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The power of weak ion-exchange resins assisted by amelogenin for natural remineralization of dental enamel: an in vitro study. Odontology 2022; 110:545-556. [PMID: 35147809 PMCID: PMC9170625 DOI: 10.1007/s10266-022-00688-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/20/2022] [Indexed: 10/28/2022]
Abstract
This study aims to develop an innovative dental product to remineralize dental enamel by a proper combination of ion-exchange resins as controlled release of mineral ions that form dental enamel, in the presence of amelogenin to guide the appropriate crystal growth. The novel product proposed consists of a combination of ion-exchange resins (weak acid and weak base) individually loaded with the remineralizing ions: Ca2+, PO43- and F-, also including Zn2+ in a minor amount as antibacterial, together with the protein amelogenin. Such cocktail provides onsite controlled release of the ions necessary for enamel remineralization due to the weak character of the resins and at the same time, a guiding tool for related crystal growth by the indicated protein. Amelogenin protein is involved in the structural development of natural enamel and takes a key role in controlling the crystal growth morphology and alignment at the enamel surface. Bovine teeth were treated by applying the resins and protein together with artificial saliva. Treated teeth were evaluated with nanoindentation, scanning electron microscopy and energy-dispersive X-ray spectroscopy. The innovative material induces the dental remineralization creating a fluorapatite layer with a hardness equivalent to sound enamel, with the appropriate alignment of corresponding nanocrystals, being the fluorapatite more acid resistant than the original mineral. Our results suggest that the new product shows potential for promoting long-term remineralization leading to the inhibition of caries and protection of dental structures.
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Balasubramaniam A, PD MK, Iyer K, Ganapathy D. Effectiveness of Organic and Inorganic Fluoridated Dentifrice on Dental Caries Progression Among Institutionalized Geriatrics: A Randomized Intervention. Cureus 2022; 14:e21058. [PMID: 35165536 PMCID: PMC8826480 DOI: 10.7759/cureus.21058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose To assess the effects of two commercially available organic and inorganic fluoridated dentifrices on dental caries progression amongst the institutionalized geriatric population. Materials and methods A total of 80 participants were selected and randomly allocated using the coin toss method into two groups, viz. Group I with subjects receiving organic fluoridated dentifrice and Group II with subjects receiving inorganic fluoridated dentifrice. Allocation concealment was done using the Sequentially-Numbered, Opaque, Sealed Envelopes (SNOSE) method. Participants were blinded using analogous dentifrice tubes. They brushed their teeth with the dentifrices twice daily using the modified Bass technique for a period of six months. Their compliance with the intervention was monitored regularly. The outcome measure was susceptibility to dental caries assessed by a cariogram. A single, trained, and calibrated investigator assessed the cariogram at baseline and after six months. Collected data were compiled and analyzed. Results The mean age was found to be 67.75 ± 4.1 years, 70.05 ±7.4 years among Group I and Group II participants, respectively. The results showed that the efficacy of avoiding new carious lesions was higher (75.85%) in Group I participants as compared to Group II (73.4%) participants, but no significant difference in the mean cariogram sectors was observed. However, there was a statistically significant reduction in the Streptococcus (S.) mutans and Lactobacillus colony-forming unit (CFU) (p<0.05) with a considerable increase in salivary pH in Group I participants. Conclusion There is a marked increase in the possibility of avoiding new carious lesions with a reduction in S. mutans and Lactobacillus CFU and an increase in saliva buffer capacity over six months of use of organic fluoride dentifrices. Thus, organic fluoride dentifrice can be an effective agent for institutionalized geriatrics in the prevention of dental caries and oral diseases.
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Dias-Moraes MC, Castro PAA, Pereira DL, Ana PA, Freitas AZ, Zezell DM. Assessment of the preventive effects of Nd:YAG laser associated with fluoride on enamel caries using optical coherence tomography and FTIR spectroscopy. PLoS One 2021; 16:e0254217. [PMID: 34234361 PMCID: PMC8263272 DOI: 10.1371/journal.pone.0254217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 06/22/2021] [Indexed: 02/06/2023] Open
Abstract
Objective This in vitro study characterized and monitored, by Optical Coherence Tomography (OCT) and Fourier Transformed Infrared Spectroscopy (FTIR), the effects of the association of acidulated phosphate fluoride gel (APF-gel) and Nd:YAG (neodymiun:yttrium-aluminum-garnet) laser, as sequencial treatments, in the prevention of incipient enamel caries lesions. Methods 120 human enamel samples were randomized into 3 groups (n = 40): APF-gel (1.23% F-, 4 min.); Laser+APF (Nd:YAG laser irradiation—0.6W, 84.9J/cm2, 10Hz, followed by APF-gel); and APF+Laser (APF-gel followed by laser irradiation). The samples were subjected to a 15-day pH-cycling, evaluated by OCT (quantification of optical attenuation coefficient–OAC) and FTIR (analysis of carbonate and phosphate content) before treatments, after treatments, and on the 5th, 10th and 15th days of pH-cycling. The statistical analysis was performed (α = 5%). Results The Optical Attenuation Coefficient (OAC) assessed by OCT increases with the progression of demineralization, and the Laser+APF presented the highest values of OAC in 10th and 15th days of pH-cycling. Nd:YAG decreased the carbonate content after treatment regardless of the application order of the APF-gel, while APF-gel did not interfere in the composition of enamel. The carbonate content was also changed in the first 5 days of the pH-cycling in all groups. Conclusion Nd:YAG laser irradiation before or after the application of APF-gel did not influence the appearance of incipient caries lesions, showing no synergistic effect. Regardless of the application order of the APF-gel, laser irradiation reduces the carbonate content of the enamel, which also changes during the demineralization process. However, irradiation before the application of APF-gel increased the speed of progression of the lesions, which positively impacts public health as it can prevent caries disease, even in high risk individuals. OCT and FTIR are suitable for assessing this effect.
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Affiliation(s)
- Marcia Cristina Dias-Moraes
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Pedro Arthur Augusto Castro
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Daísa Lima Pereira
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Patrícia Aparecida Ana
- Center for Engineering, Modelling and Applied Social Sciences, Universidade Federal do ABC, Sao Bernardo do Campo, SP, Brazil
| | - Anderson Zanardi Freitas
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Denise Maria Zezell
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
- * E-mail:
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Paszynska E, Pawinska M, Gawriolek M, Kaminska I, Otulakowska-Skrzynska J, Marczuk-Kolada G, Rzatowski S, Sokolowska K, Olszewska A, Schlagenhauf U, May TW, Amaechi BT, Luczaj-Cepowicz E. Impact of a toothpaste with microcrystalline hydroxyapatite on the occurrence of early childhood caries: a 1-year randomized clinical trial. Sci Rep 2021; 11:2650. [PMID: 33514787 PMCID: PMC7846568 DOI: 10.1038/s41598-021-81112-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/01/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite is not inferior to a fluoride toothpaste in prevention of caries in children. This double-blinded randomized control trial compared two toothpastes regarding the occurrence of caries lesions using International Caries Detection and Assessment System (ICDAS) ≥ code 1 on the primary dentition within 336 days. The test group used a fluoride-free hydroxyapatite toothpaste three times daily while control group used a toothpaste with fluoride. 207 children were included in the intention-to-treat analysis; 177 of them finished the study per protocol. An increase in caries ICDAS ≥ code 1 per tooth was observed in 72.7% of the hydroxyapatite-group (n = 88), compared with 74.2% of the fluoride-group (n = 89). The exact one-sided upper 95% confidence limit for the difference in proportion of participants with ICDAS increase ≥ 1 (-1.4%) was 9.8%, which is below the non-inferiority margin of 20% demonstrating non-inferiority of hydroxyapatite compared to the fluoride control toothpaste. This RCT showed for the first time, that in children, the impact of the daily use of a toothpaste with microcrystalline hydroxyapatite on enamel caries progression in the primary dentition is not inferior to a fluoride control toothpaste (Clinical Trials NCT03553966).
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland.
| | - Malgorzata Pawinska
- Department of Integrated Dentistry, Medical University of Bialystok, Białystok, Poland
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Inga Kaminska
- Department of Integrated Dentistry, Medical University of Bialystok, Białystok, Poland
| | | | | | - Szymon Rzatowski
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Aneta Olszewska
- Department of Facial Malformation, Pediatric Dentistry Clinic, Poznan University of Medical Sciences, Poznan, Poland
| | - Ulrich Schlagenhauf
- Department of Conservative Dentistry and Periodontology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Theodor W May
- Society for Biometrics and Psychometrics, Bielefeld, Germany
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, USA
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Erdwey D, Meyer-Lueckel H, Esteves-Oliveira M, Apel C, Wierichs RJ. Demineralization Inhibitory Effects of Highly Concentrated Fluoride Dentifrice and Fluoride Gels/Solutions on Sound Dentin and Artificial Dentin Caries Lesions in vitro. Caries Res 2020; 55:41-54. [PMID: 33285548 DOI: 10.1159/000509931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/04/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this in vitro study was to compare the demineralization inhibitory effect of gels/solutions used in combination with either standard or highly fluoridated dentifrices on sound dentin as well as on artificial dentin caries-like lesions. METHODS Bovine dentin specimens (n = 240) with two different surfaces each (sound [ST] and artificial caries lesion [DT]) were prepared and randomly allocated to twelve groups. Weekly interventions during pH-cycling (28 days, 6 × 120 min demineralization/day) were: the application of gels/solutions containing amine fluoride/sodium fluoride (12,500 ppm F [ppm]; pH = 4.4; AmF); NaF (12,500 ppm; pH = 6.6; NaF1); NaF (12,500 ppm; pH = 6.3; NaF2); silver diamine fluoride (14,200 ppm; pH = 8.7; SDF); acidulated phosphate fluoride (12,500 ppm; pH = 3.8; APF), and no intervention (standard control; S). Furthermore, half of the specimens in each group were brushed (10 s; twice per day) with dentifrice slurries containing either 1,450 ppm (e.g., AmF1450) or 5,000 ppm (e.g., AmF5000). Differences in integrated mineral loss (ΔΔZ) and lesion depth (ΔLD) were calculated between values before and after pH-cycling using transversal microradiography. RESULTS After pH-cycling Ss showed significantly increased ΔZDT and LDDT values, indicating further demineralization. In contrast, except for one, all groups including fluoride gels/solutions showed significantly decreased ΔZDT values. Additional use of most fluoride gels/solutions significantly enhanced mineral gain, mainly in the surface area; however, acidic gels/solutions seemed to have negative effects on lesion depths. SIGNIFICANCE Under the present pH-cycling conditions the highly fluoridated dentifrice significantly reduced caries progression and additional application of nearly all of the fluoride gels/solutions resulted in remineralization. However, there was no difference in the remineralizing capacity of fluoride gels/solutions when used in combination with either standard or highly fluoridated dentifrices.
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Affiliation(s)
- Daniel Erdwey
- Department of Oral and Maxillofacial and Facial Plastic Surgery, School of Medicine, University Hospital RWTH Aachen, Aachen, Germany, .,Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany,
| | - Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, zmk Bern, University of Bern, Bern, Switzerland
| | - Marcella Esteves-Oliveira
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany.,Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Christian Apel
- Department of Biohybrid and Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, zmk Bern, University of Bern, Bern, Switzerland.,Department of Biohybrid and Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
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Körner P, Schleich JA, Wiedemeier DB, Attin T, Wegehaupt FJ. Effects of Additional Use of Bioactive Glasses or a Hydroxyapatite Toothpaste on Remineralization of Artificial Lesions in vitro. Caries Res 2020; 54:336-342. [PMID: 32998154 DOI: 10.1159/000510180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/11/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This in vitro study aimed to evaluate and compare the effect of two different bioactive glasses, a hydroxyapatite-containing, fluoride-free toothpaste (HTP) and a fluoride toothpaste (FTP) on the remineralization behavior of initial caries lesions. MATERIALS AND METHODS A total of 100 bovine enamel samples were randomly allocated to five groups of 20 samples each: NC = negative control group (artificial saliva); HTP = HTP group (Karex); FTP = FTP group (Elmex caries protection, 1,400 ppm); FTP + BGnano = FTP followed by Actimins bioactive glass; FTP + BGamorph = FTP followed by Schott bioactive glass. Radiographic documentation (advanced transversal microradiography; aTMR) was applied before and after all samples were exposed to a demineralizing gel for 10 days. Over a period of 28 days, samples were covered twice a day (every 12 h) with a toothpaste slurry of the respective test group or with artificial saliva in NC for 60 s and brushed with 15 brushing strokes. Samples in FTP + BGnano and FTP + BGamorph were additionally treated with the respective bioactive glass slurry for 30 s after brushing with the FTP. In the meantime, all samples were stored in artificial saliva. After 28 days, the structure of all samples was assessed again using aTMR and compared to the values measured after demineralization. The statistical evaluation of the integrated mineral loss was performed using Kruskal-Wallis test followed by a post hoc Conover test. RESULTS The FTP revealed the significantly highest increase of mineral content while the HTP showed the significantly lowest remineralization. Compared to artificial saliva, the use of the HTP or the combined application of FTP followed by bioactive glasses (FTP + BGnano and FTP + BGamorph) showed no significant remineralization. CONCLUSION Under remineralizing in vitro conditions, brushing with 1,400 ppm FTP induced significantly more remineralization compared to storage in artificial saliva. The additional administration of both bioactive glasses as well as the substitutional brushing with an HTP resulted in significantly less remineralization compared to brushing with 1,400 ppm FTP.
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Affiliation(s)
- Philipp Körner
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland,
| | - Jana A Schleich
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel B Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Florian J Wegehaupt
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Re- and demineralization characteristics of dentin depending on fluoride application and baseline characteristics in situ. J Dent 2020; 94:103305. [DOI: 10.1016/j.jdent.2020.103305] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 11/19/2022] Open
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Wierichs RJ, Rupp K, Meyer-Lueckel H, Apel C, Esteves-Oliveira M. Effects of Dentifrices Differing in Fluoride Content on Remineralization Characteristics of Dentin in vitro. Caries Res 2019; 54:75-86. [PMID: 31775152 DOI: 10.1159/000504165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 10/14/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the caries preventive effect of highly fluoridated dentifrices and gels on sound dentin as well as on artificial dentin caries-like lesions. METHODS Bovine dentin specimens (n = 240), with 2 different surfaces each (1 sound surface [sound treatment (ST)] and one caries lesion [demineralized treatment (DT)]), were prepared and randomly allocated to one highly (6 × 120 min demineralization/day [H]) and one lowly cariogenic (6 × 60 min demineralization/day [L]) pH-cycling model. Treatments during pH-cycling (28 days) were: brushing 2×/day with: 0 ppm F [H0/L0], 1,450 ppm F [H1,450/L1,450], 2,800 ppm F [H2,800/L2,800], 5,000 ppm F [H5,000/L5,000], 5,000 ppm F plus TCP [H5,000+TCP/L5,000+TCP], and 12,500 ppm F [H12,500/L12,500] containing dentifrices/gels. Dentifrice/gel slurries were prepared with deionized water (1:2 wt/wt). Differences in integrated mineral loss (∆∆Z) and ∆ lesion depth were calculated between values before and after pH-cycling using transversal microradiography. RESULTS The correlation between ΔΔZDT and F- was strong for the highly (rH = 0.691; p < 0.001) and moderate (rL = 0.500; p < 0.001) for the lowly cariogenic model, indicating a fluoride dose-response for both. Significant differences for ΔΔZDT and ΔΔZST could be found between H0, H1,450, H5,000, and H12,500 as well as L0, L5,000, and L125,000 (p ≤ 0.046; analysis of covariance [ANCOVA]). Except for 0 ppm F-, no significant difference in ΔΔZST and ΔΔZDT could be found between the highly and lowly cariogenic model (p ≥ 0.056; ANCOVA). CONCLUSION For both pH-cycling conditions a dose-response for fluoride could be revealed. For elderly people with exposed root surfaces, the use of gels containing 12,500 ppm F instead of regularly (1,450 ppm F) or highly (5,000 ppm F) fluoridated dentifrices should be further investigated, as it offered higher caries-preventive effects in vitro.
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Affiliation(s)
- Richard J Wierichs
- Department of Biohybrid and Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany, .,Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany,
| | - Katharina Rupp
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany
| | - Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, zmk Bern, University of Bern, Bern, Switzerland
| | - Christian Apel
- Department of Biohybrid and Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Marcella Esteves-Oliveira
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany.,Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2018; 120:816-878. [DOI: 10.1016/j.prosdent.2018.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 02/08/2023]
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Walther C, Kreibohm M, Paris S, Meyer-Lueckel H, Tschoppe P, Wierichs RJ. Effect of NaF, AmF, KF gels and NaF toothpaste combined with a saliva substitute on dentin lesions in vitro. Clin Oral Investig 2018; 23:2489-2496. [PMID: 30306335 DOI: 10.1007/s00784-018-2687-4] [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: 03/12/2018] [Accepted: 10/01/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the present in vitro study was to evaluate the remineralizing effects of NaF, AmF, KF gels and NaF toothpaste in combination with a potentially demineralizing saliva substitute (Glandosane; pH = 5.1) being widely used in Germany. METHODS In each of 120 dentin specimens, three artificial lesions were created. One lesion was covered for analysis of pre-demineralization (ΔZB). Treatments during pH cycling (3 × 1 h demineralization/day [pH = 5.0] and 3 × 3 h Glandosane/day; 12 h 100%humidity) were as follows: no treatment (NT), application (5 min,2×/day) of 12.500 ppm F- [pH = 6.04] (NaF-gel1), 12.500 ppm F- [pH = 7.34] (NaF-gel2), 12.500 ppm F- [pH = 5.82] (AmF-gel), 1450 ppm F- [pH = 7.35] (KF-gel), and 5000 ppm F- [pH = 8.14]; (NaF-TP) for 7 days (E1). Subsequently, from each specimen, one lesion was covered, while the remaining lesion was cycled for another 7 days (E2). Differences in integrated mineral loss (ΔΔZE1/ΔΔZE2) were calculated between values before and after pH cycling. RESULTS Mean (95%CI) ΔZB was 3851 (3762;3939) vol% × μm. Except for NaF-gel2 and NaF-TP, specimens of all other groups further demineralized. Only NaF-gel2 induced a significant gain in mineral content (p ≤ 0.004; paired t test). Significant differences in the change of mineral loss were found between NT and all fluoride groups for both ΔΔZE1 and for ΔΔZE2 (p < 0.05, Bonferroni post hoc test). However, only NaF-gel2 and NaF-TP induced remineralization. CONCLUSION Under the in vitro conditions chosen, all fluoride agents could significantly hamper the adverse effects of a demineralizing saliva substitute. CLINICAL SIGNIFICANCE In combination with a demineralizing saliva substitute, slight mineral gain was only observed for neutral NaF-gel2 and 5000 ppm F- toothpaste.
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Affiliation(s)
- Carolin Walther
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Manana Kreibohm
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Sebastian Paris
- Department of Operative Dentistry and Periodontology, University School of Dental Medicine, CharitéCentrum 3, Charité - Universitätsmedizin Berlin, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Hendrik Meyer-Lueckel
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.,Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Peter Tschoppe
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.,Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Richard Johannes Wierichs
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. .,Department of Biohybrid & Medical Textiles (BioTex), AME - Institute of Applied Medical Engineering, Helmholtz Institute, Forckenbeckstr. 55, 52074, Aachen, Germany.
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Wierichs RJ, Stausberg S, Lausch J, Meyer-Lueckel H, Esteves-Oliveira M. Caries-Preventive Effect of NaF, NaF plus TCP, NaF plus CPP-ACP, and SDF Varnishes on Sound Dentin and Artificial Dentin Caries in vitro. Caries Res 2018; 52:199-211. [DOI: 10.1159/000484483] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/16/2017] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to compare the caries-preventive effect of different fluoride varnishes on sound dentin as well as on artificial dentin caries-like lesions. Bovine dentin specimens (n = 220) with one sound surface (ST) and one artificial caries lesion (DT) were prepared and randomly allocated to 11 groups. The interventions before pH cycling were as follows: application of a varnish containing NaF (22,600 ppm F-; Duraphat [NaF0/NaF1]), NaF plus tricalcium phosphate (22,600 ppm F-; Clinpro White Varnish Mint [TCP0/TCP1]), NaF plus casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP; 22,600 ppm F-; MI Varnish [CPP0/CPP1]), or silver diamine fluoride (SDF; 35,400 ppm F-; Cariestop 30% [SDF0/SDF1]) and no intervention (NNB/N0/N1). During pH cycling (14 days, 6 × 120 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 times/day) with either fluoride-free (“0”; e.g., TCP0) or 1,100 ppm F- (“1”; e.g., TCP1) dentifrice slurry. In another subgroup, the specimens were pH cycled but not brushed (NNB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between the values after initial demineralization and those after pH cycling, using transversal microradiography and photographic images. After pH cycling, no discoloration could be observed. Furthermore, NNB, N0, and N1 showed significantly increased ΔZDT/LDDT and ΔZST/LDST values, indicating further demineralization. In contrast, CPP0, CPP1, SDF0, and SDF1 showed significantly decreased ΔZDT/LDDT values, indicating remineralization (p ≤ 0.004; paired t test). CPP0, CPP1, SDF0, and SDF1 showed significantly higher changes in ΔΔZDT/ΔLDDT and ΔΔZST/ΔLDST than NNB, N0, and N1 (p < 0.001; Bonferroni post hoc test). In conclusion, under the conditions chosen, all fluoride varnishes prevented further demineralization. However, only NaF plus CPP-ACP and SDF could remineralize artificial dentin caries-like lesions under net-demineralizing conditions, thereby indicating that NaF plus CPP-ACP and SDF may be helpful to high-caries-risk patients.
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Wierichs RJ, Kogel J, Lausch J, Esteves-Oliveira M, Meyer-Lueckel H. Effects of Self-Assembling Peptide P11-4, Fluorides, and Caries Infiltration on Artificial Enamel Caries Lesions in vitro. Caries Res 2017; 51:451-459. [PMID: 28772269 DOI: 10.1159/000477215] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 05/01/2017] [Indexed: 11/19/2022] Open
Abstract
The application of a self-assembling peptide on noncavitated caries lesions is supposed to be a feasible approach to facilitate remineralization and mask their unfavorable appearance. However, demineralizing conditions are common in the oral environment, so the aim of this pH-cycling study was to compare recommended and novel treatment methods regarding their ability to hamper demineralization and as a consequence mask artificial enamel caries lesions. Artificial caries lesions were prepared in bovine enamel and randomly allocated to 11 groups (n = 22). Treatments before pH-cycling were as follows: the application of a self-assembling peptide (Curodont™ Repair [C]), a low-viscosity resin (Icon® [I]), 2 fluoride solutions (10,000 ppm F-: Elmex fluid [E] and 43,350 ppm F-: Tiefenfluorid® [T]), and no intervention (N). During pH-cycling (28 days, 6 × 60 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 ×/day) with either fluoride-free (named e.g., C0) or NaF (1,100 ppm F-; e.g., C1) dentifrice slurry. In another subgroup specimens were pH-cycled but not brushed (NNB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between values after pre-demineralization, surface treatment, and pH-cycling. Specimens of C0, C1, NNB, N0, N1, T0, and E0 showed significantly increased ΔZ and LD values after pH-cycling (p ≤ 0.003; paired t test). C0, C1, NNB, and N0 showed significantly higher changes in ΔΔZ than E1, I0, I1, and T1 (p < 0.001; ANOVA). Significantly reduced colorimetric values could only be observed for I1, I0, E1, and E0 after treatment and after pH-cycling (p ≤ 0.027; paired t test). In conclusion, under the conditions chosen only the application of a low-viscosity resin could mask caries lesions significantly, whereas self-assembling peptides could neither inhibit lesion progression nor mask the lesions considerably.
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Affiliation(s)
- Richard J Wierichs
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany
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Lippert F. Mechanistic Observations on the Role of the Stannous Ion in Caries Lesion De- and Remineralization. Caries Res 2016; 50:378-82. [DOI: 10.1159/000446849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/06/2016] [Indexed: 11/19/2022] Open
Abstract
Two mechanistic, laboratory, factorial design studies were conducted to investigate the effect of the stannous ion (Sn2+) in the absence or presence of fluoride on caries lesion de- and remineralization. Study I was concerned with determining changes in mineral distribution of subsurface lesions, whereas study II investigated changes in surface hardness of surface-softened lesions as a function of pH. Study I showed that Sn2+ modulates the effects of fluoride by preventing lamination. Study II revealed that the effect of Sn2+ on rehardening is pH dependent. Neither study demonstrated synergy between Sn2+ and fluoride, yet interactions were observed. Sn2+ does interfere with remineralization to some extent although it provided acid resistance. The role of Sn2+ in the caries process is complex.
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