Increased Fluorohydroxyapatite across Dentin after Fluoride Iontophoresis.

Journal of dental research Pub Date : 2024-07-01 Epub Date: 2024-05-29 DOI:10.1177/00220345241254017
O Ajcharanukul, P Kosakarn, M Sujjapong, S Berkbandee, P Bussabong
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Abstract

Due to the multiple factors contributing to dentin demineralization and hypersensitivity among individuals, the effectiveness of the available treatments in the long term remains unclear. A recent study reported a simple strategy to potentially mimic natural remineralization with increased crystallization on the enamel caries using fluoride iontophoresis. Such an effect is also ideal for accomplishing dentin biomineralization and structural strength. This study aimed to investigate structural and compositional characteristics and permeability changes after fluoride iontophoresis with different polarities, cathodal iontophoresis (CIP), anodal iontophoresis (AIP), and the control without iontophoresis for the treatment of etched dentin under simulated pulpal pressure. The 24 premolars were divided into 3 groups: CIP, AIP, and topical application of 5% sodium fluoride (NaF) for 40 s. Relative to before treatment, iontophoresis with both polarities significantly decreased the permeability with a visible increase in occluding tubules containing crystal formation and growth throughout the dentin structure and depth. The CIP not only restored the etched dentin surface into a sound condition but also reinforced the dentin across the structure and depth by the synergistic effects of remineralization, increasing crystal formation and transformation toward the more crystalline structure of fluorohydroxyapatite. Following topical treatment, X-ray diffraction analysis and Raman spectra revealed a significant reduction in the crystal size and crystallinity associated with the raised B-type carbonate substitution into the hydroxyapatite compared with that in the sound dentin. The result was the first to reveal the ideal strategy to rapidly restore the etched dentin surface into a sound condition, including reinforcing the dentin across the structure and depth by the synergistic effects of decreasing permeability, increasing crystal formation, and transformation toward the more crystalline structure of fluorohydroxyapatite using the 5% NaF applied with the DC cathode iontophoresis. The technique is noninvasive and simple and deserves further development for clinical application.

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氟化物离子注入后牙本质上的氟羟基磷灰石增加
由于导致牙本质脱矿和个人过敏症的因素多种多样,现有治疗方法的长期有效性仍不明确。最近的一项研究报告了一种简单的策略,即使用氟离子透入疗法,通过增加釉质龋齿的结晶来模拟自然再矿化。这种效果也是实现牙本质生物矿化和结构强度的理想方法。本研究旨在调查不同极性的氟离子透入(阴极离子透入(CIP)、阳极离子透入(AIP)和不使用离子透入的对照组)治疗模拟牙髓压力下蚀刻牙本质后的结构和成分特征以及渗透性变化。24 颗前臼齿分为 3 组:与治疗前相比,两种极性的离子透入疗法都能显著降低渗透性,在整个牙本质结构和深度中,含有晶体形成和生长的闭塞小管明显增加。CIP 不仅能将蚀刻的牙本质表面恢复到良好状态,还能通过再矿化、增加晶体形成和向氟羟基磷灰石晶体结构转化的协同作用,在整个牙本质结构和深度上强化牙本质。局部治疗后,X 射线衍射分析和拉曼光谱显示,与健全牙本质相比,晶体尺寸和结晶度显著减小,这与羟基磷灰石中的 B 型碳酸盐取代度提高有关。该结果首次揭示了将蚀刻牙本质表面快速恢复到健全状态的理想策略,包括通过使用直流阴极离子透入法施加 5%NaF,在降低渗透性、增加晶体形成以及向氟羟磷灰石更多晶体结构转化的协同作用下,在整个牙本质结构和深度上对其进行加固。该技术无创、简单,值得进一步开发用于临床。
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