Έντυπο με έρευνες της SANGI για τον υδροξυαπατίτη

RIN-1(N)

1982-2018

● Nano<mHAP> fills and repairs minute surface deficits in tooth enamel1, restoring damaged enamel to almost its original smoothness ● Treatment with nano<mHAP> protects against plaque attachment and stains, by reducing the crevices that harbor them2 ● Nano<mHAP> shows greater affinity for tooth enamel than other calcium phosphates, including other forms of hydroxyapatite3 ● Microscopic scratches and wear are almost always present on normal adult teeth

a. Healthy enamel surface b. After etching with acid c. After acid-etching then immersion in artificial saliva d. After acid-etching then immersion in nano<mHAP> solution

a. Acid-etched enamel surface (x5,000) b. Higher magnification of a. showing dissolution of enamel rods (x100,000) c. Enamel surface after acid-etching then brushing with nano<mHAP> toothpaste (x5,000) d. Higher magnification of c. showing restoration of the enamel rods (x100,000)

Sangi s earliest studies also focused on remineralization by nano<mHAP> of subsurface demineralized areas of tooth enamel. Tooth decay begins when acids produced mainly by plaque bacteria seep into the tooth and dissolve mineral from the enamel s hydroxyapatite rods, causing white spot lesions or areas of incipient caries. Saliva provides a constant supply of mineral to restore the enamel ‒ at an early stage, demineralization can be reversed. But if the natural cycle of demineralization and remineralization is upset, for example by excessive plaque or inadequate saliva flow, demineralization sets in, and irreversible destruction of the enamel, i.e. tooth decay, occurs. Researchers study this in vitro by using sound extracted teeth and creating an artificial subsurface lesion with acid before applying test toothpaste, either by brushing or in solution. Sometimes acid and toothpaste are applied in cycles, to simulate the constant challenge of acids in the oral cavity. More recently, a chip containing a demineralized enamel sample is attached to a person s tooth, and the test carried out in situ in the saliva-filled, bacterially and acid-challenged environment of the mouth.

● Nano<mHAP> remineralizes subsurface demineralized areas of tooth enamel1 ● It removes white spots and incipient caries, and restores enamel almost to its original form. ● Moreover nano<mHAP> remineralizes tooth enamel ・more effectively than saliva ・just as effectively as fluoride compounds2

a. Healthy enamel c. Enamel remineralized by immersion in solution with Sangi s nano<mHAP>.

Its mineral profile closely resembles that of natural enamel.

c. After immersion in a nano<mHAP> solution. Progressive remineralization to the depth of the lesion is observed.

c. Demineralized enamel after brushing with nano<mHAP> toothpaste.

In this 4-month 29-person study, researchers found no significant difference in remineralizing ability between nano<mHAP> and fluoride toothpastes

Remineralization effect of nano<mHAP> toothpastes, compared with fluoride toothpastes In this 10-day in vitro study involving acid-challenge, no significant difference in remineralizing ability between the nano<mHAP> and fluoride toothpastes was observed.

Tooth enamel comprises millions of closely packed enamel rods, which are themselves made up of myriad perfectly aligned hydroxyapatite crystals. Healthy enamel is semi-transparent, and teeth appear white because of the ivory color of the dentin beneath. Demineralization of the enamel layer, plaque, staining and microscopic surface scratches all contribute to dull not only gloss, but also the color of the teeth, which differs from person to person. Sangi s nano<mHAP> is not an abrasive or a whitening agent in the sense of scrubbing or bleaching the teeth. Instead by providing mineral to repair surface crevices and demineralized spots, it restores smoothness and translucency to the enamel, improving its gloss and true color, and making it less susceptible to plaque and stains. In this sense, Sangi s nano<mHAP> enhances not only the health, but also the beauty of the teeth. Studies both in vitro and in vivo have examined the effect of nano<mHAP> toothpaste on color and gloss, both in extracted and living teeth, with observation by photocolorimeter, spectrophotometer and FE-SEM.

● Use of nano<mHAP> toothpaste improves tooth whiteness and gloss ● This improvement can be correlated with an increase in surface mineral density and smoothness Tooth color change after brushing with <mHAP> toothpaste

(A) Nano<mHAP> toothpaste (B) Placebo

This 6-week, 6-person study showed use of <mHAP> toothpaste steadily improved whiteness and gloss

Teeth brushed with nano<mHAP> toothpaste in this 30-day, 12-person study increased in whiteness by 1.0 to 1.4 shades on the Lumin scale, compared with no change for controls

(A) Enamel brushed with nano<mHAP> toothpaste In sound extracted teeth brushed similarly to those in the in vivo study, over 7 days, SEM showed a fine-particle coating over the enamel in the nano<mHAP> group, but not in controls, indicating that enamel repair affected the color change.

(1996) <Dental Diamond, Vol.21, 43-46, 1996> ●

The Term Whitening Toothpaste as Applied to Hydroxyapatite-Containing Toothpaste T.OZAKI, Nihon University School of Dentistry, Japan

「歯を白くする歯磨剤 ―この言葉とハイドロキシアパタイト配合歯磨剤―」 尾崎哲則 ＜Dental Diamond、第21巻、第13号、43-46、1996 ＞

(1997) <Proceedings of the Japan Academy of Color for Dentistry, 5th Congress, 1997> ●

The Effect of Commercially Available Oral Rinses on the Color of Extracted Human Teeth Y.OHTAKE et al, Meikai University School of Dentistry, Japan

「市販洗口液のヒト抜去る歯冠色に及ぼす影響について」 大竹洋子、市村葉、片山直、片山伊久右衛門（明海大学歯学部） 、高承志、 張春鳳（北京医科大学）、施生根、牛忠英（第四軍医大学） ＜第5回日本歯科色彩学会学術大会抄録、1997＞

（1998） < Proceedings of the Japan Academy of Color for Dentistry, 6th Congress, 1998> ●

The Effect of Apagard M Toothpaste on the Color of Vital Human Upper Front Teeth

C. GUO et al, Dept. of Stomatology, Beijing Medical University, China

「薬用歯みがき剤＂アパガードＭ のヒト上顎生活前歯の色彩に及ぼす影響について」 高承志、張春鳳、片山伊久右衛門 ＜第6回日本歯科色彩学会学術大会抄録、1998＞

(1999) <Journal of Japan Academy of Color for Dentistry, Vol.6(1), 60-63, 1999> ●

Effect of Medical Toothpaste Apagard M on Color of Human Vital Upper Front Teeth

C. GUO1, H. LIU1, I. KATAYAMA1, Y. ICHIMURA2, Y. OTAKE2 and T. KATAYAMA2 1 Dept. of Stomatology, Beijing Medical University, China, 2 Meikai University School of Dentistry, Japan

「薬用歯みがき剤アパガードMのヒト上顎生活前歯の色彩に及ぼす影響について」 高承志他 ＜歯科の色彩、第6巻、第1号、60-63、1999＞

● Nano<mHAP> coats and blocks the entrance to exposed dentin and dentinal tubules, protecting against dentinal hypersensitivity ● This coating is enhanced by the presence of potassium nitrate (KNO3) ● The coating comprises chiefly crystalline hydroxyapatite, but includes an amorphous phase ● Subjects using the nano<mHAP> formulations report significant reduction in hypersensitive pain

b. Same surface after brushing with nano<mHAP> toothpaste

〈Journal of Esthetic and Restorative Dentistry, Vol.24(4), 268-276, 2012〉 Effect of a Nano-Hydroxyapatite Paste on Bleaching-Related Tooth Sensitivity W.D. BROWNING, S.D. CHO, E.J. DESCHEPPER Indiana University School of Dentistry, USA (2015) 〈American Journal of Dentistry, Vol.28(1), 33-39, 2015〉 Evaluation of Nanohydroxyapatite-Containing Toothpaste for Occluding Dentin Tubules B.T. AMAECHI, S.M. MATHEWS, K. RAMALINGAM, P.K. MENSINKAI University of Texas Health Science Center, USA (2018) <The Open Dentistry Journal, Vol.12:572-585, 2018> Clinical Efficacy in Relieving Dentin Hypersensitivity of Nanohydroxyapatite-containing Cream: A Randomized Controlled Trial B.T.AMAECHI, L.KELLY, S.SHYAMALI, G.JONATHAN University of Texas Health Science Center, USA <publication pending> Clinical Efficacy in Relieving Dentin Hypersensitivity of Nanohydroxyapatite-Containing Toothpaste B.T. AMAECHI, L. KELLY, S. SHYAMALI, T. ARON University of Texas Health Science Center, USA

Tooth bleaching is widely practised to restore whiteness and remove accumulated stains. But it is often accompanied by problems of surface turbidity (loss of sheen), sensitivity, and early stain recurrence believed to result from microstructural changes to the enamel during bleaching. Sangi in 2003 developed a new nano-HAP enamel restorative conditioner, APAPRO1, for professional use, and has carried out or commissioned extensive research into its applications, including clinical studies and specially designed in vitro dye penetration and cyclical staining tests. Observation has been by SEM, SPM, surface gloss analyzer (SGA), profilometry scanning and color spectrophotometer.

c. After bleaching then treatment with APAPRO nano-HAP conditioner (Ra=18.3nm)

b. Same after treatment with APAPRO nano-HAP conditioner

In this 14-day, 42-person trial, subjects applied APAPRO conditioner twice daily in a retainer tray for 5 minutes after 30 minutes home bleaching.

Subjects using the nano-HAP conditioner experienced significantly fewer days of sensitivity than those in the placebo group. *P<0.01

From the 1960s and earlier, the protein adsorption properties of hydroxyapatite, for example in chromatography, have been well known, and the adherence of oral microbes to the hydroxyapatite of the tooth surface has been closely studied.

Hydroxyapatite is known to adsorb not only plaque bacteria, but also the building materials of plaque, emitted by bacteria, such as glucans, or streptococcal extracellular polysaccharides. In the oral cavity, not only do microbes adhere to the enamel s hydroxyapatite, in particular the mutans streptococci, which can only replicate on the tooth surface, but free-floating hydroxyapatite particles supplied in a toothpaste serve to mop up free-floating bacteria and also plaque bacteria and fragments dislodged during tooth brushing, facilitating their removal on rinsing from the mouth.

This function of Sangi s nano<mHAP> has been recognized by Japanese health authorities, and closely studied by Sangi and related groups, including in the context of a project to develop an anticaries drug delivery system ( 3DS ) using nano-hydroxyapatite, with Japan s National Institute of Infectious Diseases. Research has been carried out in vitro, with bacterial suspensions, but also in vivo, to assess nano<mHAP> s bacterial reduction capability in the mouth, and initial clinical results are encouraging. Observation methods range from simple optical density (OD) measurements and bacterial culture to isotopic labeling of test strains and their assessment by scintillation counter and SEM.

● Nano<mHAP>’s particles ・adhere to and help remove bacteria and plaque1, protecting against tooth decay ・show superior bacterial adsorption compared with other forms of hydroxyapatite ・exhibit strong selectivity for cariogenic mutans streptococci bacteria ・also adsorb periodontal and opportunistic pathogens such as P. gingivalis and Candida, helping to

reduce the risk of oral soft tissue infection ● Nano<mHAP> can serve as a prophylactic in cases of high caries risk ● By restoring smoothness to the enamel surface, nano<mHAP> reduces susceptibility to attachment of plaque