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Athanasiadou D, Eymael D, Hajhamid B, Carneiro KMM, Prakki A. Chemical and Ultrastructural Characterization of Dentin Treated with Remineralizing Dentifrices. J Funct Biomater 2024; 15:25. [PMID: 38248692 PMCID: PMC10816979 DOI: 10.3390/jfb15010025] [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: 12/14/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
The aim of this study is to investigate dentin chemical and ultrastructural changes upon exposure to remineralizing dentifrices. Dentin disks were obtained from permanent human molars and treated for 7 days with the dentifrices: (1) C group-control (no dentifrice); (2) S group-Sensodyne Repair & Protect; (3) D group-Dentalclean Daily Regenerating Gel; and (4) DB group-D group + Dentalclean regenerating booster. Afterwards, samples were submitted to an additional 7 days of toothbrushing associated with daily acidic challenge. Samples were imaged and analyzed (days 1, 7, and 14) for Young's modulus by atomic force microscopy (AFM), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX), transmission electron microscopy (TEM) and selected area electron diffraction (SAED). SEM and AFM revealed precipitate deposition on dentin surfaces in groups S, D, and DB, formed as early as day 1. Surface elemental analysis showed a Si increase on all brushed surfaces. Similar surface morphology was maintained after the acidic challenge period. Bright-field TEM/SAED revealed the formation of nanocrystalline hydroxyapatite inside the dentin tubules of groups S, D, and DB after day 7. Group C presented a gradual reduction of Young's modulus from days-1-14, whereas all remaining groups had increased values. All evaluated dentifrices led to successful formation of hydroxyapatite and increased dentin stiffness.
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Affiliation(s)
- Dimitra Athanasiadou
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (D.A.); (D.E.); (B.H.)
| | - Denise Eymael
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (D.A.); (D.E.); (B.H.)
| | - Beshr Hajhamid
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (D.A.); (D.E.); (B.H.)
| | - Karina M. M. Carneiro
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (D.A.); (D.E.); (B.H.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Anuradha Prakki
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (D.A.); (D.E.); (B.H.)
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Zhao X, Wang L, Pan J, Malmstrom H, Ren YF. Effects of desensitizing dentifrices on dentin tubule occlusion and resistance to erosive challenges. BMC Oral Health 2021; 21:610. [PMID: 34847898 PMCID: PMC8638163 DOI: 10.1186/s12903-021-01977-3] [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: 04/12/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022] Open
Abstract
Background Many studies have demonstrated efficacy of casein phosphopeptide (CPP) containing products for dentin tubule occlusion for treatment of dentin sensitivity, but their effectiveness under dynamic erosive challenges remains to be elucidated. The purpose of the present study was to investigate the effectiveness of a desensitizing dentifrice containing CPP in occluding dentin tubules and resisting erosive challenges in comparison to that containing polyvinyl methyl ether/maleic acid (PVM/MA) copolymers. Methods
A total of 33 dentin discs were prepared from coronal sections of human third molars and divided into 3 groups: a toothpaste containing CPP; a toothpaste containing PVM/MA and submicron silica; and a regular toothpaste (Controls). A soft-bristle toothbrush was used to brush the dentin discs with the dentifrices for 45 strokes in 30 s at a force of approximately 200 g. The brushing cycle was repeated after immersion of the dentin discs in artificial saliva overnight. The dentin discs were then challenged in orange juice for 10 min in an incubator rocking at 120 rpm. Three fields were randomly selected on each dentin disk surface to assess dentin tubule occlusions after each brushing cycle and after orange juice challenge with a 3D laser scanning microscope. Specimen cross sections were examined with a scanning electron microscope equipped with energy dispersive spectroscopy (SEM/EDS). Results After the first and second cycles of brushing, dentin tubules were occluded on average by 56.3% and 85.7% in CPP group, 66.2% and 88.1% in PVM/MA group, and 0.0 and 13.0% in the controls, respectively. There were no statistically significant differences in dentin tubule occlusions between the CPP and PVM/MA groups after two cycles of brushing (p>0.05). After dynamic erosive challenges with orange juice, 20.3% of the dentin tubules in the CPP group, 79.1% in the PVM/MA group and none in the control remained occluded (P<0.05). SEM/EDS imaging showed that dentin tubules were blocked with plugs containing dentifrice substances in CPP and PVM/MA groups after treatments, but none in the controls. Conclusions Desensitizing dentifrices containing CPP or PVM/MA could effectively occlude dentin tubules after two cycles of brushing. PVM/MA in combination with submicron silicon dioxide exhibited stronger resistance to dynamic erosive challenges by acidic beverages. Inorganic fillers that can enter dentin tubules and resist erosive challenges may be key for desensitizing dentifrices.
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Affiliation(s)
- Xiaoyi Zhao
- Department of General Dentistry, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.,University of Rochester Eastman Institute for Oral Health, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - Lin Wang
- Department of General Dentistry, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jie Pan
- Department of General Dentistry, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hans Malmstrom
- University of Rochester Eastman Institute for Oral Health, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - Yan-Fang Ren
- University of Rochester Eastman Institute for Oral Health, 625 Elmwood Ave, Rochester, NY, 14620, USA.
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Francisconi-Dos-Rios LF, Dantas LM, Calabria MP, Pereira JC, Mosquim V, Wang L. Obliterating potential of active products for dentin hypersensitivity treatment under an erosive challenge. J Dent 2021; 112:103745. [PMID: 34252489 DOI: 10.1016/j.jdent.2021.103745] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To compare the effect of 5 desensitizing agents on the hydraulic conductance (Lp) of dentin and to analyze its surface under a Laser Scanning Confocal Microscope (LSCM) before and after an erosive challenge. METHODS Lp was analyzed in the following sequence: in the presence of smear layer (pMin), after a 15-second acid etching (pMax), after treatment with a desensitizing agent (pTreat) and after a 1-minute erosive challenge (6% citric acid - pEro). Fifty 1.0 ± 0.2 mm-thick dentin disks were prepared from sound human third molars and were randomly distributed into 5 groups (n = 10): FG-Fluoride gel (control), SA-Sensiactive, PR-Sensitive Pro-Relief, NP-Desensibilize Nano-P and EV-Enamel Pro Varnish. Data were analyzed by two-way ANOVA and Tukey tests (α<0.05). Additional specimens were analyzed under a Laser Scanning Confocal Microscope (LSCM) and by Energy Dispersive X-ray Spectroscopy (EDS). RESULTS All materials reduced the Lp in some extent, except for FG and EV. After the erosive challenge, SA was the only material effectively able to keep the same Lp of the post-treatment phase, while the other products showed lower resistance upon an erosive challenge. Under the LSCM, the SA and NP materials were more effective to obliterate the opened dentin tubules and demonstrated higher resistance upon an erosive challenge. The EDS analysis evidenced levels of Ca, O, P, Si, Na and S. CONCLUSIONS Product containing potassium oxalate was the most effective in reducing Lp of dentin samples before and after an erosive challenge. Under a LSCM, products containing potassium oxalate or hydroxyapatite crystals seemed to be occluding the dentin tubules after an erosive challenge.
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Affiliation(s)
| | | | | | - José Carlos Pereira
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Victor Mosquim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
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Machado AC, Maximiano V, Eduardo CDP, Azevedo LH, de Freitas PM, Aranha AC. Associative Protocol for Dentin Hypersensitivity Using Nd:YAG Laser and Desensitizing Agent in Teeth with Molar-Incisor Hypomineralization. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:262-266. [PMID: 31050957 DOI: 10.1089/photob.2018.4575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The aim of this article was to describe and discuss a clinical case in which the Nd:YAG laser and a desensitizing agent were associated in a protocol for dentin hypersensitivity (DH) in teeth with molar-incisor hypomineralization (MIH). Background data: DH is a common condition among the population, being one of the main reasons for patients to seek for a dental treatment. MIH can be considered a condition that induces DH. Methods: The patient was referred for evaluation, complaining of hypersensitivity during eating or drinking cold foods. Clinical evaluation revealed the presence of MIH on the first lower molars. Aiming to treat DH, two strategies for dentin desensitization were associated: the use of a high-power laser (Nd:YAG laser, 1.064 nm; Lares Research), with a 300 μm quartz optical fiber, 1 W of power, 100 mJ of energy, 10 Hz of repetition rate, and 85 J/cm2 of energy density, followed by the application of two layers of a desensitizing agent (Gluma Desensitizer). Results: DH was evaluated immediately, after 1 week and after 1 month of the treatment. Clinical outcomes were satisfactory, confirming the efficacy and considerable durability of the protocol used for the reduction of DH originated from MIH. Conclusions: The association of Nd:YAG laser and a desensitizing agent for controlling DH was effective, showing to be an interesting protocol.
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Affiliation(s)
- Alana Cristina Machado
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vinícius Maximiano
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Carlos de Paula Eduardo
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luciane Hiramatsu Azevedo
- 2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Patricia Moreira de Freitas
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ana Cecilia Aranha
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Aguiar JD, Medeiros IS, Souza Junior MHSE, Loretto SC. Influence of the Extended Use of Desensitizing Toothpastes on Dentin Bonding, Microhardness and Roughness. Braz Dent J 2018; 28:346-353. [PMID: 29297556 DOI: 10.1590/0103-6440201601292] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 03/14/2017] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the influence of an extended use of desensitizing toothpastes (DTs) on dentin bonding, microhardness and roughness. One hundred and twenty bovine incisor teeth were randomly divided into four groups: G1, distilled water (WATER); G2, Colgate Total 12 (CT12); G3, Colgate Sensitive Pro-Relief (CSPR); and G4, Sensodyne Repair ?αμπ; Protect (SRP). Dentin surfaces were etched with 17% EDTA and 2 years of simulated tooth brushing (20,000 cycles) was performed on their surfaces. Knoop microhardness, surface roughness and scanning electron microscopy (SEM) were performed before and after the simulated tooth brushing. For microshear bonding test, a 2-step self-etching adhesive system (Clearfil SE Bond) was used and 0.8 mm diameter composite resin (Filtek Z350 XT) cylinders were built. Microshear test was performed with an orthodontic wire and with a crosshead speed of 0.5 mm/min. The data were analyzed for: 1) bond strength (one-way ANOVA), 2) microhardness intra-group (Student's test) and inter-group (one-way ANOVA/Tukey's test) comparisons, 3) roughness intra-group (Student's test/Wilcoxon's test) and inter-group (Kruskal-Wallis/Student-Newman-Keuls test) comparisons. The extended use of both dentifrices (conventional and for sensitive teeth) did not affect the bond strength and produced a significant increase in microhardness and roughness of the dentin, except for the microhardness of the SRP group. The simulated tooth brushing technique with water produced an increase in roughness, without reducing significantly the dentin microhardness.
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Affiliation(s)
- Juliana Dias Aguiar
- Department of Biomaterials and Oral Biology, Dental School, USP - Universidade de São Paulo, São Paulo, SP, Brazil
| | - Igor Studart Medeiros
- Department of Biomaterials and Oral Biology, Dental School, USP - Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Sandro Cordeiro Loretto
- Department of Restorative Dentistry, Dental School, UFPA - Universidade Federal do Pará, Belém, PA, Brazil
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Randomised clinical trial to evaluate changes in dentine tubule occlusion following 4 weeks use of an occluding toothpaste. Clin Oral Investig 2017; 22:225-233. [PMID: 28365809 PMCID: PMC5748408 DOI: 10.1007/s00784-017-2103-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/12/2017] [Indexed: 12/25/2022]
Abstract
Objectives The objective of this study is to determine whether a silicone impression material could precisely replicate dentine tubule changes following 4 weeks toothbrushing with occluding or non-occluding toothpaste and whether changes reflected hypersensitivity clinical assessment. Materials and methods This was a single site, examiner blind, parallel, two treatment arm, randomised clinical trial. Participants were healthy, ≥18, with ≥1 sensitive tooth with exposed dentine, Schiff sensitivity score ≥2, and patent tubules with dentine occlusion score 4–5 as determined by scanning electron microscopy of replica impressions. Nine participants received Sensodyne® Rapid Relief (occluding toothpaste) and 10 Crest® Decay Prevention (non-occluding toothpaste), and were re-evaluated for sensitivity and occlusion score after two timed minutes and 4 weeks twice-daily home brushing. Results Occlusion scores did not correlate significantly with pain scores, but correlations were positive and impressions showed characteristic dentine tubule patency and occlusion. After 4 weeks, thermal VAS was significantly lower than baseline for the non-occluding toothpaste; all other pain scores were significantly lower for both treatments. Dentine occlusion scores also decreased after 4 weeks of either treatment, but did not achieve significance (p = 0.0625). Conclusions Both toothpastes reduced clinical sensitivity and increased tubule occlusion. It is hypothesised that during impression, taking some material may have sheared off and occluded tubules resulting in false positives. Clinical relevance This study has demonstrated that a silicone impression material can accurately replicate the dentine surface to demonstrate dentine tubular occlusion and patency; however, although the association between occlusion and pain score was positive, this technique needs to be refined before use in future studies.
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