for systematic management of dental caries.The main results were as follows:1. Pathology and diagnosis of caries process(1) A Laser apparatus was proved to be useful for diagnostic method for caries.(2) Localizational changes of antigen presenting cells after caries treatment were evaluated immunohistochemically. The results showed that they remained for a long time after treatment.2. Caries as an infectious disease(1) Genetic diversity was revealed in Pseudoramibacter alactolyticus that is frequently identified in carious dentin.(2) To elucidate the structure and the function of bacterial biofilms, artificial biofilms were made in vitro. This model is useful for elucidating bacterial functions in biofilms, and also for estimating the bactericidal efficacy of antibacterial drugs in biofilms.3. Caries treatment(1) Application of Er:YAG laser for caries removal and cavity preparation was evaluated by morphological changes in the tooth hard tissue and pulpal responses.(2) To elucidate the mechanisms of repair and regeneration of dentin/pulp complex after direct pulp capping and in the pulp of transplanted tooth were immunohistochemically observed. The results suggested the involvement of noncollagenous proteins in hard tissue formation.(3) Efficiency of propylene glycol was revealed as vehicles for intracanal medicaments in the intractable root canal treatment.4. Prevention of reinfection (secondary caries) after treatmentFluoride-releasing materials for their acid resistance were evaluated. The results indicated the important enhancement of tooth structure acid resistance by fluoridate materials, suggesting their clinical usefulness.5. Patient education, periodic recall examination and risk assessment Bacteriological evaluation of a new oral brush for dependent elderly revealed its effectiveness for removal of bacterial plaque and usefulness for clinical use.