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Kashash Y, Hein S, Göstemeyer G, Aslanalp P, Weyland MI, Bartzela T. Resin infiltration versus fluoride varnish for visual improvement of white spot lesions during multibracket treatment. A randomized-controlled clinical trial. Clin Oral Investig 2024; 28:308. [PMID: 38733458 PMCID: PMC11088558 DOI: 10.1007/s00784-024-05695-2] [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: 02/12/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
AIMS This study aimed to evaluate the visual improvement of resin infiltration of white spot lesions (WSL) during orthodontic treatment with the multibracket appliance (MBA) compared to fluoride varnish. METHODS Patients aged 12-17 years with at least one WSL with an International Caries Detection and Assessment System (ICDAS) score of 1-2 during an active MBA treatment were included and randomized to receive either resin infiltration (Icon) or fluoride application (Flairesse). Standardized digital images were obtained before, one-day, one-week, one-month, three-months and six-months after treatment using a DSLR camera and a matching polarization filter. A grey reference card was used for color standardization. A Matlab routine was used to measure the color difference between adjacent healthy enamel and treated WSL. The independent-samples t-test was used for intergroup and paired-samples t-test for intragroup comparison. RESULTS Images of 116 teeth from 36 patients were analyzed. The ΔE for the "Icon" treated WSL was smaller (T1ICON = 5.0 ± 1.4) than in the fluoride group (T1Fluoride = 8.4 ± 3.2). Caries infiltration significantly improved the aesthetic appearance of WSL (p < 0.001), which remained satisfactory at six months (T5ICON = 5.2 ± 1.6). CONCLUSION WSL infiltration management during orthodontic treatment was superior to topical fluoridation in not only arresting the enamel lesions but also significantly improving the aesthetic appearance of demineralized regions around the brackets. CLINICAL RELEVANCE WSL treatment in orthodontic patients is usually initiated after debonding. Research has shown that the earlier WSL is treated, the better the aesthetic outcome. There is limited data on the efficacy of resin infiltration of WSL during orthodontic treatment.
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Affiliation(s)
- Yamen Kashash
- Depatment of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Sascha Hein
- School of Design, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, England
| | - Gerd Göstemeyer
- Department of Conservative, Preventive and Pediatric Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Pervin Aslanalp
- Depatment of Orthodontics and Dentofacial Orthopedics, Charité - Universitätsmedizin Berlin, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Manon Isabelle Weyland
- Department of Orthodontics, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Theodosia Bartzela
- Department of Orthodontics, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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Kanzow P, Witt C, Lechte C, Barke S, Rohland B, Schmidt A, Wiegand A. Effect of different brushing parameters on erosive tooth wear in primary bovine enamel and dentin. PLoS One 2024; 19:e0302261. [PMID: 38626124 PMCID: PMC11020396 DOI: 10.1371/journal.pone.0302261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/31/2024] [Indexed: 04/18/2024] Open
Abstract
This in-vitro study aimed to analyse the effect of brushing and different brushing parameters (kind of toothpaste, kind of toothbrush, brushing force) on erosive tooth wear of primary bovine enamel and dentin. Specimens were prepared from primary bovine enamel or dentin (each group n = 12) and cyclically eroded (6 × 60 s/d, citric acid, pH 2.4) and brushed with children's toothbrushes (2 × 15 s/d) over 5 days. The brushing parameters under investigation were: toothpaste (fluoridated, fluoride-free), toothbrush (manual; rotating-oscillating and sonic, each at two different activation modes) and brushing force (1 N, 2 N). Specimens that were only eroded and not brushed served as controls. Enamel and dentin wear was quantified using widefield confocal microscopy. Statistical analysis was performed using three- and one-way ANOVAs followed by Scheffe's (enamel) or Tamhane's (dentin) post-hoc tests (p < 0.05). Brushing with the fluoridated toothpaste was able to significantly reduce erosive wear in enamel (by 15 to 37%, 6 of 10 groups) and in dentin (by 58 to 72%, all groups), while brushing with the fluoride-free toothpaste was not different from the controls. Considering the kind of toothpaste and brushing force, slight differences between the toothbrushes were observed in enamel, but not in dentin. Within the same toothbrush and activation mode, almost no differences between 1 and 2 N brushing force were detected. In conclusion, erosive tooth wear on primary bovine dental hard tissue mainly depends on the kind of toothpaste, rather than on the kind of toothbrush and the brushing force.
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Affiliation(s)
- Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Corinna Witt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Clemens Lechte
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Sarah Barke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Bianca Rohland
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Schmidt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Lee JCM, Burrow MF, Botelho MG. A qualitative analysis of dentists' understanding and management of non-carious cervical lesions (NCCL). J Dent 2023; 136:104640. [PMID: 37516340 DOI: 10.1016/j.jdent.2023.104640] [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: 04/20/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 07/31/2023] Open
Abstract
INTRODUCTION Non-carious cervical lesions (NCCLs) are considered to have a multi-factorial aetiology and their management is affected by a range of variables perhaps most importantly clinical judgement. The aim of this study was to elicit information from practicing dentists, using interviews, to explore their understanding of NCCL aetiology, the decision-making criteria of when to restore, and the restorative techniques used to restore NCCLs. This may help identify gaps or anomalies in our understanding to inform future research and clinical practice for the management of NCCLs. METHODS An interview guide was developed from a literature search which formed 2 domains framed around understanding and management of NCCLs based on: understanding of diagnosis and aetiology, and factors affecting decision making for management. Practicing dentists with more than 10 years of experience were purposively recruited to conduct in-depth, semi-structured interviews. Fifteen interviews were audio recorded and transcribed verbatim. A thematic content analysis was conducted and the results analysed. RESULTS From the thematic analysis, 2 domains were identified. In the domain of "diagnosis and aetiology", while participants have similar understanding and methods of diagnosing NCCL, most stated NCCLs in a patient were caused by a "main aetiology" such as "abrasion", "abfraction" while few described the inter-relationship of these aetiological factors. In the domain of "factors affecting decision making". "Patient reported symptoms" and "lesion dimension" were the main factors that affected participants' decision to provide restorative or non-restorative management. However, a "restorative threshold" was not able to be identified. CONCLUSION There was notable variety in participants' understanding of the aetiology, management, and treatment of NCCLs, particularly the restorative threshold of when to treat. CLINICAL SIGNIFICANCE The variability demonstrates the need to have a clearer understanding of the key elements that affect the management of NCCLs and better information to support the decision of when to treat.
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Affiliation(s)
- Johnson Chun Ming Lee
- Prince Philip Dental Hospital, 34 Hospital road, University of Hong Kong, Hong Kong, SAR China
| | - Michael Francis Burrow
- Prince Philip Dental Hospital, 34 Hospital road, University of Hong Kong, Hong Kong, SAR China
| | - Michael George Botelho
- Prince Philip Dental Hospital, 34 Hospital road, University of Hong Kong, Hong Kong, SAR China.
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Guma E, Kiliaridis S, Scherrer SS, Antonarakis GS. An In Vitro Evaluation of the Effects of Air-Polishing Powders on Sound and Demineralised Enamel. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4811. [PMID: 37445125 DOI: 10.3390/ma16134811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
AIM To evaluate the effects of two air-polishing powders, during orthodontic treatment, on the surface roughness of sound and demineralised enamel. MATERIALS AND METHODS Forty-two caries-free human molars were collected, and the enamel surfaces were flattened and polished. Teeth were assigned to two groups (n = 21 each), a sound- and a demineralised-enamel group (subjected to pH-cycling over 2 weeks to create artificially induced white spot-like lesions). Within each group, teeth were further assigned to three groups (n = 7 each), air polished with either sodium bicarbonate, erythritol, or a negative control (water). Each sample was treated for 5 and 150 s. The average surface roughness (Ra) for each sample was measured using white-light-sensor profilometry. RESULTS On sound enamel, the Ra was roughly 0.17 ± 0.07 μm. After 150 s of air polishing, the Ra increased with erythritol (by 0.28 μm), and even more so with bicarbonate treatment (by 0.68 μm) (p < 0.01). On demineralised enamel, the Ra was roughly 0.79 ± 0.56 μm. The Ra increased after 5 s of air-polishing treatment similarly with erythritol and bicarbonate powders (by 1.03 μm and 1.04 μm, respectively) (p = 0.025), and even more after 150 s (by 2.48 μm and 2.49 μm, respectively) (p < 0.001). CONCLUSIONS On white spot lesions, one should be aware that enamel surface roughness will increase with both erythritol and bicarbonate air-polishing powders, especially with longer exposure times.
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Affiliation(s)
- Elton Guma
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, 3012 Bern, Switzerland
| | - Susanne S Scherrer
- Division of Fixed Prosthetics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
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Pereira TP, Vieira TAF, Júnior WLDS, Bezerra SJC, Sobral MÂP, Scaramucci T. Influence of different ultra-soft toothbrushes on erosive tooth wear. J Dent 2023; 132:104502. [PMID: 36997084 DOI: 10.1016/j.jdent.2023.104502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE To investigate the influence of different ultra-soft toothbrushes on the progression of erosive tooth wear (ETW). METHODS Bovine enamel and dentin specimens (n=10) were submitted to a 5-day erosive-abrasive cycling model (0.3% citric acid for 5min, artificial saliva for 60min, 4x/day). Toothbrushing was carried out 2x/day for 15s, with the different toothbrushes tested (A- Edel White: flexible handle, tapered bristles; B- Oral-B Gengiva Detox: regular handle, criss-cross tapered bristles; C- Colgate Gengiva Therapy: flexible handle, tapered bristles, high tuft density; D- Oral-B Expert Gengiva Sensi: regular handle, round bristles, high tuft density; E- Oral-B Indicator Plus: soft brush, round end bristles (control). Surface loss (SL, in μm) was assessed by optical profilometry. The toothbrush characteristics were evaluated by surgical microscope. Data were statistically analyzed (α=0.05). RESULTS For enamel, toothbrush C showed the highest SL (means±SD: 9.86±1.28) and it did not differ significantly from A (8.60±0.50), both with flexible handle. The lowest SL was observed for the toothbrush Control E (6.76±0.63), which differed significantly from A and C, but not from the other toothbrushes. For dentin, the highest SL was found for toothbrush D (6.97±1.05) and it did not differ significantly from E (6.23±0.71). The lowest SL was observed for B (4.61±0.71) and C (4.85+0.83), without significant differences from A (5.01±1.24). CONCLUSIONS The ultra-soft toothbrushes had different impacts on the progression of ETW on the dental substrates. On enamel, higher ETW values were observed for the flexible handle toothbrushes, while for dentin, round-end bristles (ultra-soft and soft) caused more ETW. CLINICAL SIGNIFICANCE Knowledge about the effect of different ultra-soft toothbrushes on ETW can help clinicians to recommend the most suitable types for their patients, bearing in mind that toothbrushes can impact enamel and dentin differently.
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Kruzic JJ, Hoffman M, Arsecularatne JA. Fatigue and wear of human tooth enamel: A review. J Mech Behav Biomed Mater 2023; 138:105574. [PMID: 36473402 DOI: 10.1016/j.jmbbm.2022.105574] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/14/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
Human tooth enamel must withstand the cyclic contact forces, wear, and corrosion processes involved with typical oral functions. Furthermore, unlike other human tissues, dental enamel does not have a significant capacity for healing or self-repair and thus the longevity of natural teeth in the oral environment depends to a large degree on the fatigue and wear properties of enamel. The purpose of this review is to provide an overview of our understanding of the fatigue and wear mechanisms of human enamel and how they relate to in vivo observations of tooth damage in the complex oral environment. A key finding of this review is that fatigue and wear processes are closely related. For example, the presence of abrasive wear particles significantly lowers the forces needed to initiate contact fatigue cracking while subsurface fatigue crack propagation drives key delamination wear mechanisms during attrition or attrition-corrosion of enamel. Furthermore, this review seeks to bring a materials science and mechanical engineering perspective to fatigue and wear phenomena. In this regard, we see developing a mechanistic description of fatigue and wear, and understanding the interconnectivity of the processes, as essential for successfully modelling enamel fatigue and wear damage and developing strategies and treatments to improve the longevity of our natural teeth. Furthermore, we anticipate that this review will stimulate ideas for extending the lifetime of the natural tooth structure and will help highlight where our understanding is too limited and where additional research into fatigue and wear of human tooth enamel is warranted.
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Affiliation(s)
- Jamie J Kruzic
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney NSW 2052, Australia.
| | - Mark Hoffman
- School of Engineering, University of Newcastle, Callaghan NSW 2308, Australia; School of Materials Science and Engineering, University of New South Wales (UNSW Sydney), Sydney NSW 2052, Australia
| | - Joseph A Arsecularatne
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney NSW 2052, Australia
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Souza CDMS, Sakae LO, Carneiro PMA, Esteves RA, Scaramucci T. Interplay between different manual toothbrushes and brushing loads on erosive tooth wear. J Dent 2020; 105:103577. [PMID: 33388388 DOI: 10.1016/j.jdent.2020.103577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/23/2020] [Accepted: 12/26/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the effect of different types of manual toothbrushes and brushing loads on the progression of erosive tooth wear (ETW) on enamel. METHODS Bovine enamel specimens (n = 10) were submitted to a 5-day erosive-abrasive cycling model (0.3 % citric acid for 5 min, artificial saliva for 60 min, 4x/day). Toothbrushing was carried out 2x/day for 15 s, according to the toothbrushes tested (ultra-soft (a): Curaprox 5460; ultra-soft (b): Sensodyne Repair & Protect; soft (a): Colgate Slim Soft; soft (b): Oral-B Indicator Plus; medium: Johnson's Professional; hard: Tek) and brushing loads (1.5 N, 3 N). Surface loss (SL, in μm) was assessed by optical profilometry on conclusion of the cycling. Some of the toothbrush characteristics were evaluated. Data were statistically analyzed (α = 0.05). RESULTS For the 1.5 N load, the hard brush showed the highest SL value, with statistical significance. The other toothbrushes did not differ significantly, except that ultra-soft (a) caused significantly higher SL than ultra-soft (b). For the 3 N load, hard and soft (a) exhibited the highest SL. Soft (b) and medium had the lowest SL value, with statistical significance. Only soft (a) and ultra-soft (b) showed significant difference between loads, with lower SL for the load of 1.5 N. None of the toothbrush characteristics were significantly correlated with SL. CONCLUSIONS Although different degrees of enamel surface loss were observed with use of the different toothbrushes, no association was found between the toothbrush characteristics and SL. Depending on the toothbrush, the force of brushing was capable of modulating the ETW of enamel. Based on the brushing loads usually applied by healthy individuals, hard brushes are not recommended for use by patients with ETW. CLINICAL SIGNIFICANCE The use of hard bristle brushes is not recommended for use by individuals who exert healthy forces when brushing their teeth. The toothbrush characteristics are of secondary importance in terms of causing enamel loss in ETW.
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Affiliation(s)
- Cíntia de Melo Silva Souza
- Department of Clinic, University Center of State of Para, School of Dentistry, Tv. 9 de Janeiro 927, Belém, PA, 66060-080, Brazil.
| | - Letícia Oba Sakae
- Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
| | - Paula Mendes Acatauassú Carneiro
- Department of Clinic, University Center of State of Para, School of Dentistry, Tv. 9 de Janeiro 927, Belém, PA, 66060-080, Brazil.
| | - Renata Antunes Esteves
- Department of Clinic, University Center of State of Para, School of Dentistry, Tv. 9 de Janeiro 927, Belém, PA, 66060-080, Brazil.
| | - Taís Scaramucci
- Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
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Marin E, Hiraishi N, Honma T, Boschetto F, Zanocco M, Zhu W, Adachi T, Kanamura N, Yamamoto T, Pezzotti G. Raman spectroscopy for early detection and monitoring of dentin demineralization. Dent Mater 2020; 36:1635-1644. [PMID: 33168225 DOI: 10.1016/j.dental.2020.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
Early detection of dental caries and variations in composition/structure of both enamel and dentin represents an important issue in modern dentistry. Demineralization has been associated to teeth discoloration, development of caries, and formation of cavities. OBJECTIVE In this study, we systematically monitored the processes of demineralization/remineralization in dentin samples by means of three different spectroscopic techniques, namely, Raman spectroscopy, X-Ray Photo-electron spectroscopy (XPS), and X-Ray Diffractometry (XRD). METHODS Bovine dentin samples were first exposed to acidic solutions and their structure systematically monitored as a function of time and pH. Then, the samples were rinsed in artificial saliva to simulate remineralization. RESULTS The above three spectroscopic techniques provided quantitative structural information spanning from the nanometer to the millimeter scale of sample penetration depth. An irreversible level of demineralization was reached when dentin was exposed to pH 2 beyond a time threshold of 6h, successive treatments with artificial saliva being unable to restore the mineral fraction. On the other hand, short-term treatments at pH 5 and long-term treatments at pH 6 could partially or completely recover the dentin structure within one week of remineralization treatment. SIGNIFICANCE Two specific Raman parameters, namely, the bandwidth of the symmetric phosphate-stretching signal and the mineral-to-matrix intensity ratio, showed strong correlations with XPS and XRD data, and matched laser microscopy observations. Such correlations open the path to apply Raman spectroscopy in monitoring dentin demineralization in vivo and provide quantitative working algorithms for the prevention of oral caries.
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Affiliation(s)
- Elia Marin
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, 606-8585 Kyoto, Japan; Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan.
| | - Noriko Hiraishi
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 113-8510 Tokyo, Japan
| | - Taigi Honma
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, 606-8585 Kyoto, Japan
| | - Francesco Boschetto
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan; Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, 465 Kajii-cho, Kawaramachi dori, 602-0841 Kyoto, Japan
| | - Matteo Zanocco
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, 606-8585 Kyoto, Japan; Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, 465 Kajii-cho, Kawaramachi dori, 602-0841 Kyoto, Japan
| | - Wenliang Zhu
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, 606-8585 Kyoto, Japan
| | - Tetsuya Adachi
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Narisato Kanamura
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Toshiro Yamamoto
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Giuseppe Pezzotti
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, 606-8585 Kyoto, Japan; Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, 465 Kajii-cho, Kawaramachi dori, 602-0841 Kyoto, Japan; Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, 160-0023 Tokyo, Japan; The Center for Advanced Medical Engineering and Informatics, Osaka University, Yamadaoka, Suita, 565-0871 Osaka, Japan
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The use of index teeth vs. full mouth in erosive tooth wear to assess risk factors in the diet: A cross-sectional epidemiological study. J Dent 2019; 88:103164. [DOI: 10.1016/j.jdent.2019.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/30/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022] Open
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Hara AT, Turssi CP. Baking soda as an abrasive in toothpastes: Mechanism of action and safety and effectiveness considerations. J Am Dent Assoc 2019; 148:S27-S33. [PMID: 29056187 DOI: 10.1016/j.adaj.2017.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Toothpastes can be formulated with different abrasive systems, depending on their intended clinical application. This formulation potentially affects their effectiveness and safety and, therefore, requires proper understanding. In this article, the authors focused on abrasive aspects of toothpastes containing sodium bicarbonate (baking soda), which have gained considerable attention because of their low abrasivity and good compatibility, while providing clinical effectiveness (further detailed in the other articles of this special issue). The authors first appraised the role of toothpaste abrasivity on tooth wear, exploring some underlying processes and the existing methods to determine toothpaste abrasivity. TYPES OF STUDIES REVIEWED The authors reviewed the available data on the abrasivity of toothpastes containing baking soda and reported a summary of findings highlighting the clinical implications. CONCLUSIONS On the basis of the collected evidence, baking soda has an intrinsic low-abrasive nature because of its comparatively lower hardness in relation to enamel and dentin. Baking soda toothpastes also may contain other ingredients, which can increase their stain removal effectiveness and, consequently, abrasivity. PRACTICAL IMPLICATIONS Even those formulations have abrasivity well within the safety limit regulatory agencies have established and, therefore, can be considered safe.
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Rios D, Oliveira GC, Zampieri CR, Jordão MC, Dionisio EJ, Buzalaf M, Wang L, Honório HM. Resin-Based Materials Protect Against Erosion/Abrasion-a Prolonged In Situ Study. Oper Dent 2019; 44:302-311. [PMID: 30629465 DOI: 10.2341/17-198-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
While patient compliance is key to preventive measures related to dental erosion, the application of resin-based materials could serve as an additional treatment to inhibit erosion progression. This in situ study evaluated the effect of applying resin-based materials, including resin infiltrant, on previously eroded enamel subjected to prolonged erosive and abrasive challenges. The factors under study were types of treatment (infiltrant [Icon], sealant [Helioseal Clear], adhesive [Adper Scotchbond Multi-Purpose Plus], and control [no treatment]); wear conditions (erosion [ERO] and erosion + abrasion [ERO + ABR]) and challenge time (5 and 20 days) in a single-phase study. The blocks were prepared from bovine enamel, eroded (0.01 M HCl, pH 2.3 for 30 seconds) and randomized among treatments, wear conditions, and volunteers. The application of resin-based materials followed the manufacturers' recommendations. Twenty-one volunteers wore the palatal intraoral device, in which one row corresponded to ERO and the other to ERO + ABR. In each row, all treatments were represented (2 blocks per treatment). For 20 days, the erosive challenge was performed 4 times/day (immersion in 0.01 M HCl, pH 2.3, for 2 minutes) for the ERO condition. For the ERO + ABR condition, two of the erosive challenges were followed by abrasion for 15 seconds with fluoride dentifrice slurry. Enamel and/or material loss was measured using profilometry (initial, after treatment, and after the end of the fifth and 20th days of in situ erosive challenge) and analyzed by ANOVA models and Tukey's test (α=0.05). The results showed that the application of resin-based materials did not cause superficial enamel loss. The infiltrant group showed a thicker layer of material above the enamel compared with the other materials (p=0.001). After the erosive challenge, there was no difference between the conditions ERO and ERO + ABR (p=0.869). All materials protected the enamel against erosion progression compared with the control group (p=0.001). Based on these results, we conclude that the application of resin-based materials results in protection of previously eroded enamel subjected to in situ erosive and abrasive challenge for 20 days.
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Ionta FQ, Alencar CRBD, Santos NMD, Bergantin BTP, Val PP, Honório HM, Oliveira TMD, Rios D. Effect of palm oil alone or associated to stannous solution on enamel erosive-abrasive wear: A randomized in situ/ex vivo study. Arch Oral Biol 2018; 95:68-73. [DOI: 10.1016/j.archoralbio.2018.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/14/2018] [Accepted: 07/17/2018] [Indexed: 11/30/2022]
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Knösel M, Eckstein A, Helms HJ. Long-term follow-up of camouflage effects following resin infiltration of post orthodontic white-spot lesions in vivo. Angle Orthod 2018; 89:33-39. [PMID: 30324799 DOI: 10.2319/052118-383.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To reassess the long-term camouflage effects of resin infiltration (Icon, DMG, Hamburg, Germany) of white spot lesions (WSL) and sound adjacent enamel (SAE) achieved in a previous trial. The null hypothesis was tested that there were no significantly different CIE-L*a*b*-ΔE-values between WSL and SAE areas of assessment after at least 24 months (T24) compared to those at baseline (T0). MATERIALS AND METHODS Of twenty subjects who received previous resin infiltration treatment of nteeth = 111 nonrestored, noncavitated postorthodontic WSL after multibracket treatment during a randomized controlled trial and were contacted 20 months after baseline, eight subjects (trial teeth nteeth = 40; m/f ratio 1/7; age range (mean; SD) 12-17 [15.25; 2.12] years); response rate: 40%) were available for follow-up after at least 24 months (T24). CIE-L*a*b* differences between summarized color and lightness values (ΔEWSL/SAE) of WSL and SAE were assessed using a spectrophotometer and compared to baseline data assessed prior to infiltration (T0), and those after 6 (T6), and 12 (T12) months using paired t tests at a significance level of α = 5%. RESULTS T24 assessments were performed after a mean 33.86 (SD: 8.64; Min: 24; Max: 45) months following T0. Mean (SD) ΔEWSL/SAE units of available teeth were 8.76 (5.33) at baseline; 5.5 (2.75) at T6; 5.2 (2.41) at T12; and 5.57 (2.6) at T24. Comparisons of T6, T12, and T24 with T0 yielded highly significant differences, whereas T6-T24 and T12-T24 differences were found to be not significant. CONCLUSIONS Assimilation of infiltrated WSL to the color of adjacent enamel by resin infiltration is considered to be suitable for the long-term improvement in the esthetic appearance of postorthodontic WSL.
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In vitro evaluation of the early erosive lesion in polished and natural human enamel. Dent Mater 2018; 34:1391-1400. [DOI: 10.1016/j.dental.2018.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/12/2018] [Accepted: 06/07/2018] [Indexed: 12/29/2022]
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Lippert F, Arrageg MA, Eckert GJ, Hara AT. Interaction between toothpaste abrasivity and toothbrush filament stiffness on the development of erosive/abrasive lesions in vitro. Int Dent J 2017; 67:344-350. [DOI: 10.1111/idj.12305] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Joshi CP, Patil AG, Karde PA, Mahale SA, Dani NH. Comparative evaluation of cemental abrasion caused by soft and medium bristle hardness toothbrushes at three predetermined toothbrushing forces: An in vitro study. J Indian Soc Periodontol 2017; 21:10-15. [PMID: 29386794 PMCID: PMC5767981 DOI: 10.4103/jisp.jisp_118_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Plaque control has been shown to have a pivotal role in maintaining optimal periodontal health. Toothbrushing as a mechanical plaque control tool is the most popular and effective option for self-performed oral health maintenance. However, the detrimental effects of bristle hardness and force exerted by toothbrushes on the tooth surface are the areas of concern. Objective: The aim of this in vitro study was to evaluate the abrasive effect of two different manual toothbrushes exerting predetermined forces on cemental surfaces of the teeth. Materials and Methods: Sixty extracted first molars were selected. Totally six experimental groups were formed based on the three predetermined forces 1.5, 3, and 4.5 Newton (N) and two types of manual toothbrushes, i.e., soft and medium bristle hardness. Buccal and lingual surfaces were independently brushed for 5000 cycles using specially designed toothbrushing machine. Throughout the experiment, type and quantity of toothpaste were kept constant. Post 5000 cycles of toothbrushing, change in surface roughness was measured using profilometer in microns and change in weight indicating loss of substance was measured in milligrams. Results: Abrasion of cementum is force dependent. Data revealed that both soft and medium bristle hardness toothbrushes cause significant cemental abrasion at 3 and 4.5 N forces. Conclusions: Higher is the force, more is the cemental surface abrasion. Soft bristled toothbrush causes more cemental abrasion than medium bristled toothbrush at 3 and 4.5 N forces.
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Affiliation(s)
- Chaitanya Pradeep Joshi
- Department of Periodontology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Agraja Ganpat Patil
- Department of Periodontology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Prerna Ashok Karde
- Department of Periodontology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Swapna Arunkumar Mahale
- Department of Periodontology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Nitin Hemchandra Dani
- Department of Periodontology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
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Hannas AR, Kato MT, Cardoso CDAB, Magalhães AC, Pereira JC, Tjäderhane L, Buzalaf MAR. Preventive effect of toothpastes with MMP inhibitors on human dentine erosion and abrasion in vitro. J Appl Oral Sci 2016; 24:61-6. [PMID: 27008258 PMCID: PMC4775011 DOI: 10.1590/1678-775720150289] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 12/11/2015] [Indexed: 11/22/2022] Open
Abstract
The use of gels and mouthrinses with MMP inhibitors (chlorhexidine, and green tea extract) was shown to prevent erosive wear. The aim of this study was to analyze the protective effect of toothpastes containing MMP inhibitors on dentine loss induced by erosion in vitro.
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Affiliation(s)
- Angelica Reis Hannas
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
| | - Melissa Thiemi Kato
- Departamento de Odontologia, Universidade do Sagrado Coração, Bauru, SP, Brasil
| | | | - Ana Carolina Magalhães
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
| | - José Carlos Pereira
- Departamento de Dentística, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
| | - Leo Tjäderhane
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Marília Afonso Rabelo Buzalaf
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
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Carvalho TS, Baumann T, Lussi A. Does erosion progress differently on teeth already presenting clinical signs of erosive tooth wear than on sound teeth? An in vitro pilot trial. BMC Oral Health 2016; 17:14. [PMID: 27430320 PMCID: PMC4948097 DOI: 10.1186/s12903-016-0231-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/11/2016] [Indexed: 11/22/2022] Open
Abstract
Background Erosive tooth wear (ETW) is clinically characterized by a loss of tooth surface, and different enamel depths may have different susceptibility to demineralization. Therefore, the aim of this in vitro pilot study was to assess if the progression of erosive demineralization is faster on teeth already presenting signs of ETW when compared to originally sound teeth. Methods We selected 23 central incisors: 14 were clinically sound (Sound) and 9 presented clinical signs of early erosive tooth wear (ETW-teeth). The teeth were embedded in resin, leaving an uncovered window of native enamel (6.69 ± 2.30 mm2) on the incisal half of the labial surface. We measured enamel surface reflection intensity (SRI) initially and after each consecutive erosive challenge (1 % citric acid, total of 4, 8, 12, 16, 20 and 24 min). Calcium released to the citric acid was measured with an atomic absorption spectrometer. Results We observed higher initial SRI values in ETW-teeth than in Sound teeth (p = 0.007). During in vitro erosive demineralization, we observed that erosion on originally Sound teeth progressed significantly slower (p = 0.033) than on ETW-teeth: SRI decreased by 75 % (from 100 to 25 %) on Sound teeth, and by 89 % (from 100 to 11 %) on ETW-teeth. Calcium release increased during erosion, but presented no significant differences (p = 0.643) between originally Sound (0.031 μmol/mm2) and ETW-teeth (0.032 μmol/mm2). There was satisfactory correlation between calcium release and rSRI values (rs = −0.66). Conclusion The optical reflectometer distinguished originally sound teeth from those with signs of ETW, and the results suggest that acid demineralization progresses differently on teeth already presenting clinical signs of ETW than on sound teeth. Electronic supplementary material The online version of this article (doi:10.1186/s12903-016-0231-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thiago Saads Carvalho
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | - Tommy Baumann
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
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Carvalho TS, Baumann T, Lussi A. A new hand-held optical reflectometer to measure enamel erosion: correlation with surface hardness and calcium release. Sci Rep 2016; 6:25259. [PMID: 27121129 PMCID: PMC4848505 DOI: 10.1038/srep25259] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 04/14/2016] [Indexed: 11/24/2022] Open
Abstract
In the present study, the surface reflection intensity (SRI) was measured from enamel with different induced erosion degrees using a hand-held pen-size reflectometer (Hand-Held) and a Table-Top reflectometer. To validate the Hand-Held reflectometer, we correlated its optical signals with the change of surface microhardness (SMH), and amount of calcium released from the enamel samples during erosion. We used 124 tooth enamel specimens that were exposed to an erosive challenge of either 1, 2, 4, 6, 8, or 10 minutes. SRI and SMH were measured before and after the erosive challenge and we also measured the amount of calcium released to the citric acid. Relative SRI loss (rSRIloss) and relative SMH loss (rSMHloss) were calculated. rSRIloss from the Hand-Held and the Table-Top reflectometers were similar and significantly correlated to rSMHloss and calcium release. The regression analyses showed a significant association between rSRIloss from both reflectometers and rSMHloss and calcium, showing that both reflectometers can be used to measure erosive demineralization of enamel. The Hand-Held reflectometer is capable of assessing in vitro erosion, correlating to other commonly used methods. It is small, easy to handle and provides fast measurement, being a possible candidate to measure erosion in clinical studies.
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Affiliation(s)
- Thiago Saads Carvalho
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Tommy Baumann
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
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Knösel M, Bojes M, Jung K, Ziebolz D, Renger S. [Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area]. Orthod Fr 2015; 86:233-44. [PMID: 26370594 DOI: 10.1051/orthodfr/2015023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/12/2014] [Indexed: 11/15/2022]
Abstract
INTRODUCTION There is a paucity of information with regard to the susceptibility of iatrogenic white spot lesion formation after inattentive, surplus orthodontic etching with 30% phosphoric acid and the subsequent provision or absence of adequate oral hygiene. METHODS Ninety sound enamel specimens were randomly allocated to 6 trial groups (N = 15 each) for etching with 30% phosphoric acid for either 15 seconds and standardized daily enamel brushing or no brushing, etching for 30 seconds with daily brushing or no brushing, or nonetched controls with brushing or no brushing. Nutritive acidic assaults were simulated by demineralization cycles 3 times per day for 1 hour with interim storage in artificial saliva. Lesion depths in terms of percentage of fluorescence loss (delta F, delta Q) and lesion extension compared with the baseline were assessed by using quantitative light-induced fluorescence after 2, 7, 14, 21, and 42 days. Etching duration, trial time elapse, and oral hygiene, as well as the significance of factor interactions, were analyzed with 3-way analysis of variance (α=5%). RESULTS The impact of the factors of enamel brushing, trial time elapse, and etching each had a comparably significant effect on lesion progression. The effect of surplus etching on white spot lesion formation was significantly enhanced by the simultaneous absence of enamel brushing and also the progression of trial time. The combination of 30 seconds of surplus etching with inadequate oral hygiene was especially detrimental. CONCLUSIONS Excessive surplus orthodontic etching of the complete labial enamel surface, instead of the bracket bases only, must be avoided to prevent iatrogenic white spot lesions. Etching times not exceeding 15 seconds are favorable.
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Affiliation(s)
- Michael Knösel
- Private Orthodontic Practice, Kirchröder Street 77, 30625 Hannover, Allemagne
| | - Mariana Bojes
- Universitätsmedizin Göttingen, Robert-Koch-Straße 40, D-37075 Göttingen, Allemagne
| | - Klaus Jung
- Department of Medical Statistics, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, D-37075 Göttingen, Allemagne
| | - Dirk Ziebolz
- Dentistry Center, Department of Preventive Dentistry, Periodontology and Cariology, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, D-37075 Göttingen, Allemagne
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Eckstein A, Helms HJ, Knösel M. Camouflage effects following resin infiltration of postorthodontic white-spot lesions in vivo: One-year follow-up. Angle Orthod 2015; 85:374-380. [PMID: 25126675 PMCID: PMC8612424 DOI: 10.2319/050914-334.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Indexed: 08/22/2023] Open
Abstract
OBJECTIVE To assess camouflage effects by concealment of postorthodontic white-spot lesions (WSLs) to sound adjacent enamel (SAE) achieved over 12 months with resin infiltration (Icon, DMG, Hamburg, Germany). METHODS Twenty subjects (trial teeth nteeth = 111) who had received resin infiltration treatment of noncavitated postorthodontic WSLs were contacted for a 1-year follow-up assessment of CIE-L*a*b* colors (T12). Color and lightness (CIE-L*a*b*) data for WSLs and SAE were compared to baseline data assessed before infiltration (T0) and those assessed after 6 months (T6), using a spectrophotometer. The target parameter was the difference between the summarized color and lightness values (ΔEWSL/SAE). Intergroup (WSL, SAE) and intertime comparisons (T0 vs T6, T12) were performed using paired t-tests at a significance level of α = 5%. RESULTS Nine subjects (trial teeth nteeth = 49; male/female ratio 5/4; age range 13-19 years) were available at T12. After the highly significant reduction of ΔEWSL/SAE discrepancies between T0 and T6, analysis of 12-month records revealed color and lightness discrepancy of WSL vs SAE that was significantly decreased compared with baseline, indicating an assimilation of WSL color to SAE appearance after infiltration, while an additional reduction of discrepancies between T6 and T12 was not significant. CONCLUSION As color and lightness characteristics of the Icon infiltrant as well as the esthetic camouflage effects achieved by WSL infiltration were not altered significantly or clinically relevant after 12 months, the method of resin infiltration can be recommended for an enduring esthetic improvement of postorthodontic WSL.
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Affiliation(s)
- Amely Eckstein
- Research Fellow, Department of Orthodontics, University of Göttingen, Göttingen, Germany
| | - Hans-Joachim Helms
- Research Assistant, Department of Medical Statistics, University Medical Centre, Göttingen, Germany
| | - Michael Knösel
- Senior Lecturer, Department of Orthodontics, University of Göttingen, Göttingen, Germany
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Heasman PA, Holliday R, Bryant A, Preshaw PM. Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing. J Clin Periodontol 2015; 42 Suppl 16:S237-55. [DOI: 10.1111/jcpe.12330] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Peter A. Heasman
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | | | - Andrew Bryant
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne UK
| | - Philip M. Preshaw
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
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Watanabe K, Tanaka T, Maki K, Nakashima H, Watanabe S. Amount of Calcium Elution and Eroded Lesion Depth in Bovine Enamel Derived from Single Short Time Immersion in Carbonated Soft Drink <i>in Vitro</i>. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojst.2015.53012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Enamel structural changes induced by hydrochloric and phosphoric acid treatment. J Appl Biomater Funct Mater 2014; 12:240-7. [PMID: 24700262 DOI: 10.5301/jabfm.5000179] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate enamel acid-induced structural changes after 2 different treatments, by means of Raman and infrared (IR) spectroscopy analyses, and to correlate these findings with permeability measured as fluid discharge from outer enamel. METHODS Two different treatments were investigated: 10 enamel slices were etched with 15% hydrochloric acid (HCl) for 120 seconds and 10 slices with 37% phosphoric acid gel (H3PO4) for 30 seconds, rinsed for 30 seconds and then air-dried for 20 seconds. Powders of enamel treated as previously described were produced. Replicas of enamel subjected to the same treatments were obtained to evaluate the presence of fluid droplets on enamel surface. RESULTS AND CONCLUSIONS Raman and IR spectroscopy showed that the treatment with both hydrochloric and phosphoric acids induced a decrease in the carbonate content of the enamel apatite. At the same time, both acids induced the formation of HPO42- ions. After H3PO4 treatment, the bands due to the organic component of enamel decreased in intensity, while they increased after HCl treatment. Replicas of H3PO4 treated enamel showed a strongly reduced permeability. Replicas of HCl 15% treated samples showed a maintained permeability. A decrease of the enamel organic component, as resulted after H3PO4 treatment, involves a decrease in enamel permeability, while the increase of the organic matter (achieved by HCl treatment) still maintains enamel permeability.The results suggested a correlation between organic matter and enamel permeability. Permeability was affected by etching technique and could be involved in marginal seal, gap and discoloration at the enamel interface, still causes of restoration failure.
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Three-dimensional profilometric assessment of early enamel erosion simulating gastric regurgitation. J Dent 2014; 42:1411-21. [PMID: 24995810 DOI: 10.1016/j.jdent.2014.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES A priority research area in minimal intervention dentistry is the characterization of the early stages of dental erosion. The aim of this in vitro study was to assess the effect of short, repetitive erosive challenges to human enamel over 2 min at pH 1.5 and 3.0 under conditions simulating gastric regurgitation. METHODS Enamel surfaces were subjected to erosive challenges at pH 1.5 (Group 1, n=10) and pH 3.0 (Group 2, n=9) for periods of 30s (stage 1), 60s (stage 2) and 120 s (stage 3). Quantitative changes were assessed longitudinally by measuring the 3D average surface roughness (Sa) values using 3D confocal microscopy. Qualitative micrographic assessment of surface changes was also conducted by using environmental scanning electron microscopy. RESULTS Linear mixed model analysis showed significant effects of the pH values (p<0.001) and the stages (p<0.001) on the observed Sa values. Post hoc tests showed significant increases in the Sa values between baseline and other stages in both groups (p<0.01). The mean Sa values also increased significantly from stage 1 to stage 2 in Group 1 (p<0.05). Micrographic analysis displayed severely etched enamel rods in Group 1, but only subtle changes in Group 2. CONCLUSIONS The complexity of the enamel surface is influenced by both acid concentration (pH value) and duration of acid exposure during early stages of erosion. Erosion occurring under conditions simulating GORD can be detected in its initial stages, opening up the possibilities of early diagnosis and management of this condition. CLINICAL SIGNIFICANCE Erosive tooth wear occurs progressively and insidiously, often creating complex treatment challenges. This emphasizes the need for early diagnosis and management in accordance with minimal intervention philosophy. Our findings provide a foundation for further research that could lead to the development of highly-sensitive clinical diagnostic tools and preventive strategies.
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Magalhaes AC, Wiegand A, Buzalaf MAR. Use of dentifrices to prevent erosive tooth wear: harmful or helpful? Braz Oral Res 2014; 28 Spec No:1-6. [PMID: 24554098 DOI: 10.1590/s1806-83242013005000035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 09/28/2013] [Indexed: 12/29/2022] Open
Abstract
Dental erosion is the loss of dental hard tissues caused by non-bacterial acids. Due to acid contact, the tooth surface becomes softened and more prone to abrasion from toothbrushing. Dentifrices containing different active agents may be helpful in allowing rehardening or in increasing surface resistance to further acidic or mechanical impacts. However, dentifrices are applied together with brushing and, depending on how and when toothbrushing is performed, as well as the type of dentifrice and toothbrush used, may increase wear. This review focuses on the potential harmful and helpful effects associated with the use of dentifrices with regard to erosive wear. While active ingredients like fluorides or agents with special anti-erosive properties were shown to offer some degree of protection against erosion and combined erosion/abrasion, the abrasive effects of dentifrices may increase the surface loss of eroded teeth. However, most evidence to date comes from in vitro and in situ studies, so clinical trials are necessary for a better understanding of the complex interaction of active ingredients and abrasives and their effects on erosive tooth wear.
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Affiliation(s)
- Ana Carolina Magalhaes
- Department of Biological Sciences, Bauru School of Dentistry, Universidade de Sao Paulo, Bauru, SP, Brazil
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University of Gottingen, Gottingen, Germany
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Carvalho T, Lussi A. Combined effect of a fluoride-, stannous- and chitosan-containing toothpaste and stannous-containing rinse on the prevention of initial enamel erosion–abrasion. J Dent 2014; 42:450-9. [DOI: 10.1016/j.jdent.2014.01.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/20/2013] [Accepted: 01/06/2014] [Indexed: 01/13/2023] Open
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Durability of esthetic improvement following Icon resin infiltration of multibracket-induced white spot lesions compared with no therapy over 6 months: a single-center, split-mouth, randomized clinical trial. Am J Orthod Dentofacial Orthop 2013; 144:86-96. [PMID: 23810050 DOI: 10.1016/j.ajodo.2013.02.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 02/01/2013] [Accepted: 02/01/2013] [Indexed: 02/07/2023]
Abstract
INTRODUCTION White spot lesions that form during orthodontic treatment are a problem for patients and clinicians. Lesion infiltration with low-viscosity light-cured resin has been proposed as a treatment to inhibit further demineralization. The purpose of this study was to assess the durability of assimilation of white spot lesions and sound adjacent enamel achieved over 6 months with resin infiltration. METHODS Twenty-one consecutive subjects with 231 noncavitated, unrestored white spot lesions after multibracket treatment were recruited at the Department of Orthodontics, University of Göttingen (Germany), for lesion infiltration. A simple randomized, split-mouth, controlled design was used to allocate subjects to the treatment and control groups. In the treatment group, white spot lesion infiltration of the anterior teeth was performed with low-viscosity light-cured resin after enamel conditioning with a 15% HCl gel. Color and lightness of the white spot lesions and the sound adjacent enamel were assessed with a spectrophotometer before infiltration and after 1 day, 1 week, 4 weeks, 3 months, and 6 months, using the system of the Commission Internationale de l'Eclairage. Multifactorial analysis of variance with repeated measures and pair-wise comparisons were used to analyze the effects of infiltration and time elapsed on the color differences at an α level of 5% and a power of 80%. RESULTS Analysis of 20 subjects and 39 quadrants in each group (108 teeth in the control group; 111 teeth in the treatment group) showed that both parameters of treatment and time duration had globally a highly significant influence on the color difference values. Assimilation of white spot lesion color to the surrounding enamel after infiltration was stable with no significant changes over 6 months; the mean color difference of white spot lesions vs sound adjacent enamel (ΔE baseline vs 6 months) was 2.55 (95% confidence interval [CI], 1.431-3.678). The untreated control teeth showed no significant changes over 6 months compared with the baseline: mean (ΔE), 0.29 (95% CI, -0.335-0.928). No important adverse events or side effects were observed. CONCLUSIONS Resin infiltration improves the esthetic appearance of demineralized teeth. The results showed sufficient durability over 6 months.
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West NX, Lussi A, Seong J, Hellwig E. Scaffold-free microtissues: differences from monolayer cultures and their potential in bone tissue engineering. Clin Oral Investig 2013; 17:9-17. [PMID: 22695872 PMCID: PMC3585766 DOI: 10.1007/s00784-012-0763-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Accepted: 05/23/2012] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Cell-based therapies for bone augmentation after tooth loss and for the treatment of periodontal defects improve healing defects. Usually, osteogenic cells or stem cells are cultivated in 2D primary cultures, before they are combined with scaffold materials, even though this means a loss of the endogenous 3D microenvironment for the cells. Moreover, the use of single-cell suspensions for the inoculation of scaffolds or for the direct application into an area of interest has the disadvantages of low initial cell numbers and susceptibility to unwanted cellular distribution, respectively. MATERIALS AND METHODS We addressed the question whether an alternative to monolayer cultures, namely 3D microtissues, has the potential to improve osteogenic tissue engineering and its clinical outcome. RESULTS By contrast, to monolayer cultures, osteogenic differentiation of 3D microtissues is enhanced by mimicking in vivo conditions. It seems that the osteogenic differentiation in microtissues is enhanced by strong integrin-extracellular matrix interaction and by stronger autocrine BMP2 signaling. Moreover, microtissues are less prone to wash out by body fluids and allow the precise administration of large cell numbers. CONCLUSION Microtissue cultures have closer characteristics with cells in vivo and their enhanced osteogenic differentiation makes scaffold-free microtissues a promising concept in osteogenic tissue engineering. CLINICAL RELEVANCE Microtissues are particularly suitable for tissue engineering because they improve seeding efficiency of biomaterials by increasing the cell load of a scaffold. This results in accelerated osteogenic tissue formation and could contribute to earlier implant stability in mandibular bone augmentation.
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Affiliation(s)
- N. X. West
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - A. Lussi
- />Department of Operative Dentistry, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - J. Seong
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - E. Hellwig
- />Department of Operative Dentistry and Periodontology, Dental School and Hospital Dentistry, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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Passos VF, Melo MA, Vasconcellos AA, Rodrigues LK, Santiago SL. Comparison of methods for quantifying dental wear caused by erosion and abrasion. Microsc Res Tech 2012; 76:178-83. [DOI: 10.1002/jemt.22150] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 10/10/2012] [Indexed: 11/08/2022]
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Wiegand A, Burkhard JPM, Eggmann F, Attin T. Brushing force of manual and sonic toothbrushes affects dental hard tissue abrasion. Clin Oral Investig 2012; 17:815-22. [PMID: 22791283 DOI: 10.1007/s00784-012-0788-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 07/05/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to determine the brushing forces applied during in vivo toothbrushing with manual and sonic toothbrushes and to analyse the effect of these brushing forces on abrasion of sound and eroded enamel and dentin in vitro. MATERIALS AND METHODS Brushing forces of a manual and two sonic toothbrushes (low and high frequency mode) were measured in 27 adults before and after instruction of the respective brushing technique and statistically analysed by repeated measures analysis of variance (ANOVA). In the in vitro experiment, sound and eroded enamel and dentin specimens (each subgroup n = 12) were brushed in an automatic brushing machine with the respective brushing forces using a fluoridated toothpaste slurry. Abrasion was determined by profilometry and statistically analysed by one-way ANOVA. RESULTS Average brushing force of the manual toothbrush (1.6 ± 0.3 N) was significantly higher than for the sonic toothbrushes (0.9 ± 0.2 N), which were not significantly different from each other. Brushing force prior and after instruction of the brushing technique was not significantly different. The manual toothbrush caused highest abrasion of sound and eroded dentin, but lowest on sound enamel. No significant differences were detected on eroded enamel. CONCLUSION Brushing forces of manual and sonic toothbrushes are different and affect their abrasive capacity. CLINICAL SIGNIFICANCE Patients with severe tooth wear and exposed and/or eroded dentin surfaces should use sonic toothbrushes to reduce abrasion, while patients without tooth wear or with erosive lesions confining only to enamel do not benefit from sonic toothbrushes with regard to abrasion.
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Affiliation(s)
- Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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West NX, Lussi A, Seong J, Hellwig E. Scaffold-free microtissues: differences from monolayer cultures and their potential in bone tissue engineering. Clin Oral Investig 2012; 17 Suppl 1:S9-19. [PMID: 22695872 PMCID: PMC3585766 DOI: 10.1007/s00784-012-0887-x] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 11/21/2012] [Indexed: 12/13/2022]
Abstract
Objectives The paper’s aim is to review dentin hypersensitivity (DHS), discussing pain mechanisms and aetiology. Materials and methods Literature was reviewed using search engines with MESH terms, DH pain mechanisms and aetiology (including abrasion, erosion and periodontal disease). Results The many hypotheses proposed for DHS attest to our lack of knowledge in understanding neurophysiologic mechanisms, the most widely accepted being the hydrodynamic theory. Dentin tubules must be patent from the oral environment to the pulp. Dentin exposure, usually at the cervical margin, is due to a variety of processes involving gingival recession or loss of enamel, predisposing factors being periodontal disease and treatment, limited alveolar bone, thin biotype, erosion and abrasion. Conclusions The current pain mechanism of DHS is thought to be the hydrodynamic theory. The initiation and progression of DHS are influenced by characteristics of the teeth and periodontium as well as the oral environment and external influences. Risk factors are numerous often acting synergistically and always influenced by individual susceptibility. Clinical relevance Whilst the pain mechanism of DHS is not well understood, clinicians need to be mindful of the aetiology and risk factors in order to manage patients’ pain and expectations and prevent further dentin exposure with subsequent sensitivity.
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Affiliation(s)
- N. X. West
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - A. Lussi
- />Department of Operative Dentistry, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - J. Seong
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - E. Hellwig
- />Department of Operative Dentistry and Periodontology, Dental School and Hospital Dentistry, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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Knösel M, Bojes M, Jung K, Ziebolz D. Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area. Am J Orthod Dentofacial Orthop 2012; 141:574-82. [DOI: 10.1016/j.ajodo.2011.11.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 11/01/2011] [Accepted: 11/01/2011] [Indexed: 11/28/2022]
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West NX, Hooper SM, O'Sullivan D, Hughes N, North M, Macdonald EL, Davies M, Claydon NCA. In situ randomised trial investigating abrasive effects of two desensitising toothpastes on dentine with acidic challenge prior to brushing. J Dent 2011; 40:77-85. [PMID: 22051246 DOI: 10.1016/j.jdent.2011.10.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 10/19/2011] [Accepted: 10/20/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To determine if brushing dentine with 2 moderate RDA desensitising toothpastes, results in a significant dentine wear difference and whether this difference continues to be relevant when preceded with an erosive challenge. METHODS An in situ, single centre, single blind, randomised, split mouth study, evaluated the difference in abrasion of 2 toothpastes (SFM - Sensodyne Fresh Mint(®) RDA 70; CPHM - Crest Pro-Health Clean Mint(®) RDA 120) in 28 healthy volunteers. Two toothpaste treatments were administered 3×/day, for each of the two 15 day periods, subjects wearing bi-lateral, lower buccal appliances each with 4 dentine sections. A 2 min extra-oral acidic challenge preceded toothbrushing for 2 study arms. Contact profilometry measured samples at baseline, days 5, 10 and 15. RESULTS Brushing with SFM was significantly less abrasive than brushing with CPHM at all time points, with or without a preceding acidic challenge (p<0.0001). The additional dentine loss arising from the erosive challenge prior to brushing with each paste was linear with time and independent of abrasive effect. CONCLUSIONS The desensiting toothpastes' RDA, directly related to dentine loss with toothbrushing. An acidic challenge prior to brushing did not negate the benefits of reduced wear from the lower RDA paste compared to the higher RDA paste. When brushing eroded dentine, the additional wear appeared independent of abrasive effect. Dentine hypersensitivity sufferers should be recommended to use a low-moderate RDA toothpaste, not to brush more than 2×/day and not immediately following an acidic challenge.
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Affiliation(s)
- N X West
- Applied Clinical Research Group, Department of Oral and Dental Science, University of Bristol, UK.
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Prevention of toothbrushing abrasion of acid-softened enamel by CO(2) laser irradiation. J Dent 2011; 39:604-11. [PMID: 21741428 DOI: 10.1016/j.jdent.2011.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 06/15/2011] [Accepted: 06/16/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the effect of CO(2) laser irradiation (10.6μm) at 0.3J/cm(2) (0.5μs; 226Hz) on the resistance of softened enamel to toothbrushing abrasion, in vitro. METHODS Sixty human enamel samples were obtained, polished with silicon carbide papers and randomly divided into five groups (n=12), receiving 5 different surface treatments: laser irradiation (L), fluoride (AmF/NaF gel) application (F), laser prior to fluoride (LF), fluoride prior to laser (FL), non-treated control (C). After surface treatment they were submitted to a 25-day erosive-abrasive cycle in 100ml sprite light (90s) and brushed twice daily with an electric toothbrush. Between the demineralization periods samples were immersed in supersaturated mineral solution. At the end of the experiments enamel surface loss was determined using a contact profilometer and morphological analysis was performed using scanning electron microscopy (SEM). For SEM analysis of demineralization pattern, cross-sectional cuts of cycled samples were prepared. The data were statistically analysed by one-way ANOVA model with subsequent pairwise comparison of treatments. RESULTS Abrasive surface loss was significantly lower in all laser groups compared to both control and fluoride groups (p<0.0001 in all cases). Amongst the laser groups no significant difference was observed. Softened enamel layer underneath lesions was less pronounced in laser-irradiated samples. CONCLUSION Irradiation of dental enamel with a CO(2) laser at 0.3J/cm(2) (5μs, 226Hz) either alone or in combination with amine fluoride gel significantly decreases toothbrushing abrasion of softened-enamel, in vitro.
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Wiegand A, Attin T. Design of Erosion/Abrasion Studies – Insights and Rational Concepts. Caries Res 2011; 45 Suppl 1:53-9. [DOI: 10.1159/000325946] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schlueter N, Hara A, Shellis R, Ganss C. Methods for the Measurement and Characterization of Erosion in Enamel and Dentine. Caries Res 2011; 45 Suppl 1:13-23. [DOI: 10.1159/000326819] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Lussi A, Schlueter N, Rakhmatullina E, Ganss C. Dental Erosion – An Overview with Emphasis on Chemical and Histopathological Aspects. Caries Res 2011; 45 Suppl 1:2-12. [DOI: 10.1159/000325915] [Citation(s) in RCA: 265] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Aggarwal VR, Javidi H, Joughin A, Crawford FIJ, Sharif MO. Patients' knowledge of risk factors for dental disease. A pilot service evaluation in a general dental practice. ACTA ACUST UNITED AC 2010; 17:173-7. [PMID: 20887671 DOI: 10.1308/135576110792936159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
UNLABELLED The major dental diseases, including erosion, caries and periodontal disease, are preventable, and the Department of Health has produced guidelines in a 'Prevention Toolkit' to aid prevention of these diseases in primary care. AIM To investigate patients' knowledge of the key themes in the Prevention Toolkit and to compare their knowledge of the different dental diseases. METHODS Patients attending a general dental practice in North West England were asked to complete a questionnaire while they waited to see their dentist. The questionnaire had been piloted for readability, relevance of questions, and ease of use. It included nine true/false questions on key prevention messages. Data from the respondents were used to assess whether there were differences in knowledge by age or gender and between the types of dental diseases. Results were analysed using chi-square tests. RESULTS 105 patients completed the questionnaire. Of the 420 questions relating to periodontal diseases, 322 (77%) were answered correctly and 196 (47%) of the 420 questions on caries were answered correctly; however, only 32 (31%) of the 105 questions relating to erosion were answered correctly. There were significantly lower levels of knowledge of caries (P<0.01) compared with periodontal diseases. Worryingly, 47 (45%) of 105 respondents stated incorrectly that brushing teeth immediately after consuming a 'fizzy' drink would protect the teeth. CONCLUSION The results of this pilot service evaluation indicate that in the practice concerned, more needs to be done to promote disease prevention at the primary care level. The current questionnaire could form a valuable tool to audit and reinforce patients' knowledge, although it needs further development and validation. Longitudinal evaluation of the questionnaire, linking it with disease outcome measures, has the potential to indicate whether change in knowledge translates into behavioural change.
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da Costa-Silva CM, Jeremias F, de Souza JF, Cordeiro RDCL, Santos-Pinto L, Zuanon ACC. Molar incisor hypomineralization: prevalence, severity and clinical consequences in Brazilian children. Int J Paediatr Dent 2010; 20:426-34. [PMID: 20738434 DOI: 10.1111/j.1365-263x.2010.01097.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The prevalence of molar incisor hypomineralization (MIH) varies considerably around the world; however, few studies have examined MIH in South American countries. OBJECTIVE To evaluate the prevalence, severity, and clinical consequences of MIH in Brazilian children residing in rural and urban areas of the municipality of Botelhos, Minas Gerais, Brazil. METHODS Children aged 6 to 12 years (n = 918) with all four-first permanent molars erupted had these teeth evaluated according to the European Academy of Paediatric Dentistry (EAPD) criteria. The examinations were conducted by two previously trained examiners, and the dental impact caused by MIH was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index (WHO). RESULTS Molar incisor hypomineralization was present in 19.8% of the 918 children, with a higher prevalence in rural areas. The majority of the defects presented were demarcated opacities without post-eruptive structural loss, which has been considered as mild defects. Children with MIH had higher DMFT values. CONCLUSION Despite the high prevalence of MIH, the severity of the defects was mild. The results indicate a positive association between MIH and the presence of dental caries.
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Affiliation(s)
- Cristiane Maria da Costa-Silva
- Department of Pediatric Dentistry, São Paulo State University, Araraquara School of Dentistry, UNESP - Araraquara, São Paulo, Brazil
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Ganss C, Hardt M, Blazek D, Klimek J, Schlueter N. Effects of toothbrushing force on the mineral content and demineralized organic matrix of eroded dentine. Eur J Oral Sci 2009; 117:255-60. [PMID: 19583752 DOI: 10.1111/j.1600-0722.2009.00617.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Eroded dentine has a complex histological structure, and its organic fraction becomes increasingly exposed as a result of the continual action of acids. The present study sought to investigate the effects of brushing forces up to 4 N on mineralized and organic dentine fractions. The study was a cyclic demineralization and remineralization experiment (carried out over 9 d). Erosion was performed with HCl (6 x 2 min d-1), pH 1.6. Samples exposed to erosion alone served as controls; test samples were eroded and brushed with a powered toothbrush (2 x 15 s d-1), applying forces of 2, 3, or 4 N. Samples were analysed (using profilometry and longitudinal microradiography) before and after the removal of superficial organic material with collagenase. Randomly selected samples were subjected to scanning electron microscopy. Demineralized organic material was present on all samples regardless of brushing force. Loss values (determined using profilometry) after erosion only, and after brushing with forces of 2, 3, and 4 N, were 11.7 +/- 5.1, 13.6 +/- 11.2, 30.7 +/- 19.0, and 25.5 +/- 20.3, respectively, before treatment with collagenase, and 111.7 +/- 11.6, 122.0 +/- 11.8, 121.9 +/- 15.7, and 123.0 +/- 12.0, respectively, after treatment with collagenase. Microradiography confirmed the results. Significant effects of brushing force were only found on the demineralized organic fraction, and mineral loss was unaffected. The notion that eroded dentine is particularly prone to abrasion should be reconsidered.
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Affiliation(s)
- Carolina Ganss
- Department of Conservative and Preventive Dentistry, Dental Clinic, Giessen, Germany.
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Magalhães AC, Wiegand A, Rios D, Honório HM, Buzalaf MAR. Insights into preventive measures for dental erosion. J Appl Oral Sci 2009; 17:75-86. [PMID: 19274390 PMCID: PMC4327581 DOI: 10.1590/s1678-77572009000200002] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Accepted: 09/16/2008] [Indexed: 01/28/2023] Open
Abstract
Dental erosion is defined as the loss of tooth substance by acid exposure not involving bacteria. The etiology of erosion is related to different behavioral, biological and chemical factors. Based on an overview of the current literature, this paper presents a summary of the preventive strategies relevant for patients suffering from dental erosion. Behavioral factors, such as special drinking habits, unhealthy lifestyle factors or occupational acid exposure, might modify the extent of dental erosion. Thus, preventive strategies have to include measures to reduce the frequency and duration of acid exposure as well as adequate oral hygiene measures, as it is known that eroded surfaces are more susceptible to abrasion. Biological factors, such as saliva or acquired pellicle, act protectively against erosive demineralization. Therefore, the production of saliva should be enhanced, especially in patients with hyposalivation or xerostomia. With regard to chemical factors, the modification of acidic solutions with ions, especially calcium, was shown to reduce the demineralization, but the efficacy depends on the other chemical factors, such as the type of acid. To enhance the remineralization of eroded surfaces and to prevent further progression of dental wear, high-concentrated fluoride applications are recommended. Currently, little information is available about the efficacy of other preventive strategies, such as calcium and laser application, as well as the use of matrix metalloproteinase inhibitors. Further studies considering these factors are required. In conclusion, preventive strategies for patients suffering from erosion are mainly obtained from in vitro and in situ studies and include dietary counseling, stimulation of salivary flow, optimization of fluoride regimens, modification of erosive beverages and adequate oral hygiene measures.
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Affiliation(s)
- Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil.
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Wegehaupt FJ, Widmer R, Attin T. Is bovine dentine an appropriate substitute in abrasion studies? Clin Oral Investig 2009; 14:201-5. [DOI: 10.1007/s00784-009-0283-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Accepted: 05/05/2009] [Indexed: 11/29/2022]
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Wiegand A, Schwerzmann M, Sener B, Carolina Magalhães A, Roos M, Ziebolz D, Imfeld T, Attin T. Impact of toothpaste slurry abrasivity and toothbrush filament stiffness on abrasion of eroded enamel - an in vitro study. Acta Odontol Scand 2008; 66:231-5. [PMID: 18622830 DOI: 10.1080/00016350802195041] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Toothbrush abrasion is significant in the development of tooth wear, particularly when combined with erosion. This in vitro study aimed to evaluate the impact of toothpaste slurry abrasivity and toothbrush filament stiffness on abrasion of eroded enamel. MATERIAL AND METHODS Eroded enamel samples (hydrochloric acid, pH: 2.6, 15 s) were brushed with 40 strokes in an automatic brushing machine using manual toothbrushes with different filament stiffness (filament diameter: 0.15, 0.20, or 0.25 mm). A paste-free control slurry (relative enamel abrasion (REA) value 2) and toothpaste slurries with different abrasivity (REA values 6 or 9) were used for brushing. Erosion and abrasion were followed by storing the enamel samples in artificial saliva for 3 h. After each 4th cycle, the samples were stored in artificial saliva for 15 h. After 60 cycles, enamel loss was measured by profilometry and statistically analyzed by two-way and one-way ANOVA and Bonferroni/Dunn post-hoc tests. RESULTS Loss of enamel (mean, microm) was influenced mainly by the abrasivity of the slurry and increased along with REA value (REA 2: 0.0-0.2, REA 6: 2.1-3.3, REA 9: 2.9-3.7). Abrasion of eroded enamel was also affected by filament stiffness of the toothbrush, but only groups brushed with toothpaste slurry of REA 6 showed any significant difference between the different toothbrushes. Thereby, toothbrushes with 0.2 mm filament diameter caused higher enamel loss than 0.15 and 0.25 mm filaments. CONCLUSIONS Toothbrush abrasion of eroded enamel is influenced mainly by the abrasivity of the toothpaste slurry, but is also modified by toothbrush filament stiffness.
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