Demineralization-remineralization dynamics in teeth and bone

The Influence of Different Classes of Amino Acids on Calcium Phosphates Seeded Growth

Amino acids (AAs) attract attention for elucidating the role of proteins in biomineralization and the preparation of functionalized biomaterials. The influence that AAs exert on calcium phosphate (CaP) mineralization is still not completely understood, as contradictory results have been reported. In this paper, the influence of the addition of different classes of AAs, charged (L-aspartic acid, Asp; L-lysine, Lys), polar (L-asparagine, Asn; L-serine, Ser; L-tyrosine, Tyr), and non-polar (L-phenylalanine, Phe), on CaP growth in the presence of octacalcium phosphate (OCP) and calcium hydrogenphosphate dihydrate (DCPD) seeds was investigated. In control systems (without AAs), a calcium-deficient apatite (CaDHA) layer was formed on the surface of OCP, while a mixture of CaDHA and OCP in the form of spherical aggregates was formed on the surface of DCPD crystals. Charged and non-polar promoted, while polar AAs inhibited CaDHA formation on the OCP seeds. In the case of DCPD, Lys, Asp, and Phe promoted CaP formation, while the influence of other AAs was negligible. The most efficient promotor of precipitation in both cases was non-polar Phe. No significant influence of AAs on the composition and morphology of precipitates was observed. The obtained results are of interest for understanding biomineralization processes and additive controlled material synthesis.

The potential of Streptococcus salivarius oral films in the management of dental caries: An inkjet printing approach

The use of probiotics, which can be administered in oro-dispersible films (ODFs) and have prolonged activity in the mouth, was explored. ODFs made of xylitol and containing Streptococcus salivarius were formulated using inkjet printing and tested against Streptococcus mutans - a causative organism of dental caries. The testing of the prepared ODFs involved co-incubating an ink-jetted formulation of S. salivarius and xylitol with S. mutans and monitoring the microbial growth kinetics in real-time using isothermal microcalorimetry and colony plate counts. Cell-free supernatants (CFS) of S. salivarius were also tested against S. mutans. The phosphate solubilisation potential of S. salivarius was also determined and found to be negative, an indication that the species will not deplete phosphate from teeth. From the tests, it was observed that the formulation reduced the S. mutans population from 7.9 to 5.04 Log CFU/mL post-calorimetry (approximately 3 Log reduction) which was comparable to the 99.9% reduction expected during antimicrobial activity testing. A gradual decrease in S. mutans population was also observed with increasing of CFS of S. salivarius volumes indicative of pathogen suppression. This study demonstrates that S. salivarius can be useful in managing dental caries and ODFs of S. salivarius can be formulated easily using ink-jetting for such management.

Importance of Dietary Phosphorus for Bone Metabolism and Healthy Aging

Inorganic phosphate (Pi) plays a critical function in many tissues of the body: for example, as part of the hydroxyapatite in the skeleton and as a substrate for ATP synthesis. Pi is the main source of dietary phosphorus. Reduced bioavailability of Pi or excessive losses in the urine causes rickets and osteomalacia. While critical for health in normal amounts, dietary phosphorus is plentiful in the Western diet and is often added to foods as a preservative. This abundance of phosphorus may reduce longevity due to metabolic changes and tissue calcifications. In this review, we examine how dietary phosphorus is absorbed in the gut, current knowledge about Pi sensing, and endocrine regulation of Pi levels. Moreover, we also examine the roles of Pi in different tissues, the consequences of low and high dietary phosphorus in these tissues, and the implications for healthy aging.

Resorption analysis of deproteinized cancellous bovine bone

Commercially available deproteinized cancellous bovine bone (DPBB) has been indicated as non-absorbable bone filling materials. Stoichiometric hydroxyapatite (HA) was not resorbed by osteoclasts while calcium-deficient and carbonate-rich apatite converted from octacalcium (OCP hydrolysate) was resorbed by osteoclasts. We analyzed the chemical composition of DPBB and compared the tissue reactions around two materials after implanting into mouse bone marrow. X-ray diffraction analysis and Fourier transform infrared spectroscopy showed that DPBB was a carbonate-rich apatite. Micro-CT analysis indicated the massive bone formation on both materials at 2 weeks, then gradually resorbed. At 12 weeks, osteoclasts were directly attached to both materials. The ultrastructure of ruffled borders on DPBB was identical to osteoclasts resorbing normal bone while ruffled border on OCP hydrolysate showed irregular shape. These results indicated that DPBB was the absorbed material and that the structure of ruffled border of osteoclasts might be regulated by the size or orientation of HA.

Recent Advances of Magnetic Nanomaterials in Bone Tissue Repair

The magnetic field has been proven to enhance bone tissue repair by affecting cell metabolic behavior. Magnetic nanoparticles are used as biomaterials due to their unique magnetic properties and good biocompatibility. Through endocytosis, entering the cell makes it easier to affect the physiological function of the cell. Once the magnetic particles are exposed to an external magnetic field, they will be rapidly magnetized. The magnetic particles and the magnetic field work together to enhance the effectiveness of their bone tissue repair treatment. This article reviews the common synthesis methods, the mechanism, and application of magnetic nanomaterials in the field of bone tissue repair.

Evaluation of F, Ca, and P release and microhardness of eleven ion-leaching restorative materials and the recharge efficacy using a new Ca/P containing fluoride varnish

OBJECTIVES

The objectives of this study were to evaluate fluoride (F), calcium (Ca), and phosphate (P) release of ion-leaching restorative materials (ILMs), their recharge efficacy with a Ca/P-containing F varnish, and relative microhardness.

METHODS

Thirteen groups of materials were investigated. Cylindrical-shaped specimens were fabricated. Deionised water or lactic-acid solution were used as the storage media. Solutions were changed after 1d, 4d, 7d, and 14d of ion release and at the same periods after recharge with MI Varnish (7 -h storage). F, Ca, and P measurements were accomplished using a fluoride-ion selective electrode, atomic absorption spectrometry, and colourimetric method by spectrophotometer, respectively. Relative Vickers hardness was proceeded with similar specimens used in the F assay (4 periods). SEM/EDS was additionally performed. Statistical analyses were calculated in each parameter (p < 0.05).

RESULT

Hardness of several ILMs immediately increased after recharge. After 28d, Ketac Universal [a high-viscosity glass-ionomer cement (HVGIC)] showed the highest hardness similar to the resin composite control. Although 2 HVGICs (Zirconomer and Equia Forte Fil) ranked as first and second for F release/re-release, some HVGICs had inferior or comparable F capacity to RMGICs (Fuji VIII and Fuji II LC) and a resin-based (RB) ILM (Cention N). Cention N, Activa-Restorative (RB-ILM), and Zirconomer were the top-3 ranking for Ca release/re-release. Activa-Restorative showed the highest P release, whereas Cention N displayed the greatest recharge ability for P.

CONCLUSIONS

Zirconomer showed a versatile performance for ion-release/re-release, especially for F. Cention N had excellent capacity in relation to Ca release and recharge ability of Ca/P.

CLINICAL SIGNIFICANCE

With the F varnish recharge protocol, Zirconomer, Equia Forte, and Fuji VIII seems to have an ability to inhibit initial caries initiation. Cention N is a promising resin-based material that could be an alternative for high caries risk patients due to the high Ca release/recharge with acceptable F release.

Identification of Key Functional Motifs of Native Amelogenin Protein for Dental Enamel Remineralisation

Dental caries or tooth decay is a preventable and multifactorial disease that affects billions of people globally and is a particular concern in younger populations. This decay arises from acid demineralisation of tooth enamel resulting in mineral loss from the subsurface. The remineralisation of early enamel carious lesions could prevent the cavitation of teeth. The enamel protein amelogenin constitutes 90% of the total enamel matrix protein in teeth and plays a key role in the biomineralisation of tooth enamel. The physiological importance of amelogenin has led to the investigation of the possible development of amelogenin-derived biomimetics against dental caries. We herein review the literature on amelogenin, its primary and secondary structure, comparison to related species, and its’ in vivo processing to bioactive peptide fragments. The key structural motifs of amelogenin that enable enamel remineralisation are discussed. The presence of several motifs in the amelogenin structure (such as polyproline, N- and C-terminal domains and C-terminal orientation) were shown to play a critical role in the formation of particle shape during remineralization. Understanding the function/structure relationships of amelogenin can aid in the rational design of synthetic polypeptides for biomineralisation, halting enamel loss and leading to improved therapies for tooth decay.

Compositional and microhardness findings in tooth affected by X-linked hypophosphatemic rickets

Background

This study aimed to evaluate the X-linked hypophosphatemic rickets (XLHR)-related compositional and microhardness tooth aspects.

Material and Methods

One affected and one non-affected teeth by XLHR were sectioned transversely, and each section was separated for Micro-Raman spectroscopy, Knoop microhardness and scanning electron microscopy with energy dispersive x-ray microanalysis (SEM-EDS). The outcomes of these analyses were assessed.

Results

Outcomes of Raman analysis of inorganic/organic components (~958/~1250+~1450 cm−1) and carbonate/phosphate (~1070/~958 cm−1) ratios showed areas of altered enamel and dentin (interglobular dentin, calcospherites, and mantle dentin) with an increase of inorganic content in the rickets tooth. Microhardness reduction was observed in the affected tooth, with a more evident drop in regions of mantle dentin, interglobular dentin, and calcospherites. SEM-EDS analysis showed demonstrated the absence of calcium and phosphorus in interglobular spaces.

Conclusions

In conclusion, compositional and structural deficiencies were observed in deciduous tooth affected by XLHR. Also, it was observed the absence of hydroxyapatite in the interglobular dentin by using Raman spectroscopy analysis.

Key words:Dentin, dentin permeability, X-linked hypophosphatemic rickets, tooth, tooth calcification, Raman spectroscopy.

Bisphosphonate-related osteonecrosis induced change in alveolar bone architecture in rats with participation of Wnt signaling

OBJECTIVE

This work aimed to study the role of inflammation in medication-related osteonecrosis of the jaw (MRONJ) in rats with focus on Wnt signaling.

METHODS

A total of 36 female Wistar rats (12 weeks ± 200 g) were divided into 2 groups (n = 6) in 3 experiments: saline (SAL) and zoledronic acid (ZOL). For MRONJ induction, rats received 0.1 mg/kg of ZOL (ip) 3×/week for 9 weeks. Animals from the SAL group received 0.1 mg/kg of 0.9% SAL, ip 3×/week for 9 weeks. On the 8th week, 3 left upper molars were extracted, and on the 11th week, they were euthanized. Maxillae were evaluated by macroscopic and histopathological analyses; scanning electron microscopy (SEM); immunohistochemistry for DKK-1, Wnt 10b, and caspase-3; and Raman spectrometry. Gingiva was also collected for TNF-α e IL-1β quantification.

RESULTS

Bone necrosis was confirmed by healing impairment, reduced number of viable osteocytes, increased caspase-3 immunoexpression, and increased number of empty lacunae (p < 0.05). ZOL enhanced inflammation and increased gingival levels of IL-1β and TNF-α (p < 0.05). Irregular indentations were seen on bone after ZOL administration. Bone necrosis was marked by reduced amount of total and type I collagen. ZOL reduced the mineral/matrix ratio and increased carbonate/phosphate ratio. It was observed a significant reduction on Wnt10b and beta-catenin immunolabeling in the bone tissue of ZOL group.

CONCLUSION

In summary, MRONJ model caused bone necrosis due to intense inflammation. Wnt signaling seems to play an important role in this process.

CLINICAL RELEVANCE

New therapeutic strategies focusing on Wnt pathway can provide an interesting approach for future treatments.

Topic Application of the Probiotic Streptococcus dentisani Improves Clinical and Microbiological Parameters Associated With Oral Health

Streptococcus dentisani 7746, isolated from dental plaque of caries-free individuals, has been shown to have several beneficial effects in vitro which could contribute to promote oral health, including an antimicrobial activity against oral pathogens by the production of bacteriocins and a pH buffering capacity through ammonia production. Previous work has shown that S. dentisani was able to colonize the oral cavity for 2–4 weeks after application. The aim of the present work was to evaluate its clinical efficacy by a randomized, double-blind, placebo-controlled parallel group study. Fifty nine volunteers were enrolled in the study and randomly assigned to a treatment or placebo group. The treatment consisted of a bucco-adhesive gel application (2.5 10⁹ cfu/dose) with a dental splint for 5 min every 48 h, for a period of 1 month (i.e., 14 doses). Dental plaque and saliva samples were collected at baseline, 15 and 30 days after first application, and 15 days after the end of treatment. At baseline, there was a significant correlation between S. dentisani levels and frequency of toothbrushing. Salivary flow, a major factor influencing oral health, was significantly higher in the probiotic group at day 15 compared with the placebo (4.4 and 3.4 ml/5 min, respectively). In the probiotic group, there was a decrease in the amount of dental plaque and in gingival inflammation, but no differences were observed in the placebo group. The probiotic group showed a significant increase in the levels of salivary ammonia and calcium. Finally, Illumina sequencing of plaque samples showed a beneficial shift in bacterial composition at day 30 relative to baseline, with a reduction of several cariogenic organisms and the key players in plaque formation, probably as a result of bacteriocins production. Only 58% of the participants in the probiotic group showed increased plaque levels of S. dentisani at day 30 and 71% by day 45, indicating that the benefits of S. dentisani application could be augmented by improving colonization efficiency. In conclusion, the application of S. dentisani 7746 improved several clinical and microbiological parameters associated with oral health, supporting its use as a probiotic to prevent tooth decay.

The Effects of Different Anticavity Agents and Er:YAG Laser Usage on Enamel Surface Microhardness

PURPOSE

The purpose of this study was to perform an in vitro evaluation of the protective effects of anticavity agents applied to enamel, by themselves and in combination with Er:YAG.

MATERIALS AND METHODS

In this study 150 extracted third molars were used. Measurements were made using DIAGNOdent, and samples with scores of 0-13 were included in the study. These were divided into 15 groups (n = 20). Use of the agents sodium fluoride (NaF), tricalcium phosphate (Ca3PO4), titanium tetrafluoride (TiF4), Tooth Mousse (CPP-ACP), MI Paste Plus (CPP-ACP), and NovaMin (bioactive glass), individually and then in combination with Er:YAG laser, was assessed based on their effects on microhardness values. After treatment, the groups were exposed to a demineralisation solution. Statistical analyses were conducted using SPSS 20.0 package software.

RESULTS

The highest test result value was observed in the TFL (TiF4/Er:YAG laser) group. Statistically significant differences were determined among all the groups (p <0.05). When the groups in which the agents were applied alone were compared with those involving combined use of Er:YAG laser, combined use provided significantly higher microhardness values, with the exception of the TML group (Tooth Mousse/Er:YAG laser) (p <0.05).

CONCLUSION

Within the limits of this study, the combined use of remineralisation agents and Er:YAG laser elicited better results than using the agents alone. The most effective remineralisation agent was TiF4/Er:YAG laser, which may be considered an alternative method for protecting the enamel against demineralisation.

Characterization of a Toothpaste Containing Bioactive Hydroxyapatites and In Vitro Evaluation of Its Efficacy to Remineralize Enamel and to Occlude Dentinal Tubules

Demineralization of dental hard tissues is a well-known health issue and the primary mechanism responsible for caries and dentinal hypersensitivity. Remineralizing toothpastes are nowadays available to improve conventional oral care formulations regarding the prevention and repair of demineralization. In this paper, we analyzed the chemical-physical features of a commercial toothpaste (Biosmalto Caries Abrasion and Erosion, Curasept S.p.A., Saronno, Italy), with particular attention paid to the water-insoluble fraction which contains the remineralizing bioactive ingredients. Moreover, the efficacy of the toothpaste to induce enamel remineralization and to occlude dentinal tubules has been qualitatively and semiquantitatively tested in vitro on human dental tissues using scanning electron microscopy and X-ray microanalysis. Our results demonstrated that the water-insoluble fraction contained silica as well as chitosan and poorly crystalline biomimetic hydroxyapatite doped with carbonate, magnesium, strontium, and fluoride ions. The formulation showed excellent ability to restore demineralized enamel into its native structure by epitaxial deposition of a new crystalline phase in continuity with the native one. It was also able to occlude the dentinal tubules exposed completely by acid-etching. Overall, this study demonstrated that the tested toothpaste contained a biomimetic ionic-substituted hydroxyapatite-based active principle and that, within the in vitro conditions analyzed in this study, it was effective in dental hard tissue remineralization.

Bioactivity assessment of bioactive glasses for dental applications: A critical review

OBJECTIVE

In the context of minimally invasive dentistry and tissue conservation, bioactive products are valuable. The aim of this review was to identify, clarify, and classify the methodologies used to quantify the bioactive glasses bioactivity.

METHODS

Specific search strategies were performed in electronic databases: PubMed, Embase, Cochrane Library, and Scopus. Papers were selected after a review of their title, abstract, and full text. The following data were then examined for final selection: BAG investigated, objectives, criteria, methods, and outcomes.

RESULTS

Sixty-one studies published from 2001 to 2019, were included. The bioactivity of BAG can be evaluated in vitro in contact with solutions, enamel, dentin, or cells. Other studies have conducted in vivo evaluation by BAG contact with dentin and dental pulp. Studies have used various analysis techniques: evaluation of apatite with or without characterization or assessment of mechanical properties. Reprecipitation mechanisms and pulp cell stimulation are treated together through the term 'bioactivity'.

SIGNIFICANCE

Based on these results, we suggested a classification of methodologies for a better understanding of the bioactive properties of BAG. According to all in vitro studies, BAG appear to be bioactive materials. No consensus has been reached on the results of in vivo studies, and no comparison has been conducted between protocols to assess the bioactivity of other bioactive competitor products.

Aging and trace elements in human coronal tooth dentine

Teeth are a fundamental tool in forensic odontology for identification in a legal context of those individuals who cannot be identified visually or by other means. Dentine presents physiological exchanges of in trace elements after a period of mineralization and several factors can affect its concentration. The aim of this study was to investigate the concentration of 25 trace elements in the coronal dentine according to sex and type of tooth to determine their relationship with age. A total of 25 trace elements were analyzed in 150 human coronal dentine. Teeth were classified into three age groups, sex and tooth type. The trace elements were grouped as potentially toxic or essential. Inductively Coupled Plasma-Mass Spectrometry and Atomic Emission Spectroscopy were used. The toxic and essential elements were detected in the following order of concentration: Al > Pb > Sn > Li > As > Cd and Ca > P > Mg > Na > S > K > Sr > Zn > Ba > Fe > B > Ti > Mn > Cr > Ni > Cu > Co > Se > V. Our findings show an increase in the concentration of toxic (Pb, Li and Sn) and essential (B, Ba, K, Sr, S and Mg) elements in coronal dentin related to the age of the teeth, regardless of sex. The concentrations of Pb and K in dentin of molars and premolars are the elements that best relate their variations with age. In view of our results, the analysis of these trace elements in dentin in combination with other types of techniques could be established as an element to consider in age dating studies in different forensic situations.

Oral manifestations of magnesium and vitamin D inadequacy

Adequate nutrition is essential for maintaining good oral health. Minerals such as magnesium, calcium, and phosphorus found in the diet constitute the main structural components of the tooth. Their inadequacy leads to absorption impairment, increased bleeding tendency, bone resorption, looseness, and premature tooth loss. Inadequacy of those essential minerals is associated with delayed tooth eruption and with enamel or dentin hypoplasia. Taking calcium without magnesium results in soft dental enamel, which cannot resist the acids causing tooth decay. In addition to magnesium, calcium, and phosphorus, adequate vitamin D is needed to maintain optimal oral health. Vitamin D exerts anti-inflammatory effects and helps in calcium absorption and bone remodeling. Moreover, adequate vitamin D status could reduce formation of dental caries by delaying its onset and progression. Here we summarize the oral manifestations of vitamin D and magnesium inadequacy.

Effect of the usage of Er,Cr:YSGG laser with and without different remineralization agents on the enamel erosion of primary teeth

The aim of the present study was to evaluate the effects of different remineralization agents associated with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) (0.5 W power, 20 Hz frequency, 60% water, 40% air, 25 mJ pulse energy, 8.84 J/cm² fluence, 60 μs pulse duration, 600 μm tip diameter, and an approximate 1-1.5 mm distance to the target) laser irradiation on erosion induced by the consumption of carbonated drinks in human primary enamel. There were 8 groups and 10 primary teeth in each g0roup. The distribution was as follows: group 1, casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF); group 2, Er,Cr:YSGG laser+CPP-ACPF; group 3, fluor varnish; group 4, Er,Cr:YSGG Laser+fluoride varnish; group 5, ROCS® medical mineral gel; group 6, Er,Cr:YSGG laser + ROCS® medical mineral gel; group 7, Er,Cr:YSGG laser; and group 8, artificial saliva. The samples in the groups were submerged in artificial saliva and acid twice a day for 6 s at 6-h intervals and were then exposed to an erosion cycle 15 times. In the groups in which the Er,Cr:YSGG laser was applied in combination with the remineralization agents, the laser application was made first, and then the remineralization agents were applied for 4 min in each group. The Friedman and Wilcoxon signed-rank tests and the Bonferroni correction were used in statistical analyses, and the significance level was taken as p < 0.05. According to the results, all agents had a statistically significant difference (groups 1, 2, 3, 4, and 6: p = 0.005, p < 0.017; groups 5 and 7: p = 0.007, p < 0.017) between BL-RM periods. However, all agents had a statistically significant remineralization effect on primary teeth enamel (groups 1, 2, 3, 6, and 7: p = 0.005, p < 0.017; group 4: p = 0.011, p < 0.017) except that group 5 (p = 0.074, p < 0.017) between DM-RM periods. The coadministration of an agent with the laser did not make any difference at a statistical level (p = 0.804, p > 0.05). The results were supported by scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. As a result of this study, CPP-ACPF had a notable impact in terms of the remineralization effect on eroded enamel, and the Er,Cr:YSGG laser alone may be an alternative method, which may be related to the modified hydroxyapatite structure, 38.5% H_0.56Ca_4.56O₁₃P₃Y_0.44, that was determined in XRD analysis.

The Effect of Bioactive Glass-Enhanced Orthodontic Bonding Resins on Prevention of Demineralization: A Systematic Review

At present, bioactive glasses (BAGs) are demonstrating promising results in the remineralization of hard tissues. Their bioactive properties can potentially overcome the demineralization effect accompanying orthodontic treatment. This review aimed to evaluate the effectiveness of bioactive glass enhanced orthodontic bonding resins on enamel remineralization, in addition to their antibacterial, ion release and acid neutralization effect. Four databases (PubMed, MEDLINE, Web of Science and Scopus) were searched. Two hundred and fifty-one full-text articles were screened independently, out of which seven studies satisfied the inclusion criteria. Quality appraisal was performed by two independent reviewers. Methodologies used to assess the anti-demineralization effect included Micro-Computed Tomography, Polarized Light Microscopy and Hardness Testing (Knoop and Berkovich). All seven articles confirmed the superior remineralization effect of BAG orthodontic bonding resins compared to their non-BAG counterparts. A proportional relationship was proved between BAG concentrations and increased anti-demineralization effect. The addition of antibacterial agents to BAG does not necessarily improve its anti-demineralization effect. Although studies have confirmed the effectiveness of BAG orthodontic bonding resins on enamel remineralization, there was a degree of heterogeneity across studies due to the lack of an in vitro studies standardized protocol.

Micro-PAD card for measuring total ammonia nitrogen in saliva

This work presents a portable microfluidic paper-based analytical device (micro-PAD) card for the quantification of total ammonia nitrogen in human saliva. The amount of total ammonia nitrogen in saliva can be an indicator of the status of the oral microbiome with potential correlation to kidney health problems. The developed micro-PAD card comprises twenty units consisting of three stacked layers of circular discs: the sample layer, paper discs impregnated with sodium hydroxide solution, the PTFE membrane layer, and the detection layer, paper discs impregnated with bromothymol blue. The twenty units were aligned on transparent laminating pouches laminated to form the micro-PAD card (7.5 cm × 10.5 cm). Saliva samples can be directly dispensed onto the micro-PAD card and the detection was achieved by the BTB indicator color change, from yellow to blue, after conversion of ammonium into ammonia and diffusion of the ammonia gas through a hydrophobic layer. The determination of total ammonia nitrogen in saliva using the developed micro-PAD card intended to be very simple method and operated without the need of laboratory equipment. A quantification limit of 11.3 NH₄⁺mg L^-1 and linear application range from up to 150 NH₄⁺mg L^-1 were obtained making it suitable for the expected concentrations of total ammonia nitrogen in human saliva. It was successfully applied to saliva samples and its validation obtained by comparison against a potentiometric method. The card is stable for at least 1 month making it ideal as a portable device for point-of-care diagnosis. Graphical Abstract.

Cervicovertebral anomalies and/or normal variants in patients with congenitally bilateral absent maxillary lateral incisors

OBJECTIVE

To determine whether there is a relationship between congenitally bilaterally absent maxillary lateral incisors (BAMLIs) and skeletal anomalies and/or normal variants.

MATERIALS AND METHODS

The records of 86 patients (62 girls, 24 boys; age 12-17 years) with congenitally BAMLIs and 86 patients (55 girls, 34 boys; age 13-18 years) without any dental or skeletal anomalies were collected and evaluated retrospectively. The study was based on the evaluation of lateral cephalometric and orthopantomographic radiographs. Posterior arch deficiency of the atlas bone (PADA); atlanto-occipital ligament calcification, known as "ponticulus posticus" (PP); and interclinoid ligament calcification, known as "sella turcica bridging" were recorded for each participant. Pearson χ2 and Fisher exact tests were used to evaluate and compare skeletal anomalies and/or normal variants between patients with BAMLIs and the control group.

RESULTS

The prevalence of cervicovertebral anomalies and/or normal variants seen in the lateral cephalometric radiographs was higher in patients with BAMLI than in the control group. The prevalence of PP was lower and that of PADA was higher in patients with BAMLIs than in the control group (P < .05).

CONCLUSION

The prevalence of PADA was increased and that of PP formation was decreased in patients with BAMLIs. There was a significant relationship between skeletal anomalies and/or normal variants.

Remineralization of dentin slices using casein phosphopeptide-amorphous calcium phosphate combined with sodium tripolyphosphate

Background

The remineralization approach mechanically occludes the exposed dentinal tubules mechanically, reduces the permeability of dentinal tubules and eliminates the symptoms of dentin hypersensitivity. The aim of the present study was to investigate the remineralization of demineralized dentin slices using CPP–ACP combined with TPP, and the research hypothesis was that CPP–ACP combined with TPP could result in extrafibrillar and intrafibrillar remineralization of dentin.

Methods

Demineralized dentin slices were prepared and randomly divided into the following groups: A (the CPP–ACP group), B (the CPP–ACP + TPP combination group), C (the artificial saliva group), D (the negative control group), and E (the positive control group). Dentin slice samples from groups A, B and C were remineralized and the remineralization effect was evaluated using scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflection–Fourier transform infrared spectroscopy (ATR–FTIR) and X-ray diffraction (XRD).

Results

Treatment with CPP–ACP combined with TPP occluded the dentinal tubules and resulted in remineralization of collagen fibrils. The hydroxyapatite crystals formed via remineralization were found to closely resemble the natural dentin components.

Conclusion

CPP–ACP combined with TPP has a good remineralization effect on demineralized dentin slices.

Quaternary ammonium silane, calcium and phosphorus-loaded PLGA submicron particles against Enterococcus faecalis infection of teeth: An in vitro and in vivo study

Refractory root canal infection of human teeth is the primary cause of dental treatment failure. Enterococcus faecalis is the major cause of refractory root canal infection. In the present study, poly(D,L-lactic-co-glycolide) (PLGA) submicron particles were used as carriers to deliver an antimicrobial quaternary ammonium silane (code-named K21) as well as calcium and phosphorus elements. The release profiles, antibacterial ability against E. faecalis, extent of infiltration into dentinal tubules, biocompatibility and in vitro mineralization potential of the particles were investigated. In addition, the antimicrobial effects of the particles against E. faecalis infection were evaluated in vivo in the teeth of beagle dogs. The encapsulated components were released from the PLGA particles in a sustained-release manner. The particles also displayed good biocompatibility, in vitro mineralization ability and antibacterial activity against E. faecalis. The particles could be driven into dentinal tubules of dentin slices by ultrasonic activation and inhibited E. faecalis colonization. In the root canals of beagle dogs, PLGA submicron particles loaded with K21, calcium and phosphorus demonstrated strong preventive effects against E. faecalis infection. The system may be developed into a new intracanal disinfectant for root canal treatment.

Effect of Two Methods of Remineralization and Resin Infiltration on Surface Hardness of Artificially Induced Enamel Lesions

Statement of the Problem:

The progression of incipient carious lesions may be simply prevented by non-invasive remineralization of lesions, eliminating the need for invasive and high-cost restorative procedures.

Purpose:

This study aimed to assess the effect of two commonly used remineralizing agents and resin infiltration on surface micro hardness of incipient enamel lesions at different time points.

Materials and Method:

In this in vitro study, 45 intact human maxillary central incisors were selected. After disinfection, enamel samples measuring 5x5x2.5 mm were cut out of the labial surface of the teeth. The surface of samples was polished and they were mounted in auto-polymerizing acrylic resin. According to Amaechi’s method, samples were immersed in acidified hydroxyethylcellulose system (pH= 4.5) for 96 hours to induce white spot lesions (WSLs). The baseline value of surface micro hardness of samples was measured using a Vickers hardness tester, then the samples were randomly divided into three groups (n=15) based on different remineralization methods: MI-Paste Plus, Remin Pro and ICON-Infiltrant according to the manufacturer’s instructions. All samples were stored in anti-dry mouth treatment agent during the experiment and their surface hardness was measured at 15 days (T1) and 20 weeks (T2).

Results:

The hardness of samples in MI-Paste Plus and Remin Pro groups significantly increased at both T1 and T2 (p< 0.001) but this increase was not significant in ICON group (p> 0.05).

Conclusion:

MI-Paste Plus and Remin Pro can efficiently increase the hardness of incipient enamel lesions.

The role of salivary contents and modern technologies in the remineralization of dental enamel: a narrative review

Human enamel once formed cannot be biologically repaired or replaced. Saliva has a significant role in remineralization of dental enamel. It not only has a buffering capacity to neutralize the oral cavity's low pH generated after acidic encounters, but also acts as a carrier of essential ions, such as fluoride, calcium and phosphate, which have a positive role in enamel's remineralization. This review discusses how salivary contents, like proteins and enzymes, have a natural role in enamel's mineralization. In addition, the presence of ions, such as fluoride, calcium and phosphate, in saliva further enhances its capability to remineralize the demineralized enamel surface. The review further examines modern innovative technologies, based on biomimetic regeneration systems, including dentin phosphoproteins, aspartate-serine-serine, recombinant porcine amelogenin, leucine-rich amelogenin peptide and nano-hydroxyapatite, that promote enamel remineralization. Fluoride boosters like calcium phosphates, polyphosphates, and certain natural products can also play an important role in enamel remineralization.

The role of salivary contents and modern technologies in the remineralization of dental enamel: a narrative review

Human enamel once formed cannot be biologically repaired or replaced. Saliva has a significant role in remineralization of dental enamel. It not only has a buffering capacity to neutralize the oral cavity’s low pH generated after acidic encounters, but also acts as a carrier of essential ions, such as fluoride, calcium and phosphate, which have a positive role in enamel’s remineralization. This review discusses how salivary contents, like proteins and enzymes, have a natural role in enamel’s mineralization. In addition, the presence of ions, such as fluoride, calcium and phosphate, in saliva further enhances its capability to remineralize the demineralized enamel surface. The review further examines modern innovative technologies, based on biomimetic regeneration systems, including dentin phosphoproteins, aspartate-serine-serine, recombinant porcine amelogenin, leucine-rich amelogenin peptide and nano-hydroxyapatite, that promote enamel remineralization. Fluoride boosters like calcium phosphates, polyphosphates, and certain natural products can also play an important role in enamel remineralization.

The role of salivary contents and modern technologies in the remineralization of dental enamel: a narrative review

Human enamel once formed cannot be biologically repaired or replaced. Saliva has a significant role in remineralization of dental enamel. It not only has a buffering capacity to neutralize the oral cavity's low pH generated after acidic encounters, but also acts as a carrier of essential ions, such as fluoride, calcium and phosphate, which have a positive role in enamel's remineralization. This review discusses how salivary contents, like proteins and enzymes, have a natural role in enamel's mineralization. In addition, the presence of ions, such as fluoride, calcium and phosphate, in saliva further enhances its capability to remineralize the demineralized enamel surface. The review further examines modern innovative technologies, based on biomimetic regeneration systems, including dentin phosphoproteins, aspartate-serine-serine, recombinant porcine amelogenin, leucine-rich amelogenin peptide and nano-hydroxyapatite, that promote enamel remineralization. Fluoride boosters like calcium phosphates, polyphosphates, and certain natural products can also play an important role in enamel remineralization.

Probing Heterogeneity in Bovine Enamel Composition through Nanoscale Chemical Imaging using Atom Probe Tomography

OBJECTIVE

The aim of this study was to determine the heterogeneity in chemical composition of bovine enamel using atom probe tomography, and thereby evaluate the suitability of bovine enamel as a substitute for human enamel in in vitro dental research.

DESIGN

Enamel samples from extracted bovine incisor teeth were first sectioned using a diamond saw and then milled into needle-like samples (<100 nm diameter) by focused ion beam (FIB) coupled with a scanning electron microscope (SEM). These samples were analyzed in the atom probe to acquire three-dimensional (3D) images and quantify the atomic chemistry and distribution in bovine enamel.

RESULTS

For the first time, the atomic-level composition and clustering of major constituents and impurities within bovine enamel were determined and imaged. We discovered that the chemical composition of bovine enamel is spatially inhomogeneous at the atomic scale. The average bulk Ca/P ratio, ∼1.4, was in agreement with previously reported literature values from alternative conventional methods. When assessed locally at the atomic scale, the Ca/P ratio varied between 1.1 and 2.03. We also discovered that the Mg impurities were significantly segregated throughout the enamel, and such clustering influenced the variation of Ca/P ratios. The increase in Mg concentrations, near the Mg clusters, correlated with increased Ca and decreased P concentrations.

CONCLUSION

The presented findings of variability in local composition should be taken into account when interpreting dental research results from bovine enamel.

Acidity-induced release of zinc ion from BioUnionTM filler and its inhibitory effects against Streptococcus mutans

BioUnion filler incorporated into restorative/coating materials is a new bio-functional glass powder. The most unique function of BioUnion filler is its ability to release Zn²⁺ in acidic environments. In this study, the ion release profile of BioUnion filler under acidic conditions and its antibacterial effects against Streptococcus mutans were evaluated. The concentrations of Zn²⁺ released from BioUnion fillers into acetic acids were greater than those released into water. S. mutans inhibition by BioUnion fillers was greater with sucrose than without sucrose, reflecting a decrease in suspension pH in response to the addition of sucrose. Exposure to acids increased Zn²⁺ release from BioUnion fillers, and the fillers after repeated exposure to acids demonstrated inhibitory effects against S. mutans. These findings suggest that BioUnion filler accelerated the release of Zn²⁺ under acidic conditions, which induced bactericidal/inhibitory effects against S. mutans.

Is there evidence for Novamin application in remineralization?: A Systematic review

Background

Calcium sodium phosphor-silicate material, a type of bio-glass was originally developed as an implant material to regenerate bone and recently adapted for use in oral care products (NovaMin Technology Inc.). Novamin is used for many dental problems like hypersensitivity, gingivitis, bleeding, non-carious lesions, carious lesions, whitening and is currently emerging as one of the treatment modality for the remineralization of the tooth. Since the prescription of these novel materials to the patients are based on cost effectiveness, efficacy and effectiveness, a clinician should make decision based on best available evidence. Hence, the objective of this review is to find out the current evidence available on the use of Novamin as an agent for remineralization.

Materials and methods

Relevant articles were searched and screened from several databases including PubMed, Cochrane review, Science Direct and trip which were published till 1988 to July 2017; The articles relevant to the objective of this review were included (RCT's) and articles out of interest of this review were excluded. The primary outcome for the chosen studies is the remineralization capacity of Novamin. Data extraction is done independently and jointly by 3 authors using data collection forms. Studies obtained were evaluated using the Cochrane Collaboration tools for accessing risk bias. The assessment of the quality of the evidence and the bias risk was obtained using the Grading of Recommendations Assessment Development and evaluation System.

Results

The articles from the database obtained for further review was N = 1. According to the study reviewed, the baseline comparisons using decalcification index obtained between Novamin study group (ReNew) and the control group (Crest) yield a P-value of 0.97 whereas after a 3 months interval follow up the value is 0.0403 suggesting there was a trend towards improvement in white spot lesions in the control group and at 6 months' time point the p-value is 0.81 concluding that there are no significant difference of remineralization process obtained by using traditional toothpaste and Novamin.

Conclusion

Review shows that Novamin has significantly less clinical evidence to prove its effectiveness as a remineralization agent in treating both carious and non-carious lesion. Hence, better designed clinical trials should be carried out in the future before definitive recommendations can be made.

Effects of lemon essential oil and limonene on the progress of early caries: An in vitro study

OBJECTIVE

The purpose of this study was to investigate the effects of Lemon essential oil (LEO) and Limonene (LIM) in the progress of early caries.

DESIGN

LEO and LIM were selected as experimental medicine, while sodium fluoride (NaF) and deionized water (DW) were positive and blank controls, respectively. Bovine incisors were used to establish enamel and dentin early caries models by demineralization method in vitro. Then specimens were subjected to pH cycling. Calcium and phosphate release of demineralizing solution were measured by an automatic biochemical analyzer; Surface microhardness tester and energy dispersive X-ray spectrometer were used to detect the surface microhardness recovery and calcium- phosphate ratio on tooth surface; Degraded collagen matrix by collagenase was investigated by assaying hydroxyproline.

RESULTS

Calcium release of dentin demineralizing solution of LEO group was lower than DW group's and higher than NaF group's. Both of LEO and LIM groups, the surface microhardness recovery were significantly lower than those of NaF group, which were similar to DW group. Dentin surface calcium- phosphate ratio of LEO and LIM groups were lower than those of NaF group and higher than those of DW group. Hydroxyproline concentration in the remineralizing solution of LEO and LIM groups were lower than DW groups' and higher than NaF groups'.

CONCLUSIONS

LEO and LIM have influence on the progress of dentin early caries, which can stabilize its structure by inhibiting collagen degradation. Meanwhile, these medicines may provide a new drug choice for the prevention and treatment of early root caries.

Polymeric and inorganic nanoscopical antimicrobial fillers in dentistry

Failure of dental treatments is mainly due to the biofilm accumulated on the dental materials. Many investigations have been conducted on the advancements of antimicrobial dental materials. Polymeric and inorganic nanoscopical agents are capable of inhibiting microorganism proliferation. Applying them as fillers in dental materials can achieve enhanced microbicidal ability. The present review provides a broad overview on the state-of-the-art research in the field of antimicrobial fillers which have been adopted for incorporation into dental materials over the last 5 years. The antibacterial agents and applications are described, with the aim of providing information for future investigations. STATEMENT OF SIGNIFICANCE: Microbial infection is the primary cause of dental treatment failure. The present review provides an overview on the state-of-art in the field of antimicrobial nanoscopical or polymeric fillers that have been applied in dental materials. Trends in the biotechnological development of these antimicrobial fillers over the last 5 years are reviewed to provide a backdrop for further advancement in this field of research.

Nanoscale chemical and mechanical heterogeneity of human dentin characterized by AFM-IR and bimodal AFM

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AFM-IR technique was used to detect the chemical heterogeneity of human dentin for the first time.

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The heterogeneity of mechanical properties of human dentin was explored by AFM AM-FM technique.

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A band at 1336 cm⁻¹ assigned to S Created by potrace 1.16, written by Peter Selinger 2001-2019 ]]>O stretching vibrations was found only in peritubular dentin.

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Peritubular dentin had a higher Young’s modulus (32.25 ± 4.67 GPa) than intertubular dentin.

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AFM-IR and AFM AM-FM are useful for understanding the mineral deposition mechanisms of dentin.

Human dentin, as an important calcified tissue in the body, plays significant roles in withstanding masticatory forces and has a complex hierarchical organization. Understanding the composition and ultrastructure of dentin is critical for elucidating mechanisms of biomineralization under healthy and pathological states. Here, atomic force microscope infrared spectroscopy (AFM-IR) and AFM-based amplitude modulation-frequency modulation (AM-FM) techniques were utilized to detect the heterogeneity in chemical composition and mechanical properties between peritubular and intertubular dentin at the nanoscale. AFM-IR spectra collected from peritubular and intertubular dentin contained similar vibrational bands in the amide regions (I, II and III), suggesting that collagen may exist in both structures. A distinctive band at 1336 cm⁻¹ indicative of SO stretching vibrations was detected only in peritubular dentin. AFM-IR imaging showed an uneven distribution of chemical components at different locations, confirming the heterogeneity of dentin. The Young’s modulus of peritubular dentin was higher, and was associated to a higher mineral content. This study demonstrated distinctive chemical and mechanical properties of peritubular dentin, implying the different development and mineralization processes between peritubular and intertubular dentin. AFM-IR is useful to provide compositional information on the heterogeneity of human dentin, helping to understand the mineral deposition mechanisms of dentin.

HMU Fluorinze Mouthwash Enhances Enamel Remineralization: An In Vitro Study

BACKGROUND:

Fluoride therapy has long been used extensively to prevent dental caries. Fluoride appears in a variety of dental care products such as mouth rinses, dentifrices, gels, etc. HMU Fluorinze is the first mouthwash containing fluoride in Vietnam.

AIM:

This research was conducted to evaluate the efficacy of HMU Fluorinze mouthwash on remineralizing enamel in laboratory conditions.

METHODS:

20 third molar teeth were cleaned and covered with nail polish, except for a 3 x 3 mm square on their buccal surfaces. These teeth underwent two steps: demineralization using Coca-cola and remineralization for 20 daysusing standard calcifying solution (control group) and standard calcifying solution + HMU Fluorinze mouthwash 2 times/day (experimental group). The index measured of enamel structure after demineralization and remineralization was assessed by a DIAGNOdent pen 2190.

RESULTS

The indices measured of the control group and experimental group at baseline were 3.65 ± 0.76 and 3.35 ± 0.64 respectively. After demineralization the control group measured 21.78 ± 4.48 and the experimental group, 20.25 ± 2.26. Following remineralization, the control group scores were 6.30 ± 1.03 and the experimental group, 3.90 ± 1.24, demonstrating statistical significance (p < 0.01) between the two groups. After 20 days, the results for the experimental group did not differ from the original results (p = 0.272), in contrast with the control group (p < 0.01).

CONCLUSION

Results show that HMU Fluorinze mouthwash is better at remineralizing than standard calcifying solution.

Comparative analysis of the remineralization potential of CPP-ACP with Fluoride, Tri-Calcium Phosphate and Nano Hydroxyapatite using SEM/EDX - An in vitro study

Background

In recent years, the non-invasive management of non cavitated caries lesions using remineralization systems to repair the enamel have received more attention from the scientific community. Aim: To quantitatively evaluate the remineralization potential of Casein phosphopeptide-amorphous calcium phosphate-fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(nHAP) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX).

Material and Methods

40 enamel specimens were prepared, and immersed in demineralising solution at a pH of 4.4 for 96 hours at 37°C, to induce artificial carious lesions. Remineralization was carried out for a period of 30 days using CPP-ACPF, TCP, nHAP. The specimens were evaluated for calcium and phosphorus content using SEM-EDX.

Results

The Ca/P mass % after remineralization was significantly higher with CPP-ACP-F and TCP-F followed by nHAP.

Conclusions

CPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions. These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface.

Key words:Remineralization, in vitro; CPP-ACP fluoride, Nano-hydroxyapatite, Tri-calcium phosphate, SEM/ EDX.

Early detection of enamel demineralization by optical coherence tomography

Enamel is the outermost layer of the tooth that protects it from invasion. In general, an acidic environment accelerates tooth demineralization, leading to the formation of cavities. Scanning electron microscopy (SEM) is conventionally used as an in vitro tool for the observation of tooth morphology changes with acid attacks. Yet, SEM has intrinsic limitations for the potential application of in vivo detection in the early demineralization process. In this study, a high-resolution optical coherence tomography (OCT) system with the axial and transverse resolutions of 2.0 and 2.7 μm in teeth has been utilized for characterizing the effect of the acidic environment (simulated by phosphoric acid) on the enamel topology. The scattering coefficient and the surface roughness of enamel can be directly derived from the OCT results, enabling a quantitative evaluation of the topology changes with demineralization. The dynamic process induced by the acid application is also recorded and analyzed with OCT, depicting the evolution of the demineralization process on enamel. Notably, the estimated enamel scattering coefficient and surface roughness significantly increase with the application time of acid and the results illustrate that the values of both parameters after demineralization are significantly larger than those obtained before the demineralization, illustrating both parameters could be effective to differentiate the healthy and demineralized teeth and determine the severity. The obtained results unambiguously illustrate that demineralization of the tooth surface can be successfully detected by OCT and further used as an indicator of early-stage cavity formation.

Surface analysis of etched enamel modified during the prenatal period

Structural changes in the enamel surface subjected to induced demineralization and assessment of the influence of prenatal administration of β-hydroxy β-methylbutyrate (HMB) on enamel resistance were investigated. The examination was conducted on five sets of teeth from one-day-old spiny mice (Acomys cahirinus), one from the control and four from the experimental groups. Surface structure, molecular arrangement and crystalline organization of offspring's enamel both before and after etching were studied. Obtained results revealed that the physical and molecular arrangements of enamel were altered after the prenatal supplementation, and significantly affected its final structure and resistance against acid action. The enamel of incisors from the offspring which mothers were supplemented with HMB in a high dose (0.2 g/kg_bw) and in the late period of gestation (26th-39th day) showed the highest endurance against acid treatment demonstrating only vestigial changes in their surface structure after acid action. Comparing to the remaining experimental groups, it was characterized by a reduced roughness and fractal dimension, significantly lower degree of demineralization and simultaneous lack of notable differences in the Raman spectra before and after acid etching. The results suggest that an increased enamel resiliency was the effect of a relatively high degree of mineralization and higher organization of the surface.

Histological comparison of three apatitic bone substitutes with different carbonate contents in alveolar bone defects in a beagle mandible with simultaneous implant installation

Since bone apatite is a carbonate apatite containing carbonate in an apatitic structure, carbonate content may be one of the factors governing the osteoconductivity of apatitic bone substitutes. The aim of this study was to evaluate the effects of carbonate content on the osteoconductivity of apatitic bone substitutes using three commercially available bone substitutes for the reconstruction of alveolar bone defects of a beagle mandible with simultaneous dental implant installation. NEOBONE, Bio-Oss, and Cytrans that contain 0.1, 5.5, and 12.0 mass% of carbonate, respectively, were used in this study. The amount of newly formed bone in the upper portion of the alveolar bone defect of the beagle's mandible was 0.7, 6.6, and 39.4% at 4 weeks after surgery and 4.7, 39.5, and 75.2% at 12 weeks after surgery for NEOBONE, Bio-Oss, and Cytrans, respectively. The results indicate that bone-to-implant contact ratio was the largest for Cytrans. Additionally, the continuity of the alveolar ridge was restored in the case of Cytrans, whereas the continuity of the alveolar ridge was not sufficient when using NEOBONE and Bio-Oss. Both Cytrans and Bio-Oss that have a relatively larger carbonate content in their apatitic structure was resorbed with time. We concluded that carbonate content is one of important factors governing the osteoconductivity of apatitic bone substitutes.

Bone Remineralization around Dental Implants following Conservative Treatment after Peri-Implantitis

The aim of this case report is to show that bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and only conservative treatment is performed. Patient came to the clinic after three years of dental implant placement complaining about swelling, sensitivity and gingiva color changes at the posterior part of the maxilla. During radiographic and intraoral examinations peri-implantitis of the #24 implant site was diagnosed. The surgical treatment method was rejected and performed conservative treatment instead. The outcome is promising; periapical radiographs three months later showed bone remineralization as well as stable bone after 10 years. A key clinical message: Bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and conservative treatment performed.

The Application of the Logistic Equation Model to Predict the Remineralization Characteristics of Desensitizing Paste

Objectives

A mathematical model making using of the Verhulst logistic equation was developed to predict the remineralization behaviors of desensitizing paste.

Methods

The input parameter used for the model was obtained experimentally by brushing twenty-one simulated dentin specimens for seven days with three sample groups, namely, EB@TiO₂, Colgate Pro-relief, and Sensodyne repair (n = 7). A field emission scanning electron microscope (FESEM) and ImageJ software were used to observe and measure the % occluded ratio of the dentin surface. The model fittings for the three sample groups were carried out using the built-in MATLAB least-squares fitting routine fmincon in the optimization toolbox.

Results

The results suggest that the experimental parameter were in agreement with the model. It was found that the logistic equation model can make a future prediction of the remineralization pattern for EB@TiO₂ and Colgate Pro-relief. It was, however, found that the trajectory for the Sensodyne repair was a bit complex, thus making the prediction difficult.

Conclusions

Overall, the salient feature of this study suggests that the logistic equation could be used to predict the remineralization behavior of desensitizing paste in the management of sensitive tooth.

Early crestal bone loss: Is it really loss?

Bone remineralization around dental implants might be possible after early crestal bone loss.

Effectiveness of Theobromine on Enamel Remineralization: A Comparative In-vitro Study

Background

Remineralizing agents demonstrate potential to reverse early carious lesions. Theobromine containing dentifrices claim to remineralize enamel lesions effectively. The aim of this in-vitro study was to evaluate and compare the remineralization potential of dentifrices containing theobromine, 0.21% sodium fluoride (NaF) with functionalized tricalcium phosphate (f-TCP) and amine fluoride on artificial enamel caries.

Materials and methods

Sound extracted human premolars were demineralized to produce deep artificial carious lesions. The teeth were sectioned longitudinally and allocated to three treatment groups with nine specimens in each group: Group A (NaF + f-TCP), Group B (amine fluoride), and Group C (theobromine). The specimens were then subjected to pH cycling for seven days. Confocal laser scanning microscopy (CLSM) was utilized to record the patterns of demineralization and remineralization. One-way ANOVA and paired t-test were used to analyze changes in lesion depth. The level of significance was set at p<0.05.

Results

All three dentifrices effectively remineralized artificial carious lesions (paired t-test, p<0.001). Of the groups, Group A (54.97%) reported the highest percentage change in lesion depth values followed closely by Group B (51.51%) and Group C (31.71%), respectively.

Conclusion

Within this in-vitro study, theobromine containing dentifrice was effective in remineralizing lesions of enamel. However, theobromine demonstrated less remineralization potential in comparison to dentifrices containing NaF + f-(TCP) and amine fluoride.

The Oral Bacterial Microbiome of Interdental Surfaces in Adolescents According to Carious Risk

Adolescence is closely associated with a high risk of caries. The identification of specific bacteria in an oral microniche, the interdental space of the molars, according to carious risk can facilitate the prediction of future caries and the anticipation of the progression or stabilization of caries in adolescents. A cross-sectional clinical study according to the bacteriological criteria of interdental healthy adolescents and carious risk factors-low and high-using a real-time polymerase chain reaction technique was conducted. The presence of 26 oral pathogens from the interdental microbiota of 50 adolescents aged 15 to 17 years were qualitatively and quantitatively analyzed. Bacteria known to be cariogenic (Bifidobacterium dentium, Lactobacillus spp., Rothia dentocariosa, Streptococcus cristatus, Streptococcus mutans, Streptococcus salivarius, Streptococcus sobrinus, and Streptococcus wiggsiae) did not present differences in abundance according to carious risk. Periodontal bacteria from the red complex are positively correlated with carious risk. However, only 3 bacteria-S. sobrinus, E corrodens and T. forsythia-presented a significant increase in the highest group. Estimating the risk of caries associated with bacterial factors in interdental sites of molars in adolescents contributes to the better definition of carious risk status, periodicity and intensity of diagnostic, prevention and restorative services.