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Informationen aus Orthodontie & Kieferorthopädie 2020; 52(03): 211-218
DOI: 10.1055/a-1200-5821
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Wirkungsweise von Fluoriden: Allgemeine Aspekte – Festsitzende KFO-Apparaturen: Karies und Prophylaxe

Effects of Fluorides: General Aspects – Fixed Orthodontic Appliances: Caries and Prophylaxis
Adrian Lussi
1   Klinik für Zahnerhaltungskunde und Parodontologie, Universitätsklinikum Freiburg, Deutschland und Zahnmedizinische Kliniken der Universität Bern, Schweiz
,
Rengin Attin
2   Zentrum für Zahnmedizin, Klinik für Kieferorthopädie und Kinderzahnmedizin, Universität Zürich, Schweiz
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Zusammenfassung

Schmelz und Dentin bestehen zum größten Teil aus dem harten mineralischen kristallinen Material „Apatit“. Die Zahnoberfläche steht in ständigem Austausch mit ihrer Umgebung: mit dem Speichel, dem Biofilm Plaque und allem, was in den Mund hineingelangt. Dazu gehören kariogene und erosive sowie die Remineralisation fördernde Substanzen.

Stoffe aus der Zahnhartsubstanz werden in die umgebende Flüssigkeit abgegeben und Stoffe aus der Umgebung in den Zahn aufgenommen und in das Kristallgitter eingelagert oder adsorbiert. Damit die Zähne intakt bleiben, darf nicht mehr Material abgegeben werden als auch wieder eingebaut wird: es herrscht ein dynamisches Gleichgewicht. Um neue Schäden (wie z. B. Karies oder Erosionen) zu verhindern, muss ein für die Zähne günstiges Gleichgewicht aufrechterhalten werden. Dies kann durch entsprechende Ernährung und Mundhygiene entscheidend beeinflusst werden. Auch Fluorid hat durch seine Eigenschaften eine positive Wirkung auf dieses Gleichgewicht. Während kieferorthopädischen Behandlungen kommt es insbesondere im Bereich der Front- und Eckzähne nicht selten zu kariösen Läsionen. Die Brackets sind eine Retentionsstelle für den Biofilm und die üblich verwendeten Hilfsmittel (Zahnbürste mit Zahnpaste zu Hause, Napf mit Paste in der Praxis) erreichen wichtige Stellen nicht. Neue Methoden wie die Guided Biofilm Therapy (GBT) und Hilfsmittel für eine bessere Reinigung der Bracketumgebung werden vorgestellt.

Abstract

Enamel and dentine consist mainly of the hard mineral crystalline material “apatite”. The tooth surface is in constant contact with its environment: with saliva, biofilm plaque and everything entering the mouth. These include cariogenic and erosive substances as well as substances that promote remineralization.

Substances from the dental hard tissue are released into the surrounding fluid and substances from the environment are absorbed into the tooth and deposited in or adsorbed on the crystal lattice. In order for the teeth to remain intact, no more material may be released than is re-integrated: a dynamic equilibrium prevails. To prevent new damage (such as caries or erosion), a balance favorable to the teeth must be maintained. This can be decisively influenced by appropriate nutrition and oral hygiene. Fluoride also has a positive effect on this balance due to its properties. During orthodontic treatment, carious lesions often occur, especially in the area of the front and canine teeth. The brackets are a retention site for the biofilm and the commonly used aids (toothbrush with toothpaste at home, bowl with paste in the practice) do not reach important areas. New methods such as Guided Biofilm Therapy (GBT) and aids for a better cleaning of the bracket environment are presented.

Schlüsselwörter

Fluoride - Karies - Prophylaxe - Guided Biofilm Therapy (GBT)

Key words

Fluorides - Caries - Prophylaxis - Guided Biofilm Therapy (GBT)


Publication History

Article published online:
11 September 2020

© 2020. Thieme. All rights reserved.

© Georg Thieme Verlag KG
Stuttgart · New York

 

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