兒茶素與氟化物對於降低軟性飲料引起之牙齒酸蝕之影響：體外實驗

Abstract

目的 牙齒酸蝕是近年來越來越值得重視的一個牙齒問題，常見於大量飲用酸性軟性飲料的人群。本實驗的目的為以體外實驗的方法來探討氟化物及兒茶素對於降低軟性飲料所引起之牙釉質及牙本質齒酸蝕之效果。 材料與方法 本實驗使用市面上常見的碳酸軟性飲料來當作牙齒酸蝕之酸性來源。本實驗共使用了40個人類牙釉質樣本及40個人類牙本質樣本，將其各平均分成四組，事前分別以去離子水(DW)、0.5M氟化鈉溶液(F)、400μM兒茶素溶液(EGCG)、0.5M氯化鈉，及400μM兒茶素混合溶液(Mix)做事前處理4分鐘。之後以軟性飲料浸泡處理15分鐘及人工唾液浸泡處理1小時之循環4次。最後以雷射掃描共軛焦顯微鏡分析酸蝕後平均喪失高度、表面圖像及表面積變化，並使用維氏微小硬度計來測量酸蝕後表面硬度變化，以及使用掃瞄式電子掃描顯微鏡觀察表面影像。 結果 牙釉質樣本方面，和DW組相比，F組有顯著較高之表面硬度，但平均喪失高度部分和表面積變化則無顯著差異。EGCG組和Mix組在之表面硬度變化、平均喪失高度及表面積變化和DW組相比都有顯著較少之變化。其中，EGCG組在表面硬度方面有最高之表面硬度，優於F組及Mix組。 牙本質樣本方面，和DW組相比，F組相比有較高之表面硬度、較少之平均喪失高度，EGCG組及Mix組則是有高之表面硬度，表面積變化則無顯著差異。 結論 本實驗顯示，0.5M氟化鈉及400μM兒茶素及其混合溶液在體外實驗中皆能顯著抑制牙釉質及牙本質酸蝕，其中兒茶素也展示了抗牙釉質酸蝕之能力，氟化物也展示了抗牙本質酸蝕之能力。混合溶液之抑制效果非簡單之加成效果，可能的原因為兒茶素與氟化物之間可能有交互作用之存在，或是彼此的抑制途徑類似而有競爭效果，尚待進一步之研究去確認。

Objectives Dental erosion is a rising problem recently, and the frequently soft-drink consuming nowadays might be one of the reasonable attributions. The present study is aim to evaluate the effect of fluoride and EGCG against soft-drink-induced dental erosion in vitro. Materials and methods A soft drink is used as acid source of erosion in the present study. 40 enamel samples and 40 dentin samples, which were made of human extracted teeth, were distributed into 4 group and received pre-treatment by deionized water (DW), 0.5M NaF (F), 400μM EGCG (EGCG), and combination of 0.5M NaF and 400μM EGCG (Mix) in rinse for 4 minutes respectively. Afterwards, the samples were immersed in the soft drink for 15 minutes for 4 times with 60 minutes interval in artificial saliva. Then, the samples were analyzed of the change of average height, surface area changing, surface hardness and surface structure after erosion by confocal laser scanning microscope, Vickers’s hardness tester, and scanning electronic microscope. Results In enamel samples, the F group showed higher surface hardness in contrast to the DW group, but it made no difference in surface area change and average height. The EGCG group and the Mix group, in contrast to the DW group, showed higher surface hardness, less surface area change and lower average height. Besides, the EGCG group exhibited highest surface hardness of 4 groups. In dentin samples, compared to the DW group, the F group showed higher surface hardness and lower average height. In the other hand, the EGCG group and the Mix group exhibited higher surface compared to the DW group. As for surface area change, the outcomes were similar in all groups. Conclusion The present study demonstrated that all of 0.5M NaF, 400μM EGCG, and combination of both rinse could reduce the amount of soft-drink-induced dental erosion in vitro. EGCG demonstrated anti-enamel-erosion effect and fluoride showed anti-dentin-erosion effect. The inhibitory effect of Mix rinse was neither simply combination effect nor the best of all. There might be a interaction or competitive effect between NaF and EGCG, and it needs further studies to assure.