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Alhamdan MM, Knowles JC, McDonald AV. In Vitro Evaluation of Remineralization Potential of Five Toothpastes on Soft Drink-Eroded Human Enamel and Dentine. Cureus 2024; 16:e62921. [PMID: 38912082 PMCID: PMC11193552 DOI: 10.7759/cureus.62921] [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: 06/22/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVE The purpose of this in vitro study was to evaluate the potential remineralization of enamel and dentine erosion lesions after the application of five different toothpastes. METHODOLOGY A total of 104 enamel and dentine samples were prepared from maxillary third molars. Each group was divided according to the toothpaste application mode (topical = 56; brushing = 48) and the toothpaste used seven topical groups and six brushing groups (n = 8). The groups included negative control (NC), positive control (PC), Sensodyne Pronamel (SP), Regenerate (R), Regenerate with boosting serum (R+), Colgate Duraphat 5000 (CD), and tooth mousse (TM). RESULTS The statistical analysis showed significant surface microhardness (SMH) change. All enamel groups showed a significant decrease in SMH compared to NC for both application modes. However, no significance was recorded between test groups. Similar results were observed between dentine groups and their relevant controls for both application modes, except brushed R and R+ groups, which were insignificant to their NC. For topical groups, TM showed a significant increase in SMH. While R and R+ showed lower loss than SP and CD. CONCLUSIONS All tested agents offered a degree of remineralization in both enamel and dentine with no significant difference between agents in enamel groups while R, R+, and TM offered better results in dentine groups. CLINICAL SIGNIFICANCE For dentine groups, similar findings were observed with superior tooth surface protection with the application of TM over other agents. Tooth surface remineralization was achieved when agents were either applied topically or brushed over the surface.
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Affiliation(s)
- Mai M Alhamdan
- Department of Prosthetic Dental Sciences, King Saud University, Riyadh, SAU
| | - Jonathan C Knowles
- Division of Biomaterials and Tissue Engineering, University College London, London, GBR
| | - Ailbhe V McDonald
- Department of Restorative Dentistry, University College London, London, GBR
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Miyayoshi Y, Hamba H, Nakamura K, Ishizuka H, Muramatsu T. Remineralization effects of enamel binding peptide, WGNYAYK, on enamel subsurface demineralization in vitro. Enamel binding peptide, WGNYAYK effect remineralization of enamel. Heliyon 2024; 10:e23176. [PMID: 38148805 PMCID: PMC10750082 DOI: 10.1016/j.heliyon.2023.e23176] [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: 04/09/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023] Open
Abstract
Objectives: We investigated remineralization effects of enamel binding peptide (EBP), WGNYAYK, on enamel subsurface demineralization in vitro.Methods: Bovine lower incisor crowns were used as subsurface enamel demineralization samples, and changes of EBP binding, remineraliztion rate, hardness and microstructure were investigated. Binding of EBP, remineralization rate, hardness and structural changes were investigated. Fluorescein isothiocyatate (FITC)-labeled EBPs (0.4 mM, 4.0 mM, and 7.0 mM) were applied to the samples for 30 min at 37 °C, with sample surfaces and cross-sections observed by confocal laser scanning microscope (CLSM). Mineralization analysis samples were divided into 4 experimental groups; distilled water (DW), EBP 0.4 mM, EBP 4.0 mM, and EBP 7.0 mM. Mineral density changes were measured by micro-CT with hardness measured by nano-indentation. Samples were also observed by scanning electron microscope (SEM) for surface and longitudinal microstructure. Results CLSM images indicated that increased fluorescence was observed in the surface layer and up to about 20 μm below the surface layer. The remineralization rate was significantly higher for EBP 7.0 mM compared to DW (p = 0.008). Enamel surface hardness was significantly higher in all EBP groups compared to DW (p < 0.05) and was highest in the 7.0 mM group. SEM images showed obscuring of the superficial columnar structure in the 7.0 mM EBP group, indicating subsurface crystalline structure recovery. Conclusion The results of this study suggest that EBP binds to demineralized enamel and promotes remineralization.
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Affiliation(s)
- Yoshihito Miyayoshi
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, 2-9-18, Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Hidenori Hamba
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, 2-9-18, Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Keiki Nakamura
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, 2-9-18, Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Hisako Ishizuka
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, 2-9-18, Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Takashi Muramatsu
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, 2-9-18, Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
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Singer L, Fouda A, Bourauel C. Biomimetic approaches and materials in restorative and regenerative dentistry: review article. BMC Oral Health 2023; 23:105. [PMID: 36797710 PMCID: PMC9936671 DOI: 10.1186/s12903-023-02808-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
Biomimetics is a branch of science that explores the technical beauty of nature. The concept of biomimetics has been brilliantly applied in famous applications such as the design of the Eiffel Tower that has been inspired from the trabecular structure of bone. In dentistry, the purpose of using biomimetic concepts and protocols is to conserve tooth structure and vitality, increase the longevity of restorative dental treatments, and eliminate future retreatment cycles. Biomimetic dental materials are inherently biocompatible with excellent physico-chemical properties. They have been successfully applied in different dental fields with the advantages of enhanced strength, sealing, regenerative and antibacterial abilities. Moreover, many biomimetic materials were proven to overcome significant limitations of earlier available generation counterpart. Therefore, this review aims to spot the light on some recent developments in the emerging field of biomimetics especially in restorative and regenerative dentistry. Different approaches of restoration, remineralisation and regeneration of teeth are also discussed in this review. In addition, various biomimetic dental restorative materials and tissue engineering materials are discussed.
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Affiliation(s)
- Lamia Singer
- Oral Technology, University Hospital Bonn, 53111, Bonn, North Rhine-Westphalia, Germany. .,Department of Orthodontics, University Hospital Bonn, 53111, Bonn, North Rhine-Westphalia, Germany.
| | - Ahmed Fouda
- grid.15090.3d0000 0000 8786 803XOral Technology, University Hospital Bonn, 53111 Bonn, North Rhine-Westphalia Germany ,grid.33003.330000 0000 9889 5690Department of Fixed Prosthodontics, Suez Canal University, Ismailia, Egypt
| | - Christoph Bourauel
- grid.15090.3d0000 0000 8786 803XOral Technology, University Hospital Bonn, 53111 Bonn, North Rhine-Westphalia Germany
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Dorozhkin SV. Synthetic amorphous calcium phosphates (ACPs): preparation, structure, properties, and biomedical applications. Biomater Sci 2021; 9:7748-7798. [PMID: 34755730 DOI: 10.1039/d1bm01239h] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Amorphous calcium phosphates (ACPs) represent a metastable amorphous state of other calcium orthophosphates (abbreviated as CaPO4) possessing variable compositional but rather identical glass-like physical properties, in which there are neither translational nor orientational long-range orders of the atomic positions. In nature, ACPs of a biological origin are found in the calcified tissues of mammals, some parts of primitive organisms, as well as in the mammalian milk. Manmade ACPs can be synthesized in a laboratory by various methods including wet-chemical precipitation, in which they are the first solid phases, precipitated after a rapid mixing of aqueous solutions containing dissolved ions of Ca2+ and PO43- in sufficient amounts. Due to the amorphous nature, all types of synthetic ACPs appear to be thermodynamically unstable and, unless stored in dry conditions or doped by stabilizers, they tend to transform spontaneously to crystalline CaPO4, mainly to ones with an apatitic structure. This intrinsic metastability of the ACPs is of a great biological relevance. In particular, the initiating role that metastable ACPs play in matrix vesicle biomineralization raises their importance from a mere laboratory curiosity to that of a reasonable key intermediate in skeletal calcifications. In addition, synthetic ACPs appear to be very promising biomaterials both for manufacturing artificial bone grafts and for dental applications. In this review, the current knowledge on the occurrence, structural design, chemical composition, preparation, properties, and biomedical applications of the synthetic ACPs have been summarized.
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Akgun OM, Haman Bayari S, Ide S, Guven Polat G, Yildirim C, Orujalipoor I. Evaluation of the protective effect on enamel demineralization of CPP-ACP paste and ROCS by vibrational spectroscopy and SAXS: An in vitro study. Microsc Res Tech 2021; 84:2977-2987. [PMID: 34213062 DOI: 10.1002/jemt.23857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/21/2021] [Accepted: 06/08/2021] [Indexed: 11/09/2022]
Abstract
The aim of this study was to investigate human dental enamel surfaces using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), Raman spectroscopy, and small angle X-ray scattering (SAXS) techniques concerning differences between the demineralized enamel surface and remineralized enamel surface by casein phosphopeptide amorphous calcium phosphate, Tooth mousse® (CPP-ACP) and remineralizing oral care systems (ROCS®) agents within the same tooth. For this purpose, 20 freshly extracted human maxillary central incisors without caries and defects were used. Labial surfaces of each of the teeth were divided into four sections, which were marked as follows: Group 1, normal enamel; Group 2, demineralized enamel with demineralization solution; Group 3, demineralized enamel + remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth); and Group 4, remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth). To describe the changes in tooth enamel, the phosphate group concentration within enamel was used as an indicator of the degree of mineralization. The phosphate and carbonate bands in the FTIR and Raman spectra were used to investigate the structural changes in the demineralized and remineralized enamel. Spectroscopic data were statistically analyzed in terms of CPP-ACP and ROCS using one-way analysis of variance. The carbonate content of demineralized enamel was higher than the carbonate content in the other groups (p < .03). The apatite carbonate-phosphate balance in the samples with only remineralizing agent-especially ROCS applied-changed significantly (p < .05) compared to the normal group. The average FTIR spectra of the groups were subjected to multivariate hierarchical cluster analysis (HCA) conducted with the use of the OPUS 5.5 software. Nanosized surface morphologies of the samples were compared using pair distance distributions obtained through SAXS analyses. According to the SAXS analyses, applications of CCP + ACP and ROCS agents were effective on nanostructures for all groups.
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Affiliation(s)
- Ozlem Marti Akgun
- Department of Pediatric Dentistry, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | | | - Semra Ide
- Department of Physics Eng., Hacettepe University, Ankara, Turkey
| | - Gunseli Guven Polat
- Department of Pediatric Dentistry, Hamidiye Dentistry Faculty, University of Health Sciences, Istanbul, Turkey
| | - Ceren Yildirim
- Department of Nanotechnology & Nanomedicine, Hacettepe University, Ankara, Turkey
| | - Ilgar Orujalipoor
- Department of Nanotechnology & Nanomedicine, Hacettepe University, Ankara, Turkey
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Yang Y, Xu Z, Guo Y, Zhang H, Qiu Y, Li J, Ma D, Li Z, Zhen P, Liu B, Fan Z. Novel core-shell CHX/ACP nanoparticles effectively improve the mechanical, antibacterial and remineralized properties of the dental resin composite. Dent Mater 2021; 37:636-647. [PMID: 33579529 DOI: 10.1016/j.dental.2021.01.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/10/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The core-shell chlorhexidine/amorphous calcium phosphate (CHX/ACP) nanoparticles were synthesized and used to modify the dental resin composite, aiming to improve its remineralized and antibacterial properties. METHODS The core-shell CHX/ACP nanoparticles were synthesized by vesicle-templating technology and characterized, and their sustained release and antibacterial properties were also evaluated. Subsequently, the synthesized nanoparticles were incorporated into the dental resin composite at 1 wt.%, 5 wt.% or 10 wt.% to obtain different experimental groups. The physical properties, including curing depth, double bond conversion rate, water absorption and solubility, the sustained-release effects, and mechanical properties of the modified resin composite were evaluated. The remineralization ability was also measured by SEM. The antibacterial experiment of the modified resin composite with fresh preparation or aging in water for 28 days was carried out by a plate count method. RESULTS The physical and chemical characterizations showed that the synthesized nanoparticles presented a core-shell structure, and their diameter was about 98.5 nm. The shell was composed of ACP with the core full of CHX. These nanoparticles had a release effect on calcium, phosphate ions, and CHX. The nanoparticles could effectively inhibit the growth of S. mutan at a lower concentration (≥50 μg/mL). The curing depth, the double bond conversion, the water absorption, the solubility, the flexural strength, the flexural modulus, and the compressive strength of the modified resin composite were 3.86-4.88 mm, 62.32-73.61%, 1.47-2.84%, 0.21-0.48%, 45.83-109.46 MPa, 2.57-4.91 GPa, and 66.43-160.38 MPa, respectively. The modified resin composite containing 5 wt.% and above CHX/ACP nanoparticles could effectively inhibit the growth of S. mutans regardless of aging in water, with immediate and aging antibacterial rate of more than 92%. In addition, the modified resin composite had a certain remineralization property in the SBF solution verified by SEM. SIGNIFICANCE The core-shell CHX/ACP nanoparticles were successfully prepared and used to modify the resin composite. The modified dental resin composite with 5 wt.% CHX/ACP nanoparticles had excellent mechanical, antibacterial, and remineralization properties. It is expected to be an ideal restorative filling material for clinical application.
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Affiliation(s)
- Yanwei Yang
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army, Lanzhou, 730050, PR China
| | - Zexian Xu
- School of Stomatology, Lanzhou University, Lanzhou, 730000, PR China
| | - Yuqing Guo
- School of Stomatology, Lanzhou University, Lanzhou, 730000, PR China
| | - Hongchen Zhang
- School of Nursing, Lanzhou University, Lanzhou, 730000, PR China
| | - Yinong Qiu
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army, Lanzhou, 730050, PR China
| | - Jianxue Li
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army, Lanzhou, 730050, PR China
| | - Dongyang Ma
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army, Lanzhou, 730050, PR China
| | - Zhiqiang Li
- Key Lab of Stomatology of State Ethnic Affairs Commission, Key Lab of Oral Diseases of Gansu Province, School of Stomatology, Northwest Minzu University, Lanzhou, 730030, PR China
| | - Ping Zhen
- Orthopedic Center, The 940th Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army, Lanzhou 730050, PR China.
| | - Bin Liu
- School of Stomatology, Lanzhou University, Lanzhou, 730000, PR China.
| | - Zengjie Fan
- School of Stomatology, Lanzhou University, Lanzhou, 730000, PR China.
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7
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Alexandria A, Valença AMG, Cabral LM, Maia LC. Comparative Effects of CPP-ACP and Xylitol F-Varnishes on the Reduction of Tooth Erosion and Its Progression. Braz Dent J 2020; 31:664-672. [DOI: 10.1590/0103-6440202002985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 03/09/2020] [Indexed: 11/22/2022] Open
Abstract
Abstract Evaluated the effect of CPP-ACP/NaF and xylitol/NaF varnishes in reduce erosion and progression of erosion. Forty enamel blocks were divided into four groups (n=10): G1=CPP-ACP/NaF varnish (MI varnishTM); G2=xylitol/NaF varnish (Profluorid®); G3=NaF varnish (Duraphat®, positive control) and G4=deionized water (MilliQ®, negative control). Samples were immersed in Sprite ZeroTM (pH 2.58, 4x/day, 3 days), in between immersions, the specimens stayed in artificial saliva. After 3 days of erosion, the eroded area was divided in two (half of one received an additional varnish layer while the other half repeated the same 3-day erosion cycle). The 3D, non-contact profilometry technique was used to determinate tooth structure loss (TSL) and surface roughness (SR). Scanning electron microscopy (SEM) and 3D images were utilized to evaluate the topography of the samples. Mann-Whitney, one-way ANOVA and Tukey tests were used (significance level of 0.05%). SEM and 3D images were descriptively evaluated. After 3 or 6 days of erosion, all tested varnishes were better than G4 (p<0.05) for TSL and SR. In addition, G1 had lower values for TSL than G3 (p<0.05) after 3 days of erosion. Under SEM and 3D images observation, all groups presented porosity, irregularities and depressions on the surface enamel after 3 and 6 days of erosion, more pronounced in G4. An application of topical NaF varnishes was effective in reducing TSL and enamel roughness after erosion challenges, being the CCP-ACP/NaF varnish more effective than NaF varnish and water after 3 days of erosion.
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Affiliation(s)
- Adílis Alexandria
- Universidade Federal do Rio de Janeiro, Brazil; Universidade do Estado do Rio de Janeiro, Brazil
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Li P, Oh C, Kim H, Chen-Glasser M, Park G, Jetybayeva A, Yeom J, Kim H, Ryu J, Hong S. Nanoscale effects of beverages on enamel surface of human teeth: An atomic force microscopy study. J Mech Behav Biomed Mater 2020; 110:103930. [PMID: 32957225 DOI: 10.1016/j.jmbbm.2020.103930] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 05/17/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022]
Abstract
Dental erosion has become a prevalence disease and attracted increasing attention worldwide. In this research, we quantitatively evaluate the mechanical and morphological changes in the very early stages of softening and weakening of human enamel surfaces induced by soft drinks using atomic force microscopy (AFM). With an increase of the immersion time in soft drinks, we found a significant increase of surface roughness (Rq) of the enamel surface. The prismatic structure of enamel was clearly observed after a 1-h immersion in Coca-Cola®, which shows its strong erosion effect. According to the elastic modulus mapping images obtained by AFM, a considerable decrease of elastic modulus (E) of enamel surface has been found as the enamel surface structures are etched away by soft drinks. A high surface roughness of enamel will result in a high chance of cavities due to easier bacterial adhesion on rougher surface, while a drastic deterioration of the mechanical properties of the enamel will weaken its protection property. Our findings show the serious influence of acidic drinks on enamel surface at the very beginning stage of etching process, which is quite meaningful for people to prevent dental erosion and keep dental health.
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Affiliation(s)
- Panpan Li
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Chungik Oh
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Hongjun Kim
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Melodie Chen-Glasser
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Gun Park
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Albina Jetybayeva
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Jiwon Yeom
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Hoon Kim
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Jeongjae Ryu
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea
| | - Seungbum Hong
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea; KAIST Institute for NanoCentury (KINC), Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Daejeon, 34141, Republic of Korea.
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Yilmaz N, Baltaci E, Baygin O, Tüzüner T, Ozkaya S, Canakci A. Effect of the usage of Er,Cr:YSGG laser with and without different remineralization agents on the enamel erosion of primary teeth. Lasers Med Sci 2020; 35:1607-1620. [PMID: 32472426 DOI: 10.1007/s10103-020-03015-0] [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: 08/11/2019] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Abstract
The aim of the present study was to evaluate the effects of different remineralization agents associated with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) (0.5 W power, 20 Hz frequency, 60% water, 40% air, 25 mJ pulse energy, 8.84 J/cm2 fluence, 60 μs pulse duration, 600 μm tip diameter, and an approximate 1-1.5 mm distance to the target) laser irradiation on erosion induced by the consumption of carbonated drinks in human primary enamel. There were 8 groups and 10 primary teeth in each g0roup. The distribution was as follows: group 1, casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF); group 2, Er,Cr:YSGG laser+CPP-ACPF; group 3, fluor varnish; group 4, Er,Cr:YSGG Laser+fluoride varnish; group 5, ROCS® medical mineral gel; group 6, Er,Cr:YSGG laser + ROCS® medical mineral gel; group 7, Er,Cr:YSGG laser; and group 8, artificial saliva. The samples in the groups were submerged in artificial saliva and acid twice a day for 6 s at 6-h intervals and were then exposed to an erosion cycle 15 times. In the groups in which the Er,Cr:YSGG laser was applied in combination with the remineralization agents, the laser application was made first, and then the remineralization agents were applied for 4 min in each group. The Friedman and Wilcoxon signed-rank tests and the Bonferroni correction were used in statistical analyses, and the significance level was taken as p < 0.05. According to the results, all agents had a statistically significant difference (groups 1, 2, 3, 4, and 6: p = 0.005, p < 0.017; groups 5 and 7: p = 0.007, p < 0.017) between BL-RM periods. However, all agents had a statistically significant remineralization effect on primary teeth enamel (groups 1, 2, 3, 6, and 7: p = 0.005, p < 0.017; group 4: p = 0.011, p < 0.017) except that group 5 (p = 0.074, p < 0.017) between DM-RM periods. The coadministration of an agent with the laser did not make any difference at a statistical level (p = 0.804, p > 0.05). The results were supported by scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. As a result of this study, CPP-ACPF had a notable impact in terms of the remineralization effect on eroded enamel, and the Er,Cr:YSGG laser alone may be an alternative method, which may be related to the modified hydroxyapatite structure, 38.5% H0.56Ca4.56O13P3Y0.44, that was determined in XRD analysis.
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Affiliation(s)
- Nagehan Yilmaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
| | - Ezgi Baltaci
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Ozgul Baygin
- Department of Pediatric Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Tamer Tüzüner
- Department of Pediatric Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Serdar Ozkaya
- Department of Materials and Metallurgical Engineering, Faculty of Engineering, Karadeniz Technical University, Trabzon, Turkey
| | - Aykut Canakci
- Department of Materials and Metallurgical Engineering, Faculty of Engineering, Karadeniz Technical University, Trabzon, Turkey
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10
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Świetlicka I, Kuc D, Świetlicki M, Arczewska M, Muszyński S, Tomaszewska E, Prószyński A, Gołacki K, Błaszczak J, Cieślak K, Kamiński D, Mielnik-Błaszczak M. Near-Surface Studies of the Changes to the Structure and Mechanical Properties of Human Enamel under the Action of Fluoride Varnish Containing CPP-ACP Compound. Biomolecules 2020; 10:biom10050765. [PMID: 32422985 PMCID: PMC7277937 DOI: 10.3390/biom10050765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/30/2020] [Accepted: 05/11/2020] [Indexed: 12/03/2022] Open
Abstract
Changes to the features of the enamel surface submitted to induced demineralisation and subsequent remineralisation were studied. The in vitro examination was conducted on polished slices of human molar teeth, divided in four groups: the untreated control (n = 20), challenged by a demineralisation with orthophosphoric acid (H3PO4) (n = 20), and challenged by a demineralisation following remineralisation with fluoride (F) varnish containing casein phosphopeptides (CPP) and amorphous calcium phosphate (ACP) compounds (n = 20). The specimens’ enamel surfaces were subjected to analysis of structure, molecular arrangement, mechanical features, chemical composition, and crystalline organization of apatite crystals. Specimens treated with acid showed a significant decrease in crystallinity, calcium, and phosphorus levels as well as mechanical parameters, with an increase in enamel surface roughness and degree of carbonates when compared to the control group. Treatment with fluoride CPP–ACP varnish provided great improvements in enamel arrangement, as the destroyed hydroxyapatite structure was largely rebuilt and the resulting enamel surface was characterised by greater regularity, higher molecular and structural organisation, and a smoother surface compared to the demineralised one. In conclusion, this in vitro study showed that fluoride CPP–ACP varnish, by improving enamel hardness and initiating the deposition of a new crystal layer, can be an effective remineralising agent for the treatment of damaged enamel.
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Affiliation(s)
- Izabela Świetlicka
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
- Correspondence: (I.Ś.); (M.A.)
| | - Damian Kuc
- Chair and Department of Paediatric Dentistry, Medical University of Lublin, 20-059 Lublin, Poland; (D.K.); (M.M.-B.)
| | - Michał Świetlicki
- Department of Applied Physics, Faculty of Mechanical Engineering, Lublin University of Technology, 20-618 Lublin, Poland; (M.Ś.); (A.P.)
| | - Marta Arczewska
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
- Correspondence: (I.Ś.); (M.A.)
| | - Siemowit Muszyński
- Department of Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
| | - Ewa Tomaszewska
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-950 Lublin, Poland;
| | - Adam Prószyński
- Department of Applied Physics, Faculty of Mechanical Engineering, Lublin University of Technology, 20-618 Lublin, Poland; (M.Ś.); (A.P.)
| | - Krzysztof Gołacki
- Department of Mechanical Engineering and Automatics, Faculty of Production Engineering, University of Life Sciences in Lublin, 20-612 Lublin, Poland;
| | | | - Krystian Cieślak
- Institute of Renewable Energy Engineering, Faculty of Environmental Engineering, Lublin University of Technology, 20-618 Lublin, Poland;
| | - Daniel Kamiński
- Department of Crystallography, Faculty of Chemistry, Maria Curie-Sklodowska University, 20-031 Lublin, Poland;
| | - Maria Mielnik-Błaszczak
- Chair and Department of Paediatric Dentistry, Medical University of Lublin, 20-059 Lublin, Poland; (D.K.); (M.M.-B.)
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Dionysopoulos D, Tolidis K, Sfeikos T. Effect of air-abrasion pre-treatment with bioactive glass 45S5 on enamel surface loss after erosion/abrasion challenge. Dent Mater 2019; 35:e193-e203. [PMID: 31133403 DOI: 10.1016/j.dental.2019.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/25/2019] [Accepted: 05/07/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the effect of air-abrasion surface pre-treatment with bioactive glass (BAG) 45S5 on enamel surface loss after erosion/abrasion challenge. METHODS Twenty-four sound bovine incisors were used for this study. Four experimental groups (n=12) were assigned as follows: Group 1 was the negative control group, Group 2 specimens were treated with a SnF2 gel (positive control group), Group 3 specimens were air-abraded with BAG 45S5 (ProSylc) and Group 4 received both treatments. The specimens were submitted to erosion/abrasion challenge using a common soft drink. Enamel surface loss was evaluated using an optical profilometer. Additionally, surface roughness (VSI method) and surface microhardness (Vickers method) changes were evaluated, as well as SEM and EDS analyses were performed on enamel surface. The data were statistically analyzed using one-way ANOVA and Tukey's post-hoc test at a level of significance a=0.05. RESULTS Surface pre-treatment with BAG 45S5 reduced surface loss in comparison with negative control group (p<0.001), which exhibited the highest surface loss of the experimental groups (p<0.05). The positive control group (SnF2 treatment) and Group 4 specimens, which received both air-abrasion pre-treatment and SnF2 treatment, presented the lowest surface loss (p<0.05), but did not show significant differences to each other (p=0.65). SIGNIFICANCE Air-abrasion pre-treatment with BAG 45S5 may be beneficial as an in-office preventive method for the limitation of enamel erosive wear induced by excessive consumption of soft drinks. The clinical significance of the results regarding this preventive method should be confirmed by clinical studies.
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Affiliation(s)
- Dimitrios Dionysopoulos
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Kosmas Tolidis
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Thrasyvoulos Sfeikos
- Department of Operative Dentistry, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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Tulumbacı F, Oba AA. Efficacy of different remineralization agents on treating incipient enamel lesions of primary and permanent teeth. J Conserv Dent 2019; 22:281-286. [PMID: 31367114 PMCID: PMC6632635 DOI: 10.4103/jcd.jcd_509_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Aims and Objectives: The aim of this study was to compare the in vitro efficacy of different remineralization (RM) agents on RM of artificial caries by evaluating the density, light reflection, and the crystal size of the newly formed mineral in primary and permanent teeth. Materials and Methods: Caries-free primary and permanent molars were divided into seven groups (n = 20) and treated with: G1 – Deionized water, G2 – Colgate Cavity Protection, G3 – Sensodyne Rapid Relief, G4 – GC MI Paste Plus, G5 – Clinpro Tooth Creme, G6 – Clinpro 5000, and G7 – Sensodyne Repair and Protect. Lesion depths were evaluated using laser fluorescence (DIAGNOdent), and polarized light microscopy (PLM), and the minerals were evaluated using X-ray diffractometry (XRD). Results: The highest decrease in laser fluorescence readings was observed in G6 for both primary and permanent teeth. No significant difference was observed between G2, G4, G5, and G6 in permanent teeth and G4 and G6 in primary teeth (P > 0.05). In PLM analyses, lesions depths were found to be lower in G6 compared to the other groups. No significant difference was observed between G2, G4, and G6 (P < 0.05). XRD evaluation showed that the newly formed mineral in G6 was denser and highly crystallized compared to the other groups. Conclusion: This in vitro study demonstrated that Clinpro 5000 is more efficient in remineralizing incipient enamel lesions compared to the other agents tested.
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Affiliation(s)
- Fatih Tulumbacı
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Aylin Akbay Oba
- Department of Pediatric Dentistry, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
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Cruz prates CD, fernandes LHF, agra de Melo JBDC, de alencar CRB, Cavalcanti AL. Effect of Cpp-aCp and Cpp-aCpf pastes on the Surface Hardness of Initial Dental Erosion Lesions: an In Situ Study. BIOMEDICAL AND PHARMACOLOGY JOURNAL 2018; 11:1781-1787. [DOI: 10.13005/bpj/1549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
To analyze the effect of intra-oral application of CPP-ACP and CPP-ACPF pastes on the surface hardness of initial dental erosion lesions.Bovine enamel specimens were randomly assigned into 6 volunteers in 3 treatment groups: GI: CPP-ACP paste, GII: CPP-ACPF paste and GIII (Control): Placebo paste without CPP-ACP and without fluoride. Enamel specimens were selected by surface hardness (SHi), in vitro eroded by immersion in hydrochloric acid for 30 seconds (SHdes) and randomized between treatment groups and volunteers, who used the palatal intraoral device for 2 hours, applied the treatment on the specimens and used the palatal intraoral device for an additional 3 hours in 3 crossed phases, interspersed with a 7-day washout period. Subsequently, the surface hardness (SHre) was measured to estimate the re-hardening potential of the softened enamel promoted by treatments. Data were analyzed using the t-test and one-way ANOVA, adopting 5% significance level. Mean final and post-erosion hardness values were statistically significant for pastes tested (p<0.05), which presented re-hardening effect of the softened enamel, but with no difference between them and placebo (p>0.05). CPP-ACP and CPP-ACPF pastes did not demonstrate higher efficacy in re-hardening the eroded enamel compared to placebo paste.
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Evaluation of a clinical preventive treatment using Er,Cr:YSGG (2780 nm) laser on the susceptibility of enamel to erosive challenge. Lasers Med Sci 2018; 34:1089-1097. [PMID: 30415288 DOI: 10.1007/s10103-018-2679-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
The purpose of this in vitro study was to evaluate the effect of a clinical preventive treatment using Er,Cr:YSGG laser irradiation on bovine enamel susceptibility after erosive challenge. Twelve sound bovine incisors were used and twenty-four enamel specimens were prepared in total. Two experimental groups (n = 12) were assigned as follows: Group 1 was the control group and in Group 2, the enamel specimens were irradiated with an Er,Cr:YSGG (2780 nm) laser system for 20 s, with average output power of 0.25 W, pulse repetition rate at 20 Hz without water or air flow and the pulse duration was fixed at 140 μsec. The tip diameter was 600 μm, the tip to tissue distance was 1 mm, the speed of handpiece movement was 2 mm/s, the power density was 88.34 W/cm2, and the fluence was 31.25 J/cm2. The specimens were submitted to erosive challenge using a common soft drink. Surface microhardness changes, surface roughness changes, and surface loss were evaluated after erosive challenge. The data were statistically analyzed using one-way ANOVA and Tukey's post-hoc test at a level of significance a = 0.05. Er,Cr:YSGG laser-treated enamel exhibited significantly less decrease in surface microhardness and significant less surface loss compared to control enamel after the erosive challenge (p < 0.05). The experimental groups did not show significant differences in surface roughness increase after the erosive challenge (p > 0.05). Er,Cr:YSGG laser treatment may be promising for the limitation of enamel erosive tooth wear induced by excessive consumption of soft drinks. Clinical studies are needed to clarify whether this protective effect is clinically significant.
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Alexandria AK, Valença AMG, Cabral LM, Maia LC. Fluoride Varnishes against Dental Erosion Caused by Soft Drink Combined with Pediatric Liquid Medicine. Braz Dent J 2017; 28:482-488. [DOI: 10.1590/0103-6440201701567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/18/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract The present study evaluated the effect of NaF and CPP-ACP/NaF varnishes to reduce erosion produced by soft drink (SD) combined or not with pediatric liquid medicine. Enamel specimens were pre-treated with fluoride varnish, according to the following groups: NaF varnish (Duraphat®) or CPP-ACP/NaF varnish (MI varnishTM). Two types of erosive cycles were made: by soft drink erosion (SDE) or by pediatric liquid medicine plus soft drink erosion (PLM/SDE). Bovine enamel specimens were randomly assigned in six groups (n=10): G1=NaF + SDE; G2=CPP-ACP/NaF + SDE; G3=Distilled and deionized (DD) water + SDE; G4=NaF + PLM/SDE; G5=CPP-ACP/NaF + PLM/SDE and G6=DD water + PLM/SDE. Before treatments, the sample surface was divided in two areas (unexposed area-UA and exposed area-EA). The specimens were evaluated by 3D non-contact profilometry technique to determinate tooth structure loss (TSL) and surface roughness (Sa). Scanning electron microscopy (SEM) analysis was also performed. After SDE, G2 presented the lowest TSL values compared to G3 (p=0.008). G1 and G2 did not differ between them (p=0.203) and no groups differed among them despite Sa. Regarding TSL and Sa, G4 and G5 differed from G6 (p=0.0001), but not between them (p=1.00). Examining 3D and SEM images, the greatest differences between UA and EA were observed for G3 and G6. CPP-ACP/NaF varnish seems to be a promising treatment to reduce enamel loss from the erosion produced by a soft drink. Both varnishes also showed capacity to reduce TSL and Sa after erosion by soft drink combined to pediatric liquid medicine.
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In vitro enamel erosion and abrasion-inhibiting effect of different fluoride varnishes. Arch Oral Biol 2017; 77:39-43. [DOI: 10.1016/j.archoralbio.2017.01.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 11/18/2016] [Accepted: 01/15/2017] [Indexed: 01/29/2023]
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Rezvani MB, Rouhollahi MR, Andalib F, Hamze F. Nano-hydroxyapatite could Compensate the Adverse Effect of soft carbonated Drinks on Enamel. J Contemp Dent Pract 2016; 17:635-8. [PMID: 27659079 DOI: 10.5005/jp-journals-10024-1903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Since one of the most important disadvantages of soft drinks includes their adverse effect on mineral content of enamel because of their low pH, this study examined the microhardness of enamel before and after exposure to a soft drink containing different concentrations of nano-hydroxyapatite (nano-HA) as an additive. MATERIALS AND METHODS Sixty caries free human premolars were mounted in epoxy resin. After polishing, the baseline micro-hardness was recorded three times for each specimen using a Vickers indenter at 50 gm load. Subsequently, the samples were divided into six groups, which were treated for 5 minutes at 9°C by a cola-based drink contacting 0, 0.5, 1, 5, and 10 wt.% of nano-HA while the control group was immersed in artificial saliva. Ultimately, the final microhardness was assessed three times again for each specimen. RESULTS Paired t-test showed that in groups containing 0 and 0.5 wt.% of nano-HA, the microhardness was significantly reduced after treatment protocol (p = 0.00 and 0.01 respectively). Whereas in the other groups the microhardness was not significantly changed after treatment (p > 0.05). CONCLUSION Pure cola-based drink has a pronounced adverse effect on enamel microhardness, while admixing it with nano-HA could act as a protective factor. CLINICAL SIGNIFICANCE Although soft beverages are hazardous to tooth structure, some additives could compensate their adverse effect.
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Affiliation(s)
- Mohammad B Rezvani
- Department of Operative Dentistry, Shahed Dental School Shahed University, Tehran, Islamic Republic of Iran
| | - Mohammad R Rouhollahi
- Department of Operative Dentistry, Shahed Dental School Shahed University, Tehran, Islamic Republic of Iran
| | - Fahimeh Andalib
- Department of Operative Dentistry, Isfahan Dental School Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran
| | - Faeze Hamze
- Assistant Professor, Oral and Dental Disease Research Center, Kerman University of Medical Science, Kerman, Islamic Republic of Iran, Phone: +983432126024, e-mail: and
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Soares LES, Soares ALS, De Oliveira R, Nahórny S. The effects of acid erosion and remineralization on enamel and three different dental materials: FT-Raman spectroscopy and scanning electron microscopy analysis. Microsc Res Tech 2016; 79:646-56. [DOI: 10.1002/jemt.22679] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/23/2016] [Accepted: 04/19/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Luís Eduardo Silva Soares
- Universidade Do Vale Do Paraíba, UNIVAP, Research and Development Institute, IP&D Laboratory of Biomedical Vibrational Spectroscopy; LEVB, São José Dos Campos São Paulo Brazil
- Universidade Do Vale Do Paraíba, UNIVAP, Faculty of Healt & Sciences, FCS, School of Dentistry; São José Dos Campos São Paulo Brazil
| | - Ana Lúcia Silva Soares
- Universidade Do Vale Do Paraíba, UNIVAP, Research and Development Institute, IP&D Laboratory of Biomedical Vibrational Spectroscopy; LEVB, São José Dos Campos São Paulo Brazil
| | - Rodrigo De Oliveira
- Universidade Do Vale Do Paraíba, UNIVAP, Research and Development Institute, IP&D Laboratory of Biomedical Vibrational Spectroscopy; LEVB, São José Dos Campos São Paulo Brazil
| | - Sidnei Nahórny
- Universidade Do Vale Do Paraíba, UNIVAP, Research and Development Institute, IP&D Laboratory of Biomedical Vibrational Spectroscopy; LEVB, São José Dos Campos São Paulo Brazil
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de Alencar CRB, Magalhães AC, de Andrade Moreira Machado MA, de Oliveira TM, Honório HM, Rios D. In situ effect of a commercial CPP-ACP chewing gum on the human enamel initial erosion. J Dent 2014; 42:1502-7. [PMID: 25174948 DOI: 10.1016/j.jdent.2014.08.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/13/2014] [Accepted: 08/15/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE This study evaluated the in situ rehardening effect of a commercial chewing gum containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) on initial erosion lesions. METHODS Seventy-two human enamel blocks, after selection (initial surface hardness - SHi) and in vitro short-term acidic exposure (cola drink for 3 min - SHd) were randomly assigned to three groups. The factors under study were treatment (3 levels: GI chewing gum with CPP-ACP, GII chewing gum without CPP-ACP and GIII control group without gum) and intraoral period (2 levels: 2 and 24h). Twelve volunteers wore intraoral palatal devices for 24h in 3 crossover phases. On each phase, after 2h the surface hardness was assessed (SHf1) and the blocks were reinserted and the devices were used for additional 22 h (SHf2). In phases of GI and GII volunteers chewed the respective gum during 30 min, for 4 times with an interval of 4h. Percentage of surface hardness recovery (%SHR) was calculated after 2 and 24 h. The data were analysed by repeated measures ANOVA and Tukey's test. RESULTS Chewing gum with CPP-ACP (2h=50.0%<24h=95.9%) showed higher hardness recovery than chewing gum without CPP-ACP (2h=30.0%<24 h=71.1%) and control (2 h=15.7%<24 h=40.9%) (p<0.05). CONCLUSIONS The results suggest that saliva increased hardness of softened enamel after the use of conventional chewing gum (GII) and this effect was enhanced by the prolonged intraoral period (24 h) and by the use of CPP-ACP chewing gum (GI). CLINICAL SIGNIFICANCE Since chewing gum is an alternative to enhance salivary defenses after erosive challenges, CPP-ACP chewing gum might be a supplementary strategy to potentiate the mineral precipitation of initial erosion lesions.
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Affiliation(s)
- Catarina Ribeiro Barros de Alencar
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil.
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil.
| | - Maria Aparecida de Andrade Moreira Machado
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil.
| | - Thais Marchini de Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil.
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil.
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru/SP - PO Box 73, 17012-101, Brazil.
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Pithon MM, dos Santos MJ, Andrade CSS, Leão Filho JCB, Braz AKS, de Araujo RE, Tanaka OM, Fidalgo TKS, dos Santos AM, Maia LC. Effectiveness of varnish with CPP–ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation. Eur J Orthod 2014; 37:177-82. [DOI: 10.1093/ejo/cju031] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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