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Chhabria DR, Ramadoss R, K HS, Sundar S, Selvam SP, Ramani P. Understanding the spatial and topographic characteristics of enamel white spot lesions for targeted remineralization. J Oral Biol Craniofac Res 2024; 14:594-599. [PMID: 39188633 PMCID: PMC11345553 DOI: 10.1016/j.jobcr.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 07/25/2024] [Accepted: 07/28/2024] [Indexed: 08/28/2024] Open
Abstract
Introduction White spot lesions are opaque, chalky white or yellowish discolorations on the surface of teeth that result from the demineralization of the tooth structure. Many methods, including SEM, XRD, and FTIR spectroscopy, are crucial for identifying and evaluating enamel white spot lesions. It is imperative to have a thorough grasp of the morphology, crystallographic structure, mineral composition, and chemical changes associated with enamel white spot lesions. Method In vitro lesions were meticulously obtained by immersing extracted teeth in hydrochloric acid for a week and drying them using artificial caries. Characterization investigations were conducted with utmost precision and thoroughness using FTIR, XRD, and SEM, ensuring the reliability and validity of the results. Results FTIR analysis revealed the existence of calcium oxide and hydroxyapatite, and SEM examination assisted in identifying differences in surface shape. The enamel's crystalline nature was revealed via XRD investigation. Conclusion White spot lesions are associated with the development of deep caries. Advanced imaging strategies are needed for additional validation.
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Affiliation(s)
- Devanshi Rajesh Chhabria
- Department of Oral Biology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Ramya Ramadoss
- Department of Oral Biology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Hema Shree K
- Department of Oral Biology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Sandhya Sundar
- Department of Oral Biology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Suganya Panneer Selvam
- Department of Oral Biology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Pratibha Ramani
- Department of Oral Pathology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and techniical Sciences, Chennai , India
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Thirumoorthy SN, Gopal S. Management of white spot enamel lesions with resin infiltration: potentials and future research directions. Evid Based Dent 2024:10.1038/s41432-024-01056-w. [PMID: 39181979 DOI: 10.1038/s41432-024-01056-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 08/16/2024] [Indexed: 08/27/2024]
Abstract
DESIGN The current study1 is a randomized controlled trial with two arm, multicenter and parallel group design. CASE SELECTION Study subjects were 38 orthodontic patients younger than 17 years who were being treated with metal braces. Patients with at least one white spot lesion (WSL) graded 1 to 2 according to the International Caries Detection and Assessment System (ICDAS) on the labial surface of permanent maxillary and mandibular canines and incisors were included for the trial. Teeth with carious lesions and restorations, anomalies of the enamel, and primary teeth were excluded. METHOD Patients were allocated by computer generated random sequence into resin infiltration and fluoride varnish intervention groups. Study subjects were blinded until the allocation, outcome assessors and statisticians remained blinded through the study, however the operators could not be blinded. Resin infiltration treatment involved removal of orthodontic wires and auxiliaries followed by cleaning the teeth with fluoride free prophylactic paste and completing the resin infiltration according to manufacturer's instructions. In the fluoride varnish group, a thin layer of the material was applied after isolating the teeth, and patients were asked not to eat or drink for 1 hour. This was continued twice a month for 6 months. Digital images of the teeth were obtained before, and 1 day (T1), 1 week (T2), 1 month (T3), 3 months (T4) and 6 months (T5) after treatment, using a DSLR camera and a matching polarization filter. The images were processed for calibration and color stability. Regions of interest representing WSL (white spot lesion) and SAE (sound adjacent enamel) were isolated in the images for comparison at different stages the images were captured. DATA ANALYSIS Statistical analysis was performed using SPSS version 28. Independent-samples t-test was utilized for comparison between the two groups, and paired-samples t-test for comparison within the groups. A statistical significance level of α = 0.05 was set. RESULTS At T1, significant color difference was observed between white spot lesion and adjacent sound enamel in the resin infiltration group and it remained stable after 6 months. Whereas in the fluoride varnish group, there were no statistical differences from baseline to 6 months. A statistical difference of 3.27 CIELAB units (p < 0.001) was reported between the infiltration group and the fluoride group at T5. No significant changes were noted in SAE with respect to changes in lightness. CONCLUSIONS Resin infiltration was found to be better at masking the demineralization produced by WSL and also enhanced the esthetic appearance of demineralized areas around the brackets. Resin infiltration did not produce any clinically visible effects in non-affected enamel. These changes remained stable for a period of 6 months.
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Affiliation(s)
| | - Saumiya Gopal
- Department of Periodontics, KMCT Dental College, Kozhikode, India
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3
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Al-Blaihed D, El Meligy O, Baghlaf K, Aljawi RA, Abudawood S. White Spot Lesions in Fixed Orthodontics: A Literature Review on Etiology, Prevention, and Treatment. Cureus 2024; 16:e65679. [PMID: 39205762 PMCID: PMC11356355 DOI: 10.7759/cureus.65679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
White spot lesions (WSLs) are a common complication after treatment using fixed orthodontic appliances. Decalcification of enamel surrounding fixed orthodontic appliances, known as WSLs, poses a significant aesthetic difficulty during and after treatment, as the purpose of fixed orthodontic therapy is to improve facial and dental appearance. Modern dentistry utilizes remineralization therapies to non-invasively treat WSLs to prevent the progression of disease and enhance the strength, appearance, and functionality of the affected tooth. This review aims to identify and assess the etiology, formation, and risk factors, as well as current treatment approaches used in achieving WSLs remineralization, induced by fixed orthodontic appliances. An electronic search on the PubMed and ScienceDirect databases was performed using a selected keyword. A total of 172 studies (from 2013 to 2023) were retrieved. Their references were also checked to find other relevant studies. Duplicate copies were excluded. After the abstract and full-text screening, only 39 studies were included. Even though numerous studies address the different treatment modalities for managing post-orthodontic WSLs, such as antiseptics; fluorides such as dentifrices, mouthwash, and varnish, and remineralizing agents such as casein phosphopeptides amorphous calcium phosphate, biomimetic self-assembling peptides, lasers, bleaching, microabrasion, and resin infiltration. There is a lack of evidence-based studies that examine the long-term effects of WSL treatment. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.
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Affiliation(s)
| | - Omar El Meligy
- Pediatric Dentistry, King Abdulaziz University Faculty of Dentistry, Jeddah, SAU
- Pediatric Dentistry and Dental Public Health, Alexandria University, Alexandria, EGY
| | - Khlood Baghlaf
- Pediatric Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Rabab A Aljawi
- Pediatric Dentistry, King Abdulaziz University Faculty of Dentistry, Jeddah, SAU
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Araujo EMDS, Vidal CDMP, Zhu M, Banas JA, Freitas AZD, Wetter NU, Matos AB. Comparison of biofilm models for producing artificial active white spot lesions. J Appl Oral Sci 2024; 32:e20230458. [PMID: 38922241 PMCID: PMC11182642 DOI: 10.1590/1678-7757-2023-0458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE This study compared three protocols for developing artificial white spot lesions (WSL) using biofilm models. METHODOLOGY In total, 45 human enamel specimens were sterilized and allocated into three groups based on the biofilm model: Streptococcus sobrinus and Lactobacillus casei (Ss+Lc), Streptococcus sobrinus (Ss), or Streptococcus mutans (Sm). Specimens were incubated in filter-sterilized human saliva to form the acquired pellicle and then subjected to the biofilm challenge consisting of three days of incubation with bacteria (for demineralization) and one day of remineralization, which was performed once for Ss+Lc (four days total), four times for Ss (16 days total), and three times for Sm (12 days total). After WSL creation, the lesion fluorescence, depth, and chemical composition were assessed using Quantitative Light-induced Fluorescence (QLF), Polarized Light Microscopy (PLM), and Raman Spectroscopy, respectively. Statistical analysis consisted of two-way ANOVA followed by Tukey's post hoc test (α=0.05). WSL created using the Ss+Lc protocol presented statistically significant higher fluorescence loss (ΔF) and integrated fluorescence (ΔQ) in comparison to the other two protocols (p<0.001). RESULTS In addition, Ss+Lc resulted in significantly deeper WSL (137.5 µm), followed by Ss (84.1 µm) and Sm (54.9 µm) (p<0.001). While high mineral content was observed in sound enamel surrounding the WSL, lesions created with the Ss+Lc protocol showed the highest demineralization level and changes in the mineral content among the three protocols. CONCLUSION The biofilm model using S. sobrinus and L. casei for four days was the most appropriate and simplified protocol for developing artificial active WSL with lower fluorescence, higher demineralization, and greater depth.
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Affiliation(s)
- Erika Michele Dos Santos Araujo
- The University of Iowa, College of Dentistry, Iowa Institute for Oral Health Research,Iowa City, IA, USA
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, SP, Brasil
| | | | - Min Zhu
- The University of Iowa, College of Dentistry, Iowa Institute for Oral Health Research,Iowa City, IA, USA
| | - Jeffrey A Banas
- The University of Iowa, College of Dentistry, Iowa Institute for Oral Health Research,Iowa City, IA, USA
- The University of Iowa, College of Dentistry, Department of Pediatric Dentistry, Iowa City, IA, USA
| | - Anderson Zanardi de Freitas
- Universidade de São Paulo, Instituto de Pesquisas Energéticas e Nucleares (IPEN), Centro de Lasers e Aplicações, São Paulo, SP, Brasil
| | - Niklaus Ursus Wetter
- Universidade de São Paulo, Instituto de Pesquisas Energéticas e Nucleares (IPEN), Centro de Lasers e Aplicações, São Paulo, SP, Brasil
| | - Adriana Bona Matos
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, SP, Brasil
- Universidade Católica Portuguesa, Faculdade de Medicina Dentária, Viseu, Portugal
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Vitiello F, Orilisi G, Notarstefano V, Furlani M, Riberti N, Bellezze T, Carrouel F, Putignano A, Orsini G. A Modern Multidisciplinary Method to Characterize Natural White Spot Lesions with 2D and 3D Assessments: A Preliminary Study. J Pers Med 2024; 14:542. [PMID: 38793124 PMCID: PMC11122579 DOI: 10.3390/jpm14050542] [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: 03/27/2024] [Revised: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
In this preliminary study, a multidisciplinary method based on high-resolution analytical techniques (such as microcomputed tomography, Raman Microspectroscopy, scanning electron microscopy, and Vickers microhardness test) was exploited to evaluate the alterations that occur in human teeth at the initial stage of the carious lesion. To this purpose, six extracted molars displaying a natural white spot lesion (WSL) were investigated. Specific morphological, structural, and chemical parameters, such as the mineral density, indentation hardness, molecular and elemental composition, and surface micromorphology were obtained on the WSL, and the results were statistically compared (t-test, p < 0.05) to those of the sound enamel on the same tooth. In the WSL, with respect to the sound area, a decrease in the mineral density and crystallinity was detected together with differences in the molecular composition and surface microstructure, such as the occurrence of micropores and irregularities. Moreover, the elemental analysis highlighted in WSL showed a statistically significant decrease in Ca and P percentages. In conclusion, this multidisciplinary approach allows us to fully characterize the area of interest, providing a deeper knowledge of these enamel lesions, which could have important clinical implications.
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Affiliation(s)
- Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, 69008 Lyon, France;
| | - Giulia Orilisi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, Polytechnic University of Marche (DISVA), Via Brecce Bianche, 60131 Ancona, Italy;
| | - Michele Furlani
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
| | - Nicole Riberti
- Department of Neurosciences Imaging and Clinical Sciences (DNISC), University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Tiziano Bellezze
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU), Università Politecnica delle Marche, 60131 Ancona, Italy;
| | - Florence Carrouel
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, 69008 Lyon, France;
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
- National Institute of Health and Science of Aging (INRCA), 60124 Ancona, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
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Rao M, Ashith MV, Suman E, Isloor AM, Shetty NJ, Natarajan S. Evaluation of the surface characteristics and antibacterial properties of Titanium dioxide nanotube and methacryloyloxyethylphosphorylcholine (MPC) coated orthodontic brackets-a comparative invitro study. Clin Oral Investig 2024; 28:323. [PMID: 38761310 PMCID: PMC11102386 DOI: 10.1007/s00784-024-05655-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 04/08/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVES White spot lesions are the most common iatrogenic effect observed during orthodontic treatment. This study aimed to compare the surface characteristics and antibacterial action of uncoated and coated orthodontic brackets. MATERIALS AND METHODS Sixty commercially available stainless steel brackets were coated with TiO2 nanotubes and methacryloyloxyethylphosphorylcholine. The sample was divided into Group 1: uncoated orthodontic brackets, Group 2: Stainless steel brackets with TiO2 nanotubes coating, Group 3: Stainless steel brackets with methacryloyloxyethylphosphorylcholine coating, and Group 4: Stainless steel brackets with TiO2 nanotubes combined with methacryloyloxyethylphosphorylcholine coating. Surface characterization was assessed using atomic force microscopy and scanning electron microscopy. Streptococcus mutans was selected to test the antibacterial ability of the orthodontic brackets, total bacterial adhesion and bacterial viability were assessed. The brackets were subjected to scanning electron microscopy to detect the presence of biofilm. RESULTS The surface roughness was the greatest in Group 1 and least in Group 2 followed by Group 4 and Group 3 coated brackets. The optical density values were highest in Group 1 and lowest in Group 4. Comparison of colony counts revealed high counts in Group 1 and low counts in Group 4. A positive correlation between surface roughness and colony counts was obtained, however, was not statistically significant. CONCLUSIONS The coated orthodontic brackets exhibited less surface roughness than the uncoated orthodontic brackets. Group 4 coated orthodontic brackets showed the best antibacterial properties. CLINICAL RELEVANCE Coated orthodontic brackets prevent adhesion of streptococcus mutans and reduces plaque accumulation around the brackets thereby preventing formation of white spot lesions during orthodontic treatment.
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Affiliation(s)
- Madhura Rao
- Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India
| | - M V Ashith
- Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Ethel Suman
- Department Of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India
- Department of Microbiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India
| | - Arun M Isloor
- Department Of Chemistry, National Institute of Technology, Surathkal, 575025, Karnataka, India
| | - Neetha J Shetty
- Department Of Periodontics Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India
| | - Srikant Natarajan
- Department Of Oral Pathology Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India
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7
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Shankarappa S, Burk JT, Subbaiah P, Rao RN, Doddawad VG. White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives. J Orthod Sci 2024; 13:21. [PMID: 38784071 PMCID: PMC11114457 DOI: 10.4103/jos.jos_205_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 05/25/2024] Open
Abstract
White spot lesions (WSLs) refer to localized areas of hypo-mineralization limited to the enamel of the teeth surface, which is noticeable clinically to the naked eye on drying of the teeth. During fixed orthodontic treatment, it is very hard for the patient to maintain excellent oral hygiene as the brackets, bands, wires, elastics, and other appliances and attachments worn intra-orally provide a platform for food retention, plaque formation, and then colonization by acidogenic bacteria like Streptococcus mutans and Lactobacillus. This review aims to elaborate and focus on etiology, pathophysiology, diagnosis, treatment aspect, and future scope for research about the WSLs occurring due to fixed orthodontic treatment.
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Affiliation(s)
- Suma Shankarappa
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Jerusha Titus Burk
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Pradeep Subbaiah
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Raghunath Nagasundara Rao
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Vidya Gowdappa Doddawad
- Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
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Shehani A F, Ramar K. Comparative Evaluation of the Remineralizing Potential of Flaxseed Paste, Chicken Eggshell Paste, and Fluoride Toothpaste on the Enamel of Primary Teeth Using Scanning Electron Microscopy-Energy Dispersive X-ray Analysis: An In-Vitro Study. Cureus 2024; 16:e60040. [PMID: 38854283 PMCID: PMC11162647 DOI: 10.7759/cureus.60040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2024] [Indexed: 06/11/2024] Open
Abstract
INTRODUCTION Dental caries in primary teeth remains a critical public health challenge globally. Although fluoride toothpaste is the standard care for remineralization, its efficacy is limited by the requirement for bioavailable calcium and phosphate ions and its diminished performance on irregular dental surfaces. This study evaluates natural alternatives for dental care, focusing on their mineralizing potential compared to fluoride. AIM This study aims to assess and compare the efficacy of remineralization by flaxseed paste and chicken eggshell paste to that of standard fluoride toothpaste on artificially demineralized primary teeth. MATERIALS AND METHODS We utilized an in vitro model, creating standardized white spot lesions on extracted primary teeth to simulate early carious lesions. The teeth were treated with preparations of flaxseed paste, chicken eggshell paste, and fluoride toothpaste. Remineralization was quantitatively analyzed using scanning electron microscopy-energy dispersive x-ray analysis (SEM-EDX) conducted with a high-resolution scanning electron microscope (HRSEM) from Thermoscientific Apreo S at Sir C V Raman Research Park, SRM Institute of Science & Technology, Kattankulathur, Chennai, Tamil Nadu. RESULTS Quantitative analysis revealed that both flaxseed and chicken eggshell pastes not only met but, in some cases, exceeded the remineralization performance of fluoride toothpaste. Significant differences were observed in the deposition of calcium and phosphate ions on the lesion surfaces. CONCLUSION The study conducted at the Department of Pediatric and Preventive Dentistry at SRM Dental College, Kattankulathur, confirms the potential of flaxseed and chicken eggshell pastes as viable, cost-effective, and accessible alternatives to fluoride toothpaste for the remineralization of enamel in primary teeth. These findings support the inclusion of these natural agents in oral hygiene regimens and underscore the importance of further research into holistic approaches for the prevention and treatment of dental caries in children.
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Affiliation(s)
- Farah Shehani A
- Pediatric and Preventive Dentistry, SRM Institute of Science and Technology, Chennai, IND
| | - Kavitha Ramar
- Pediatric and Preventive Dentistry, SRM Institute of Science and Technology, Chennai, IND
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Seevalingam R, Yahaya N, Syed Mohamed AMF, Kumar HA. Development of an Artificial White Spot Lesion Creation Protocol: A Preliminary Study. Cureus 2024; 16:e60226. [PMID: 38868265 PMCID: PMC11168806 DOI: 10.7759/cureus.60226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Protocols that determine the lesion depth of specific demineralization solutions are lacking. This in vitro study aimed to evaluate various lesion depths of artificial white spot lesions (WSLs) at different exposure times. Materials and methods: Artificial WSLs were created by placing 30 extracted human premolar teeth into 0.05M acetate buffer solution with a controlled environment of pH 4.4 at 37ºC, which were then exposed in the solution for various durations of 4, 5, 6, 8, 10, and 12 days. The specimens were visually examined using the Ekstrand-Ricketts-Kidd (ERK) system to confirm the WSL, followed by buccolingual sectioning, and evaluated under a scanning electron microscope (SEM) to measure the lesion depth. RESULTS The SEM showed that the mean lesion depths of representative specimens were 101.33 µm (day 4), 124 µm (day 5), 159 µm (day 6), 187 µm (day 8), 202 µm (day 10), and 212 µm (day 12). The artificial WSL was visually demonstrated in grades 1 and 2 of the ERK system. CONCLUSIONS The depths of the lesions increased as the duration increased from day 4 to day 12, indicating that the lesion depths increased with the more prolonged exposure to the acetate buffer solution.
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Affiliation(s)
- Rajeletchmi Seevalingam
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | - Norziha Yahaya
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | | | - Hetal A Kumar
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
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Ozsunkar PS, Özen DÇ, Abdelkarim AZ, Duman S, Uğurlu M, Demİr MR, Kuleli B, Çelİk Ö, Imamoglu BS, Bayrakdar IS, Duman SB. Detecting white spot lesions on post-orthodontic oral photographs using deep learning based on the YOLOv5x algorithm: a pilot study. BMC Oral Health 2024; 24:490. [PMID: 38658959 PMCID: PMC11044306 DOI: 10.1186/s12903-024-04262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Deep learning model trained on a large image dataset, can be used to detect and discriminate targets with similar but not identical appearances. The aim of this study is to evaluate the post-training performance of the CNN-based YOLOv5x algorithm in the detection of white spot lesions in post-orthodontic oral photographs using the limited data available and to make a preliminary study for fully automated models that can be clinically integrated in the future. METHODS A total of 435 images in JPG format were uploaded into the CranioCatch labeling software and labeled white spot lesions. The labeled images were resized to 640 × 320 while maintaining their aspect ratio before model training. The labeled images were randomly divided into three groups (Training:349 images (1589 labels), Validation:43 images (181 labels), Test:43 images (215 labels)). YOLOv5x algorithm was used to perform deep learning. The segmentation performance of the tested model was visualized and analyzed using ROC analysis and a confusion matrix. True Positive (TP), False Positive (FP), and False Negative (FN) values were determined. RESULTS Among the test group images, there were 133 TPs, 36 FPs, and 82 FNs. The model's performance metrics include precision, recall, and F1 score values of detecting white spot lesions were 0.786, 0.618, and 0.692. The AUC value obtained from the ROC analysis was 0.712. The mAP value obtained from the Precision-Recall curve graph was 0.425. CONCLUSIONS The model's accuracy and sensitivity in detecting white spot lesions remained lower than expected for practical application, but is a promising and acceptable detection rate compared to previous study. The current study provides a preliminary insight to further improved by increasing the dataset for training, and applying modifications to the deep learning algorithm. CLINICAL REVELANCE Deep learning systems can help clinicians to distinguish white spot lesions that may be missed during visual inspection.
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Affiliation(s)
- Pelin Senem Ozsunkar
- Department of Paediatric Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Duygu Çelİk Özen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Ahmed Z Abdelkarim
- Division of Oral & Maxillofacial Radiology, College of Dentistry, The Ohio State Universiy, Columbus, OH, USA
| | - Sacide Duman
- Department of Paediatric Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Mehmet Uğurlu
- Department of Orthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Mehmet Rıdvan Demİr
- Department of Orthodontics, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Batuhan Kuleli
- Department of Orthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Özer Çelİk
- Department of Mathematics-Computer, Eskişehir Osmangazi University Faculty of Science, Eskişehir, Turkey
| | - Busra Seda Imamoglu
- Department of Orthodontics, Hamidiye Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - Ibrahim Sevki Bayrakdar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Suayip Burak Duman
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, 44280, Turkey.
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Thirumoorthy SN, Gopal S. White spot enamel lesions - is treatment or prevention the answer to this 'no win scenario'? Evid Based Dent 2024; 25:51-52. [PMID: 38365868 DOI: 10.1038/s41432-024-00986-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 02/18/2024]
Abstract
DESIGN Prospective, randomized, double-blind, multicenter clinical trial. CASE SELECTION Participants between 12 and 25 years old, who were generally healthy, with 2 or more white spot lesions on the labial surface of anterior dentition. DATA ANALYSIS 79 patients who developed white spot lesions (WSL) on the labial surface of anterior teeth following orthodontic treatment were randomly assigned to 4 intervention groups. Group 1 received 5% sodium fluoride varnish every 6 months, the second group received CPP-ACP every 6 months, the third group was treated with resin infiltration at the initial visit followed by placebo every 6 months, and the final group which was the control group was coated with 1400 ppm fluoride toothpaste every 6 months. All the candidates were instructed to brush twice daily using a specific toothbrush and 1400 ppm fluoride toothpaste. The study lasted for 12 months, and photographs of the teeth with WSL were taken before and after completion of the intervention. Photographs were analyzed using ImageJ software to compare the changes in the percentage of WSL area to total tooth surface area among the four study groups. The distribution differences among groups were compared using nonparametric tests and differences between baseline and 1-year follow-up parameters were analyzed using paired chi-square tests. RESULTS Reduction in the area of WSL were noted in all groups, with different levels of significance. The percentage reduction was 46.62% in the resin infiltration group and it was significantly higher than the remaining interventions. Fluoride varnish group had 26.57% reduction, the CPP-ACP group had 28.64% reduction and the control group had 29.75% reduction in the WSL area. Plaque index was noted to have significant correlation with the change in WSL area with higher plaque index scores demonstrating lesser reduction in WSL. CONCLUSIONS The study found that resin infiltration significantly reduced the WSL area after 1-year follow-up. Fluoride toothpaste with or without CPP-ACP and fluoride varnish produced some therapeutic effects.
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Affiliation(s)
| | - Saumiya Gopal
- Dept of Periodontics, KMCT Dental College, Kerala, India
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12
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Chauncey RT, Yu Q, Armbruster PC, Ballard RW. A survey of white spot lesion prevention and resolution in the US dental school curricula. J Dent Educ 2023; 87:1552-1558. [PMID: 37414090 DOI: 10.1002/jdd.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/30/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE/OBJECTIVES White spot lesions (WSLs) are opaque white lesions on smooth tooth surfaces as a result of demineralization. Proven methods of prevention and resolution of these lesions are available yet the incidence rate, especially in orthodontic patients, is still high. Perhaps the way dental schools are educating students on the topic is insufficient. The purpose of this study was to determine if and how predoctoral dental students are taught about the prevention and resolution of WSLs. METHODS An electronic survey was developed and sent out to each of the 66 accredited dental schools in the United States and Puerto Rico. The survey consisted of 13 questions and inquired about whether the school includes instruction of WSLs in its predoctoral curriculum. If the school indicated instruction WSLs was in the predoctoral curriculum, further questions were asked pertaining to the content and method of the instruction. Demographic data was also gathered from each institution. RESULTS Twenty-eight of the 66 schools responded for a 42% response rate. Eighty-two percent of schools indicated they were teaching about prevention of WSLs, while 50% indicated they were teaching about resolution, or treatment, of WSLs. The most commonly taught methods were patient education, over-the-counter fluoride mouthrinse, toothpaste, or gel, and high fluoride content toothpaste. CONCLUSION The majority of responding dental schools are at least including some instruction of WSLs in the predoctoral curriculum. Many of the known prevention and treatment measures available, however, are not routinely taught.
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Affiliation(s)
| | - Qingzhao Yu
- Department of Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Paul C Armbruster
- Department of Orthodontics, School of Dentistry, LSUHSC Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Richard W Ballard
- Department of Orthodontics, School of Dentistry, LSUHSC Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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13
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Marques Ferreira de Sena L, Monielle Duarte Moura D, Helena Gurgel de Carvalho I, de Fatima Dantas de Almeida L, Ramos da Silva N, Othávio de Assunção E Souza R. Bond strength, degree of conversion, and microorganism adhesion using different bracket-to-enamel bonding protocols. J Orofac Orthop 2023; 84:210-221. [PMID: 36251054 DOI: 10.1007/s00056-022-00430-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/16/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE This study aimed to evaluate the effect of bonding protocols and the type of orthodontic resin on the adhesion of microorganisms, degree of conversion (DC), and shear bond strength (SBS) of metallic brackets to enamel. METHODS A total of 60 bovine incisors were prepared and randomly divided into 6 groups (n = 10): "bonding protocol" (A: phosphoric acid; AXT: A+Transbond™ XT primer adhesive [all Transbond™ products from 3M Unitek, Monrovia, CA, USA]; and SE: Transbond™ Plus Self Etching Primer) and "orthodontic resin" (XT: Transbond™ XT adhesive paste and CC: Transbond™ Plus Color Change). After bonding, the samples were subjected to thermocycling (5000 cycles) and to the SBS test. Bond failures were classified according to the adhesive remnant index (ARI). Next, 60 enamel blocks were sterilized in ethylene oxide in order to perform the CFU (Streptococcus mutans) assay in vitro to analyze the colony forming units (CFU/mL). Then, 60 discs of each orthodontic resin were made to measure the DC. The SBS (MPa), CFU/mL, and DC (%) data were statistically analyzed by two-way analysis of variance and Tukey's test (5%) was performed for the DC. RESULTS CFU and SBS revealed no significance for all factors (P > 0.05). Tukey's test showed that A_XT (acid+Transbond™ XT adhesive paste) presented the highest DC (70.38% ± 10.5), while AXT_XT (acid+Transbond™ XT primer adhesive+Transbond™ XT adhesive paste) showed the lowest (23.47% ± 10.4). An ARI score of 2 was more frequent for the CC resin and an ARI score of 4 for the XT resin. CONCLUSION The CC resin does not reduce adhesion of S. mutans around orthodontic brackets and the bonding protocol did not influence the SBS, although the SE and A_XT groups contributed to a better DC.
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Affiliation(s)
| | - Dayanne Monielle Duarte Moura
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, 59056-000, Natal, RN, Brazil
- Department of Dentistry, State University of Rio Grande do Norte, Av Rio Branco, 725, RN, 59300-000, Caicó, Brazil
| | | | | | - Nathalia Ramos da Silva
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, 59056-000, Natal, RN, Brazil
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14
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Klaisiri A, Vongsang J, leelaudom T, Krajangta N. Methylene Blue Penetration of Resin Infiltration and Resin Sealant in Artificial White-Spot Lesions. Eur J Dent 2023; 17:828-833. [PMID: 36220119 PMCID: PMC10569877 DOI: 10.1055/s-0042-1756689] [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: 10/17/2022] Open
Abstract
OBJECTIVE This study determined the potency of resin infiltrations and resin sealant in impeding microleakage on artificial white-spot lesions (AWL) by methylene blue penetration. MATERIALS AND METHODS Eighty AWL specimens were randomly separated into two groups for water storage for 24 hours (groups 1-4) and 20,000 cycles of thermocycling (TC) (groups 5-8). Each group was then separated into four subgroups (n = 10) based on the AWL surface treatments: (1) no Tx, (2) treated with resin infiltration (ICON, DMG, Hamburg, Germany), (3) treated with resin infiltration (Surface pre-reacted glass-ionomer (S-PRG) barrier coat, SHOFU, Kyoto, Japan), (4) treated with resin sealant (Clinpro sealant, 3M ESPE, Minnesota, United States). Nail varnish was covered to all samples, with the exception of a 4 × 4 mm2 patch on the buccal measurement region, which was subsequently submerged in a 2% methylene blue solution and cut into buccolingual sections. Stereomicroscope measurements were used to calculate methylene blue penetration scores. STATISTICAL ANALYSIS The Kruskal-Wallis test and the Bonferroni post-hoc correction were performed to evaluate the data. RESULTS Application of resin infiltrants and resin sealant reduced microleakage in AWL by methylene penetration both before and after thermal cycling. In addition, group 6 (ICON + TC) and group 7 (S-PRG + TC) had a significantly different value from group 8 (sealant + TC). CONCLUSION Both the resin infiltration approach and the resin sealant seem to help seal AWL and might perhaps offer long-term defense against microleakage in AWL caused by methylene blue penetration. The greatest sealing and defense for microleakage in AWL were demonstrated by the resin infiltrations.
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Affiliation(s)
- Awiruth Klaisiri
- Division of Restorative Dentistry, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand
- Thammasat University Research Unit in Restorative and Esthetic Dentistry, Thammasat University, Pathumthani, Thailand
| | - Jarukit Vongsang
- Faculty of Dentistry, Thammasat University, Pathumthani, Thailand
| | | | - Nantawan Krajangta
- Division of Restorative Dentistry, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand
- Thammasat University Research Unit in Restorative and Esthetic Dentistry, Thammasat University, Pathumthani, Thailand
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15
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Puleio F, Di Spirito F, Lo Giudice G, Pantaleo G, Rizzo D, Lo Giudice R. Long-Term Chromatic Durability of White Spot Lesions through Employment of Infiltration Resin Treatment. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040749. [PMID: 37109707 PMCID: PMC10146668 DOI: 10.3390/medicina59040749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: White spot lesions (WSLs) denote regions of subsurface demineralization on the enamel that manifest as opaque and milky-white regions. Treatment for WSLs is essential for both clinical and aesthetic reasons. Resin infiltration has been identified as the most efficacious solution for alleviating WSLs, but studies with long-term monitoring are scarce. The aim of this clinical study is to assess the color change stability of the lesion after four years of implementing the resin infiltration technique. Materials and Methods: Forty non-cavity and unrestored white spot lesions (WSLs) were treated with the resin infiltration technique. The color of the WSLs and adjacent healthy enamel (SAE) was assessed using a spectrophotometer at T0 (baseline), T1 (after treatment), T2 (1 year after) and T3 (4 years after). The Wilcoxon test was utilized to determine the significance of the variation of color (ΔE) between WSLs and SAE over the observed time periods. Results: When comparing the color difference ΔE (WSLs-SAE) at T0-T1, the Wilcoxon test demonstarated a statistically significant difference (p < 0.05). For ΔE (WSLs-SAE) at T1-T2 and T1-T3, the color variation was not statistically significant (p = 0.305 and p = 0.337). Conclusions: The study's findings indicate that the resin infiltration technique is an effective solution for resolving the appearance of WSLs, and the results have demonstrated stability for a minimum of four years.
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Affiliation(s)
- Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy
| | - Federica Di Spirito
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84084 Baronissi, Italy
| | - Giuseppe Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
| | - Giuseppe Pantaleo
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84084 Baronissi, Italy
| | - David Rizzo
- Independent Researcher, 98124 Messina, Italy
| | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
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16
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Adel SM, El-Harouni N, Vaid NR. White Spot Lesions: State of the Art Biomaterials and Workflows used in Prevention, Progression and Treatment. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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17
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Yan J, Hua F, Cao L, Yang H, He H. Multifunctional modification of orthodontic adhesives with ZnO quantum dots. Dent Mater 2022; 38:1728-1741. [PMID: 36137833 DOI: 10.1016/j.dental.2022.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 09/01/2022] [Accepted: 09/08/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To develop a multifunctional orthodontic adhesive (QDA) using ZnO quantum-dots (ZnQDs) as modifier and investigate the antibacterial capability, fluorescence property as well as biocompatibility and bonding property. METHODS ZnQDs were synthesized using sol-gel method. XPS, XRD, FT-IR, HRTEM, SAED, DLS and spectrofluorimetry were used to characterize ZnQDs. ZnQDs were incorporated into Transbond XT adhesive paste with 20 %, 30 %, 40 % mass fraction, respectively, to form the multifunctional adhesives (QDAs). Antibacterial capability was evaluated with MTT kit, CFU count and Live/Dead Bacterial Staining Kit. Ultraviolet photography and spectrofluorimetry were used to confirm the fluorescence property of QDAs. Biocompatibility assay was performed on gingival fibroblasts and subcutaneous tissue of rats. Softening in solvent rate, shear bond strength and degree of conversion (DC) were measured. RESULTS The synthesized ZnQDs presented excellent crystallinity and fluorescence properties. MTT assay, CFU count and CLSM analysis indicated that QDAs had significant antibacterial activity compared with Transbond XT adhesive paste. CCK-8 assay and Live/Dead cell staining analysis denied the cytotoxicity of QDAs and histological analysis proved that QDAs all had no inflammatory irritation to subcutaneous tissue. Softening in solvent, shear bond strength and DC evaluations indicated that 20 % mixing ratio of ZnQDs could enhance the resistance to degradation without influencing the bond strength and DC. Ultraviolet photography and spectrofluorimetry analysis proved the fluorescence capability of QDAs. SIGNIFICANCE ZnQDs can impart antibacterial and fluorescence properties to orthodontic adhesives without affecting biocompatibility and bonding performance. QDAs can be multifunctional orthodontic adhesives to reduce bacterial adhesion around brackets and help orthodontists remove residual adhesives precisely when needed.
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Affiliation(s)
- Jiarong Yan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lingyun Cao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hongye Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Prosthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Hong He
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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18
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da Freiria ACB, Ortiz MIG, de Sobral DFS, Aguiar FHB, Lima DANL. Nano-hydroxyapatite-induced remineralization of artificial white spot lesions after bleaching treatment with 10% carbamide peroxide. J ESTHET RESTOR DENT 2022; 34:1290-1299. [PMID: 36205242 DOI: 10.1111/jerd.12969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/08/2022] [Accepted: 09/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assessed in vitro the effect of nanohydroxyapatite (n-HA) to improve the aesthetic appearance and microhardness of white spot lesions (WSL) when associated with a low-concentration bleaching agent (carbamide peroxide-CP10%). MATERIAL AND METHODS Enamel/dentin specimens (n = 60) of 5 × 5 × 2.2 mm were prepared, of these, 48 were submitted to pH-cycling to create artificial WSL. Subsequently, these were allocated into five groups (n = 12): n-HA; n-HA + CP10%; CP10%; WSL control (WSLC ); sound control (Sound). The color was assessed at baseline, pre-treatment, and post-treatment using a spectrophotometer, and the color (ΔE/ΔE00 ) and whiteness index (ΔWID) alterations were determined. The enamel cross-sectional microhardness (CSMH) was evaluated (post-treatment) with a Knoop indenter, 25gf/5 s, 20-200 μm. The data was analyzed through generalized linear models (α = 5%). RESULTS ΔE and ΔE00 were significantly higher for the bleached groups (n-HA + CP10% and CP10%), and the n-HA was higher than the WSLC group (p < 0.05). ΔWID was significantly higher for the bleached groups (p < 0.05). The CSMH values were significantly higher in the sound group than in the n-HA, CP10%, and WSLC groups (p < 0.05). The WSLC had lower microhardness than the n-HA + CP10% and sound groups (p < 0.05). CONCLUSION n-HA is suitable to remineralize and recover the color of the WSL. However, its association with CP10% maintains the esthetical outcome while increasing its in-depth remineralizing effect. CLINICAL SIGNIFICANCE Considering the aesthetic and functional repercussions of the WSL persistence, treatments that tend to improve its physical appearance and reinforce its weakened substructure in a non-invasive way are ideal. For this associating low-concentration, bleaching agents to the remineralizing treatments is promising to treat this type of lesions.
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Affiliation(s)
| | | | | | - Flavio Henrique Baggio Aguiar
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Débora Alves Nunes Leite Lima
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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19
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Terakulvanich P, Auychaiwatt P, Ekkert S, Jirakran K, Trairatvorakul C, Sriarj W. Fluoridated milk enhances the mineral density of artificial proximal carious lesions in situ. Acta Odontol Scand 2022; 80:346-353. [PMID: 34903116 DOI: 10.1080/00016357.2021.2014067] [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: 10/19/2022]
Abstract
OBJECTIVE To compare the mineral density (MD) of non-fluoridated-milk (non-F-milk), fluoridated-milk (F-milk), adjunctive to 1000-ppm-fluoride dentifrice (FD), and 1000-ppm-FD alone of proximal artificial enamel carious lesions (AECL) in high caries-risk patients. MATERIALS AND METHODS This double-blind, cross-over in situ study comprised seven high caries-risk volunteers. Orthodontic brackets with one slab of AECL were fixed randomly to each volunteer per phase. The study comprised three experimental periods with a 7-d wash-out period using FD between sessions; (1) A four-week tooth brushing with FD 2×/day by all subjects as a control. The participants were then randomly allocated to (2) drinking 2.5-ppm-F-milk 1×/day or (3) non-F-milk 1×/day, adjunctive to tooth-brushing with FD for 4-weeks. The subjects crossed over from each type of milk and continued the same protocol for another four weeks. After each phase, the MD of each specimen was analyzed using micro-computed tomography (Micro-CT). RESULTS The baseline MD was not significantly differences (p = .653). When brushing with FD and drinking F-milk, the MD gain was significantly higher (11.68 ± 2.89%) compared with brushing with FD and drinking non-F-milk (4.59 ± 1.78%) (p = .003) or brushing with FD alone (5.30 ± 2.10%) (p = .003). CONCLUSIONS F-milk adjunctive to FD significantly increased MD gain compared with non-F-milk + FD or FD alone.
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Affiliation(s)
| | | | | | - Ketsupar Jirakran
- Maximizing Thai Children’s Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chutima Trairatvorakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Wannakorn Sriarj
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Weyland MI, Jost-Brinkmann PG, Bartzela T. Management of white spot lesions induced during orthodontic treatment with multibracket appliance: a national-based survey. Clin Oral Investig 2022; 26:4871-4883. [PMID: 35338421 PMCID: PMC8956138 DOI: 10.1007/s00784-022-04454-5] [Citation(s) in RCA: 4] [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: 09/30/2021] [Accepted: 03/13/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The study aimed to survey current strategies against enamel demineralization during multibracket therapy (MBT) and guide a prevention concept based on existing scientific evidence. MATERIALS AND METHODS The survey comprised questions on the prevention and management of white spot lesions (WSL). The questionnaire was sent via email to orthodontists working in practices and universities throughout Germany. The analysis involved descriptive statistics using the chi-square test (p < 0.05). RESULTS A prevention protocol was used before MBT by 80.6% of the participants. Less than a quarter of the participants regularly applied topical fluoride (gel or varnish) during MBT. According to the respondents' assessment, the prevalence of WSL during MBT is 11.6%, mainly observed in 12- to 15-year-old male patients. Orthodontists graduating after 2000 tended to recommend and apply fluoride-containing materials more often than their senior colleagues (p = 0.039). Participants from private practices applied fluoride varnish or gel more frequently than those from university clinics (p = 0.013). Fluoridation was the most common (70.7%) treatment for WSL after MBT, followed by resin infiltration (21.2%). The majority (80.9%) of the participants favor a guideline for preventing WSL. CONCLUSIONS WSL prevention during MBT is challenging. Males in puberty are predominantly affected. Younger orthodontists are more concerned about the prevention of WSL during MBT. CLINICAL RELEVANCE The non-negligible prevalence of individuals with WSL emphasizes the need for dental education and health care reform. This would help to implement standardized procedures and establish innovative applications.
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Affiliation(s)
- Manon Isabelle Weyland
- Dept. of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Paul-Georg Jost-Brinkmann
- Dept. of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Theodosia Bartzela
- Dept. of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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21
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Nafarrate-Valdez RA, Martínez-Martínez RE, Zaragoza-Contreras EA, Áyala-Herrera JL, Domínguez-Pérez RA, Reyes-López SY, Donohue-Cornejo A, Cuevas-González JC, Loyola-Rodríguez JP, Espinosa-Cristóbal LF. Anti-Adherence and Antimicrobial Activities of Silver Nanoparticles against Serotypes C and K of Streptococcus mutans on Orthodontic Appliances. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:877. [PMID: 35888596 PMCID: PMC9323808 DOI: 10.3390/medicina58070877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Streptococcus mutans (S. mutans) is the main microorganism associated with the presence of dental caries and specific serotypes of this bacteria have been related to several systemic diseases limiting general health. In orthodontics, white spot lesions (WSL), represent a great challenge for clinicians due to the great fluctuation of their prevalence and incidence during conventional orthodontic treatments. Although silver nanoparticles (AgNP) have been demonstrated to have great antimicrobial properties in several microorganisms, including S. mutans bacteria, there is no available information about anti adherence and antimicrobial properties of AgNP exposed to two of the most relevant serotypes of S. mutans adhered on orthodontic materials used for conventional therapeutics. The objective of this study was to determine anti-adherence and antimicrobial levels of AgNP against serotypes c and k of S. mutans on conventional orthodontic appliances. Materials and Methods: An AgNP solution was prepared and characterized using dispersion light scattering (DLS) and transmission electron microscopy (TEM). Antimicrobial and anti-adherence activities of AgNP were determined using minimal inhibitory concentrations (MIC) and bacterial adherence testing against serotypes c and k of S. mutans clinically isolated and confirmed by PCR assay. Results: The prepared AgNP had spherical shapes with a good size distribution (29.3 ± 0.7 nm) with negative and well-defined electrical charges (−36.5 ± 5.7 mV). AgNP had good bacterial growth (55.7 ± 19.3 µg/mL for serotype c, and 111.4 ± 38.6 µg/mL for serotype k) and adherence inhibitions for all bacterial strains and orthodontic wires (p < 0.05). The serotype k showed statistically the highest microbial adherence (p < 0.05). The SS wires promoted more bacterial adhesion (149.0 ± 253.6 UFC/mL × 104) than CuNiTi (3.3 ± 6.0 UFC/mL × 104) and NiTi (101.1 ± 108.5 UFC/mL × 104) arches. SEM analysis suggests CuNiTi wires demonstrated better topographical conditions for bacterial adherence while AFM evaluation determined cell wall irregularities in bacterial cells exposed to AgNP. Conclusions: This study suggests the widespread use of AgNP as a potential anti-adherent and antimicrobial agent for the prevention of WSL during conventional orthodontic therapies and, collaterally, other systemic diseases.
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Affiliation(s)
- Rosa Amalia Nafarrate-Valdez
- Speciality Program in Orthodontics, Department of Dentistry, Biomedical Science Institute, Autonomous University of Ciudad Juarez (UACJ), Envolvente del PRONAF and Estocolmo Avenues, Juarez City 32310, Mexico;
| | - Rita Elizabeth Martínez-Martínez
- Master Program in Advanced Dentistry, Faculty of Dentistry, Autonomous University of San Luis Potosi, Manuel Nava Avenue, Universitary Campus, San Luis Potosí 78290, Mexico;
| | - Erasto Armando Zaragoza-Contreras
- Department of Engineering and Materials Chemistry, Centro de Investigación en Materiales Avanzados, S. C., Miguel de Cervantes 120, Complejo Industrial Chihuahua, Chihuahua 31136, Mexico;
| | - José Luis Áyala-Herrera
- School of Dentistry, Universidad De La Salle Bajío, Universidad Avenue, Lomas del Campestre, Guanajuato 37150, Mexico;
| | - Rubén Abraham Domínguez-Pérez
- Laboratory of Multidisciplinary Dental Research, Faculty of Medicine, Autonomous University of Queretaro, Clavel Street, Prados de La Capilla, Santiago de Querétaro 76176, Mexico;
| | - Simón Yobanny Reyes-López
- Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Mexico;
| | - Alejandro Donohue-Cornejo
- Master Program in Dental Sciences, Stomatology Department, Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Mexico; (A.D.-C.); (J.C.C.-G.)
| | - Juan Carlos Cuevas-González
- Master Program in Dental Sciences, Stomatology Department, Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Mexico; (A.D.-C.); (J.C.C.-G.)
| | - Juan Pablo Loyola-Rodríguez
- Faculty of Dentistry, Autonomous University of Sinaloa, Josefa Ortiz de Domínguez, Ciudad Universitaria, Universitaria, Culiacán 80013, Mexico;
| | - León Francisco Espinosa-Cristóbal
- Master Program in Dental Sciences, Stomatology Department, Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Mexico; (A.D.-C.); (J.C.C.-G.)
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22
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Marya A, Venugopal A, Karobari MI, Rokaya D. White Spot Lesions: A Serious but Often Ignored Complication of Orthodontic Treatment. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2202230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
The objective of this narrative review is to present an overview of the prevalence, clinical manifestation, diagnosis, and latest advances on white spot lesions.
Background:
White spot lesions have been defined as the earliest stage of demineralization on enamel surfaces that are easily discernible to the human eye.
Methods:
Relevant articles on white spot lesions were searched and reviewed from March 1975 till May 2021 in Pubmed, Scopus, Google Scholar, and ScienceDirect and were included in this review.
Results:
Even though the orthodontic field has seen several advances over the last few years, this is one complication that persists. White spot lesions are very commonly seen after completion of fixed orthodontic therapy when brackets are debonded. Previously conducted research has shown that there is a high prevalence rate of white spot lesions, which ranges from 50 to 90%. On intra-oral examination, a white spot can be seen as a matte-textured, opaque white lesion. Since the demineralization process takes place below the enamel surface, the outer layer only demonstrates pores that affect the natural light refractory properties of a tooth. This is what leads to the characteristic appearance of these lesions. One of the goals of modern dentistry is to treat non-cavitated lesions by promoting remineralization without the involvement of any invasive procedures.
Conclusion:
Fixed orthodontic therapy is usually a lengthy process and requires active cooperation between the orthodontist and the patient. However, it is the responsibility of the treating orthodontist to examine the tooth surfaces at each appointment to diagnose a developing white spot lesion as early as possible. With recent advances in diagnostic techniques, it has become much easier to identify these initial lesions and prevent their progression to cavitated lesions.
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23
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Toti Ç, Meto A, Kaçani G, Droboniku E, Hysi D, Tepedino M, Zaja E, Fiorillo L, Meto A, Buci D, Tanellari O. White Spots Prevalence and Tooth Brush Habits during Orthodontic Treatment. Healthcare (Basel) 2022; 10:healthcare10020320. [PMID: 35206934 PMCID: PMC8872019 DOI: 10.3390/healthcare10020320] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
White spots (WS) are one of the most undesirable side effects in patients undergoing orthodontic therapy and are usually located around bracket bases and even detected under the molar bands. The aim of the present cross-sectional study was to evaluate the WS lesion during orthodontic therapy and the correlation between WS and oral hygiene habits. Patients requiring orthodontic treatment with a fixed appliance were screened for the inclusion/exclusion criteria, and 74 subjects were finally enrolled. Each patient received three examinations: at T0, the day of the application of the fixed appliance; at T1, three months later; and at T2, six months after treatment start. After calculating descriptive statistics, differences between groups were evaluated with an independent sample t-test. The first type error was set as p ≤ 0.01. The observed prevalence of WS lesions was 59.5% on T1 and 60.8% on T2. The most affected teeth result to be upper molars, lower left first molar, upper right central incisor and upper left lateral incisor, upper right canine, upper left first premolar, and lower right first molar. A higher frequency of daily tooth brushing was accompanied by a lower prevalence of WS. No significant effect of sex was observed.
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Affiliation(s)
- Çeljana Toti
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania; (G.K.); (O.T.)
- Correspondence: (Ç.T.); (A.M.)
| | - Agron Meto
- Department of Dentistry, University of Aldent, 1000 Tirana, Albania; (A.M.); (L.F.)
| | - Gerta Kaçani
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania; (G.K.); (O.T.)
| | - Etleva Droboniku
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania; (E.D.); (D.H.)
| | - Dorjan Hysi
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania; (E.D.); (D.H.)
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Edlira Zaja
- Department of Public Health, University of Medicine, 1005 Tirana, Albania;
| | - Luca Fiorillo
- Department of Dentistry, University of Aldent, 1000 Tirana, Albania; (A.M.); (L.F.)
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
| | - Aida Meto
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania; (E.D.); (D.H.)
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy
- Correspondence: (Ç.T.); (A.M.)
| | - Denada Buci
- Independent Researcher, 1000 Tirana, Albania;
| | - Olja Tanellari
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania; (G.K.); (O.T.)
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24
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Prevalence of white spot lesions during clear aligner therapy: a systematic review. AUSTRALASIAN ORTHODONTIC JOURNAL 2022. [DOI: 10.2478/aoj-2022-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives: To determine if an association exists between the prevalence of white spot lesions (WSLs) and orthodontic treatment using clear aligners.
Methods: Electronic databases were searched with no restrictions on year. Article selection criteria included human clear aligner studies conducted during the permanent dentition and with a full description of the applied technique and oral hygiene status.
Results: The search strategy resulted in a total of 4177 articles. After title and abstract screening, 156 relevant articles were identified from which five remained after the application of the exclusion criteria. The articles were mostly classified as having a low risk of bias.
Conclusions: Clear aligner therapy induces a lower development rate of new WSLs than orthodontic treatment by fixed appliances. In patients who have poor oral hygiene and/or existing WSLs, clear aligner treatment could be recommended.
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25
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Dasari A, Edunoori R, Chagam M, Velpula D, Kakuloor J, Renuka G. Comparison of the efficacy of Icon resin infiltration and Clinpro XT varnish on remineralization of white spot lesions: An in-vitro study. J Orthod Sci 2022; 11:12. [PMID: 35754423 PMCID: PMC9214422 DOI: 10.4103/jos.jos_141_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/05/2021] [Accepted: 11/25/2021] [Indexed: 11/04/2022] Open
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26
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Puleio F, Fiorillo L, Gorassini F, Iandolo A, Meto A, D'Amico C, Cervino G, Pinizzotto M, Bruno G, Portelli M, Amato A, Lo Giudice R. Systematic Review on White Spot Lesions Treatments. Eur J Dent 2021; 16:41-48. [PMID: 34450678 PMCID: PMC8890924 DOI: 10.1055/s-0041-1731931] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The difference in refractive index between the healthy enamel and the demineralized area generates a lesion with a milky white opaque appearance, clearly distinguishable from the surrounding healthy enamel. The aim of this systematic review was to evaluate if the infiltration technique is the most efficient treatment to resolve a white spot lesion when compared with remineralization and microabrasion techniques. The Population/Intervention/Comparison/Outcome question investigated: “in enamel WS lesion, the infiltration treatment compared to remineralization or microabrasion treatments is more or less effective in the camouflage effect?.” The research was performed on electronic databases, including Ovid MEDLINE, PubMed, and web of science. The search was conducted up to April 1, 2020. The scientific search engines produced 324 results. Only 14 were screened after screening. Based on the articles analyzed in this systematic review, the resin infiltration technique seems to be the most effective and predictable treatment for the aesthetic resolution of WSLs.
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Affiliation(s)
- Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy.,Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli," Naples, Italy.,Department of Implantology, Faculty of Dentistry, University of Aldent, Tirana, Albania
| | - Francesca Gorassini
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Aida Meto
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, Tirana, Albania
| | - Cesare D'Amico
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Mirta Pinizzotto
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Giancarlo Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Marco Portelli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
| | - Alessandra Amato
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, Messina, Italy
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27
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Qin D, Wang Y, Levey C, Ngan P, He H, Hua F. Protocol for the development of a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). Trials 2021; 22:507. [PMID: 34332635 PMCID: PMC8325281 DOI: 10.1186/s13063-021-05371-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Enamel white spot lesions (WSLs), characterized by an opaque, matt, and chalky white appearance of enamel, are a sign of incipient caries. WSLs are common in orthodontic practice and can affect both the oral health and dental aesthetics of patients. Extensive studies have been conducted to evaluate the effectiveness of prevention or treatment for orthodontically induced enamel WSLs. However, substantial heterogeneity has been found in the outcomes used for the prevention and treatment of WSLs in literature, which prevents researchers from comparing and combining the results of different studies to draw more decisive conclusions. Therefore, we aim to develop a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). METHODS The development of COS-OWSL comprises four phases: (1) a scoping review to identify and summarize all existing outcomes that have been used in trials on the prevention or treatment of orthodontically induced WSLs; (2) qualitative interviews with orthodontic patients without (for prevention) and with WSL-affected teeth (for treatment) and relevant dental professionals to identify additional outcomes relevant to them; (3) Delphi surveys to collect opinions from key stakeholders including patients, dental professionals, and researchers and to reach a preliminary consensus; and (4) a consensus meeting to develop the final COS-OWSL. DISCUSSION The COS-OWSL will be developed to facilitate the synthesis of evidence regarding the prevention and treatment of orthodontically induced WSLs and to promote the consistent use of relevant patient-important outcomes among future studies in this field. TRIAL REGISTRATION Core Outcome Measures in Effectiveness Trials (COMET) initiative (the COS-WSL project) 1399.
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Affiliation(s)
- Danchen Qin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Yunlei Wang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Colin Levey
- School of Dentistry, University of Dundee, Dundee, UK
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, Morgantown, USA
| | - Hong He
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China. .,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China.
| | - Fang Hua
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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28
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Teixeira LP, Gontijo LC, Franco Júnior AR, Pereira MF, Schuenck RP, Malacarne-Zanon J. Evaluation of antimicrobial potential and surface morphology in thin films of titanium nitride and calcium phosphate on orthodontic brackets. Am J Orthod Dentofacial Orthop 2021; 160:209-214. [PMID: 33975749 DOI: 10.1016/j.ajodo.2020.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The goal of this research was to experimentally evaluate the surface morphology and adhesion capacity of Streptococcus mutans (U159) on brackets with thin films of titanium nitride (TN) and of titanium nitride doped with calcium phosphate (TNCP). METHODS Twenty-four metallic brackets were equally allocated to 3 groups (n = 8), according to the type of covering (no covering, TNCP, and TN). The coatings were deposited by cathodic cage (TNCP and TN groups) and were evaluated by scanning electron microscopy and energy dispersive x-ray spectrometry. The biofilm formation of S. mutans on the surface of brackets was determined by crystal violet assay and subsequent optical density quantification. RESULTS There was homogeneity on the surface morphology of the tie wing area in all groups, whereas the TNCP group has presented particles in the slot. After 24 hours, a biofilm of S. mutans was formed in all the observed groups. The optical density obtained in all 3 groups was similar (no covering, 0.347 ± 0.042; TNCP, 0.238 ± 0.055; TN, 0.226 ± 0.057), with no statistically relevant difference (P = 0.06). CONCLUSIONS The thin film of TNCP has altered the surface of the bracket's slot, whereas the coatings of TN and TNCP have not altered the superficial morphology of the tie wings. The presence of coatings have not influenced the formation of the S. mutans biofilm on the surface of metallic brackets.
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Affiliation(s)
- Licia Pacheco Teixeira
- Graduate Program in Clinical Dentistry, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
| | - Leonardo Cabral Gontijo
- Graduate Program in Metallurgical and Materials Engineering, Federal Institute of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Adonias Ribeiro Franco Júnior
- Graduate Program in Metallurgical and Materials Engineering, Federal Institute of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Monalessa Fábia Pereira
- Department of Pathology, Graduate Program in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Ricardo Pinto Schuenck
- Department of Pathology, Graduate Program in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Juliana Malacarne-Zanon
- Department of Prosthodontics, Graduate Program in Clinical Dentistry, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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29
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Malik Z, Qasim Butt D, Qasim Butt Z, Muhammad N, Kaleem M, Liaqat S, Adnan Khan M, Samad Khan A. Evolution of Anticariogenic Resin‐Modified Glass Ionomer Cements. CHEMBIOENG REVIEWS 2021. [DOI: 10.1002/cben.202100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Zuleikha Malik
- National University of Medical Sciences (NUMS) Department of Dental Materials Rawalpindi Pakistan
| | - Danial Qasim Butt
- Dental College HITEC-IMS Department of Oral Pathology Taxila Cantt Pakistan
| | - Zainab Qasim Butt
- National University of Medical Sciences (NUMS) Department of Dental Materials Rawalpindi Pakistan
| | - Nawshad Muhammad
- Khyber Medical University Department of Dental Materials Institute of Basic Medical Sciences 25100 Peshawar Khyber Pakhtunkhwa Pakistan
| | - Muhammad Kaleem
- National University of Medical Sciences (NUMS) Department of Dental Materials Rawalpindi Pakistan
| | - Saad Liaqat
- Khyber Medical University Department of Dental Materials Institute of Basic Medical Sciences 25100 Peshawar Khyber Pakhtunkhwa Pakistan
| | - Muhammad Adnan Khan
- Khyber Medical University Department of Dental Materials Institute of Basic Medical Sciences 25100 Peshawar Khyber Pakhtunkhwa Pakistan
| | - Abdul Samad Khan
- Imam Abdulrahman Bin Faisal University Department of Restorative Dental Sciences College of Dentistry Dammam Saudi Arabia
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30
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Daneshkazemi P, Sadeghian S, Khodaei M. Shear bond strength of orthodontic brackets on intact and demineralized enamel after application of resin infiltrant, fluoride varnish and casein phosphopeptide-amorphous calcium phosphate remineralizing agents: in-vitro study. Int Orthod 2021; 19:259-268. [PMID: 33775598 DOI: 10.1016/j.ortho.2021.03.001] [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: 01/29/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the effects of remineralizing agents on the shear bond strength (SBS) of orthodontic brackets bonded to intact and demineralized enamel. MATERIAL AND METHODS In this in-vitro study, 160 human premolars were divided into 8 groups, including group 1 with intact enamel as the positive control, group 2 with demineralized enamel as the negative control, groups 3-5 treated with fluoride varnish, Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and resin infiltrant on intact enamel, and groups 6-8 treated with the same agents on demineralized enamel. Brackets were bonded using the conventional method, and the samples were thermocycled. SBS of the brackets was measured using a universal testing machine, and the adhesive remnant index (ARI) was assessed. Data were analysed with one-way ANOVA and post hoc statistical test at the significance level of 0.05. RESULTS SBS of the brackets in all groups with intact enamel was higher than that of their counterparts on demineralized enamel, which was only significantly different between groups 1 and 2 (P-value<0.001). SBS values of groups 7 and 8 were not significantly different from group 1 (P-value=1), yet the application of fluoride varnish on both intact (P-value=0.091) and demineralized enamel (P-value<0.001) created less SBS than in group 1. CONCLUSIONS All pre-treatment methods increased SBS of the brackets bonded to demineralized enamel, yet only the resin infiltrant and CPP-ACP produced SBS similar to that of intact enamel. Also, the use of fluoride varnish on intact enamel significantly reduced SBS.
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Affiliation(s)
- Pedram Daneshkazemi
- Department of orthodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Sousan Sadeghian
- Department of orthodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
| | - Mohammad Khodaei
- Department of Material Science and engineering, Golpayegan university of technology, Golpayegan, Iran
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31
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Park S, Wang X, Wang B, Xu HHK, Zhang N, Bai Y. The long observation in vitro of prevention effect of novel self-etching orthodontic adhesive modified with 2-methacryloxyethyl phosphorylcholine in enamel demineralization. Dent Mater J 2021; 40:631-640. [PMID: 33518689 DOI: 10.4012/dmj.2019-193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The enamel demineralization is common in fixed orthodontics. Plaque accumulation around the bracket plays a critical role and could cause various degrees of white spot lesions (WSLs) on the surface of teeth. The 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer is a biological polymer with protein repellent and an anti-bacterial adhesion effects. In this study, the enamel shear bond strength (SBS) and protein repellent property in vitro of self-etching orthodontic adhesive with MPC were evaluated. It was found that the self-etching adhesive with 0-7.5%MPC met the orthodontic clinical requirement on the SBS values at three different points of time. The incorporation of 7.5%MPC significantly reduced the bacterial adhesion and total microorganism of the yield biofilm. Moreover, the MTT assay showed that the amount of plaque metabolism in 7.5%MPC was the lowest among the groups. To conclude, the novel protein repellent self-etching adhesive was able to inhibit biofilm formation efficiently and minimize enamel demineralization.
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Affiliation(s)
- SooRo Park
- Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Xiaomeng Wang
- Department of Orthodontics, School of Stomatology, Capital Medical University.,Department of Stomatology, Children's Hospital of Shanghai
| | - Bo Wang
- Department of Orthodontics, School of Stomatology, Capital Medical University.,Department of Orthodontics, The First Affiliated Hospital of Dalian Medical University
| | - Hockin H K Xu
- Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School
| | - Ning Zhang
- Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University
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32
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Sampson V, Sampson A. Diagnosis and treatment options for anterior white spot lesions. Br Dent J 2020; 229:348-352. [PMID: 32978577 DOI: 10.1038/s41415-020-2057-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Indexed: 11/10/2022]
Abstract
White spot lesions on teeth present as white opacities due to enamel surface and/or subsurface demineralisation. Unfortunately, dentistry has seen a marked jump in prevalence and severity of white spot lesions over the past decade. In response to the rise in white spot lesions, the dental industry has been pushed to create less invasive alternatives for the removal of these lesions, particularly when located anteriorly. There are numerous different causes of white spot lesions that influence how the enamel substructure is affected and which treatment option is selected. Once, the only treatment option for white spot lesions was drilling the defects away, but with a better understanding of the science and the aetiology, we have now been able to create minimally invasive, preventive alternatives. It is vital that the cause, size and depth of the white spot lesions are ascertained before providing treatment options to a patient, as treatment results will vary depending on the enamel substructure available. This paper will explore the main causes of white spot lesions and the recommended treatments for them.
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Affiliation(s)
| | - Ariane Sampson
- Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Oral and Maxillofacial Surgery and Orthodontics, UK
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Klaisiri A, Janchum S, Wongsomtakoon K, Sirimanathon P, Krajangta N. Microleakage of resin infiltration in artificial white-spot lesions. J Oral Sci 2020; 62:427-429. [PMID: 32830164 DOI: 10.2334/josnusd.19-0321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study examined the effectiveness of resin infiltration in inhibiting microleakage from artificial white-spot lesions (AWL) in enamel. Fifty sound extracted premolars were selected and randomly divided into five groups (n = 10 each). Group 1 included sound teeth. In contrast, an AWL was created in all specimens in groups 2 to 5, as follows-Group 2: AWL with no treatment; Group 3: AWL treated with resin infiltration; Group 4: AWL treated with resin infiltration and 5,000 cycles of thermocycling; Group 5: AWL treated with resin infiltration and 10,000 cycles of thermocycling. All specimens were then coated with nail varnish, except for a 4 × 4 mm2 area on the buccal surface (the measurement area), immersed in 2% methylene blue solution, and sectioned buccolingually. Microleakage was evaluated with a stereomicroscope. Data were analyzed by using the Kruskal-Wallis test and Bonferroni post-hoc correction. Application of resin infiltrant reduced microleakage in AWL. No microleakage was seen in Group 3, and differences between Groups 3, 4, and 5 were not significant (P > 0.05). The resin infiltration technique appears to aid in sealing enamel AWL and may help provide long-term protection against microleakage in enamel AWL.
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Affiliation(s)
- Awiruth Klaisiri
- Division of Operative Dentistry, Faculty of Dentistry, Thammasat University
| | | | | | | | - Nantawan Krajangta
- Division of Operative Dentistry, Faculty of Dentistry, Thammasat University
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Synergetic Effect of 2-Methacryloyloxyethyl Phosphorylcholine and Mesoporous Bioactive Glass Nanoparticles on Antibacterial and Anti-Demineralisation Properties in Orthodontic Bonding Agents. NANOMATERIALS 2020; 10:nano10071282. [PMID: 32629909 PMCID: PMC7407988 DOI: 10.3390/nano10071282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/16/2022]
Abstract
2-methacryloyloxyethyl phosphorylcholine (MPC) is known to have antibacterial and protein-repellent effects, whereas mesoporous bioactive glass nanoparticles (MBN) are known to have remineralisation effects. We evaluated the antibacterial and remineralisation effects of mixing MPC and MBN at various ratios with orthodontic bonding agents. MPC and MBN were mixed in the following weight percentages in CharmFil-Flow (CF): CF, 3% MPC, 5% MPC, 3% MPC + 3% MBN, and 3% MPC + 5% MBN. As the content of MPC and MBN increased, the mechanical properties of the resin decreased. At 5% MPC, the mechanical properties decreased significantly with respect to CF (shear bond strength), gelation of MPC occurred, and no significant difference was observed in terms of protein adsorption compared to the control group. Composition 3% MPC + 5% MBN exhibited the lowest protein adsorption because the proportion of hydrophobic resin composite decreased; CF (91.8 ± 4.8 μg/mL), 3% MPC (73.9 ± 2.6 μg/mL), 3% MPC + 3% MBN (69.4 ± 3.6 μg/mL), and 3% MPC + 5% MBN (55.9 ± 1.6 μg/mL). In experiments against S. mutans and E. coli, addition of MPC and MBN resulted in significant antibacterial effects. In another experiment, the anti-demineralisation effect was improved when MPC was added, and when MBN was additionally added, it resulted in a synergetic effect. When MPC and MBN were added at an appropriate ratio to the orthodontic bonding agents, the protein-repellent, antibacterial, and anti-demineralisation effects were improved. This combination could thus be an alternative way of treating white spot lesions.
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Wang Y, Hua F, Jiang H. CPP-ACP May be effective, but not Significantly Greater than using Fluorides Alone, in Preventing and Treating white Spot Lesions Around Orthodontic Brackets. J Evid Based Dent Pract 2020; 20:101416. [PMID: 32381413 DOI: 10.1016/j.jebdp.2020.101416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Effectiveness of casein phosphopeptide-amorphous calcium phosphate-containing products in the prevention and treatment of white spot lesions in orthodontic patients: A systematic review. Pithon MM, Baião FS, Sant'Anna LID, Tanaka OM, Cople-Maia L. J Invest Clin Dent 2019;e12391. SOURCE OF FUNDING No financial support was reported. TYPE OF STUDY/DESIGN Systematic review.
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Lo Giudice R, Lipari F, Puleio F, Alibrandi A, Lo Giudice F, Tamà C, Sazonova E, Lo Giudice G. Spectrophotometric Evaluation of Enamel Color Variation Using Infiltration Resin Treatment of White Spot Lesions at One Year Follow-Up. Dent J (Basel) 2020; 8:E35. [PMID: 32290119 PMCID: PMC7344573 DOI: 10.3390/dj8020035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.
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Affiliation(s)
- Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
| | - Frank Lipari
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Angela Alibrandi
- Department of Economics, Section of Statistical and Mathematical Sciences, Messina University, 98100 Messina, Italy;
| | - Fabrizio Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Cristina Tamà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Evgenia Sazonova
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
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Khanduri N, Kurup D, Mitra M. Quantitative evaluation of remineralizing potential of three agents on artificially demineralized human enamel using scanning electron microscopy imaging and energy-dispersive analytical X-ray element analysis: An in vitro study. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.294329] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lacerda Rangel Esper MÂ, Junqueira JC, Uchoa AF, Bresciani E, Nara de Souza Rastelli A, Navarro RS, de Paiva Gonçalves SE. Photodynamic inactivation of planktonic cultures and Streptococcus mutans biofilms for prevention of white spot lesions during orthodontic treatment: An in vitro investigation. Am J Orthod Dentofacial Orthop 2019; 155:243-253. [PMID: 30712696 DOI: 10.1016/j.ajodo.2018.03.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This study evaluated the efficacy of photodynamic inactivation (PDI) with hematoporphyrin IX (H) and modified hematoporphyrin IX (MH) at 10 μmol/L, using a blue light-emitting diode (LED), fluence of 75 J/cm,2 over planktonic cultures and biofilm of Streptococcus mutans (UA 159). METHODS Suspensions containing 107 cells/mL were tested under different experimental conditions: a) H and LED (H+L+), b) MH and LED (MH+L+), c) only LED (P-L+), d) only H (H+L-), e) only MH (MH+L-), and f) control group, no LED or photosensitizer treatment (P-L-). The study also evaluated the effect of PDI on S mutans biofilm on metallic or ceramic brackets bonded on specimens of human teeth. The strains were seeded onto Mitis salivarius-bacitracin-sacarose agar to determine the number of colony-forming units. RESULTS H and MH under LED irradiation were effective on planktonic cultures (P <0.0001). H and MH (H+L+ and MH+L+) caused a reduction of 3.80 and 6.78 log10 CFU/mL. PDI with the use of H or MH and LED exerted a strong antimicrobial effect over S mutans showing 54% and 100% reduction, respectively. PDI on S mutans biofilm on metallic and ceramic brackets with the use of H was not effective (P = 0.0162, P = 0.1669), however, MH caused a significant reduction of 44% and 53% of the cell count on metallic and ceramic brackets, respectively (P = 0.0020, P = 0.004). CONCLUSIONS In vitro planktonic cultures with the use of H or MH and LED exerted significant antimicrobial activity. No effect was observed on S mutans biofilm on either bracket type with the use of H, MH showed better results, suggesting a promising use against dental caries and white spot lesions.
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Affiliation(s)
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University, São Paulo, Brazil
| | | | - Eduardo Bresciani
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University, São Paulo, Brazil
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WANG B, ZHANG N, WANG X, PARK SR, WEIR MD, OATES TW, XU HHK, BAI Y. Novel self-etch adhesive with antibacterial and protein-repellent functions to prevent enamel demineralization. Dent Mater J 2018; 37:904-911. [DOI: 10.4012/dmj.2017-422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Bo WANG
- Department of Orthodontics, School of Stomatology, Capital Medical University
- Department of Orthodontics, The First Affiliated Hospital of Dalian Medical University
| | - Ning ZHANG
- Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Xiaomeng WANG
- Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Soo Ro PARK
- Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Michael D. WEIR
- Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School
| | - Thomas W. OATES
- Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School
| | - Hockin H. K. XU
- Department of Endodontics, Periodontics and Prosthodontics, University of Maryland Dental School
- Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine
- Department of Mechanical Engineering, University of Maryland
| | - Yuxing BAI
- Department of Orthodontics, School of Stomatology, Capital Medical University
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Choi YY, Lee DY, Kim YJ. Colorimetric evaluation of white spot lesions following external bleaching with fluoridation: An in-vitro study. Korean J Orthod 2018; 48:377-383. [PMID: 30450330 PMCID: PMC6234118 DOI: 10.4041/kjod.2018.48.6.377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/10/2018] [Accepted: 05/12/2018] [Indexed: 11/10/2022] Open
Abstract
Objective This study was performed to investigate the effects of external tooth bleaching with flouridation on the appearance of white spot lesions (WSLs) in vitro. Methods In total, 125 bracket-bonded bovine incisor enamel blocks with artificial WSLs were randomly divided into a control group and four treatment groups (home bleaching, home bleaching + fluoridation, in-office bleaching, and in-office bleaching + fluoridation). A spectroradiometer (SR) and digital images (DIs) were used to evaluate colorimetric parameters (Commission Internationale l'Eclairage L*a*b*) for all specimens. Color measurements were obtained before WSL formation (T1), after WSL formation (T2), and after completion of the external tooth bleaching treatment (T3). Results The SR-based color change after bleaching was significantly greater in the treatment groups than in the control group (p < 0.05). SR-based lightness (L*) and red-green (a*) values were significantly higher at T2 than at T1 (p < 0.001), with no significant changes in yellow-blue (b*) values. At T3, SR-based L* values had increased while a* and b* values had decreased in the treatment groups (p < 0.001). The DI-based color difference between the sound enamel and WSL areas (ΔE*DI) increased significantly from T1 to T2 in all groups (p < 0.001) and significantly decreased from T2 to T3 in the treatment groups (p < 0.001). No significant differences in ΔE*DI at T3 were shown between the four treatment groups (p > 0.05). Conclusions The findings of this study suggested that external tooth bleaching with fluoridation can alleviate the conspicuity of WSLs.
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Affiliation(s)
- Yoon-Young Choi
- Major in Dentistry, Department of Medicine, Graduate School of Korea University, Seoul, Korea
| | - Dong-Yul Lee
- Department of Dentistry, Korea University College of Medicine, Seoul, Korea
| | - Yae-Jin Kim
- Department of Orthodontics, Korea University Guro Hospital, Seoul, Korea
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Alp S, Baka ZM. Effects of probiotics on salivary Streptecoccus mutans and Lactobacillus levels in orthodontic patients. Am J Orthod Dentofacial Orthop 2018; 154:517-523. [PMID: 30268262 DOI: 10.1016/j.ajodo.2018.01.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In this study, we aimed to determine the effect of regular probiotic consumption on microbial colonization in saliva in orthodontic patients and to comparatively evaluate the difference between the systemic consumption of probiotic products and the local application. METHODS This study included 3 groups with 15 orthodontic patients in each. The control group included patients who had no probiotic treatment, the subjects in the kefir group consumed 2 × 100 ml of kefir (Atatürk Orman Ciftligi, Ankara, Turkey) per day, and the subjects in the toothpaste group brushed their teeth with toothpaste with probiotic content (GD toothpaste; Dental Asia Manufacturing, Shah Alam, Selangor, Malaysia) twice a day. Samples were collected at 3 times: beginning of the study, 3 weeks later, and 6 weeks later. The salivary flow rate, buffer capacity, and Streptococcus mutans and Lactobacillus levels in the saliva were evaluated. Chair-side kits were used to determine the S mutans and Lactobacillus levels. RESULTS A statistically significant decrease was observed in the salivary S mutans and Lactobacillus levels in the kefir and toothpaste groups compared with the control group (P <0.05). A statistically significant increase was observed in the toothpaste group compared with the control and kefir groups in buffer capacity. Changes in the salivary flow rate were not statistically significant. CONCLUSIONS The regular use of probiotics during fixed orthodontic treatment reduces the S mutans and Lactobacillus levels in the saliva.
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Affiliation(s)
- Sevtap Alp
- Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Zeliha Müge Baka
- Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey.
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Remineralization capacity of carious and non-carious white spot lesions: clinical evaluation using ICDAS and SS-OCT. Clin Oral Investig 2018; 23:863-872. [DOI: 10.1007/s00784-018-2503-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/30/2018] [Indexed: 10/14/2022]
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Mahmoudzadeh M, Rezaei-Soufi L, Farhadian N, Jamalian SF, Akbarzadeh M, Momeni M, Basamtabar M. Effect of CO2 Laser and Fluoride Varnish Application on Microhardness of Enamel Surface Around Orthodontic Brackets. J Lasers Med Sci 2017; 9:43-49. [PMID: 29399311 DOI: 10.15171/jlms.2018.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Orthodontic treatment has many advantages such as esthetic improvement and self-esteem enhancement; yet it has some disadvantages such as increasing the risk of formation of white spot lesions, because it makes oral hygiene more difficult. It is rational to implement procedures to prevent these lesions. The present study was aimed to assess the effect of CO2 laser and fluoride varnish on the surface of the enamel surface microhardness around the orthodontic braces. Methods: Eighty extracted premolar teeth were selected, scaled, polished with nonfluoridated pumic and metal brackets were bonded to them. Then, they were randomly allocated to 5 groups: control (neither fluoride nor laser is used on enamel surfaces), fluoride (4 minutes fluoride varnish treatment of the enamel surfaces), CO2 laser (10.6 µm CO2 laser irradiation of the teeth), laserfluoride (fluoride application after laser irradiation) and fluoride-laser (fluoride was applied and then teeth were irradiated with laser). After surface treatment around brackets on enamel, the samples were stored in 0.1% thymol for less than 5 days and then they were exposed to a 10-day microbiological caries model. Microhardness values of enamel were evaluated with Vickers test. One sample of each group (5 teeth from 80 samples) was prepared for SEM (scanning electron microscopy) and the data from 75 remaining teeth were analyzed with analysis of variance (ANOVA) and chi-square tests (α =0.05). Results: Microhardness mean values from high to low were as follow: fluoride-laser, laser-fluoride, laser, fluoride and control. Microhardness in fluoride-laser group was significantly higher compared with that of the control group. Distribution adhesive remnant index (ARI) scores were significantly different between groups and most of bond failures occurred at the enamel-adhesive interface in groups 2 to 5 and at the adhesive-bracket interface in the control group. Conclusion: Combination of fluoride varnish and CO2 laser irradiation can reduce enamel demineralization around orthodontic brackets.
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Affiliation(s)
- Majid Mahmoudzadeh
- Orthodontics Department, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Loghman Rezaei-Soufi
- Department of Restorative Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasrin Farhadian
- Orthodontics Department, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Mahdi Akbarzadeh
- Department of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammadali Momeni
- Orthodontics Department, Dental Faculty, Shahrekord University of Medical Sciences, Chaleshtar, Shahrekord, Iran
| | - Masome Basamtabar
- Orthodontic Department, Dental Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Molaasadollah F, Asnaashari M, Mashhadi Abbas F, Jafary M. In Vitro Comparison Of Fluoride Gel Alone and in Combination With Er,Cr:YSGG Laser on Reducing White Spot Lesions in Primary Teeth. J Lasers Med Sci 2017; 8:160-165. [PMID: 29071020 DOI: 10.15171/jlms.2017.29] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Laser therapy has been suggested as a method for caries-prevention, and ErCr:YSGG laser is increasingly used in dentistry. This study aimed to compare the efficacy of fluoride gel alone and in conjunction with Er,Cr:YSGG laser for remineralization of white spot lesions (WSLs) in primary teeth. Methods: This study was conducted on 20 primary teeth with WSLs extracted for orthodontic reasons. Three sections were made of each tooth at the site of WSLs. The surface area of WSLs was measured under a stereomicroscope at ×25 magnification. Samples were assigned to 3 groups of control (group 1), exposure to 1.23% APF gel for 4 minutes (group 2) and Er,Cr:YSGG laser (0.5 W power, 20 Hz frequency, 60% water, 40% air, pulse duration of 5±1 seconds) plus fluoride (group 3). All samples were stored in artificial saliva for 10 days and then the surface area of the WSLs was measured again under a stereomicroscope. Data were analyzed using the Kruskal-Wallis, MannWhitney and Wilcoxon signed rank tests. Results: The reduction in surface area of the WSLs was significantly different between the control and fluoride (P<0.001) and also the control and laser plus fluoride groups (P<0.001); the difference between fluoride and laser plus fluoride groups was not significant (P=0.265). Comparison of the surface area of WSLs before and after the intervention showed no significant difference in group one (P=0.737) while this difference in groups 2 (P<0.001) and 3 (P<0.001) was statistically significant. Conclusion: The results showed that Er,Cr:YSGG laser irradiation plus 1.23% APF gel was not significantly different from the application of fluoride gel alone in enhancing the remineralization of WSLs.
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Affiliation(s)
- Fatemeh Molaasadollah
- Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mashhadi Abbas
- Department of Oral & Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences
| | - Maral Jafary
- Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bock NC, Seibold L, Heumann C, Gnandt E, Röder M, Ruf S. Changes in white spot lesions following post-orthodontic weekly application of 1.25 per cent fluoride gel over 6 months-a randomized placebo-controlled clinical trial. Part I: photographic data evaluation. Eur J Orthod 2017; 39:134-143. [PMID: 27702806 DOI: 10.1093/ejo/cjw060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background White spot lesions (WSLs) are a frequent side-effect of multibracket appliance treatment. The effect of local fluoridation on post-orthodontic WSL is however inconclusive. Objective Assessment of WSL changes in response to weekly 1.25 per cent fluoride gel application after multibracket appliance treatment. Trial design Randomized, single-centre, double-blind, parallel-group, placebo-controlled study. Participants Patients with not less than 1 WSL (modified score 1 or 2) on not less than 1 upper front teeth after debonding. Interventions Professional fluoride/placebo gel application during weeks 1-2; self-administered home application (weeks 3-24). Outcomes Photographic WSL assessment (dimension and luminance) of the upper front teeth (T0-T5). Randomization Random assignment to test (n = 23) or placebo group (n = 23) using a sequentially numbered list (random allocation sequence generated for 50 subjects in 25 blocks of 2 subjects each). Recruitment The clinical study duration lasted from March 2011 to September 2013. Blinding Unblinding was performed after complete data evaluation. Numbers analysed Intent-to-treat analysis set comprising 39 participants (test: n = 21, placebo: n = 18). Outcome Dimensional WSL quantification showed limited reliability. Luminance improvement (%) of WSL, however, was seen after 6 months (test/placebo: tooth 12, 24.8/18.0; tooth 11, 38.4/35.4; tooth 21, 39.6/38.3; and tooth 22, 15.2/25.0). No statistically significant group difference existed. Data suggest that WSLs are difficult to measure with respect to reliability and repeatability and methods for monitoring WSLs in clinical trials require improvement/validation. Harms Similar adverse events occurred in both groups; none was classified as possibly related to the study product. Limitations The number of dropouts was higher than expected and the socio-economic status was not assessed. Furthermore, the unknown level of compliance during the home application phase must be considered as limitation. Conclusion Based on the results of this study, no difference could be detected with respect to the development of WSL under post-orthodontic high-dose fluoride treatment. Registration The study was registered with ClinicalTrials.gov (Identifier: NCT01329731). Protocol The protocol wasn't published before trial commencement.
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Affiliation(s)
- Niko C Bock
- Department of Orthodontics, University of Giessen
| | | | | | | | | | - Sabine Ruf
- Department of Orthodontics, University of Giessen
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Feng X, Zhang N, Xu HHK, Weir MD, Melo MAS, Bai Y, Zhang K. Novel orthodontic cement containing dimethylaminohexadecyl methacrylate with strong antibacterial capability. Dent Mater J 2017; 36:669-676. [PMID: 28652555 DOI: 10.4012/dmj.2016-370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Orthodontic treatments increase the incidence of white spot lesions. The objectives of this study were to develop an antibacterial orthodontic cement to inhibit demineralization, and to evaluate its enamel shear bond strength and anti-biofilm properties. Novel antibacterial monomer dimethylaminohexadecyl methacrylate (DMAHDM) was synthesized and incorporated into Transbond XT at 0, 1.5 and 3% by mass. Anti-biofilm activity was assessed using a human dental plaque microcosm biofilm model. Shear bond strength and adhesive remnant index were also tested. Biofilm activity precipitously dropped when contacting orthodontic cement with DMAHDM. Orthodontic cement containing 3% DMAHDM significantly reduced biofilm metabolic activity and lactic acid production (p<0.05), and decreased biofilm colony-forming unit (CFU) by two log. Water-aging for 90 days had no adverse influence on enamel shear bond strength (p>0.1). By incorporating DMAHDM into Transbond XT for the first time, the modified orthodontic cement obtained a strong antibacterial capability without compromising the enamel bond strength.
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Affiliation(s)
- Xiaodong Feng
- Division of Dentistry, Beijing Tongren Hospital, Capital Medical University.,Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Ning Zhang
- Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Hockin H K Xu
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry.,Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine.,Department of Mechanical Engineering, University of Maryland
| | - Michael D Weir
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry
| | - Mary Anne S Melo
- Biomaterials & Tissue Engineering Division, Department of Endodontics, Periodontics and Prosthodontics, University of Maryland School of Dentistry
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University
| | - Ke Zhang
- Department of Orthodontics, School of Stomatology, Capital Medical University
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Eltayeb MK, Ibrahim YE, El Karim IA, Sanhouri NM. Distribution of white spot lesions among orthodontic patients attending teaching institutes in Khartoum. BMC Oral Health 2017; 17:88. [PMID: 28545439 PMCID: PMC5445351 DOI: 10.1186/s12903-017-0380-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 05/16/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Fixed orthodontic appliances render teeth cleaning arduous, thus when orthodontic treatment is associated with inadequate oral hygiene practice, development of white spot lesions (WSLs) imposes a significant risk on the dentition. Salivary reservoir of calcium, magnesium, phosphorous and fluoride counteracts demineralization and encourages remineralization providing protection against caries challenge. The investigation of the factors leading to WSLs' development is mandatory for appropriate prevention strategies planning. The present study aimed at evaluating the prevalence, pattern of distribution and contributing factors to WSLs' development, among orthodontic patients attending orthodontic departments in teaching institutes in Khartoum. METHODS This cross-sectional descriptive, analytical clinical based study was carried out among fixed orthodontic patients attending teaching institutes in Khartoum State. All patients visiting the clinics for their follow up during a 3 months period and fulfilling the inclusion criteria were included. The International Caries Detection and Assessment System (ICDAS) served as a guide for standardized visual caries assessment. Saliva samples were collected from a sample of patients and the levels of calcium and phosphorus were measured. Patients were interviewed regarding their oral hygiene habits (frequency of tooth brushing, use of interdental brushes and mouth washes). Frequency distribution tables as well as graphs, Pearson's correlations and Spearman's correlation were used in the statistical analysis. RESULTS The overall prevalence of WSLs was 61.4%. The prevalence for each tooth was: 48.1% in the canine, 32.3% in the lateral incisor, 31.6% in both the central incisor and the first premolar, 27.2% in the second premolar and 8.9% in the first molar. No significant relationship between WSLs prevalence, age and gender or oral hygiene measures was found. There was no significant difference in calcium and phosphorus level between participants with WSLs or those with sound teeth (p-values for calcium and phosphorus were 0.154 and 0.567 respectively). CONCLUSIONS Within the limitations of this study it was found that WSLs among fixed orthodontic patients represented an issue of concern. High prevalence of WSLs was recorded among orthodontic patients in Sudan, indicating a need for more stringent prevention programmes and oral hygiene practices prior to initiation of orthodontic treatment.
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Affiliation(s)
- Maha Kamal Eltayeb
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Yahia Eltayeb Ibrahim
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | | | - Nada Mirghani Sanhouri
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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Bock NC, Seibold L, Heumann C, Gnandt E, Röder M, Ruf S. Changes in white spot lesions following post-orthodontic weekly application of 1.25 per cent fluoride gel over 6 months-a randomized placebo-controlled clinical trial. Part II: clinical data evaluation. Eur J Orthod 2017; 39:144-152. [PMID: 27702807 DOI: 10.1093/ejo/cjw061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background White spot lesions (WSL) frequently occur as side-effect of multibracket appliance treatment. The clinical effects of local fluoridation on post-orthodontic WSL and oral health development are however inconclusive. Objective In vivo monitoring of clinical WSL and oral health changes in response to weekly 1.25 per cent fluoride gel application after multibracket appliance treatment. Trial design Randomized, single-centre, double-blind, parallel-group, placebo-controlled study. Participants Patients with not less than 1 WSL (modified score 1 or 2) on not less than 1 upper front teeth after debonding. Interventions Professional fluoride/placebo gel application during weeks 1-2; self-administered home application (weeks 3-24). Outcomes Clinical evaluation of WSL index, lesion activity, plaque index, gingival bleeding index, and decayed, missing, and filled teeth index as well as saliva buffer capacity and stimulated salivary flow rate (T0-T5). Randomization Random assignment to test (n = 23) or placebo group (n = 23) using a sequentially numbered list (random allocation sequence generated for 50 subjects in 25 blocks of 2 subjects each). Recruitment The clinical study duration lasted from March 2011 to September 2013. Blinding Unblinding was performed after complete data evaluation. Numbers analysed Intention-to-treat analysis set comprised 39 participants (test: n = 21, placebo: n = 18). Outcome No clinical parameter except stimulated salivary flow rate (fluoride group: 1.1ml/min, placebo group: 0.74ml/min; P = 0.022) showed a statistically significant group difference after 24 weeks. Harms Several adverse events occurred similarly frequent in both groups; none was classified as possibly related to the study product. Limitations The number of dropouts was higher than expected and the socio-economic status was not assessed. Furthermore, the unknown level of compliance during the home application phase must be considered as limitation. Conclusion Based on the results of this study, no clinical effect of post-orthodontic high-dose fluoride treatment on WSL and oral health changes could be detected. Registration The study was registered with ClinicalTrials.gov (Identifier: NCT01329731). Protocol The protocol wasn't published before trial commencement.
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Affiliation(s)
- Niko C Bock
- Department of Orthodontics, University of Giessen
| | | | | | | | | | - Sabine Ruf
- Department of Orthodontics, University of Giessen
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Antibacterial Activity and Bonding Ability of an Orthodontic Adhesive Containing the Antibacterial Monomer 2-Methacryloxylethyl Hexadecyl Methyl Ammonium Bromide. Sci Rep 2017; 7:41787. [PMID: 28169312 PMCID: PMC5294631 DOI: 10.1038/srep41787] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/29/2016] [Indexed: 11/08/2022] Open
Abstract
Irreversible white spot lesion (WSL) occurs in up to 50% of patients during orthodontic treatment. Therefore, orthodontic adhesives need to be able to inhibit or reduce bacterial growth in order to prevent or minimize WSL. This study evaluated the antibacterial effect and shear bond strength (SBS) of a resin-based orthodontic adhesive containing the antibacterial monomer 2-methacryloxylethyl hexadecyl methyl ammonium bromide (MAE-HB). MAE-HB was added at three concentrations (1, 3, and 5 wt%) to a commercial orthodontic adhesive Transbond XT, while the blank control comprised unmodified Transbond XT. Their antibacterial effects on Streptococcus mutans were investigated after 0 and 180 days of aging. The SBS of metal brackets bonded to the buccal enamel surface of human premolars was assessed. Compared with the blank control, the MAE-HB-incorporated adhesive exhibited a significant contact inhibitory effect on the growth of S. mutans (P < 0.05), even after 180 days of aging. SBS and adhesive remnant index values revealed that the bonding ability of the experimental adhesive was not significantly adversely affected by the incorporation of MAE-HB at any of the three concentrations. Therefore, orthodontic adhesives with strong and long-lasting bacteriostatic properties can be created through the incorporation of MAE-HB without negatively influencing bonding ability.
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Shahmoradi M, Swain MV. Micro-CT analysis of naturally arrested brown spot enamel lesions. J Dent 2017; 56:105-111. [DOI: 10.1016/j.jdent.2016.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/09/2016] [Accepted: 11/19/2016] [Indexed: 11/28/2022] Open
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