摘要
病理损伤和临床医源性操作均可导致牙本质脱矿,形成脱矿牙本质基质(demineralized dentin matrix,DDM)。牙本质脱矿激活内源性基质金属蛋白酶(matrix metalloproteinase,MMP)和半胱氨酸组织蛋白酶(cysteine cathepsin,CC);同时DDM力学性能降低,因此在酶促降解和物理破坏下DDM易丧失结构完整性,降低DDM在牙本质-树脂粘接修复中的临床价值。采用交联剂和MMP/CC抑制剂是保护DDM结构完整性和实现其临床价值的有效策略。多种化学合成试剂和植物来源提取物能显著改善DDM力学性能,增强DDM酶解耐受性,但化学合成试剂的细胞毒性和植物提取物引起的牙齿着色可显著影响其临床适用性。在保护牙本质胶原的同时发挥抗菌性能是未来DDM保护剂研究的新方向。因此,本综述分别从胶原交联剂、胶原降解酶抑制剂和集两者功效于一体的化合物展开,探讨DDM保护的最新研究进展,并展望其在牙本质-树脂粘接中的应用前景,以期为DDM保护策略的临床应用提供参考。
Both pathological injuries and clinical iatrogenic operations can lead to dentin demineralization,forming demineralized dentin matrix(DDM).Dentin demineralization activates endogenous matrix metalloproteinase(MMP)and cysteine cathepsin(CC),and the mechanical properties of DDM decrease,so DDM is prone to lose its structural integrity under the action of enzymatic degradation and mechanical destruction,which in turn results in the reduction of clinical functional value of DDM in dentin-resin bonding restoration.The administrations of dentin collagen cross-linking reagents and MMP/CC inhibitors are effective strategies to protect DDM structural integrity and achieve its clinical functional value.A variety of chemically synthesized reagents and plant-derived extracts are capable of significantly improving the mechanical properties of DDM and enhancing its enzymatic tolerance.However,the cytotoxicity caused by chemically synthesized reagents and the tooth staining aroused by plant extracts have considerably affected their clinical applicability.Protecting dentin collagen while exerting antibacterial properties is a new direction for future DDM protective agent research.Accordingly,from the perspectives of cross-linking reagents,enzyme inhibitors and compounds which possess the dual proper ties,this review discusses the latest research progress in DDM protection,and looks into its application prospects in dentin-resin bonding,in an attempt to provide reference for the clinical promotion of DDM protection strategy.
作者
蔡明轩
毛靖
汪一帆
邹杰林
石鑫
Cai Mingxuan;Mao Jing;Wang Yifan;Zou Jielin;Shi Xin(Department of Orthodontics,Center of Stomatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2021年第11期1144-1149,共6页
Chinese Journal of Stomatology
基金
湖北省卫生健康委员会重点项目(WJ2019Z006)
口腔颌面发育与再生湖北省重点实验室开放基金(2020kqhm002)。
