DENTIN STRUCTURE, DEMINERALIZATION AND REMINERALIZATION

牙本质结构、脱矿和再矿化

• 批准号: 7904364
• 负责人: GRAYSON W MARSHALL
• 金额: $ 17.57万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-15 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7904364
• 关键词: Acetic Acids; Acids; Affect; Apatites; Binding; Cattle; Cell Nucleus; Characteristics; Clinical Treatment; Clinical Trials; Collagen; Collagen Fibril; Complex; Dental Enamel; Dental caries; Dentin; Dentistry; Effectiveness; Environment; Exposure to; Foundations; Hardness; Human; Image; Intervention; Kinetics; Lactic acid; Lead; Lesion; Light; Mechanics; Methods; Microscopy; Minerals; Modeling; Nature; Operative Surgical Procedures; Oral; Process; Property; Proteins; Risk Factors; Solutions; Structure; Techniques; Testing; Tissues; Tooth structure; base; deciduous tooth; demineralization; insight; mineralization; minimally invasive; nanoindentation; nanomechanical; novel strategies; permanent tooth; remineralization; repaired; restoration; trend

DESCRIPTION (provided by applicant): Current trends in minimally invasive dentistry emphasize the reversal and repair of the active caries process as a first step to restoring the damaged tissue. Enamel remineralization is an accepted phenomenon, and the mechanisms are established. Dentin remineralization appears to be possible, but due to its complex composite structure, it has not been established if proper mechanical function can be restored by remineralization of affected dentin. New methods now permit quantitative studies of the nature of dentin remineralization. We seek to define the structure and property changes associated with dentin remineralization to gain insight into the controlling mechanisms, and aid in defining the "quality" (hydrated elastic modulus and hardness) of the remineralized tissue. The central hypothesis is that bound, intrafibrillar mineral must be present for proper mechanical function. We contend that this will be possible if remnant apatite crystals remain in the intrafibrillar compartment to provide nuclei for the remineralization process within collagen fibrils. In Aim 1. we determine if much slower demineralization occurs for intrafibrillar mineral than for extrafibrillar mineral by cariogenic acids at pH = 5. Aim 2. determines if various zones of dentin caries contain substantial intrafibrillar mineral, and if this is associated with characteristic bulk properties of the intertubular dentin for permanent and primary teeth. Aim 3. evaluates carious teeth successfully treated by ART to determine if they have been functionally remineralized, while Aim 4. evaluates strategies for functionally remineralizing 1) dentin that has been demineralized by cariogenic acids and 2) multiple zones of large natural carious dentin lesions. Clinical treatment of caries (tooth decay) is increasingly more conservative and emphasizes management of risk factors and minimally invasive restoration. Clinicians believe that dentin caries lesions reharden under some circumstances, but are justifiably cautious since the exact conditions are unknown. New approaches emphasizing remineralization are supported by clinical trials showing effectiveness, yet the scientific evidence supporting functional remineralization efforts for dentin caries lesions is weak. We seek to provide the needed foundation that defines the conditions for functional remineralization. This will lead to therapies that will repair the dentin, restore its mechanical properties, and reduce the cycle of surgical-restorative interventions.

描述（由申请人提供）：微创牙科的当前趋势强调了活动龋齿过程的逆转和修复，这是恢复受损组织的第一步。搪瓷回忆是一种公认​​的现象，并建立了机制。牙本质的回忆似乎是可能的，但是由于其复杂的复合结构，如果可以通过回想受影响的牙本质的矿产来恢复适当的机械功能，则尚未确定它。现在，新方法允许对牙本质的性质进行定量研究。我们试图定义与牙本质的结构和性质变化，以洞悉控制机制，并有助于定义回想起组织的“质量”（水合弹性模量和硬度）。中心假设是必须存在结合的，纤维内矿物的矿物，以进行适当的机械功能。我们认为，如果残留的磷灰石晶体保留在原纤维内室中，以为胶原原纤维内的回忆过程提供核。在AIM 1中。我们确定对原纤维内矿物质的脱矿质比在pH = 5处通过pH = 5的富本纤维矿物质的矿化速度要慢，AIM 2。确定牙本质龋齿的各个区域是否含有大量的不含纤维内矿物质，并且是否含有persultibular dentin和Permant pertent牙齿和初级牙齿的特性。 AIM 3。评估ART成功治疗的习俗牙齿，以确定它们是否已在功能上进行了回忆，而AIM 4。评估功能上回忆的策略1）牙本质已被牙源性酸脱矿和2）多个大型天然雄性牙齿牙本质病变的多个区域。龋齿（牙齿衰减）的临床治疗越来越保守，并强调了危险因素的管理和最小的侵入性恢复。临床医生认为，在某些情况下，牙本质龋齿病变重新症，​​但由于确切的条件尚不清楚，因此很谨慎。临床试验显示出有效性的临床试验支持了强调回忆性的新方法，但是支持牙本质龋齿病变功能性的回忆性工作的科学证据却很弱。我们寻求提供定义功能回忆条件的必要基础。这将导致疗法可以修复牙本质，恢复其机械性能，并减少手术效率的干预措施。