Comprehensive studies on the establishment of clinical cariology for systematic

本研究的目的是建立系统的龋病防治的临床龋病学，主要结果如下：1。龋病过程的病理与诊断（1）激光龋病诊断仪是一种有效的龋病诊断方法。(2)用免疫组化方法评价龋病治疗后抗原提呈细胞的定位变化。结果表明，治疗后，它们仍能保持较长时间.龋病是一种传染性疾病。（1）在龋性牙本质中常见的非溶乳假支杆菌存在遗传多样性。(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。该模型可用于阐明生物膜中细菌的功能，也可用于评价抗菌药物在生物膜中的杀菌效果.龋病的治疗（1）通过观察牙体硬组织的形态学变化和牙髓的反应，评价Er：YAG激光在龋病治疗中的作用。(2)为探讨直接盖髓后牙本质/牙髓复合体的修复再生机制，对直接盖髓后的牙本质/牙髓复合体及移植牙的牙髓进行了组织化学观察。结果提示非胶原蛋白参与硬组织形成。(3)丙二醇作为根管内药物载体在难治性根管治疗中的有效性。治疗后预防再感染（继发龋）评估了氟释放材料的耐酸性能。结果表明，含氟材料能显著提高牙齿结构的抗酸性，具有临床应用价值.病人教育、定期回顾性检查和风险评估对一种新的老年人用口腔刷进行的细菌学评价表明，它能有效地清除菌斑，并可用于临床。

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.