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研究生:余思嫺
研究生(外文):Szu-Hsien Yu
論文名稱:鈣離子濃度梯度對於牙釉質酸蝕之影響:體外實驗
論文名稱(外文):Effect of Concentration Gradient of Calcium Ion on Enamel Erosion: An in vitro Study
指導教授:林俊彬林俊彬引用關係
指導教授(外文):Chun-Pin Lin
口試委員:郭敏光林弘萍王姻麟
口試委員(外文):Ming-Kuang GuoHong-Ping LinYin-Lin Wang
口試日期:2015-06-07
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:臨床牙醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:58
中文關鍵詞:牙齒酸蝕鈣離子濃度梯度牙釉質感應耦合電漿質譜儀
外文關鍵詞:dental erosionconcentration gradientcalciumdental enamelinductively coupled plasma mass spectrometer
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目的:牙齒酸蝕問題隨盛行率上升日益受到重視,過去文獻指出在軟性飲料中添加鈣離子能有效降低其酸蝕潛能。本實驗目的在於以體外實驗探討不同酸度下鈣離子濃度梯度對於降低牙釉質酸蝕程度的影響。
材料與方法:使用鹽酸當作酸性來源,並以氫氧化鈉滴定成pH 2.5、pH 3、pH 5.5三種酸度,分別調配成鈣離子濃度為1 M、0.1 M、10-2 M、10-3 M、10-4 M、10-5 M、10-6 M等七種濃度的含鈣溶液,與一組不含鈣者當成實驗對照組,總共24組,共使用72片人類牙釉質樣本。樣本浸泡溶液3分鐘後,以感應耦合電漿質譜儀分析溶液內磷離子含量、以維氏微小硬度計測量樣本表面硬度變化、使用雷射掃描共軛焦顯微鏡以及電子掃描顯微鏡觀察表面影像。
結果:在pH 3以及pH 5.5下鈣離子濃度1 M的組別,溶液中沒有檢出磷析出。在各組pH值下,添加鈣離子能有效降低牙釉質表面硬度下降量。pH 2.5下鈣離子濃度為10-5M與10-6M組可觀察到實驗區與對照區明顯高度落差。
結論:在酸性溶液中添加一定濃度的鈣離子,能有效降低酸性環境對牙釉質所造成的影響。隨著pH值下降,要達到有效降低酸蝕影響,需添加更高濃度的鈣離子。溶液pH值大於3,添加鈣離子濃度1 M時,在溶液中無法測得磷元素。pH 5.5以下的溶液,鈣離子含量小於1 M的各組,皆會使牙釉質表面硬度下降。檢出磷離子析出、表面硬度下降、表面粗糙度改變,三者不一定會同時發生,三者關係需進一步實驗釐清。


Objectives: With the rising prevalence, dental erosion gradually becomes seriously taken. The aim of this study was to evaluate the effect of concentration gradient of calcium ion on dental erosion in vitro.
Materials and methods: HCl was chosen as acid source in the present study. The pH value was adjusted by NaOH to pH values of 2.5, 3 and 5.5. Calcium chloride dehydrate was added to the former solutions to achieve a calcium concentration of 1 M, 0.1 M, 0.01 M, 10-3 M, 10-4 M, 10-5 M, 10-6 M and 0 M. Seventy two enamel discs made of human extracted teeth were divided into 24 groups. Each enamel samples was then exposed to 30 ml of the appropriate solution for 3 minutes individually. After the exposure, the solution was tested by ICP-MS to detect the concentration of phosphorus and the samples were rinsed in gently running distilled water for 30 seconds. The samples were then analyzed of surface hardness change and surface structure by confocal laser scanning microscope, Vickers’ hardness tester and electronic scanning microscope.
Results: At pH 3 and pH 5.5, the addition of 1 M calcium resulted in no detection of phosphorus in the solution. At each of the pH values, the addition of calcium ion significantly decreased the amount of surface hardness loss. At pH 2.5, with 10-5 M and 10-6 M calcium, there was a significant difference between eroded area and the control area.
Conclusion: By adding a particular amount of calcium to acid, the acid showed less effect on enamel samples. With a pH value lower than 5.5, surface hardness loss would take place in spite of adding high concentration (1 M) of calcium.


口試委員會審定書 i
中文摘要 ii
Abstract iii
第一章:文獻回顧 1
1.1 牙釉質 1
1.1.1 組成 1
1.1.2 結構 2
1.1.3 性質 2
1.2 牙齒酸蝕 3
1.2.1 定義 4
1.2.2 成因 4
1.2.3 臨床診斷 5
1.2.4 預防方法 6
1.3 牙釉質酸蝕 7
1.3.1 酸蝕過程 7
1.3.2 臨界pH值 8
1.3.3 影響因素 8
第二章:研究目的 9
第三章:實驗材料與方法 10
3.1 牙齒樣本 10
3.1.1 樣本來源 10
3.1.2 樣本製備 10
3.1.3 樣本分組 11
3.2 實驗溶液 11
3.3 實驗步驟 12
3.4 雷射掃描共軛焦顯微鏡 13
3.4.1 原理 13
3.4.2 實驗步驟 13
3.4.3 分析步驟 14
3.5 維氏微小硬度計 15
3.5.1 原理 15
3.5.2 測量步驟 15
3.6 感應耦合電漿質譜儀 16
3.6.1 實驗步驟 16
3.7 掃描式電子顯微鏡 17
3.7.1 操作條件 17
3.7.2 實驗步驟 17
第四章:實驗結果 18
4.1 牙釉質析出磷離子濃度 18
4.2 牙釉質初始表面硬度 20
4.3 牙釉質表面硬度之變化 20
4.4 雷射掃描共軛焦顯微鏡影像 22
4.4.1 pH 5.5 22
4.4.2 pH 3 23
4.4.2 pH 2.5 23
4.5 雷射掃描共軛焦顯微鏡影像表面輪廓分析 24
4.6 電子掃描顯微鏡之影像 24
第五章:討論 25
5.1 研究方法 25
5.1.1 酸性溶液種類 25
5.1.2 酸性溶液pH值 26
5.1.2 酸性溶液作用時間 26
5.1.3 酸蝕程度評估方法 27
5.2 鈣離子對於降低牙釉質酸蝕程度的效果 29
5.3 體外實驗與體內實驗差異 29
第六章:結論 31
第七章:未來研究努力方向 32
第八章:圖次 33
第九章:表次 49
參考文獻 52





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