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Ruetters M, Gehrig H, Kronsteiner D, Weyer V, Kim TS, Lux CJ, Sen S. Ex-vivo imaging of buccal and oral periodontal bone with low-dose CBCT in porcine jaws. Dentomaxillofac Radiol 2022; 51:20210233. [PMID: 34233504 PMCID: PMC8693329 DOI: 10.1259/dmfr.20210233] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES New CBCT devices have been developed which can provide "low-dose CBCTs (LD-CBCT)". Aim of this study is to investigate the suitability of LD-CBCT for measurement of alveolar buccal/oral bone. METHODS AND MATERIALS Vestibular and oral bone loss of the teeth of seven porcine mandibles free of soft tissues were investigated by Micro-CT and three CBCT-modes: high-dose (HD), standard-dose (SD) and low-dose (LD). Radiographic measurements of bone loss (bl) and vestibular and oral bone thickness (bt) were made by two raters at 69 sites. Measurement means and differences, Intraclass correlation (ICC) and Bland-Altman plots were calculated. RESULTS ICCs between raters(r) concerning bl were 0.954 for HD, 0.949 for SD and 0.945 for LD; concerning bt they were 0.872 for HD, 0.845 for SD and 0.783 for LD. Means of differences of bt measurements were -0.01 mm(r1)/0.00 mm(r2) for HD, 0.04 mm(r1)/0.02 mm(r2) for SD and 0.02 mm(r1)/0.04 mm(r2) for LD; for bl measurements they were 0.06 mm(r1)/0.05 mm(r2) for HD, -0.01 mm(r1)/0.13 mm(r2) for SD and 0.07 mm(r1)/0.16 mm(r2) for LD.Linear regression indicates no noticeable differences between methods and the raters with respect to bl and bt. CONCLUSIONS Relating to the CBCT-device used in this study, LD-CBCT is a promising method to detect and describe buccal and oral periodontal bl and bt. Further studies with human anatomic structures must confirm these results.
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Affiliation(s)
- Maurice Ruetters
- Section of Periodontology, Department of Operative Dentistry, University Hospital Heidelberg, Germany Im Neuenheimer Feld, Heidelberg, Germany
| | - Holger Gehrig
- Section of Periodontology, Department of Operative Dentistry, University Hospital Heidelberg, Germany Im Neuenheimer Feld, Heidelberg, Germany
| | - Dorohtea Kronsteiner
- Institute of Medical Biometry, University Hospital Heidelberg Im Neuenheimer Feld, Heidelberg, Germany
| | | | - Ti-Sun Kim
- Section of Periodontology, Department of Operative Dentistry, University Hospital Heidelberg, Germany Im Neuenheimer Feld, Heidelberg, Germany
| | - Christopher J. Lux
- Department of Orthodontics, University Hospital Heidelberg, Germany Im Neuenheimer Feld, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics, University Hospital Heidelberg, Germany Im Neuenheimer Feld, Heidelberg, Germany
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Humanized 3D scaffold xenotransplantation models for Myelodysplastic Syndromes. Exp Hematol 2021; 107:38-50. [DOI: 10.1016/j.exphem.2021.12.395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 12/10/2021] [Accepted: 12/18/2021] [Indexed: 11/19/2022]
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Bone marrow sinusoidal endothelium controls terminal erythroid differentiation and reticulocyte maturation. Nat Commun 2021; 12:6963. [PMID: 34845225 PMCID: PMC8630019 DOI: 10.1038/s41467-021-27161-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 10/28/2021] [Indexed: 12/19/2022] Open
Abstract
Within the bone marrow microenvironment, endothelial cells (EC) exert important functions. Arterial EC support hematopoiesis while H-type capillaries induce bone formation. Here, we show that BM sinusoidal EC (BM-SEC) actively control erythropoiesis. Mice with stabilized β-catenin in BM-SEC (Ctnnb1OE-SEC) generated by using a BM-SEC-restricted Cre mouse line (Stab2-iCreF3) develop fatal anemia. While activation of Wnt-signaling in BM-SEC causes an increase in erythroblast subsets (PII-PIV), mature erythroid cells (PV) are reduced indicating impairment of terminal erythroid differentiation/reticulocyte maturation. Transplantation of Ctnnb1OE-SEC hematopoietic stem cells into wildtype recipients confirms lethal anemia to be caused by cell-extrinsic, endothelial-mediated effects. Ctnnb1OE-SEC BM-SEC reveal aberrant sinusoidal differentiation with altered EC gene expression and perisinusoidal ECM deposition and angiocrine dysregulation with de novo endothelial expression of FGF23 and DKK2, elevated in anemia and involved in vascular stabilization, respectively. Our study demonstrates that BM-SEC play an important role in the bone marrow microenvironment in health and disease.
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Trebing CT, Sen S, Rues S, Herpel C, Schöllhorn M, Lux CJ, Rammelsberg P, Schwindling FS. Non-invasive three-dimensional thickness analysis of oral epithelium based on optical coherence tomography-development and diagnostic performance. Heliyon 2021; 7:e06645. [PMID: 33898808 PMCID: PMC8055558 DOI: 10.1016/j.heliyon.2021.e06645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/12/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives Evaluating structural changes in oral epithelium can assist with the diagnosis of cancerous lesions. Two-dimensional (2D) non-invasive optical coherence tomography (OCT) is an established technique for this purpose. The objective of this study was to develop and test the diagnostic accuracy of a three-dimensional (3D) evaluation method. Methods The oral lip mucosa of 10 healthy volunteers was scanned using an 870-nm spectral-domain OCT device (SD-OCT) with enhanced depth imaging (EDI). Four raters semi-automatically segmented the epithelial layer twice. Thus, eighty 3D datasets were created and analyzed for epithelial thickness. To provide a reference standard for comparison, the raters took cross-sectional 2D measurements at representative sites. The correlation between the 2D and 3D measurements, as well as intra- and inter-rater reliability, were analyzed using intraclass correlation coefficients (ICC). Results Mean epithelial thickness was 280 ± 64μm (range 178–500 μm) and 268 ± 49μm (range 163–425 μm) for the 2D and 3D analysis, respectively. The inter-modality correlation of the thickness values was good (ICC: 0.76 [0.626–0.846]), indicating that 3D analysis of epithelial thickness provides valid results. Intra-rater and inter-rater reliability were good (3D analysis) and excellent (2D analysis), suggesting high reproducibility. Conclusions Diagnostic accuracy was high for the developed 3D analysis of oral epithelia using non-invasive, radiation-free OCT imaging. Clinical significance This new 3D technique could potentially be used to improve time-efficiency and quality in the diagnosis of epithelial lesions compared with the 2D reference standard.
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Affiliation(s)
| | - Sinan Sen
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Herpel
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Maria Schöllhorn
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
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The Efficiency of Fluoride Bioactive Glasses in Protecting Enamel Surrounding Orthodontic Bracket. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5544196. [PMID: 33834066 PMCID: PMC8016578 DOI: 10.1155/2021/5544196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/21/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this study was to evaluate the protective effect of using four different fluoride bioactive enamel sealers against an acidic erosion challenge. Materials and Methods A sample of 50 freshly extracted sound upper premolars had their buccal surface bonded to 50 orthodontic brackets using Transbond PLUS color change adhesive; the first four groups had four compositions of fluoride bioactive glasses based on 37 mol% SiO2, 43.9-53.9 mol% CaO, 6.1 mol% P2O5 and CaF2, and 0-10 mol% of Na2O applied to their surfaces and the fifth group served as control (which was not treated by any bioactive sealer). All specimens were challenged by 1% citric acid for 18 minutes which was stirred by a magnetic stirrer. The enamel surfaces next to the orthodontic brackets were examined by SEM. The Wilcoxon signed-rank test was used to compare the area covered by the fluoride bioactive pastes before/after erosion (p < 0.05). Samples from the layer formed on top of the examined teeth were tested before/after erosion to be examined by the attenuated total reflectance Fourier-transform infrared spectroscopy (FTIR/ATR). Results The FTIR/ATR test showed that fluoride bioactive pastes' applications resulted in the formation of a hydroxyapatite-rich layer; the SEM analysis showed that the aforementioned layer significantly resisted erosion challenge when compared to the control group (p < 0.05). Conclusions Fluoride bioactive pastes can efficiently protect the enamel surfaces next to orthodontic brackets from acidic erosion challenges.
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Şen S, Erber R, Orhan G, Zingler S, Lux CJ. OCT evaluation of orthodontic surface sealants: a 12-month follow-up randomized clinical trial. Clin Oral Investig 2021; 25:1547-1558. [PMID: 32789656 PMCID: PMC7878257 DOI: 10.1007/s00784-020-03462-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/10/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this single-center randomized controlled trial (NCT03753256) was to assess orthodontic surface sealant layer thickness and integrity in vivo during a 12-month follow-up by optical coherence tomography (OCT). MATERIALS AND METHODS Using a split-mouth design, quadrants of 20 patients treated with fixed orthodontic appliances were included. Quadrants were randomly assigned to the sealants Pro Seal® (PS) or Opal® Seal™ (OS). OCT scans were performed immediately after the application of the sealants and after 3, 6, 9, and 12 months. Sealant layer thicknesses and their integrity were determined at 5 regions of interest (ROIs) known for high risks of demineralization. Sealant integrity loss was determined using a self-developed scale. RESULTS A total of 16 patients successfully completed the study. The studied sealants showed significant differences in initial layer thickness. Mean layer thickness was significantly lower for PS (67.8 μm, (95% CI, 56.1-79.5)) than for OS (110.7 μm, (95% CI, 97.3-124.1)). Layer thickness loss was significant after 3 months for PS and after 6 months for OS. Sealant integrity was compromised in more than 50% of the ROIs already after 3 months for both sealants. CONCLUSIONS Patients treated with fixed orthodontic surface sealants lost the integrity of the protective layer in more than 50% of cases after 3 months, and the layer thickness of the sealants was significantly reduced after 3-6 months. CLINICAL RELEVANCE The protective effect against demineralization lesions of orthodontic sealants in patients treated with fixed appliances appears to be limited in time. Further preventive measures should be investigated. TRIAL REGISTRATION ClinicalTrials.gov (NCT03753256).
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Affiliation(s)
- Sinan Şen
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Ralf Erber
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gül Orhan
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Deurer N, Erber R, Orhan G, Zingler S, Lux CJ, Şen S. Abrasion of Pro Seal® and Opal® Seal™ by professional tooth cleaning protocols: results from an in vitro study and a randomized controlled trial. Eur J Orthod 2020; 42:596-604. [PMID: 31765473 DOI: 10.1093/ejo/cjz096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The integrity of orthodontic surface sealants after professional tooth cleaning (PTC) has previously only been evaluated in vitro. Recently, we have shown that optical coherence tomography (OCT) can successfully be used for the longitudinal assessments of sealant thickness in vitro and in vivo. OBJECTIVES Thus, the aim of the present study was to assess the sealant thickness after PTC in vitro and in vivo by OCT. TRIAL DESIGN Single-centre four-arm parallel-group randomized controlled trial. METHODS Ninety-six extracted human teeth were randomly assigned to the surface sealants Pro Seal® (PS) and Opal® Seal™ (OS) and to PTC protocols: (1) polishing with brush and prophy paste (Cleanic®) or (2) erythritol air-polishing. Sealant thickness was assessed by OCT immediately after application (baseline), after thermocycling and after polishing for totals of 5, 10, 15, 30, 60, 90, and 120 seconds. Additionally, a clinical trial was conducted. Therefore, using a split-mouth design, quadrants of 20 patients and PTC protocols were randomized by an external randomization centre using computer generated tables to assign the surface sealants and PTC protocols. Sealant thicknesses were analysed at baseline, before and after PTC. Due to the optical properties of sealants, a complete blinding was not feasible. RESULTS In vitro both sealants revealed significant layer thickness losses after both PTC protocols. PS lost 0.77 µm/s [95% CI (confidence interval): 0.67, 0.87] from air-polishing and 0.43 µm/s (95% CI: 0.37, 0.49) from polishing with brush while OS lost 0.44 µm/s (95% CI: 0.32, 0.55) from air-polishing and 0.79 µm/s (95% CI: 0.68, 0.89) from polishing with brush of layer thickness. Sealant thickness loss of was significantly higher after erythritol air-polishing for PS and after polishing with brush for OS. The results of a concurrent randomized controlled trial (RCT) were comparable to those achieved in the in vitro part of this study. LIMITATIONS Long-term surface sealant abrasion should be validated by additional RCTs. CONCLUSIONS For PTC on surface sealant treated teeth, low abrasive protocols should be used. Air-polishing should be avoided on PS protected teeth and polishing with brush on OS treated teeth. TRIAL REGISTRATION ClinicalTrials.gov NCT03753256.
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Affiliation(s)
- Nadine Deurer
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Heidelberg, Germany
| | - Ralf Erber
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Heidelberg, Germany
| | - Gül Orhan
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Heidelberg, Germany
| | - Sinan Şen
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Heidelberg, Germany
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Trebing CT, Schwindling FS, Leisner L, Trebing J, Lux CJ, Rammelsberg P, Sen S. Diagnostic accuracy of 870-nm spectral-domain OCT with enhanced depth imaging for the detection of caries beneath ceramics. J Dent 2020; 102:103458. [PMID: 32866552 DOI: 10.1016/j.jdent.2020.103458] [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: 04/24/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To evaluate the diagnostic accuracy of optical coherence tomography (OCT) for the non-invasive detection of caries adjacent to ceramic materials. METHODS Disks made from five ceramic materials (hybrid ceramic, feldspathic ceramic, zirconia-reinforced lithium silicate, lithium disilicate, and high-translucent zirconia) were ground to the recommended material thickness for single crown restorations and laminated with a 100 μm thick layer of one of three adhesive cements. The disks were fixed to extracted human molars with or without carious lesions of one of three standardized sizes. A total of 240 stacks of cross-sectional scans obtained using an 870-nm SD-OCT with enhanced depth imaging (EDI) were presented to five raters. Diagnostic accuracy was determined by rating the teeth beneath the cemented material as carious or healthy. RESULTS Carious samples were distinguished from sound teeth with high diagnostic accuracy, even for early stage caries. Sensitivity (SE) and specificity (SP) pooled over all raters and all materials were 0.9 and 0.97, respectively. When analyzing the effect of the ceramic and cement materials on detection rates, high SE and SP values of >0.96 and >0.91, respectively, were recorded for lithium disilicate, zirconia-reinforced lithium silicate, and high-translucent zirconia irrespective of the cement type. For hybrid and feldspathic ceramics, the cement material was found to have a significant effect on caries detection. CONCLUSIONS Given its high diagnostic accuracy, 870-nm SD-OCT with EDI might be useful for the detection of caries beneath restorative materials. The effect of the prescribed ceramic and cement material on optical penetration depth is substantial.
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Affiliation(s)
| | | | - Laura Leisner
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Johannes Trebing
- Department of Internal Medicine III: Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
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Ten Years of Micro-CT in Dentistry and Maxillofacial Surgery: A Literature Overview. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10124328] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Micro-computed tomography (micro-CT) is a consolidated imaging technology allowing non-destructive three-dimensional (3D) qualitative and quantitative analysis by the observation of microstructures with high resolution. This paper aims at delivering a structured overview of literature about studies performed using micro-CT in dentistry and maxillofacial surgery (MFS) by analyzing the entire set of articles to portray the state of the art of the last ten years of scientific publications on the topic. It draws the scenario focusing on biomaterials, in vitro and in/ex vivo applications, bone structure analysis, and tissue engineering. It confirms the relevance of the micro-CT analysis for traditional research applications and mainly in dentistry with respect to MFS. Possible developments are discussed in relation to the use of the micro-CT combined with other, traditional, and not, techniques and technologies, as the elaboration of 3D models based on micro-CT images and emerging numerical methods. Micro-CT results contribute effectively with whose ones obtained from other techniques in an integrated multimethod approach and for multidisciplinary studies, opening new possibilities and potential opportunities for the next decades of developments.
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Şen S, Erber R, Şen G, Deurer N, Zingler S, Lux CJ. Discoloration of surface sealants by plaque disclosing solution. J Orofac Orthop 2020; 81:258-266. [PMID: 32377773 PMCID: PMC7316847 DOI: 10.1007/s00056-020-00227-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/28/2020] [Indexed: 12/11/2022]
Abstract
Purpose Surface sealants are widely used as a prevention strategy and are indicated for young patients with insufficient oral hygiene who also need plaque removal by professional tooth cleaning. The aim of this study was to evaluate discoloration of surface sealants by plaque disclosing solutions and to test to what extent this discoloration can be reduced again by professional tooth cleaning. Methods In all, 96 extracted lesion-free human teeth were randomly assigned to treatment with either Pro Seal® (PS; Opal Orthodontics, South Jordan, UT, USA) or Opal®Seal™ (OS; Reliance Orthodontic Products, Itasca, IL, USA). Color evaluations after application of the plaque disclosing solution Mira-2-Ton® (Hager & Werken, Duisburg, Germany) were performed using a clinical spectrophotometer. Staining and polishing were repeated once. Color differences (∆E) above 3.77 were regarded as clinically relevant. Results All sealants showed high, clinically relevant ∆E values after the first staining. Polishing led to significantly decreased ∆E values on PS-treated teeth; however, the median ∆E value remained above the clinically relevant threshold. Polishing on OS-treated teeth only slightly reduced ∆E values. After professional tooth cleaning both PS and OS showed clinically relevant ∆E values. Conclusion Surface sealants show clinically relevant discoloration after exposure to plaque disclosing solution under in vitro conditions. Such discolorations could not be removed by professional tooth cleaning. Thus, in clinical practice, plaque disclosing solutions might cause esthetic deficits in surface sealant-treated teeth. The impact of plaque disclosing solutions under clinical conditions (e.g., in the presence of saliva and by various aspects of a person’s nutrition) should be investigated in clinical studies.
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Affiliation(s)
- Sinan Şen
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Ralf Erber
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gözde Şen
- MVZ Dentale Praxisklinik, Dr. Dilling & Kollegen GmbH, Fleiner Straße 3, 74072, Heilbronn, Germany
| | - Nadine Deurer
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Şen S, Erber R, Deurer N, Orhan G, Lux CJ, Zingler S. Demineralization detection in orthodontics using an ophthalmic optical coherence tomography device equipped with a multicolor fluorescence module. Clin Oral Investig 2019; 24:2579-2590. [PMID: 31848715 DOI: 10.1007/s00784-019-03116-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 10/07/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Demineralizations such as white spot lesions are among the most prevalent side effects during orthodontic treatment. Fluorescence devices, including quantitative light-induced fluorescence (QLF), exploiting the intrinsic fluorescence of enamel and teeth and most recently optical coherence tomography (OCT) were introduced for early demineralization detection. In addition to near-infrared OCT scanning, multicolor modules allow for imaging with different laser wavelengths and the detection of reflective- and fluorescent light. The aim of this study was to evaluate a modified multicolor ophthalmic OCT device for the detection of early carious lesions in vitro and in vivo. MATERIALS AND METHODS Twenty-seven extracted lesion free human teeth were randomly assigned to three different demineralization protocols. Carious lesion detection was performed using macrophotography, OCT, and reflectance/fluorescence imaging using green laser and blue laser light. In addition, teeth of 5 orthodontic patients were OCT scanned, and fluorescence imaging using blue laser light was performed to assess demineralization after orthodontic therapy. RESULTS Both in vitro and in vivo, OCT allowed for precise determination of lesion depth and enamel loss. Fluorescence imaging using blue laser light was most sensitive for the detection of early demineralization in vitro and in vivo. However, established and severe demineralizations were also reliably detected by macrophotography in vitro and in vivo. CONCLUSION Demineralization can be detected with high sensitivity using blue fluorescence imaging with multicolor OCT devices. CLINICAL RELEVANCE In the future, OCT fluorescence imaging might be considered for longitudinal monitoring of dental hard tissue during orthodontic treatment in clinical trials.
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Affiliation(s)
- Sinan Şen
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Ralf Erber
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Nadine Deurer
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gül Orhan
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Corcodel N, Hassel AJ, Sen S, Saure D, Rammelsberg P, Lux CJ, Zingler S. Effects of staining and polishing on different types of enamel surface sealants. J ESTHET RESTOR DENT 2018; 30:580-586. [PMID: 30394680 DOI: 10.1111/jerd.12423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/29/2018] [Accepted: 08/05/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess surface discoloration of four enamel sealants based on different chemical compositions after exposure to artificial aging and staining solutions. Furthermore, their cleanability after polishing will be evaluated. MATERIALS AND METHODS Selected sealants were a composite resin-based sealant with fillers (Pro Seal), a composite resin-based sealant without fillers (Light BondSealant), a resin-modified glass ionomer-based sealant (ClinproXT Varnish) and a silicon-based sealant (Protecto). Natural teeth served as medium. Immersion solutions were water, juice, tea, and turmeric. In a standardized setting, all samples were measured seven times with a spectroradiometer (Photoresearch PR670) at baseline, after thermocycling; 7 days; 2 and 4 weeks of immersion; and after finally polishing. RESULTS Thermocycling had no significant effect on color stability. After exposure to staining solutions, all sealed surfaces showed significant color changes. Color change predominately occurred for all sealants in the first week of staining (P ≤ .01). Best resistance to staining decreased as follows: Protecto > Light Bond Sealant > ProSeal > Clinpro XT Varnish. Surface cleaning by polishing significantly reduced the color change. CONCLUSION Sealed enamel surfaces are prone to discoloration, which is most prominent in filled composite and glass-ionomer-based sealants. Staining can be reduced by polishing; however, in this in vitro setting the original color could not be restored. CLINICAL SIGNIFICANCE Enamel sealants might exert adverse effects in terms of discoloration. This should be taken into consideration by clinicians and patients, particularly when sealants are applied in esthetically critical areas.
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Affiliation(s)
- Nicoleta Corcodel
- Department of Prosthodontics, University Hospital of Heidelberg, Heidelberg, Germany
| | - Alexander J Hassel
- Department of Prosthodontics, University Hospital of Heidelberg, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics, University Hospital of Heidelberg, Heidelberg, Germany
| | - Daniel Saure
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, University Hospital of Heidelberg, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics, University Hospital of Heidelberg, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics, University Hospital of Heidelberg, Heidelberg, Germany
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