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Anastasiadis K, Nassar M. The effect of different conditioning agents on dentin roughness and collagen structure. J Dent 2024; 148:105222. [PMID: 38950766 DOI: 10.1016/j.jdent.2024.105222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES To assess the impact of various organic and inorganic acids on the roughness, demineralization, and collagen secondary structures of human dentin and to compare these effects with those of traditional agents, specifically phosphoric acid (PA) and ethylenediaminetetraacetic acid (EDTA). METHODS Coronal dentin discs (n = 10) were examined by optical profilometry (roughness) and ATR-FTIR before and after conditioning with 32 % PA, 3 % nitric acid (NA), 20 % citric acid (CA), 20 % phytic acid (IP6) or 17 % EDTA. Spectra data were processed to quantify dentin demineralization (DM%) and percentage area of amide I curve-fitted components of β-turns, 310-helix, α-helix, random coils, β-sheets, and collagen maturation index. Statistical analysis was performed by one-way ANOVA or Kruskal-Wallis for DM% and roughness parameters, and paired t-test/Wilcoxon test for amide I components at significance level set at α = 0.05. RESULTS All treatments resulted in increased roughness parameters, with the most significant changes occurring primarily with PA, while EDTA exhibited the least changes. DM% was NA>PA>IP6>CA>EDTA in a descending order. Regarding amide I components, NA demonstrated a significant reduction in β-turns, 310-helices, and α-helices and it increased β-sheets and random coils. PA resulted in reduction in β-turns and α-helices while it increased β-sheets. CA and EDTA did not cause significant changes. The collagen maturation index significantly increased only after IP6 treatment. CONCLUSIONS The effect on dentin roughness parameters, demineralization, and collagen secondary structures varied based on the type of dentin surface treatment. CLINICAL SIGNIFICANCE Understanding the impact of acids on the intrinsic properties of dentin is clinically essential for gaining insights into how these effects influence adhesion to dentin, the long-term stability of resin-based restorations, and the success of remineralization therapies.
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Affiliation(s)
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
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Ibrahim DFA, Hasmun NN, Liew YM, Venkiteswaran A. Effects of repeated etching cycles using 15% hydrochloric acid on enamel loss and relative attenuation coefficient in resin infiltration. Photodiagnosis Photodyn Ther 2024; 45:103989. [PMID: 38280674 DOI: 10.1016/j.pdpdt.2024.103989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/14/2023] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Resin infiltration is used to mask enamel opacities and the recommended etching cycles are three. However, anecdotal evidence suggests that favorable esthetics outcomes can be obtained by increasing the etching cycles. AIM To determine the incremental and total enamel loss when enamel surfaces are exposed to multiple etching cycles and to assess the relative attenuation coefficient after multiple etching cycles and resin infiltration treatment. METHODS Ninety extracted sound human premolars teeth were divided into 9 groups (n = 10); with each consecutive group having one additional etching cycle up to 9 cycles. The teeth were scanned with optical coherence tomography and enamel loss and attenuation coefficient were measured with MATLAB software. Enamel loss (one-way ANOVA, p ≤ 0.05) and attenuation coefficient (two-way ANOVA, p ≤ 0.05) were statistically analyzed. RESULTS There was a significant total enamel loss of more than 33% found at the 7th etching cycle and more. There was no statistically significant difference in the incremental mean depth of penetration of resin between various etching cycles (F(8, 134) = [2.016], one-way ANOVA, p = 0.185). CONCLUSION This study recommends that etching should not be repeated more than seven cycles to prevent excessive enamel loss. Following eight etching cycles, resin infiltration penetration appears approximately equal to that of healthy enamel.
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Affiliation(s)
- Dayang Fadzlina Abang Ibrahim
- Paediatric Dental Specialist Clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia; Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Noren Nor Hasmun
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Wilayah 50603, Persekutuan Kuala Lumpur, Malaysia
| | - Annapurny Venkiteswaran
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia.
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Ibrahim DFA, Hasmun NN, Liew YM, Venkiteswaran A. Repeated Etching Cycles of Resin Infiltration up to Nine Cycles on Demineralized Enamel: Surface Roughness and Esthetic Outcomes-In Vitro Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1148. [PMID: 37508644 PMCID: PMC10378243 DOI: 10.3390/children10071148] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023]
Abstract
Resin infiltration (RI) is used to mask enamel opacities. There are three recommended etching cycles. However, anecdotal evidence suggests that favorable esthetics outcomes can be obtained by increasing the etching cycles. This study aimed to evaluate the effects of repeated etching cycles during RI application on esthetic changes and surface roughness of demineralized enamel at multiple treatment stages. Artificial demineralization was prepared on the buccal surface of ninety sound extracted premolars. The teeth were divided into nine groups (n = 10); with each consecutive group having one additional etching cycle up to nine etching cycles. Resin infiltrant was performed twice, first for 3 min (Resin 1) and again for 1 min (Resin 2). Surface roughness and esthetic changes were assessed using a profilometer (Ambios XP-200) and Minolta spectrophotometer, respectively, at baseline (sound enamel), etching, resin 1, resin 2, 7 days, and 28 days post resin applications. Data were analyzed with two-way ANOVA (p < 0.05). There was a significant interaction between the different stages and various groups of etching cycles on surface roughness, F(48, 126) = 3.48, p < 0.001. There was a significant interaction between the different stages and various groups of etching cycles on color changes, F(4, 126) = 1.177, p = 0.045. The surface roughness of demineralized enamel infiltrated with RI was less than that of sound enamel (baseline). There is a significant difference in color changes between resin 1 and resin 2 (p < 0.05). After five etching cycles, RI improved the esthetic of the color of teeth similar to the baseline. Surface roughness and color changes remained constant for 28 days. RI can be considered an effective and predictable treatment option for the restoration of early enamel lesions owing to its better surface characteristics and reliable masking effects. The color stability and surface roughness stay unaltered for up to 28 days.
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Affiliation(s)
- Dayang Fadzlina Abang Ibrahim
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Campus Sungai Buloh, Sungai Buloh 47000, Malaysia
| | - Noren Nor Hasmun
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Annapurny Venkiteswaran
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Campus Sungai Buloh, Sungai Buloh 47000, Malaysia
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Besnard C, Marie A, Sasidharan S, Harper RA, Marathe S, Moffat J, Shelton RM, Landini G, Korsunsky AM. Time-Lapse In Situ 3D Imaging Analysis of Human Enamel Demineralisation Using X-ray Synchrotron Tomography. Dent J (Basel) 2023; 11:dj11050130. [PMID: 37232781 DOI: 10.3390/dj11050130] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
Caries is a chronic disease that causes the alteration of the structure of dental tissues by acid dissolution (in enamel, dentine and cementum) and proteolytic degradation (dentine and cementum) and generates an important cost of care. There is a need to visualise and characterise the acid dissolution process on enamel due to its hierarchical structure leading to complex structural modifications. The process starts at the enamel surface and progresses into depth, which necessitates the study of the internal enamel structure. Artificial demineralisation is usually employed to simulate the process experimentally. In the present study, the demineralisation of human enamel was studied using surface analysis carried out with atomic force microscopy as well as 3D internal analysis using synchrotron X-ray tomography during acid exposure with repeated scans to generate a time-lapse visualisation sequence. Two-dimensional analysis from projections and virtual slices and 3D analysis of the enamel mass provided details of tissue changes at the level of the rods and inter-rod substance. In addition to the visualisation of structural modifications, the rate of dissolution was determined, which demonstrated the feasibility and usefulness of these techniques. The temporal analysis of enamel demineralisation is not limited to dissolution and can be applied to other experimental conditions for the analysis of treated enamel or remineralisation.
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Affiliation(s)
- Cyril Besnard
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - Ali Marie
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - Sisini Sasidharan
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - Robert A Harper
- School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham B5 7EG, UK
| | | | - Jonathan Moffat
- Oxford Instruments Asylum Research, High Wycombe HP12 3SE, UK
| | - Richard M Shelton
- School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham B5 7EG, UK
| | - Gabriel Landini
- School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham B5 7EG, UK
| | - Alexander M Korsunsky
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
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Besnard C, Marie A, Sasidharan S, Harper RA, Shelton RM, Landini G, Korsunsky AM. Synchrotron X-ray Studies of the Structural and Functional Hierarchies in Mineralised Human Dental Enamel: A State-of-the-Art Review. Dent J (Basel) 2023; 11:98. [PMID: 37185477 PMCID: PMC10137518 DOI: 10.3390/dj11040098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/19/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023] Open
Abstract
Hard dental tissues possess a complex hierarchical structure that is particularly evident in enamel, the most mineralised substance in the human body. Its complex and interlinked organisation at the Ångstrom (crystal lattice), nano-, micro-, and macro-scales is the result of evolutionary optimisation for mechanical and functional performance: hardness and stiffness, fracture toughness, thermal, and chemical resistance. Understanding the physical-chemical-structural relationships at each scale requires the application of appropriately sensitive and resolving probes. Synchrotron X-ray techniques offer the possibility to progress significantly beyond the capabilities of conventional laboratory instruments, i.e., X-ray diffractometers, and electron and atomic force microscopes. The last few decades have witnessed the accumulation of results obtained from X-ray scattering (diffraction), spectroscopy (including polarisation analysis), and imaging (including ptychography and tomography). The current article presents a multi-disciplinary review of nearly 40 years of discoveries and advancements, primarily pertaining to the study of enamel and its demineralisation (caries), but also linked to the investigations of other mineralised tissues such as dentine, bone, etc. The modelling approaches informed by these observations are also overviewed. The strategic aim of the present review was to identify and evaluate prospective avenues for analysing dental tissues and developing treatments and prophylaxis for improved dental health.
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Affiliation(s)
- Cyril Besnard
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, Oxfordshire, UK
| | - Ali Marie
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, Oxfordshire, UK
| | - Sisini Sasidharan
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, Oxfordshire, UK
| | - Robert A. Harper
- School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham B5 7EG, West Midlands, UK
| | - Richard M. Shelton
- School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham B5 7EG, West Midlands, UK
| | - Gabriel Landini
- School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham B5 7EG, West Midlands, UK
| | - Alexander M. Korsunsky
- MBLEM, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, Oxfordshire, UK
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Bonchev A, Simeonov M, Shestakova P, Vasileva R, Titorenkova R, Apostolov A, Dyulgerova E, Vassileva E. Bioinspired Remineralization of Artificial Caries Lesions Using PDMAEMA/Carbomer/Calcium Phosphates Hybrid Microgels. Gels 2022; 8:gels8100681. [PMID: 36286182 PMCID: PMC9601719 DOI: 10.3390/gels8100681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
Dental caries remains one of the most prevalent bacterium-caused chronic diseases affecting both adults and children worldwide. The development of new materials for enhancing its remineralization is one of the most promising approaches in the field of advanced dental materials as well as one of the main challenges in non-invasive dentistry. The aim of the present study is to develop novel hybrid materials based on (PDMAEMA)/Carbomer 940 microgels with in situ deposited calcium phosphates (CaP) and to reveal their potential as a remineralization system for artificial caries lesions. To this purpose, novel PDMAEMA/Carbomer 940 microgels were obtained and their core–shell structure was revealed by transmission electron microscopy (TEM). They were successfully used as a matrix for in situ calcium phosphate deposition, thus giving rise to novel hybrid microgels. The calcium phosphate phases formed during the deposition process were studied by X-ray diffraction and infrared spectroscopy, however, due to their highly amorphous nature, the nuclear magnetic resonance (NMR) was the method that was able to provide reliable information about the formed inorganic phases. The novel hybrid microgels were used for remineralization of artificial caries lesions in order to prove their ability to initiate their remineralization. The remineralization process was followed by scanning electron microscopy (SEM), X-ray diffraction, infrared and Raman spectroscopies and all these methods confirmed the successful enamel rod remineralization upon the novel hybrid microgel application. Thus, the study confirmed that novel hybrid microgels, which could ensure a constant supply of calcium and phosphate ions, are a viable solution for early caries treatment.
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Affiliation(s)
- Alexander Bonchev
- Faculty of Dental Medicine, Medical University, 1, G. Sofiiski Str., 1431 Sofia, Bulgaria
| | - Marin Simeonov
- Laboratory on Structure and Properties of Polymers, Faculty of Chemistry and Pharmacy, University of Sofia, 1, James Bourchier Blvd., 1164 Sofia, Bulgaria
| | - Pavletta Shestakova
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 9, 1113 Sofia, Bulgaria
| | - Radosveta Vasileva
- Faculty of Dental Medicine, Medical University, 1, G. Sofiiski Str., 1431 Sofia, Bulgaria
| | - Rositsa Titorenkova
- Institute of Mineralogy and Crystallography, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 107, 1113 Sofia, Bulgaria
| | - Anton Apostolov
- Laboratory on Structure and Properties of Polymers, Faculty of Chemistry and Pharmacy, University of Sofia, 1, James Bourchier Blvd., 1164 Sofia, Bulgaria
| | - Elena Dyulgerova
- Faculty of Dental Medicine, Medical University, 1, G. Sofiiski Str., 1431 Sofia, Bulgaria
| | - Elena Vassileva
- Laboratory on Structure and Properties of Polymers, Faculty of Chemistry and Pharmacy, University of Sofia, 1, James Bourchier Blvd., 1164 Sofia, Bulgaria
- Correspondence:
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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions. Curr Osteoporos Rep 2022; 20:90-105. [PMID: 35129809 PMCID: PMC8930910 DOI: 10.1007/s11914-022-00722-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF THE REVIEW Compare pathophysiology for infectious and noninfectious demineralization disease relative to mineral maintenance, physiologic fluoride levels, and mechanical degradation. RECENT FINDINGS Environmental acidity, biomechanics, and intercrystalline percolation of endemic fluoride regulate resistance to demineralization relative to osteopenia, noncarious cervical lesions, and dental caries. Demineralization is the most prevalent chronic disease in the world: osteoporosis (OP) >10%, dental caries ~100%. OP is severely debilitating while caries is potentially fatal. Mineralized tissues have a common physiology: cell-mediated apposition, protein matrix, fluid logistics (blood, saliva), intercrystalline ion percolation, cyclic demineralization/remineralization, and acid-based degradation (microbes, clastic cells). Etiology of demineralization involves fluid percolation, metabolism, homeostasis, biomechanics, mechanical wear (attrition or abrasion), and biofilm-related infections. Bone mineral density measurement assesses skeletal mass. Attrition, abrasion, erosion, and abfraction are diagnosed visually, but invisible subsurface caries <400μm cannot be detected. Controlling demineralization at all levels is an important horizon for cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- grid.257413.60000 0001 2287 3919Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- grid.1008.90000 0001 2179 088XDepartment of Biochemistry and Pharmacology, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Parkville, Victoria 3010 Australia
| | - Paul M. Schneider
- grid.1008.90000 0001 2179 088XMelbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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Brauchli L, Steineck M. Etching Patterns of Self-Etching Primers in Relation to Shear Bond Strength on Unground Enamel Samples. Dent J (Basel) 2021; 9:dj9110138. [PMID: 34821602 PMCID: PMC8621149 DOI: 10.3390/dj9110138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/25/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
It was the intention of the study to evaluate the etching effects of several self-etching primers on unground enamel and their relevance for shear bond strength testing. Seven self-etching primers (Clearfil SE, Futurabond NR, M-Bond, One Coat, Optibond, Transbond SEP+, Xeno III) and a conventional 35% phosphoric gel acid were applied to bovine incisors according to the manufacturer's instructions. All specimens were analyzed by electron microscopy. A visual four-step grading was used for the characterization of the macroscopic (5000×) and microscopic (20,000×) etching patterns. In addition, shear bond strength for all the products was tested with an Instron 3344 after 1000 thermocycles between 5 °C and 55 °C. Statistical analysis was carried out using Kruskal-Wallis with Dunn's post-test and Pearson's correlation coefficient. Very strong etching patterns with well-defined prisms were found for the conventional etching, Transbond SEP+, and to a lesser degree, for Xeno III. Clearfil SE and Futurabond NR revealed moderate etching patterns, and M-Bond, One Coat, and Optibond revealed very weak etching patterns. The bond strength correlated well with the etching patterns. The highest shear strength was obtained with conventional etching and Transbond SEP+, followed by Clearfil SE. Moderate shear bond strengths were found for Xeno III, Futurabond NR, One Coat, and M-Bond, and the lowest were found with Optibond.
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Finite Element Modelling and Experimental Validation of the Enamel Demineralisation Process at the Rod Level. J Adv Res 2021; 29:167-177. [PMID: 33842014 PMCID: PMC8020348 DOI: 10.1016/j.jare.2020.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 11/26/2022] Open
Abstract
In the past years, a significant amount of effort has been directed at the observation and characterisation of caries using experimental techniques. Nevertheless, relatively little progress has been made in numerical modelling of the underlying demineralisation process. The present study is the first attempt to provide a simplified calculation framework for the numerical simulation of the demineralisation process at the length scale of enamel rods and its validation by comparing the data with statistical analysis of experimental results. FEM model was employed to simulate a time-dependent reaction-diffusion equation process in which H ions diffuse and cause demineralisation of the enamel. The local orientation of the hydroxyapatite crystals was taken into account. Experimental analysis of the demineralising front was performed using advanced high-resolution synchrotron X-ray micro-Computed Tomography. Further experimental investigations were conducted by means of SEM and STEM imaging techniques. Besides establishing and validating the new modelling framework, insights into the role of the etchant solution pH level were obtained. Additionally, some light was shed on the origin of different types of etching patterns by simulating the demineralisation process at different etching angles of attack. The implications of this study pave the way for simulations of enamel demineralisation within different complex scenarios and across the range of length scales. Indeed, the framework proposed can incorporate the presence of chemical species other than H ions and their diffusion and reaction leading to dissolution and re-precipitation of hydroxyapatite. It is the authors’ hope and aspiration that ultimately this work will help identify new ways of controlling and preventing caries.
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