Diş Sert Doku Remineralizasyonunda Son Güncellemeler
Özet
Diş çürüklerinin demineralizasyon ve kavitasyon ile karakterize pandemik yapısını ele alan bu çalışma, geleneksel florür tedavilerinin ötesine geçen güncel non-florür remineralizasyon teknolojilerini ve biyomimetik yaklaşımları incelemektedir. Diş sert dokularının onarımı için ideal materyallerin yüzey altına kalsiyum ve fosfat iyonları iletmesi gerektiğini belirten makale; β-TCP, fTCP, DCPD ve ACP gibi kalsiyum fosfat bileşikleri ile tükürük biyomimetiği olan CPP-ACP sistemlerinin etki mekanizmalarını açıklamaktadır. Ayrıca NovaMin gibi biyocam materyalleri ile rezin kompozitlere entegre edilen nano-HAP ve nano-CaF2 bazlı nanomalzemelerin, demineralize yüzeylere tutunarak asit direncini artırmadaki rollerini ortaya koymaktadır. Tamamen demineralize dentin kolajeninin yenilenmesini hedefleyen polidopamin, proantosiyanidin (PA) ve kendiliğinden birleşen P11-4 peptitleri gibi biyomimetik yaklaşımların yanı sıra, iyontoforez kullanan elektriksel olarak hızlandırılmış remineralizasyon (EAER), PAMAM dendrimerleri, teobromine ve arginin bikarbonat gibi yenilikçi teknolojilerin klinik potansiyelleri değerlendirilmektedir. Sonuç olarak, minimal invaziv diş hekimliğinde koruyucu yaklaşımların maliyet ve doku koruma avantajları vurgulanmakta, bu teknolojilerin in vitro ve in vivo çalışmalarla geliştirilmesinin klinik başarıyı optimize edeceği belirtilmektedir.
This article addresses the pandemic nature of dental caries characterized by demineralization and cavitation, and reviews current non-fluoride remineralization technologies and biomimetic approaches that extend beyond traditional fluoride treatments. Stating that ideal materials for repairing dental hard tissues must deliver calcium and phosphate ions beneath the surface, the study explains the mechanisms of calcium phosphate compounds such as β-TCP, fTCP, DCPD, and ACP, as well as CPP-ACP systems acting as salivary biomimetics. Furthermore, it demonstrates the roles of bioactive glass materials like NovaMin and nanomaterials based on nano-HAP and nano-CaF2 integrated into resin composites in increasing acid resistance by adhering to demineralized surfaces. Alongside biomimetic approaches aimed at regenerating completely demineralized dentin collagen—such as polydopamine, proanthocyanidins (PA), and self-assembling P11-4 peptides—the clinical potentials of innovative technologies including electrically accelerated and enhanced remineralization (EAER) using iontophoretic flow, PAMAM dendrimers, theobromine, and arginine bicarbonate are evaluated. In conclusion, the advantages of conservative approaches in minimally invasive dentistry regarding cost and tissue preservation are emphasized, noting that advancing these technologies through further in vitro and in vivo studies is expected to optimize clinical outcomes.
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