中国实用口腔科杂志 ›› 2025, Vol. 18 ›› Issue (3): 300-306.DOI: 10.19538/j.kq.2025.03.008

• 论著 • 上一篇    下一篇

不同防龋试剂对早期邻面龋再矿化及抗菌作用效果的对比研究

吴嘉锜1,刘文彬1,魏丽冉1,刘美霞2,徐    延1,张桂荣1   

  1. 1. 沈阳市口腔医院,辽宁 沈阳 110002;2. 中国科学院金属研究所,辽宁 沈阳 110016
  • 出版日期:2025-05-30 发布日期:2025-05-30
  • 通讯作者: 徐延,张桂荣
  • 基金资助:
    沈阳市科技计划项目(23-408-3-02)

  • Online:2025-05-30 Published:2025-05-30

摘要: 目的    研究不同防龋试剂[含硒生物活性玻璃(selenium-doped bioactive glass,SBG)、生物活性玻璃(bioactive glass,BG)和氟化钠(NaF)]对早期邻面龋再矿化作用及抗菌性能的影响,为龋病防治的合理用药提供理论依据。方法    选取2023年6—8月在沈阳市口腔医院因正畸治疗需要拔除的前磨牙48颗,建立早期邻面龋模型(共96个样本)。将所有样本随机分为SBG组、BG组、NaF组和空白对照组(每组24个),前3组分别使用5%SBG溶胶、5%BG溶胶、多乐氟进行再矿化处理,空白对照组不做再矿化处理;采用显微维氏硬度计、白光干涉仪、扫描电子显微镜(scanning electron microscope,SEM)、能量色散光谱分析各组脱矿后和再矿化后的釉质表面显微硬度,以及再矿化后的釉质表面形态结构和钙磷质量比值。分别用3种防龋试剂(SBG组、BG组、NaF组)与变异链球菌接触共培养,通过抑菌环法、直接接触法、激光共聚焦扫描显微镜(confocal laser scanning microscope,CLSM)观察其对变异链球菌的抗菌效果。结果    各组脱矿后显微硬度值比较,差异无统计学意义(F = 0.716,P = 0.457);再矿化后,SBG组的釉质表面显微硬度值显著高于BG组、NaF组和空白对照组,且钙磷质量比值(2.21 ± 0.07)显著优于BG组(2.12 ± 0.08)、NaF组(1.85 ± 0.06)和空白对照组(1.56 ± 0.03),差异均有统计学意义(均P < 0.05)。白光干涉仪和SEM示,再矿化后SBG组釉质表面沉积物更为致密、脱矿凹陷深度均匀,其再矿化效果显著优于其他3组。SBG组对变异链球菌的抑菌圈直径[(18.70 ± 1.39)mm]显著大于BG组[(12.02 ± 1.64)mm]和NaF组[(7.53 ± 0.87)mm],且菌落计数[(13.33 ± 2.49)CFU]显著低于BG组[(55.67 ± 1.33)CFU]和NaF组[(252.33 ± 5.00)CFU];CLSM示,SBG组的菌斑活菌百分比[(57.80 ± 3.10)%]显著低于BG组[(63.70 ± 1.74)%]和NaF组[(77.40 ± 1.98)%],差异均有统计学意义(均P < 0.05)。结论    SBG作为一种新型生物活性材料,在促进早期邻面龋再矿化和抗菌性能方面可能优于BG和氟化物。

关键词: 邻面龋, 生物活性玻璃, 硒, 氟化钠, 再矿化, 抗菌性能

Abstract: Objective    To study the effects of different anti-caries reagents[selenium-doped bioactive glass(SBG),bioactive glass(BG)and sodium fluoride(NaF)]on the remineralization and antibacterial properties of early adjacent caries,so as to provide a theoretical basis for rational drug use in caries prevention and treatment. Methods    Totally 48 premolars removed for orthodontic treatment in Shenyang Stomatological Hospital from June to August 2023 were selected to establish an early adjacent caries model(96 samples were obtained). All sample models were randomly divided into SBG group,BG group,NaF group and blank control group(24 in each group). The first three groups were remineralized with 5% SBG sol,5% BG sol and Dulefluoride respectively,while the blank control group was not remineralized. Microhardness tester,white light interferometer,scanning electron microscope(SEM)and energy dispersive spectrometer(EDS)were used to analyze the microhardness of demineralized and remineralized enamel surface,as well as the morphology and structure of remineralized enamel surface and the mass ratio of calcium and phosphorus after remineralization. In addition,three kinds of anti-caries reagents(SBG group,BG group and NaF group)were used to contact and co-culture with Streptococcus mutans(S.mutans),and their antibacterial effects on S.mutans were observed by bacteriostatic ring method,direct contact method and confocal laser scanning microscope(CLSM). Results    There was no significant difference in the microhardness values of each group after demineralization(F = 0.716,P = 0.457). After remineralization,the enamel surface microhardness of SBG group was significantly higher than that of BG group,NaF group and blank control group,and the calcium-phosphorus mass ratio(2.21 ± 0.07)was significantly better than that of BG group(2.12 ± 0.08),NaF group(1.85 ± 0.06)and blank control group(1.56 ± 0.03),the differences being statistically significant(all P < 0.05). White light interferometer and SEM showed that the enamel surface sediment of SBG group was denser after remineralization,and the depth of demineralization sag was uniform,indicating that its remineralization effect was significantly better than that of the other three groups. In addition,the diameter of the zone of inhibition[(18.70 ± 1.39)mm]against S.mutans in the SBG group was significantly larger than that in the BG group[(12.02 ± 1.64)mm]and NaF group[(7.53 ± 0.87)mm],and the colony count[(13.33 ± 2.49)CFU]was significantly lower than that in the BG group[(55.67 ± 1.33)CFU]and NaF group[(252.33 ± 5.00)CFU]. CLSM showed that the percentage of viable plaque in the SBG group[(57.80 ± 3.10)%]was significantly lower than that in the BG group[(63.70 ± 1.74)%]and NaF group[(77.40 ± 1.98)%],and the differences were statistically significant(all P < 0.05). Conclusion    As a new bioactive material,SBG may be superior to BG and fluoride in promoting the remineralization and antibacterial performance of early adjacent caries.

Key words: adjacent caries, bioactive glass, selenium, sodium fluoride, remineralization, antimicrobial properties