本文選題：牙本質(zhì) + 羥基磷灰石��； 參考：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：背景牙體硬組織(牙釉質(zhì)、牙本質(zhì)、牙骨質(zhì))一旦受損,機體很難實現(xiàn)自愈性修復,臨床上必須采用人工材料進行修復。當前,體外研究已經(jīng)證實,載有鈣磷離子的新型瓊脂水凝膠仿生礦化模型能夠誘導牙體硬組織再生修復,和傳統(tǒng)的充填治療相比,這種牙體硬組織自愈性仿生修復更符合生理機制,生成的礦化物的組分、晶體結(jié)構(gòu)、硬度與人牙體組織高度相似。因而,該仿生礦化模型很可能在齲病、磨損和牙本質(zhì)敏感等疾病的治療上具有良好的應用前景。目的載有鈣磷離子的新型瓊脂水凝膠仿生礦化模型能夠誘導牙本質(zhì)的再生修復。但是,前期體外實驗是在一個穩(wěn)定的、清潔的、不受口腔環(huán)境影響的薄層牙本質(zhì)片上進行的。和單一恒定的實驗室環(huán)境相比,人類的口腔微環(huán)境顯然更為復雜和多變,為了探索該仿生礦化模型在人類復雜的口腔微環(huán)境下的實際礦化效果并實現(xiàn)其臨床應用轉(zhuǎn)化,本實驗構(gòu)建了以新西蘭大白兔為對象的實驗動物模型,利用兔口腔微環(huán)境,探索該水凝膠仿生礦化模型在真實口腔環(huán)境下誘導牙本質(zhì)仿生礦化的能力,為該仿生礦化模型在復雜的人類口腔微環(huán)境下的實際臨床應用轉(zhuǎn)化做準備。方法選取新西蘭大白兔(兔齡3個月,平均體重2.25 kg)為研究對象,全麻后磨除上、下前牙唇面釉質(zhì)層,暴露牙本質(zhì)于口腔環(huán)境。選擇上前牙為實驗組,下前牙為自身對照組。首先,制作兔上頜前牙的個性化透明塑料托盤(用于盛載和保護水凝膠仿生礦化體系);然后,在酸蝕去除玷污層的牙本質(zhì)表面覆蓋一層2mm厚的Ca Cl_2水凝膠,待水凝膠膠凝后,將載有一層2mm厚Na_2HPO_4水凝膠的個性化透明塑料托盤戴入兔上頜牙,確保Ca Cl_2水凝膠與Na_2HPO_4水凝膠充分接觸。瓊脂水凝膠礦化時間持續(xù)8小時(定義為一個礦化周期)。對照組的下前牙酸蝕后不處理直接暴露于口腔。分別礦化1,3個周期后,拔除實驗組和對照組前牙,利用場發(fā)射掃描電鏡(SEM),X射線衍射儀(XRD)和納米壓痕儀對牙本質(zhì)表面的沉積層進行表征和分析。結(jié)果掃描電鏡結(jié)果顯示在酸蝕的牙本質(zhì)表面形成了厚厚的一層晶體層。X射線衍射儀結(jié)果證實新形成晶體層為高度礦化的羥基磷灰石晶體層,在脫礦的膠原纖維表面及內(nèi)部有大量的羥基磷灰石晶體沉積,形成了礦化的牙本質(zhì)。在礦化的牙本質(zhì)表面羥基磷灰石晶體的c軸方向與牙本質(zhì)的表面垂直并緊密結(jié)合沉積于其表面,牙本質(zhì)小管被羥基磷灰石晶體封閉,新沉積的羥基磷灰石晶體層其彈性模量和納米硬度與天然牙本質(zhì)相近,從而實現(xiàn)了牙本質(zhì)的再礦化。結(jié)論在兔的口腔環(huán)境中,瓊脂水凝膠仿生礦化模型具有形成牙體微結(jié)構(gòu)的能力,從而實現(xiàn)脫礦牙本質(zhì)的再生修復,并為牙本質(zhì)暴露相關疾病,如酸蝕癥、磨損、牙本質(zhì)敏感癥等的治療提供了一種新的治療方法。
[Abstract]:Background once the hard tissue (enamel, dentin, cementum) is damaged, it is very difficult for the body to achieve self-healing repair. At present, in vitro studies have shown that a new Agar hydrogel biomimetic mineralization model containing calcium and phosphorus ions can induce hard tissue regeneration and repair, compared with traditional filling therapy. The biomimetic restoration of hard tissue is more in line with the physiological mechanism. The composition, crystal structure and hardness of the mineralized substance are highly similar to those of the human tooth tissue. Therefore, the biomimetic mineralization model is likely to have a good prospect in the treatment of dental caries, wear and dentin sensitivity. Aim A new bionic mineralization model of Agar hydrogel containing calcium and phosphorus ions can induce dentin regeneration and repair. However, pre-vitro experiments were performed on a stable, clean, oral-free, thin-layer dentin. Compared with the single and constant laboratory environment, the oral microenvironment of human is obviously more complex and changeable. In order to explore the actual mineralization effect of the biomimetic mineralization model in the complex oral microenvironment of human beings and to realize its clinical application transformation, An experimental animal model of New Zealand white rabbit was established in this study. The ability of the hydrogel biomimetic mineralization model to induce biomimetic mineralization of dentin in real oral environment was explored by using rabbit oral microenvironment. This biomimetic mineralization model can be applied in complex human oral microenvironment. Methods New Zealand white rabbits (3 months old, average weight 2.25 kg) were selected as the study objects. After general anesthesia, the enamel layer on the labial surface of the lower anterior teeth was removed, and the dentin was exposed to the oral environment. The upper anterior teeth were selected as the experimental group and the lower anterior teeth as the self-control group. First, a personalized transparent plastic tray for rabbit maxillary anterior teeth (used to hold and protect hydrogels from biomimetic mineralization system) was made. Then, a layer of 2mm thick Ca Cl_2 hydrogel was coated on the surface of dentin with acid etching and tarnishing layer, after which the hydrogel was cemented. A personalized transparent plastic tray with a layer of 2mm thick Na_2HPO_4 hydrogels was worn into rabbit maxillary teeth to ensure that Ca Cl_2 hydrogels were in full contact with Na_2HPO_4 hydrogels. Agar hydrogel mineralization lasts 8 hours (defined as a mineralization cycle). In the control group, the anterior teeth of the control group were exposed directly to the oral cavity without treatment after acid etching. After 1,3 cycles of mineralization, the anterior teeth of the experimental group and the control group were extracted, and the deposit layer on the dentin surface was characterized and analyzed by field emission scanning electron microscopy (SEM) and nano-indentation apparatus. Results the SEM results showed that a thick layer of crystal layer was formed on the etched dentin surface. The results of X-ray diffractometer confirmed that the newly formed crystal layer was highly mineralized hydroxyapatite crystal layer. A large amount of hydroxyapatite crystals were deposited on the surface and interior of demineralized collagen fibers, forming mineralized dentin. The c-axis of hydroxyapatite crystals on the surface of mineralized dentin is perpendicular to the surface of dentin and deposited on the surface of dentin, and the dentine tubules are sealed by hydroxyapatite crystals. The elastic modulus and nano-hardness of the newly deposited hydroxyapatite crystal layer are similar to those of natural dentin, so that the dentin can be remineralized. Conclusion in rabbit oral environment, Agar hydrogel biomimetic mineralization model has the ability to form dentin microstructures, thus to achieve the regeneration and repair of demineralized dentin, and is related to dentin exposure diseases, such as acidosis, wear and tear. The treatment of dentin hypersensitivity provides a new treatment method.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R781

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