Akademik Veri Yönetim Sistemi
Uluslararası 3.Tıp ve Sağlık Bilimleri Çalışmaları Kongresi, Ankara, Türkiye, 13 - 14 Aralık 2024, ss.3-4
Tooth decay is a
multifactorial chronic disease that results from enamel demineralization. It
has been reported that 60%–90% of school-age children are affected by tooth
decay. The enamel is the most calcified and hardest tissue in the human body.
The inorganic content of enamel is composed of hydroxyapatite crystals. It is
known that hydroxyapatite crystals dissolve at a pH below 5.0-5.5 and Ca+2,
PO4-3, and OH- ions are released. The demineralization
process begins with the dissolution of hydroxyapatite crystals as a result of
the loss of phosphate and calcium ions from the enamel surface. The
acid-sensitive chemistry of the tooth enamel forms the basis of tooth decay.
Initial caries lesions are the earliest stage of caries formation and can be
diagnosed at an early stage and treated before cavitation occurs. These
lesions, also called ‘white spot lesions’, are limited to enamel tissue. As it
is possible to stop and treat the lesion at this stage, early diagnosis and
treatment are of great importance in terms of preventive dentistry. These
dynamics, which are called demineralization-remineralization and express the
mineral balance in hard tissue, can be disrupted by many factors affecting oral
tissues. With the determination of the pathological process of dental caries
and the factors affecting the demineralization–remineralization dynamics in
current studies, preventive applications have gained importance. The aim of
caries prevention applications is to prevent demineralization before it occurs
or to restore hard tissues to their former health by ensuring the
remineralisation of demineralized areas before cavitation occurs. It has been
experimentally and clinically proven that as a result of the remineralization of
white spot lesions by the penetration of Ca+2 and PO4-3
ions in saliva and plaque fluid, the porosity of the lesion decreases, its
hardness increases, and its opaque white appearance improves. To shift the demineralization
process to remineralization, many different agents, such as calcium sodium
phosphosilicate, nanohydroxyapatite, tricalcium silicate, tricalcium phosphate,
casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein
phosphopeptide amorphous calcium fluoride phosphate (CPP-ACPF), and
self-assembling peptides (anionic peptides) can be used. The aim of the current
preventive approach and protective/preventive strategies in the treatment of
dental caries is to inhibit demineralization before irreversible destruction of
teeth occurs, and to treat initial lesions without the need for invasive
interventions. This review presents a comprehensive evaluation of bioactive and
nanotechnological products used in the treatment of initial caries lesions.
Keywords:
White spot lesions, Remineralization, Nanotechnological
agents, Bioactive materials, Pediatric dentistry