Abstract
Many studies regarding Casein phosphopeptides-amorphous calcium phosphate(CPP-ACP) have demonstrated the remineralization ability on the demineralized enamel surface. A question is still remained that how deep can the calcium (Ca) and phosphorus (P) ions supplied by the CPP-ACP paste penetrate into the enamel subsurface. The aims of this study were to measure the penetrating depth of Ca and P ions in the demineralized human enamel in vitro, and were to determine the amount and depth of Ca and P ions according to the duration. The amount and depth of Ca and P ions were measured by microscopic observation with Field Emission Scanning Electron Microscopy (FE-SEM; LEO SUPRA 55, Carl Zeiss, Germany) and Energy Dispersive X-ray Spectrometer (EDS; GENESIS 2000, EDAX, USA: Linescan of Calcium and Phosphorus). Freshly extracted four human 1st premolars were obtained from the Dept. of Pediatric Dent., Kyung Hee Univ. Buccal surfaces of the 1st premolars were covered with nail varnish to form a window on the middle third of buccal surface. All of the teeth with enamel windows were immersed in a solution of 0.1 M lactic acid, Carbopol C907 (carboxypolymethylene BF Goodrich, Cleveland, OH, USA) at pH 4.8, and then incubated for 7 days. Each tooth crown was sawn in half through the midline of buccal window along the long axis of premolar. The four blocks of premolars were immersed in a 10-times diluted solution of CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan) for 1, 2, 3 and 5 weeks while the rests were immersed in a placebo solution (distilled water) for the same duration. Each specimen was embedded in epoxy resin, and was sectioned perpendicular to the window, using a water-cooled diamond blade saw. The spectrum density indices of Ca and P were measured in the sound, de- and remineralized enamels by FE-SEM and EDS. The Student's t test was performed to compare the Spectrum Density Indices (SDI) of sound, re-and demineralized enamels, and to compare the differences among the durations. Followings are the conclusion : 1. The penetration depth of the remineralizing ions (Ca & P) of CPP-ACP paste is related to the depth of demineralized enamel (approximately $1050{\sim}1350{\mu}m$). It is revealed that the penetration depth of both ions reaches full thickness of decalcification and even slightly into the sound enamel. 2. The Ca & P levels of remineralized enamels in 1, 2 weeks were significantly higher than those of the sound enamels (p<0.05). 3. No statistically significant difference of Ca & P levels was found in relation with the increasing duration of remineralization (p>0.05).
이 연구는 Casein phosphopeptides-amorphous calcium phosphate (CPP-ACP)paste에 의해 제공되는 Calcium(Ca)과 Phosphorous(P) 이온이 탈회된 법랑질 표면에 적용된 시간에 따라 침투되는 깊이와 Ca/P의 상대적 정량값을 평가하고자 하였다. Field Emission Scanning Electron Microscopy(FE-SEM)와 Energy Dispersive X-ray Spectrometer(EDS)를 이용하여 Ca/P 이온의 정량적 측정으로 탈회된 법랑질 내로의 침투깊이를 계측하였다. 교정치료를 위해 발거된 제 1소구치 치관 협측면의 중앙 1/3부위에 $4{\times}9mm$의 법랑질 window를 제외한 나머지 치관부위는 nail varnish로 도포하여 window 부위의 법랑질만 노출시킨 후, 모든 치아를 0.1M lactic acid로 7일 동안 탈회시켰다. 탈회된 각 치아의 정중앙을 장축에 따라 절단한 후 그 중 4개의 소구치 절편은 10배 희석된 CPP-ACP paste 용액에 각각 1, 2, 3 및 5주 동안 침지시켰고, 나머지 4개의 소구치 절편은 증류수에 동일 기간 침지시켰다. 각 절편을 window에 대해 수직으로 절단하여 건전 법랑질, 탈회된 법랑질 및 재광화된 법랑질의 깊이에 따른 Ca/P의 Spectrum Density Index(SDI)를 FE-SEM과 EDS로 계측하였다. 각 계측치를 Student's t test로 비교 평가하여 다음과 같은 결과를 얻었다. 1. Ca/P 이온이 법랑질 표면으로부터 약 $1050{\sim}1400{\mu}m$까지 침투하여 탈회 법랑질의 깊이인 $1050{\sim}1350{\mu}m$까지 재 광화되었다. 2. 1주군과 2주군의 재광화된 법랑질의 Ca/P SDI는 건전 법랑질보다 유의성 있게 높았으나(p<0.05), 3주군에서는 건전 법랑질보다 유의하게 낮았고(p<0.05), 5주군은 건전 법랑질과 유의한 차이가 없었다(p>0.05). 3. 모든 재광화된 법랑질 간에 Ca/P의 SDI는 유의한 차이가 없었다(p>0.05).
