1
|
Dur MP, Celik N, Seven N. Evaluation of the changes in physical properties and mineral content of enamel exposed to radiation after treating with remineralization agent. Clin Oral Investig 2022; 26:5673-5685. [PMID: 35552532 DOI: 10.1007/s00784-022-04524-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of different remineralization agents on the physical properties and elemental content of enamel exposed to radiation. MATERIAL AND METHOD The enamel surfaces of impacted third molar teeth were prepared, and six study groups were created (n = 6). Next, 60 Gy radiation was applied to each group. Between applications, each group except for the control group was treated with a different remineralization agent (sodium fluoride, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium phosphate with fluorite (CPP-ACFP), bioactive glass, or chitosan). The results were evaluated in terms of pre- and post-radiation values and the difference between the two. The paired-samples t test and analysis of variance test were used in the analysis of normally distributed hardness and roughness values, while Wilcoxon's signed ranks test, and the Kruskal Wallis and Mann-Whitney U tests were used in the analysis of elemental content without normal distribution. RESULTS A statistically significant decrease was observed in microhardness measurements in all groups. Intragroup evaluation revealed a statistically significant difference between the NaF and bioactive glass groups (p < 0.05). No significant difference was observed between the groups' roughness measurements (p < 0.05). Intergroup evaluation of surface roughness revealed a significant difference in the CPP-ACFP and chitosan groups (p < 0.05). Pre- and post-radiation oxygen, magnesium, and potassium levels and Ca/P ratios also differed significantly (p < 0.05). CONCLUSION Radiation caused a statistically significant difference in the microhardness and elemental content of enamel. However, no significant difference was observed in enamel roughness. The applied remineralizing agents have a partial ameliorating effect on the adverse impacts of radiation. CLINICAL RELEVANCE Radiation causes changes in the mechanical properties and elemental content of tooth enamel. Remineralizing agent application is a promising option in reducing the adverse effects of irradiation.
Collapse
Affiliation(s)
- Merve Pelin Dur
- Department of Restorative Dentistry, Faculty of Dentistry, Ataturk University, 25240, Erzurum, Turkey.
| | - Neslihan Celik
- Department of Restorative Dentistry, Faculty of Dentistry, Ataturk University, 25240, Erzurum, Turkey
| | - Nilgun Seven
- Department of Restorative Dentistry, Faculty of Dentistry, Ataturk University, 25240, Erzurum, Turkey
| |
Collapse
|
2
|
Effect of ionizing radiation and cariogenic biofilm challenge on root-dentin caries. Clin Oral Investig 2021; 25:4059-4068. [PMID: 33765193 DOI: 10.1007/s00784-020-03736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 12/07/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the effect of ionizing radiation and cariogenic biofilm challenge using two continuous flow models, normal and reduced salivary flow, on the development of initial root-dentin caries lesions. MATERIALS AND METHODS Microcosm biofilms were grown under two salivary flow rates (0.06 and 0.03 mL min-1) and exposed to 5% sucrose (3 × daily, 0.25 mL min-1, 6 min) dripped over non-irradiated and irradiated root-dentin blocks for up to 7 days. The vibration modes of root dentin, matrix/mineral (M/M), and carbonate/mineral (C/M) ratios were evaluated by FTIR. The mineral density was assessed by micro-CT. RESULTS With normal salivary flow, FTIR revealed an increase in the organic matrix (amide III) and a decrease in the mineral phase (ν4, ν2 PO43-, AII + ν2 CO32-, C/M) in caries lesions. Irradiated dentin exhibited a reduction in the mineral phase (ν1, ν3 PO43-, ν2 CO32-, C/M). Differences in mineral densities were not significant. With reduced salivary flow, FTIR also revealed increased organic matrix (amide III) for irradiated caries lesions and decrease in mineral phase (v4, v2 PO43-, v2 CO32-, and C/M) in caries lesions. ν1, ν3 PO43- precipitated on the surface of irradiated dentin and a lower mineral density was observed. CONCLUSIONS Initial caries lesions differed between non-irradiated and irradiated dentin and between normal and reduced salivary flow rates. Significant mineral loss with exposure of the organic matrix and low mineral density were observed for irradiated dentin with a reduced salivary flow rate. CLINICAL RELEVANCE Ionizing radiation associated with a reduced salivary flow rate enhanced the progression of root-dentin caries.
Collapse
|
3
|
Hajhamid B, Mohammad Rahimi R, F Bahr D, M De Souza G. Effect of ionizing radiation and chewing simulation on human enamel and zirconia. J Prosthodont Res 2020; 65:67-72. [PMID: 32938881 DOI: 10.2186/jpr.jpor_2019_592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the effect of ionizing irradiation on human enamel and zirconia after chewing simulation. METHODS Twenty enamel and twenty translucent Yttria-stabilized zirconia (Y-PSZ) specimens were divided in 4 groups: Co (control) - no irradiation on enamel cusps/opposing zirconia slabs; E70 - irradiated (70 Gray) enamel cusps/opposing irradiated enamel slabs; Z70 - irradiated zirconia cusps/opposing irradiated zirconia slabs; EZ70 - irradiated enamel cusps/opposing irradiated zirconia slabs. Cusps were abraded against slabs in a chewing simulator (CS - one million cycles, 80 N, artificial saliva, 37˚C). Wear and roughness of zirconia and enamel were analyzed using a stylus profilometer. The abraded enamel was analyzed by Electron probe micro-analyzer (EPMA) and zirconia was characterized by nanoindentation and X-ray diffraction. One-way analysis of variance (ANOVA) and Tukey test were used for analysis of wear, Repeated Measures and Bonferroni test for roughness, and hardness and modulus values were compared using Wilcoxan Mann Whitney rank sum test (overall 5% significance). RESULTS Significantly higher volume loss was presented by cusps in the E70 group (p<0.001). Wear was similar between Co and EZ70 groups. There was no significant effect of irradiation on roughness of enamel or zirconia slabs (p=0.072). Irradiated Y-PSZ slabs had significantly higher hardness and modulus than non-irradiated ones and a 7% increase in m phase content was detected after irradiation. CONCLUSIONS The opposing surface characteristics played a more significant role on enamel wear than did ionizing radiation. However, radiation affects Y-PSZ crystalline composition, hardness and modulus of elasticity.
Collapse
Affiliation(s)
- Beshr Hajhamid
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G1G6
| | - Raheleh Mohammad Rahimi
- School of Materials Engineering, Purdue University, 701West Stadium Avenue, West Lafayette, IN 47907-2045
| | - David F Bahr
- School of Materials Engineering, Purdue University, 701West Stadium Avenue, West Lafayette, IN 47907-2045
| | - Grace M De Souza
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G1G6
| |
Collapse
|
4
|
Marko T, Ivana Š, Kristina P. Comparison of Fluoride Ion Release from Fluoride Gel in Various Solvents. Acta Stomatol Croat 2020; 54:147-154. [PMID: 32801373 PMCID: PMC7362733 DOI: 10.15644/asc54/2/4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the concentration of fluoride ions present in various solvent solutions and compare it to the label amount of fluoride concentration. MATERIAL AND METHODS The gel containing amine fluoride and sodium fluoride was compared to gel containing sodium fluoride only. The solvents used in this study were distilled water, redistilled water, tap water, 0.9% sodium chloride solution and the artificial saliva. The amount of fluoride ion (F-) was determined by the use of fluoride ion-selective electrode. The ANOVA and the Post hoc Tukey's test were used. The significance level was α = 5%. RESULTS The differences between F- ion release in various solvents were statistically significant (p < 0.05). The F- ion concentrations measured in both gels' redistilled water solutions were higher than the label concentration. There was a significant difference in fluoride ion release in sodium fluoride only gel solutions. Fluoride ion release was significantly different in combined fluoride gel solutions. CONCLUSIONS Amine fluorides do not interact with other ions present in the solution, whereas F- ion release from sodium fluoride alters when other ions are dissolved in the same solution. Amine fluorides deliver F- ions for caries prevention more efficiently.
Collapse
Affiliation(s)
- Turkalj Marko
- University of Zagreb, School of Dental Medicine Croatia
| | - Šutej Ivana
- Department of Pharmacology, School of Dental Medicine University of Zagreb, Croatia
| | - Peroš Kristina
- Department of Pharmacology, School of Dental Medicine University of Zagreb, Croatia
| |
Collapse
|
5
|
Radiation-related caries: current diagnostic, prognostic, and management paradigms. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:52-62. [DOI: 10.1016/j.oooo.2020.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/02/2020] [Accepted: 04/08/2020] [Indexed: 11/23/2022]
|
6
|
Wu L, Geng K, Gao Q. Effects of different anti-caries procedures on microhardness and micromorphology of irradiated permanent enamel. Dent Mater J 2020; 39:118-125. [PMID: 31582598 DOI: 10.4012/dmj.2018-385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To explore the effects of infiltration resin, casein phosphate polypeptide-amorphous calcium phosphate (CPP-ACP) and fluoride on microhardness and micromorphology of irradiated enamel. Sixty human permanent teeth were mesiodistally sectioned, yielding 120 enamel samples, which randomly divided into 8 groups: G1: blank control; G2: irradiation control; G3: irradiation+fluoride; G4: irradiation+CPP-ACP; G5: irradiation+CPP-ACP+fluoride; G6: irradiation+infiltration resin; G7: irradiation+infiltration resin+fluoride; G8: irradiation+infiltration resin+CPP-ACP. A progressive improvement was observed on the superficial morphology of enamel treated with different anti-caries procedures. The order of microhardness values after irradiation from the highest to the lowest was as follows: G1>G8~G7>G6>G5>G4~G3>G2. CPP-ACP, infiltration resin and fluoride can effectively restore the direct destruction of enamel caused by irradiation and promote the occurrence of remineralization. Infiltration resin and its combined effects with fluoride or CPP-ACP have the most potential anti-caries agent to resist radiation-caries.
Collapse
Affiliation(s)
- LiLing Wu
- Department of Stomatology, Zhongshan Hospital Xiamen University.,Center of Stomatology, Xiangya Hospital, Central South University
| | - Kun Geng
- Center of Stomatology, Xiangya Hospital, Central South University
| | - QingPing Gao
- Center of Stomatology, Xiangya Hospital, Central South University
| |
Collapse
|
7
|
Wu L, Geng K, Gao Q. Effects of different anti-caries agents on microhardness and superficial microstructure of irradiated permanent dentin: an in vitro study. BMC Oral Health 2019; 19:113. [PMID: 31200708 PMCID: PMC6570839 DOI: 10.1186/s12903-019-0815-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/04/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND To compare different anti-caries agents on microhardness and micromorphology of irradiated permanent dentin in vitro, and try to find the most effective agent to prevent radiation-dentin-destruction. METHODS A total of 120 dentin samples were prepared from 60 human teeth and randomly divided into 8 groups (n = 15), [ (1)] blank control [2]; irradiation control [3]; irradiation+ fluoride [4]; irradiation+ casein phosphate polypeptide-amorphous calcium phosphate (CPP-ACP) [5]; irradiation+ CPP-ACP+ fluoride [6]; irradiation+ infiltration resin [7]; irradiation+ infiltration resin+ fluoride [8]; irradiation+ infiltration resin+ CPP-ACP. Seven samples of each groups were chosen randomly for microhardness test and eight for scanning electron microscope observation. RESULTS A decrease of microhardness (P < 0.05) and an obvious morphological change were presented on dentin surface after radiotherapy. After applications of anti-caries agents, the morphological destructions were effectively restored. The infiltration resin plus fluoride group (56.00 ± 4.02 Kg/mm2), infiltration resin plus CPP-ACP group (56.05 ± 3.69 Kg/mm2), infiltration resin group (54.70 ± 4.42Kg/mm2) and CPP-ACP plus fluoride group (53.84 ± 6.23Kg/mm2) had the highest dentin microhardness value after radiotherapy, and no statistically significant difference were found between them. CONCLUSIONS Infiltration resin, CPP-ACP, fluoride and their pairwise combination can effectively prevent radiation-dentin-destruction. Among them, infiltration resin with CPP-ACP, infiltration resin with fluoride, CPP-ACP with fluoride, and infiltration resin have the most protective effects on irradiation-dentin-destructions.
Collapse
Affiliation(s)
- LiLing Wu
- Center of Stomatology, Xiangya Hospital Central South University, Changsha, 410008 Hunan Province China
- Department of Stomatology, ZhongShan Hospital Xiamen University, Xiamen, 361004 China
| | - Kun Geng
- Center of Stomatology, Xiangya Hospital Central South University, Changsha, 410008 Hunan Province China
| | - QingPing Gao
- Center of Stomatology, Xiangya Hospital Central South University, Changsha, 410008 Hunan Province China
| |
Collapse
|
8
|
Lu H, Zhao Q, Guo J, Zeng B, Yu X, Yu D, Zhao W. Direct radiation-induced effects on dental hard tissue. Radiat Oncol 2019; 14:5. [PMID: 30635005 PMCID: PMC6329176 DOI: 10.1186/s13014-019-1208-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 01/02/2019] [Indexed: 11/27/2022] Open
Abstract
Background Radiation caries is a complication of radiotherapy characterized by enamel erosion and dentin exposure. The mechanisms of characteristic radiation caries formation are not well-understood. The aim of this study was to evaluate the direct radiation-induced effects on dental hard tissue and investigate their role in the formation of radiation caries. Methods Sixty non-carious third molars were divided into three groups (n = 20), which would be exposed to 0 Gy, 30 Gy, and 60 Gy radiation, respectively. After radiation, microhardness and elastic modulus were measured at four depths by means of a Vickers microhardness tester and atomic force microscopy (AFM). The microstructure was observed by scanning electron microscopy (SEM). X-ray diffraction and Raman microspectroscopy were used to determine crystal properties and protein/mineral (2931/960 cm− 1) ratios. Results A statistically significant decrease in microhardness and elastic modulus values 50 μm from the dentino-enamel junction (DEJ) in enamel was revealed in the 30-Gy and 60-Gy groups. With the increasing dose, destruction of interprismatic substance and fissures at the DEJ-adjacent region were found. A greater reduction of crystallinity was revealed in enamel compared with dentin. Raman spectroscopic analysis showed a slight increase of the protein/mineral ratio for enamel following accumulated radiation, while the protein/mineral ratio for dentin was decreased. Conclusions Radiation could directly alter the mechanical properties, micro-morphology, crystal properties, and chemical composition of dental hard tissue. The early destruction of DEJ-adjacent enamel, combined with decreased crystallinity of enamel under radiation exposure, may be related to the formation of characteristic radiation caries.
Collapse
Affiliation(s)
- Hui Lu
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, China
| | - Qi Zhao
- Department of Oncology, Central Hospital of Xianning City, Tongji Xianning Hospital of Huazhong University of Science and Technology, Hubei, China
| | - Jiang Guo
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, China
| | - Binghui Zeng
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, China
| | - Xinlin Yu
- International Department, The Affiliated High School of SCNU, Guangzhou, China
| | - Dongsheng Yu
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, China.
| | - Wei Zhao
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510055, China.
| |
Collapse
|
9
|
Lopes CDCA, Soares CJ, Lara VC, Arana-Chavez VE, Soares PB, Novais VR. Effect of fluoride application during radiotherapy on enamel demineralization. J Appl Oral Sci 2018; 27:e20180044. [PMID: 30540070 PMCID: PMC6296282 DOI: 10.1590/1678-7757-2018-0044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/25/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Radiation-related caries are one the most undesired reactions manifested during or after head and neck radiotherapy. Fluoride application is an important strategy to reduce demineralization and enhance remineralizaton. To evaluate the effect of the topical application of fluoride during irradiation on dental enamel demineralization. MATERIAL AND METHODS Thirty molars were randomly divided into three groups: Non-irradiated (NI), Irradiated (I), Irradiated with fluoride (IF). Each group was subdivided according to the presence or absence of pH-cycling (n=5). In the irradiated groups, the teeth received 70 Gy. The enamel's chemical composition was measured using Fourier Transform Infrared Spectrometry (organic matrix/mineral ratio - M/M and relative carbonate content - RCC). Vickers microhardness (VHN) and elastic modulus (E) were evaluated at three depths (surface, middle and deep enamel). Scanning electron microscopy (SEM) was used to assess the enamel's morphology. RESULTS The FTIR analysis (M/M and RCC) showed significant differences for irradiation, pH-cycling and the interaction between factors (p<0.001). Without pH-cycling, IF had the lowest organic matrix/mineral ratio and relative carbonate content. With pH-cycling, the organic matrix/mineral ratio increased and the relative carbonate content decreased, except for IF. VHN was influenced only by pH-cycling (p<0.001), which generated higher VHN values. ANOVA detected significant differences in E for irradiation (p<0.001), pH-cycling (p<0.001) and for the interaction between irradiation and pH-cycling (p<0.001). Increased E was found for group I without pH-cycling. With pH-cycling, groups I and IF were similar, and showed higher values than NI. The SEM images showed no morphological changes without pH-cycling. With pH-cycling, fluoride helped to maintain the outer enamel's morphology. CONCLUSIONS Fluoride reduced mineral loss and maintained the outer morphology of irradiated and cycled enamel. However, it was not as effective in preserving the mechanical properties of enamel. Radiotherapy altered the enamel's elastic modulus and its chemical composition.
Collapse
Affiliation(s)
| | - Carlos José Soares
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| | - Vitor Carvalho Lara
- Universidade Federal do Triângulo Mineiro, Faculdade de Medicina, Setor de Radioterapia, Uberaba, Minas Gerais, Brasil
| | - Victor Elias Arana-Chavez
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Biomateriais e Biologia Oral, São Paulo, São Paulo, Brasil
| | - Priscilla Barbosa Soares
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Periodontia, Uberlândia, Minas Gerais, Brasil
| | - Veridiana Resende Novais
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| |
Collapse
|
10
|
Abdalla R, Omar A, Eid K. Detecting demineralization of enamel and cementum after gamma irradiation using radiographic densitometry. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2018; 57:293-299. [PMID: 29948141 DOI: 10.1007/s00411-018-0749-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 06/09/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to evaluate the ability of radiographic densitometry in detecting the early demineralization of human enamel and cementum in irradiated and non-irradiated teeth. Sixty extracted teeth were divided into two groups: irradiated group and non-irradiated group. After irradiation, the groups were subjected to demineralization-remineralization (PH) cycling. Radiographic densitometric measurements (gray values) of a selected area of interest in the enamel and in the cementum of each tooth were performed at baseline and after PH cycling. After PH cycling, there was a significant reduction in gray values for both groups. The difference between "baseline" and "after PH cycling" values represents the reduction in the mineral content of the hard tissue, i.e., the demineralization. Results show that the demineralization of irradiated tooth enamel and cementum was significantly higher compared to that of non-irradiated tissues as determined by gray-level values. It is concluded that densitometric measurements by means of digital radiographs allow for the detection of demineralization of enamel and cementum, and can be used successfully for diagnosis of the early carious lesions in patients who received head and neck radiotherapy. This will allow implementation of remineralizing therapy and avoid the risk of progression of radiation caries. Furthermore, it is concluded that gamma irradiation with typical therapeutic doses for head and neck carcinoma is a direct cause of demineralization of tooth enamel and cementum.
Collapse
Affiliation(s)
- Rowida Abdalla
- Division of Restorative Dentistry, Department of Oral Health Practice, D632A UK Chandler Hospital, University of Kentucky, Lexington, KY, 40536-0297, USA.
- Health Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Atomic Energy Authority, Cairo, Egypt.
| | - Amr Omar
- Fixed Prosthodontics Department, Misr International University, Cairo, Egypt
| | - Kareem Eid
- State University of New York at Geneseo, New York, NY, USA
| |
Collapse
|