口腔疾病防治 ›› 2022, Vol. 30 ›› Issue (6): 443-448.DOI: 10.12016/j.issn.2096-1456.2022.06.010

• 综述 • 上一篇    下一篇

纳米粒子在正畸釉质脱矿预防中的应用

罗婷1(), 颜家榕1(), 花放1,2,3(), 贺红1,2()   

  1. 1.武汉大学口腔医学院口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室,湖北 武汉(430079)
    2.武汉大学口腔医院口腔正畸一科,湖北 武汉(430079)
    3.武汉大学口腔医院循证口腔医学中心,湖北 武汉(430079)
  • 收稿日期:2021-06-18 修回日期:2021-11-16 出版日期:2022-06-20 发布日期:2022-04-15
  • 通讯作者: 花放,贺红
  • 作者简介:罗婷,住院医师,八年制在读,Email: luo_ting@whu.edu.cn
    共同第一作者,颜家榕,住院医师,博士在读,Email: yanjiarong@whu.edu.cn
  • 基金资助:
    国家自然科学基金(81901044);中华口腔医学会口腔正畸专委会青年人才科研基金(COS-B2021-08);武汉中青年医学骨干人才培养工程([2019]87)

Application of nanoparticles in preventing enamel demineralization during orthodontics

LUO Ting1(), YAN Jiarong1(), HUA Fang1,2,3(), HE Hong1,2()   

  1. 1. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
    2. Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
    3. Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2021-06-18 Revised:2021-11-16 Online:2022-06-20 Published:2022-04-15
  • Contact: HUA Fang, HE Hong
  • Supported by:
    grants from National Natural Science Foundation of China(81901044);Chinese Stomatological Association COS Basic Research Fund(COS-B2021-08);Wuhan Young and Middle-aged Medical Talents Training Program([2019]87)

摘要:

牙釉质脱矿是正畸治疗最常见的不良反应之一。正畸矫治器影响口腔清洁能力,易导致菌斑堆积及口腔菌群失调,致龋菌产酸引起牙釉质脱矿,不仅影响美观,还可能危害口腔健康,是一个亟待解决的难题。纳米粒子(nanoparticles,NPs)通常指直径为1~100 nm的固体颗粒,理化性质独特,能为正畸釉质脱矿预防提供新策略。回顾相关文献,用于预防正畸釉质脱矿的NPs按其功能可分为抗菌、再矿化及载体型三类。应用NPs改性正畸粘接剂赋予其抗菌或再矿化性能的研究最多;也有研究利用NPs对正畸矫治器进行表面涂层或整体掺杂改性使其具备抗菌性能。上述两种方式的优势在于不依赖患者的依从性。此外,NPs改性的氟保护漆及负载抗菌或再矿化制剂的纳米载体可用于促进正畸患者的口腔保健,该途径能发挥持续预防作用,但依赖患者配合。研究显示,NPs的小尺寸效应可增强其性能,但可能存在一定安全性问题,且仍对改性后材料本身理化性能有一定的影响,这些问题还需进一步探索。虽然现有研究还存在一定局限性,但可预见,未来纳米粒子在正畸釉质脱矿的预防中有望发挥重要作用。

关键词: 纳米粒子, 纳米载体, 口腔正畸, 牙釉质脱矿, 白垩斑, 粘接剂, 矫治器, 口腔保健, 抗菌, 再矿化

Abstract:

Enamel demineralization is one of the most common adverse reactions to orthodontic treatment. The existence of orthodontic appliances affects oral hygiene maintenance, which easily leads to plaque accumulation and oral flora dysbiosis, and cariogenic bacteria produce acid to cause enamel demineralization. It not only affects aesthetics but may develop into caries and endanger oral health. Therefore, enamel demineralization has become an urgent problem. Nanoparticles generally refer to solid particles with diameters of 1 to 100 nm and have unique physicochemical properties that provide a new strategy for preventing enamel demineralization during orthodontics. Reviewing the relevant literature, nanoparticles used for the prevention of enamel demineralization in orthodontics may be classified into antibacterial, remineralization and carrier-type nanoparticles according to their functions. Most research was performed on the application of nanoparticles to modify orthodontic adhesives for enhancement of antibacterial or remineralization properties, but some studies also focused on the modification of orthodontic appliances with nanoparticles for surface coating or overall doping to provide antimicrobial properties. The advantage of these two approaches is that they are not dependent on patient compliance. Nanoparticle-modified fluoride varnishes and nanocarriers loaded with antimicrobial or remineralization agents may be used to promote oral health care in orthodontic patients, which have a sustained preventive effect but depend on the cooperation of the patient. It was indicated that the small size effect of nanoparticles provides better performance, but there may be certain safety issues, and there is still some influence on the physicochemical properties of the modified materials themselves. These issues must be further explored. Although there are some limitations in the current studies, nanoparticles are expected to play an important role in the prevention of enamel demineralization during orthodontics in the future.

Key words: nanoparticles, nano-carrier, orthodontics, enamel demineralization, white spot lesions, adhesive, appliance, oral health care, antibacterial, remineralization

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