Tooth Formation: Are the Hardest Tissues of Human Body Hard to Regenerate?

With increasing life expectancy, demands for dental tissue and whole-tooth regeneration are becoming more significant. Despite great progress in medicine, including regenerative therapies, the complex structure of dental tissues introduces several challenges to the field of regenerative dentistry. Interdisciplinary efforts from cellular biologists, material scientists, and clinical odontologists are being made to establish strategies and find the solutions for dental tissue regeneration and/or whole-tooth regeneration. In recent years, many significant discoveries were done regarding signaling pathways and factors shaping calcified tissue genesis, including those of tooth. Novel biocompatible scaffolds and polymer-based drug release systems are under development and may soon result in clinically applicable biomaterials with the potential to modulate signaling cascades involved in dental tissue genesis and regeneration. Approaches for whole-tooth regeneration utilizing adult stem cells, induced pluripotent stem cells, or tooth germ cells transplantation are emerging as promising alternatives to overcome existing in vitro tissue generation hurdles. In this interdisciplinary review, most recent advances in cellular signaling guiding dental tissue genesis, novel functionalized scaffolds and drug release material, various odontogenic cell sources, and methods for tooth regeneration are discussed thus providing a multi-faceted, up-to-date, and illustrative overview on the tooth regeneration matter, alongside hints for future directions in the challenging field of regenerative dentistry.

Calcium isotopic patterns in enamel reflect different nursing behaviors among South African early hominins

Nursing is pivotal in the social and biological evolution of hominins, but to date, early-life behavior among hominin lineages is a matter of debate. The calcium isotopic compositions (δ^44/42Ca) of tooth enamel can provide dietary information on this period. Here, we measure the δ^44/42Ca values in spatially located microsized regions in tooth enamel of 37 South African hominins to reconstruct early-life dietary-specific variability in Australopithecus africanus, Paranthropus robustus, and early Homo. Very low δ^44/42Ca values (<-1.4‰), indicative of milk consumption, are measured in early Homo but not in A. africanus and P. robustus. In these latter taxa, transitional or adult nonmilk foods must have been provided in substantial quantities relative to breast milk rapidly after birth. The results suggest that early Homo have continued a predominantly breast milk-based nursing period for longer than A. africanus and P. robustus and have consequently more prolonged interbirth interval.

Modelling of stress distribution and fracture in dental occlusal fissures

The aim of this study was to investigate the fracture behaviour of fissural dental enamel under simulated occlusal load in relation to various interacting factors including fissure morphology, cuspal angle and the underlying material properties of enamel. Extended finite element method (XFEM) was adopted here to analyse the fracture load and crack length in tooth models with different cusp angles (ranging from 50° to 70° in 2.5° intervals), fissural morphologies (namely U shape, V shape, IK shape, I shape and Inverted-Y shape) and enamel material properties (constant versus graded). The analysis results showed that fissures with larger curved morphology, such as U shape and IK shape, exhibit higher resistance to fracture under simulated occlusal load irrespective of cusp angle and enamel properties. Increased cusp angle (i.e. lower cusp steepness), also significantly enhanced the fracture resistance of fissural enamel, particularly for the IK and Inverted-Y shape fissures. Overall, the outcomes of this study explain how the interplay of compositional and structural features of enamel in the fissural area contribute to the resistance of the human tooth against masticatory forces. These findings may provide significant indicators for clinicians and technicians in designing/fabricating extra-coronal dental restorations and correcting the cuspal inclinations and contacts during clinical occlusal adjustment.

Effect of Two Remineralizing Agents on Initial Caries-like Lesions in Young Permanent Teeth: An in Vitro Study

AIM

To compare the effect of nano-hydroxyapatite (9000 ppm F) and casein phosphopeptide-amorphous calcium phosphate fluoride (900 ppm F) pastes on initial enamel carious lesions of young permanent teeth.

MATERIALS AND METHODS

Sixty extracted young premolars with a standardized window on enamel were immersed in a demineralizing solution for 48 hours to produce subsurface enamel lesions. They were divided into three groups according to remineralizing agents (n = 20) group I: nano-hydroxyapatite paste; group II: casein phosphopeptide-amorphous calcium phosphate fluoride paste; and group III: control (without an agent). The enamel surface microhardness (SMH) was measured at baseline, after the incipient enamel lesion, and after treatment. Additional twenty young premolars were selected and prepared as mentioned above for surface morphology evaluation by scanning electron microscope (SEM).

RESULTS

No significant difference was found in mean surface microhardness in teeth treated with nano-hydroxyapatite paste and those treated with casein phosphopeptide-amorphous calcium phosphate fluoride p = 0.26. SEM showed improvement in surface defects of demineralized enamel in the two test groups.

CONCLUSION

Nano-hydroxyapatite and casein phosphopeptide-amorphous calcium phosphate fluoride pastes were effec -tive in rehardening the initial enamel caries lesions in young permanent teeth.

CLINICAL SIGNIFICANCE

The best strategy for caries management is to focus on the methods of improving the reminer-alization process with the aid of the remineralizing agents. The current study compared the remineralizing effect of two remineralizing agents. Within the limitations of the study, both remineralizing agents were effective for remineralization of early caries-like lesions.

[Electronic probe analysis of enamel remineralization effect of casein phosphopeptide-amorphous calcium phosphate promoted by different concentrations of fluorine]

Objective: To evaluate the remineralization effect and mechanism of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) with different concentrations of fluorine on demineralized enamel using electronic probe. Methods: Extracted premolar teeth for orthodontic purpose were immersed into lactic acid gel to prepare artificial white spot lesions (10 teeth in each group). Then the specimens were randomly assigned to three groups: Control group, with 5% of the CPP-ACP+deionized water; Group A with 5% CPP-ACP+500 mg/L F(-) and Group B with 5% CPP-ACP+900 mg/L F(-). The teeth in each group were soaked in different solutions for 4 days and then were measured using electron probe tester. The changes of contents among the three groups were compared. Results: No statistically significant difference in the percentage of fluorine was found in the control group before and after treatment (P=0.06), and the difference in the percentage of fluorine quality in the other two groups was statistically significant (P<0.05). Statistically significant difference was found between calcium oxide and phosphorus peroxide in the three groups before and after mineralization (P<0.05). The percentage change of fluorine mass in group B [(0.107±0.035)%] was significantly greater than that in group A [(0.057±0.038)%] (P<0.05), while fluorine mass in group A was significantly greater than that in control group [(0.013±0.019)%] (P<0.05). In group A and group B, the change in quality of calcium oxide and phosphorus peroxide was significantly greater than that in control group (P<0.05), while no significant difference was found between group A and group B (P>0.05). Conclusions: The addition of fluorine in CPP-ACP increased the transport and penetration of calcium, phosphorus and fluorine on enamel surface.

Impact of a simplified in situ protocol on enamel loss after erosive challenge

This study investigated the effect of the period of use and location of intraoral appliances on enamel surface loss. This randomized, single blind in situ study was conducted in 2 crossover phases based on the period of use, in which maxillary and mandibular appliances were simultaneously worn. Bovine enamel blocks (n = 120) were randomly divided among the studied groups by surface hardness. In each phase, fifteen volunteers used one maxillary appliance and two mandibular appliances for 5 days. Erosive challenge was performed 4X/day by immersion in 0.01 M HCL for 2 minutes. In the continuous phase, the intraoral appliances were worn for 20 hours. In the intermittent phase the appliances were worn for 8 hours and 30 minutes. Enamel loss was determined profilometrically. The discomfort of use of the appliances were evaluated in a questionnaire. Data were analyzed by two-way ANOVA/Tukey’s test and chi-square test (p<0.05). The maxillary appliance promoted higher enamel loss compared to the mandibular one (p<0.001). Intermittent use of appliances resulted in similar enamel loss to the continuous one (p = 0.686). All volunteers preferred to use the maxillary appliance in an intermittent regimen. The intermittent use of maxillary appliance is a simplified reliable protocol appropriated for in situ erosion studies in enamel.

A Review of Enamel Remineralisation Potential of Calcium- and Phosphate-based Remineralisation Systems

PURPOSE

Along with calcium and phosphate ions, fluoride ions promote remineralisation of noncavitated carious lesions to form fluorapatite. However, the supply of calcium and phosphate ions from saliva may not be adequate for effective remineralisation in patients with high caries risk. Therefore, an additional supply of calcium and phosphate ions is mandatory to enhance effective remineralisation with fluoride ions. Several calcium- and phosphate-based remineralisation agents are available for clinical use. However, the nature of the incorporated calcium and phosphate ions and the method of their stabilisation are not similar. Therefore, this review summarises research findings on the enamel remineralisation potential of calcium- and phosphate-based remineralisation agents.

MATERIALS AND METHODS

Appropriate key words were used and the Pubmed electronic database was searched to retrieve articles. Screening through titles and abstracts identified relevant articles. Full text review of the identified relevant articles was performed and the significant findings were summarised and presented in this review.

RESULTS

Several studies including laboratory-based studies, in situ and randomised controlled clinical trials showed casein phosphopeptide amorphous calcium phosphate (CPP-ACP)-containing remineralisation agents to have superior remineralisation potential compared to other forms of calcium- and phosphate-based remineralisation agents, such as functionalised tri-calcium phosphate (fTCP) and amorphous calcium phosphate (ACP).

CONCLUSIONS

More long-term clinical studies are necessary to compare the enamel remineralisation potential of calcium- and phosphate-based agents that contain fTCP and ACP with those containing CPP-ACP. Additional well-designed randomised controlled clinical trials are also necessary to justify long-term clinical supplemental use of products containing CPP-ACP.

The compression dome concept: the restorative implications

Evidence now supports the concept that the enamel on a tooth acts like a compression dome, much like the dome of a cathedral. With an overlying enamel compression dome, the underlying dentin is protected from damaging tensile forces. Disruption of a compression system leads to significant shifts in load pathways. The clinical restorative implications are significant and far-reaching. Cutting the wrong areas of a tooth exposes the underlying dentin to tensile forces that exceed natural design parameters. These forces lead to crack propagation, causing flexural pain and eventual fracture and loss of tooth structure. Improved understanding of the microanatomy of tooth structure and where it is safe to cut teeth has led to a revolution in dentistry that is known by several names, including microdentistry, minimally invasive dentistry, biomimetic dentistry, and bioemulation dentistry. These treatment concepts have developed due to a coalescence of principles of tooth microanatomy, material science, adhesive dentistry, and reinforcing techniques that, when applied together, will allow dentists to repair a compromised compression dome so that it more closely replicates the structure of the healthy tooth.

Enamel biorhythms of humans and great apes: the Havers-Halberg Oscillation hypothesis reconsidered

The Havers-Halberg Oscillation (HHO) hypothesis links evidence for the timing of a biorhythm retained in permanent tooth enamel (Retzius periodicity) to adult body mass and life history traits across mammals. Potentially, these links provide a way to access life history of fossil species from teeth. Recently we assessed intra-specific predictions of the HHO on human children. We reported Retzius periodicity (RP) corresponded with enamel thickness, and cusp formation time, when calculated from isolated deciduous teeth. We proposed the biorhythm might not remain constant within an individual. Here, we test our findings. RP is compared between deciduous second and permanent first molars within the maxillae of four human children. Following this, we report the first RPs for deciduous teeth from modern great apes (n = 4), and compare these with new data for permanent teeth (n = 18) from these species, as well as with previously published values. We also explore RP in teeth that retain hypoplastic defects. Results show RP changed within the maxilla of each child, from thinner to thicker enameled molars, and from one side of a hypoplastic defect to the other. When considered alongside correlations between RP and cusp formation time, these observations provide further evidence that RP is associated with enamel growth processes and does not always remain constant within an individual. RP of 5 days for great ape deciduous teeth lay below the lowermost range of those from permanent teeth of modern orangutan and gorilla, and within the lowermost range of RPs from chimpanzee permanent teeth. Our data suggest associations between RP and enamel growth processes of humans might extend to great apes. These findings provide a new framework from which to develop the HHO hypothesis, which can incorporate enamel growth along with other physiological systems. Applications of the HHO to fossil teeth should avoid transferring RP between deciduous and permanent enamel, or including hypoplastic teeth.

Influence of trace elements on dental enamel properties: A review

Dental enamel, an avascular, irreparable, outermost and protective layer of the human clinical crown has a potential to withstand the physico-chemical effects and forces. These properties are being regulated by a unique association among elements occurring in the crystallites setup of human dental enamel. Calcium and phosphate are the major components (hydroxyapatite) in addition to some trace elements which have a profound effect on enamel. The current review was planned to determine the aptitude of various trace elements to substitute and their influence on human dental enamel in terms of physical and chemical properties.

Does Layering Minimize Shrinkage Stresses in Composite Restorations?

Polymerization shrinkage of resin composites may impair restoration longevity. It is hypothesized that layering, rather than bulk, techniques result in less stress in the tooth-restoration complex. The aim of this study was to compare shrinkage stresses for different restorative techniques used for cusp-replacing restorations with direct resin composite. In a 3-D FE model, the dynamic process of shrinkage during polymerization was simulated. Time-dependent parameters (shrinkage, apparent viscosity, Young’s modulus, Poisson ratio, and resulting creep), which change during the polymerization process, were implemented. Six different restorative procedures were simulated: a chemically cured bulk technique, a light-cured bulk technique, and 4 light-cured layering techniques. When polymerization shrinkage is considered, a chemically cured composite shows the least resulting stress. The differences seen among various layering build-up techniques were smaller than expected. The results indicate that the stress-bearing locations are the interface and the cervical part of the remaining cusp.

Chemical and Structural Information from the Enamel of a Troodon Tooth Leading to an Understanding of Diet and Environment

Synchrotron micro X-ray fluorescence (XRF) spectroscopy with two-dimensional element mapping, micro X-ray diffraction (XRD), electron spin resonance spectroscopy (ESR) and atomic force microscopy (AFM) were used to investigate the chemical and structural nature of the enamel of a tooth from Troodon, a small theropod dinosaur. These methods show that the crystallites in the Troodon tooth are submicron-sized carbonated calcium hydroxyapatite, which are semi-randomly oriented with a preferred orientation of (002) towards the surface of the tooth. Transition metal ions are distributed in the voids between crystallite clusters. Comparison of the ESR spectra indicates that the Troodon tooth had less exposure to UV than a fossilized crocodile tooth.

Investigation of Intra- and Inter-individual Variations of Mineralisation in Healthy Permanent Human Enamel by Raman Spectroscopy

PURPOSE

To systematically examine mineralisation of healthy human enamel using Raman spectroscopy and provide an understanding of baseline variations that may be inherent in the healthy enamel from individual to individual as well as variations within a tooth.

MATERIALS AND METHODS

Human teeth were obtained in compliance with the NIH guidelines. The teeth were collected fresh within the date of the extraction and kept moist at all times with wet tissue paper without any additional disinfecting treatment. The samples were individually wrapped in wet tissue paper and stored in a -20°C freezer. Prior to Raman analysis, the specimens were thawed at room temperature for 30 min. A Raman microscope was employed with a 10X objective used to focus the laser light (785 nm). Raman spectroscopy scores were validated by microcomputed tomography (μCT) on the two teeth which had the highest and lowest mineralisation found in the Raman scans.

RESULTS

Mineralisation levels varied substantially between individuals. The highest Raman-based mineralisation intensity was about 5-fold greater than the lowest mineralisation score. Incisor mineralisation also varied dramatically depending on different sites on the tooth.

CONCLUSIONS

Clinically applicable non-invasive techniques such as Raman spectroscopy that can quantify mineral content, such as Raman spectroscopy, may help answer whether or not mineralisation is associated with caries risk.

Tooth enamel properties and morphology after microabrasion: an in situ study

AIM

This study evaluated the effect of saliva on enamel after microabrasion with different microabrasive compounds under in situ conditions.

METHODS

Enamel/dentin blocks (16 mm² ) from bovine incisors were divided into nine groups (n = 19): one control group (no treatment), four groups treated with microabrasion using 35% phosphoric acid (H₃ PO₄ ) + pumice, and the last four groups treated with microabrasion using 6.6% hydrochloric acid (HCl) + silica. The treated groups were subdivided according to the in situ regimen: without salivary exposure, 1 h, 24 h, or 7 days of saliva exposure. Surface microhardness (SMH) and cross-sectional microhardness (CSMH) were tested. Scanning electron microscopy (SEM) was used to evaluate enamel morphology. Microhardness data were tested by analysis of variance, and Tukey's and Dunnett's tests (α = 0.05).

RESULTS

The SMH analysis revealed that all the microabrasion-treated groups presented significantly-reduced SMH values when compared to the control group (P < 0.05). Treatment with HCl + silica was more prone to the effect of saliva than H₃ PO₄ + pumice, even for CSMH analysis, once the superficial layers reached the same microhardness of that of the control group (P > 0.05). These results were confirmed by SEM, which demonstrated the mineral recovery effect over time.

CONCLUSION

Saliva was effective in promoting the rehardening of enamel after microabrasion, mainly for the surfaces treated with HCl + silica.

The role of organic proteins on the crack growth resistance of human enamel

With only 1% protein by weight, tooth enamel is the most highly mineralized tissue in mammals. The focus of this study was to evaluate contributions of the proteins on the fracture resistance of this unique structural material. Sections of enamel were obtained from the cusps of human molars and the crack growth resistance was quantified using a conventional fracture mechanics approach with complementary finite element analysis. In selected specimens the proteins were extracted using a potassium hydroxide treatment. Removal of the proteins resulted in approximately 40% decrease in the fracture toughness with respect to the fully proteinized control. The loss of organic content was most detrimental to the extrinsic toughening mechanisms, causing over 80% reduction in their contribution to the total energy to fracture. This degradation occurred by embrittlement of the unbroken bridging ligaments and consequent reduction in the crack closure stress. Although the organic content of tooth enamel is very small, it is essential to crack growth toughening by facilitating the formation of unbroken ligaments and in fortifying their potency. Replicating functions of the organic content will be critical to the successful development of bio-inspired materials that are designed for fracture resistance.

A Systematic Study on Tooth Enamel Microstructures of Lambdopsalis bulla (Multituberculate, Mammalia)--Implications for Multituberculate Biology and Phylogeny

Tooth enamel microstructure is a reliable and widely used indicator of dietary interpretations and data for phylogenetic reconstruction, if all levels of variability are investigated. It is usually difficult to have a thorough examination at all levels of enamel structures for any mammals, especially for the early mammals, which are commonly represented by sparse specimens. Because of the random preservation of specimens, enamel microstructures from different teeth in various species are often compared. There are few examples that convincingly show intraspecific variation of tooth enamel microstructure in full dentition of a species, including multituberculates. Here we present a systematic survey of tooth enamel microstructures of Lambdopsalis bulla, a taeniolabidoid multituberculate from the Late Paleocene Nomogen Formation, Inner Mongolia. We examined enamel structures at all hierarchical levels. The samples are treated differently in section orientations and acid preparation and examined using different imaging methods. The results show that, except for preparation artifacts, the crystallites, enamel types, Schmelzmuster and dentition types of Lambdopsalis are relatively consistent in all permanent teeth, but the prism type, including the prism shape, size and density, may vary in different portions of a single tooth or among different teeth of an individual animal. The most common Schmelzmuster of the permanent teeth in Lambdopsalis is a combination of radial enamel in the inner and middle layers, aprismatic enamel in the outer layer, and irregular decussations in tooth crown area with great curvature. The prism seam is another comparably stable characteristic that may be a useful feature for multituberculate taxonomy. The systematic documentation of enamel structures in Lambdopsalis may be generalized for the enamel microstructure study, and thus for taxonomy and phylogenetic reconstruction, of multituberculates and even informative for the enamel study of other early mammals.

Modifying the biomechanical response of mouthguards with hard inserts: A finite element study

PURPOSE

To investigate the influence of a high elastic modulus material insert on the stress, shock absorption and displacement of mouthguards.

METHODS

Finite element models of a human maxillary central incisor with and without mouthguard were created based on cross-sectional CT-tomography. The mouthguard models had four designs: without insert, and middle, external, or palatal hard insert. The hard inserts had a relatively high elastic modulus when compared to the elastic modulus of ethylene vinyl acetate (EVA): 15 GPa versus 18 MPa. A non-linear dynamic impact analysis was performed in which a heavy rigid object hit the model at 1 m/s. Strain and stress (von Mises and critical modified von Mises) distributions and shock absorption during impact were calculated as well as the mouthguard displacement.

RESULTS

The model without mouthguard had the highest stress values at the enamel and dentin structures in the tooth crown during the impact. It was concluded that the use of a mouthguard promoted lower stress and strain values in the teeth during impact. Hard insertion in the middle and palatal side of the mouthguard improved biomechanical response by lowering stress and strain on the teeth and lowering mouthguard displacement.

[Periodontal health during pregnancy and the dental health of the child]

Several studies have shown an association between local/systemic infections and preterm-low birth weight (PTLBW), and it might be an important part of the etiology. Oral Infections such as periodontitis may act as a distant reservoir of microbes, microbial products and inflammatory mediators. These might influence pregnancy and contribute to restriction of fetal growth and induction of early labor and PTB. Enamel formation of the primary teeth begins at 11-14 weeks of fetal life and is completed by the end of 3rd postnatal month. The initial phase consists of matrix formation, followed by calcification in utero. Since enamel is a stable structure, defects involving its matrix secretion and/or maturation of primary teeth can act as a permanent record of insults occurring pre- or perinatally. Any stressful event during pregnancy and birth may lead to metabolic changes in the formation of the enamel, resulting in clinically enamel defects. Severe infections occurring during amelogenesis may be associated with enamel hypoplasia. Babies born after maternal complications during pregnancy or babies who experience a traumatic birth must be considered to be at risk of developing Early Childhood Caries - ECC when exposed to excessive bottle nursing. Therefore oral healthcare should be kept during pregnancy.

Influence of structural hierarchy on the fracture behaviour of tooth enamel

Tooth enamel has the critical role of enabling the mastication of food and also of protecting the underlying vital dentin and pulp structure. Unlike most vital tissue, enamel has no ability to repair or remodel and as such has had to develop robust damage tolerance to withstand contact fatigue events throughout the lifetime of a species. To achieve such behaviour, enamel has evolved a complex hierarchical structure that varies slightly between different species. The major component of enamel is apatite in the form of crystallite fibres with a nanometre-sized diameter that extend from the dentin-enamel junction to the oral surface. These crystallites are bound together by proteins and peptides into a range of hierarchical structures from micrometre diameter prisms to 50-100 μm diameter bundles of prisms known as Hunter-Schreger bands. As a consequence of such complex structural organization, the damage tolerance of enamel increases through various toughening mechanisms in the hierarchy but at the expense of fracture strength. This review critically evaluates the role of hierarchy on the development of the R-curve and the stress-strain behaviour. It attempts to identify and quantify the multiple mechanisms responsible for this behaviour as well as their impact on damage tolerance.

Electrical Pulp Testing: Sources of Error

INTRODUCTION

Accurate identification and assessment of an inflamed or necrotic tooth is essentialfor endodontic treatment. The purpose of this research was to investigate possible sources of error associated with the use of the electric pulp tester (EPT).

METHODS

Forty-six intact teeth (23 tooth pairs) in 22 patients were evaluated in vivo. For the tooth pairs, one tooth had to have been previously endodontically treated and restored with a class II amalgam restoration. The restoration was required to have proximal contact with a class II amalgam of another vital posterior tooth. EPT was performed on pulpless and vital teeth for experimental groups (enamel, restoration, contacting, or isolated).

RESULTS

The highest rate of false positive responses (82%) was found in the pulpless restored contacting group, suggesting that EPT impulses are able to travel through proximal metallic contacts and stimulate teeth distant from the EPT probe. All vital tooth groups had a high rate of positive responses with no significant diferences.

CONCLUSIONS

If a tested tooth contains an interproximal restoration contacting adjacent restorations or the gingival, the teeth must be isolated (rubber dam) and the EPT probe should be placed in a region suspected to have uninterrupted tubule paths to the pulp.

[Physiological changes in the morphology of the main structural enamel unit - hydroxyapatite crystal - during its life span (in vitro study)]

The in vitro study by means of complex laboratory techniques including X-ray faze analysis, infrared spectroscopy, scanning electron and atomic force microscopy defined age-related physiological mineralization process as a shift of the structural enamel unit - nanocrystalline hydroxyapatite crystals - TO microcrystal phase. Relevant anatomical sites with age-dependent enamel optical characteristics corresponding to certain ratio of hydroxyapatite phases and the compliance of their color characteristics to composites enamel layers were revealed.

[The possibility of increasing the tooth enamel caries in children and adolescents through an integrated remineralizes fluoropolymer coatings with tricalcium phosphate]

In the survey we conducted a prospective cohort oral 138 children and adolescents living in the same environmental conditions. To study the effect of the complex representation remineralizes fluorine-containing tricalcium phosphate coating for the prevention of caries-the process in childhood, all surveyed were divided into 3 groups with high, medium and low enough average caries based on clinical and laboratory examination. The authors found a 7-fold the efficiency of preventive measures in the group with sufficient average caries and 5 times the efficiency in the group with low average caries in relation to subgroups where remineralizes-present fluorine-containing coating with tricalcium phosphate is not applicable. Furthermore, it was found that the accumulation of fluorine occurs only in a surface layer of the enamel within 100 micrometers.

Dynamic finite element analysis and moving particle simulation of human enamel on a microscale

BACKGROUND

The study of biomechanics of deformation and fracture of hard biological tissues involving organic matrix remains a challenge as variations in mechanical properties and fracture mode may have time-dependency. Finite element analysis (FEA) has been widely used but the shortcomings of FEA such as the long computation time owing to re-meshing in simulating fracture mechanics have warranted the development of alternative computational methods with higher throughput. The aim of this study was to compare dynamic two-dimensional FEA and moving particle simulation (MPS) when assuming a plane strain condition in the modeling of human enamel on a reduced scale.

METHODS

Two-dimensional models with the same geometry were developed for MPS and FEA and tested in tension generated with a single step of displacement. The displacement, velocity, pressure, and stress levels were compared and Spearman׳s rank-correlation coefficients R were calculated (p<0.001).

RESULTS

The MPS and FEA were significantly correlated for displacement, velocity, pressure, and Y-stress.

CONCLUSIONS

The MPS may be further developed as an alternative approach without mesh generation to simulate deformation and fracture phenomena of dental and potentially other hard tissues with complex microstructure.