Addition of CPP-ACP to yogurt inhibits enamel subsurface demineralization

Oral Hygiene, Dietary Habits, and Saliva Properties in Relation to the Decayed, Missing, and Filled Teeth Index of Dental Students: A Pilot Study

Background and Objectives: Caries development is associated with poor oral hygiene, inadequate dietary habits, quantitative and qualitative food content, and a high level of bacterial plaque. Physical and chemical changes in saliva composition and particularly changes in its buffering capability play a significant role in caries development. This study aimed to determine the predictors of poor oral health among a sample of second-year dental students. Materials and Methods: The oral health of students was estimated with clinical examination and the DMFT index. The interview included questions about demographics status (gender, age), a dietary habits questionnaire, questions about oral hygiene, and a demonstration of tooth brushing technique. Unstimulated saliva samples were collected to measure buffering capacity and pH. Results: Almost half of the students have a low level of caries experience (46.7%), followed by a slightly smaller number having a medium level (41.3%), while one in eight students (12.0%) demonstrates a high level of caries experience. Male students have a statistically higher DMFT index 5.7 ± 1.2 than female participants 4.5 ± 0.5 (p = 0.036). Significant predictors for the DMFT index score in students were milk [β-coefficient = -0.338, p = 0.011] and yoghurt [β-coefficient = 0.284, p = 0.040] consumption. All students brushed their teeth two or more times during the day, usually after waking up before breakfast and before bedtime. Most students (85.3%) apply the proper tooth brushing technique, with female students applying it more frequently (p = 0.038). The mean salivary pH was 6.9, while the mean buffer capacity was 5.8. Female respondents have a statistically lower buffer capacity (5.8 ± 0.5) than male respondents (6.1 ± 0.4) (p = 0.047). Conclusions: Dentistry students are introduced to good oral hygiene habits, especially female students, while dietary habits should be improved. However, one in eight dental students is at high caries risk. By assessing the level of caries experience, targeted strategies can be developed to promote, maintain, and enhance oral health among dental students.

The damage and remineralization strategies of dental hard tissues following radiotherapy

OBJECTIVES

This study pursued two main purposes. The first aim was to expound on the microscopic factors of radiation-related caries (RRC). Further, it aimed to compare the remineralization effect of different remineralizing agents on demineralized teeth after radiotherapy.

METHODS

The enamel and dentin samples of bovine teeth were irradiated with different doses of radiation. After analysis of scanning electron microscope (SEM), X-Ray diffraction (XRD), and energy dispersive spectrometer (EDS), the samples irradiated with 50 Gy radiation were selected and divided into the demineralization group, the double distilled water (DDW) group, the Sodium fluoride (NaF) group, the Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group, the NaF + CPP-ACP group, and the Titanium tetrafluoride (TiF4) group. After demineralization, remineralizing agents treatment, and remineralization, the samples were evaluated using SEM, atomic force microscope (AFM), EDS, and transverse microradiography (TMR).

RESULTS

A radiation dose of 30 Gy was sufficient to cause damage to the dentinal tubules, but 70 Gy radiation had little effect on the microstructure of enamel. Additionally, the NaF + CPP-ACP group and the TiF4 group significantly promoted deposit formation, decreased surface roughness, and reduced mineral loss and lesion depth of demineralized enamel and dentin samples after radiation.

CONCLUSIONS

Radiation causes more significant damage to dentin compared to enamel. NaF + CPP-ACP and TiF4 had a promising ability to promote remineralization of irradiated dental hard tissues.

ADVANCES IN KNOWLEDGE

This in vitro study contributes to determining a safer radiation dose range for teeth and identifying the most effective remineralization approach for RRC.

Comparing the effect of animal and plant-based yogurt extracts on enamel demineralization: an in vitro study

BACKGROUND

Yogurt, due to its rich casein phosphopeptide (CPP) content could promote remineralization of enamel. Contrary to the age-old usage of animal milk based yogurt, vegan dairy products are gaining momentum due to multiple reasons. Considering this change, the aim of the present study was to assess the in vitro effect of animal and plant-based yogurt extracts on demineralization of enamel.

METHODS

Enamel windows were prepared on the crowns of sixty premolar teeth using nail paint. Teeth were divided into four groups of fifteen each and were treated with distilled water, demineralizing agent, solution with a mixture of demineralizing agent and yogurt supernatants, respectively for 96 hrs. Quantitative analysis was done using EDXRF (baseline and postexperimental calcium and phosphorus content). Additionally, confocal microscopic analysis was performed to assess the extent of demineralization.

RESULTS

The animal-based yogurt (Group III) had the highest post experimental calcium value (mean±SD=81.15±5.02) and positive percentage of change in calcium level (15%; P=0.007) among the groups. This was followed by plant-based yogurt (Group IV) (mean calcium= 76.18±5.12; positive percentage change =8.11%; P=0.003).

CONCLUSIONS

Animal based yogurt could provide higher protection against enamel demineralization when compared to plant-based yogurt.

New generation of orthodontic devices and materials with bioactive capacities to improve enamel demineralization

OBJECTIVE

The article reviewed novel orthodontic devices and materials with bioactive capacities in recent years and elaborated on their properties, aiming to provide guidance and reference for future scientific research and clinical applications.

DATA, SOURCES AND STUDY SELECTION

Researches on remineralization, protein repellent, antimicrobial activity and multifunctional novel bioactive orthodontic devices and materials were included. The search of articles was carried out in Web of Science, PubMed, Medline and Scopus.

CONCLUSIONS

The new generation of orthodontic devices and materials with bioactive capacities has broad application prospects. However, most of the current studies are limited to in vitro studies and cannot explore the true effects of various bioactive devices and materials applied in oral environments. More research, especially in vivo researches, is needed to assist in clinical application.

CLINICAL SIGNIFICANCE

Enamel demineralization (ED) is a common complication in orthodontic treatments. Prolonged ED can lead to dental caries, impacting both the aesthetics and health of teeth. It is of great significance to develop antibacterial orthodontic devices and materials that can inhibit bacterial accumulation and prevent ED. However, materials with only preventive effect may fall short of addressing actual needs. Hence, the development of novel bioactive orthodontic materials with remineralizing abilities is imperative. The article reviewed the recent advancements in bioactive orthodontic devices and materials, offering guidance and serving as a reference for future scientific research and clinical applications.

Research progress of biomimetic materials in oral medicine

Biomimetic materials are able to mimic the structure and functional properties of native tissues especially natural oral tissues. They have attracted growing attention for their potential to achieve configurable and functional reconstruction in oral medicine. Though tremendous progress has been made regarding biomimetic materials, significant challenges still remain in terms of controversy on the mechanism of tooth tissue regeneration, lack of options for manufacturing such materials and insufficiency of in vivo experimental tests in related fields. In this review, the biomimetic materials used in oral medicine are summarized systematically, including tooth defect, tooth loss, periodontal diseases and maxillofacial bone defect. Various theoretical foundations of biomimetic materials research are reviewed, introducing the current and pertinent results. The benefits and limitations of these materials are summed up at the same time. Finally, challenges and potential of this field are discussed. This review provides the framework and support for further research in addition to giving a generally novel and fundamental basis for the utilization of biomimetic materials in the future.

Comparative evaluation of four treatments for postorthodontic white spot lesions: a randomized controlled trial

OBJECTIVES

To evaluate the treatment efficacy of fluoride toothpaste alone and those of adjunctive use of resin infiltration, sodium fluoride varnish, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs).

MATERIALS AND METHODS

Seventy-nine patients (356 teeth) with WSLs after orthodontic treatment were randomly allocated into four groups. The WSLs of the participants received resin infiltration only at baseline, and the other groups received fluoride varnish, CPP-ACP mousse, and placebo treatment every 6 months, respectively. A toothpaste containing 1400 ppm fluoride and toothbrushes were distributed to all participants, and oral hygiene instructions were provided. Photos of the teeth with WSL were taken to compare the change between groups which was measured by ImageJ software.

RESULTS

Twelve months later, different degrees of reduction in the area of WSLs were observed in all groups. The percentage of lesion area reduction in WSLs in the resin infiltration group was 46.6%, which was significantly higher than that in fluoride varnish group (26.6%), CPP-ACP group (28.6%), and control group (29.8%), and the differences were statistically significant (p < 0.001).

CONCLUSIONS

This study shows that after 1-year follow-up, the use of fluoride toothpaste, with or without the use of fluoride varnish or CPP-ACP, can reduce the area of WSLs. While resin infiltration can immediately improve dental aesthetics and continuously improved in 12 months, resin infiltration group showed much better results than other groups.

TRIAL REGISTRATION

Clinical Trials Registration Number: ChiCTR2000032516.

CLINICAL SIGNIFICANCE

The use of fluoride toothpaste, with or without adjunctive use of fluoride varnish and CPP-ACP, can reduce the area of WSLs, while resin infiltration treatment has additional effect and can immediately improve dental aesthetics.

An epigallocatechin gallate-amorphous calcium phosphate nanocomposite for caries prevention and demineralized enamel restoration

Biomineralization with amorphous calcium phosphate (ACP) is a highly effective strategy for caries prevention and defect restoration. The identification and interruption of cariogenic biofilm formation during remineralization remains a challenge in current practice. In this study, an epigallocatechin gallate (EGCG)-ACP functional nanocomposite was developed to prevent and restore demineralization by integrating the antibacterial property of EGCG and the remineralization effect of ACP. The synthesized EGCG-ACP showed good biocompatibility with L-929 ​cells and human gingival fibroblasts. Under neutral conditions, the sustained release of ACP from EGCG-ACP restored the microstructure and mechanical properties of demineralized enamel. Under acidic conditions, protonated EGCG released from EGCG-ACP exerted a strong antibacterial effect, and the ACP release rate doubled within 4 ​h, resulting in the prevention of demineralization in the presence of cariogenic bacteria. The pH-responsive features of EGCG-ACP to promote the protonation of EGCG and ACP release facilitated its performance in remineralization effect to overcome the difficulty of restoring demineralized enamel in a cariogenic acidic environment, which was evidenced by the in vivo experiment carried out in a rat oral cariogenic environment. The results of this study indicate the potential of EGCG-ACP for the prevention of enamel demineralization and provide a theoretical basis its application in populations with high caries risk.

Enhancing yogurt products’ ingredients: preservation strategies, processing conditions, analytical detection methods, and therapeutic delivery—an overview

As a dairy product, yogurt delivers nourishing milk components through the beneficial microbial fermentation process, improved by bioavailability and bioaccessibility–an exclusive combined food asset. In recent decades, there has been considerable attention to yogurt product development particularly in areas like influence by antioxidant-rich fruits, different factors affecting its probiotic viability, and the functionality of inulin and probiotics. Essentially, many published reviews frequently focus on the functionalities associated with yogurt products, however, those articulating yogurt ingredients specific to associated preservation strategies, processing conditions, and analytical detection techniques are very few, to the best of our knowledge. The knowledge and understanding of preservation strategies that enhance the ingredients in yogurt products, and their function as modern drug delivery systems are essential, given the opportunities it can provide for future research. Therefore, this overview discussed how yogurt product ingredients have been enhanced, from preservation strategies, processing conditions, analytical detection methods, and therapeutic delivery standpoints. The survey methodology involved major stages, from the brainstorming of research questions, search strategy, effective utilization of databases, inclusion and exclusion criteria, etc. The innovative successes of yogurts would be enhanced via the physicochemical, nutritional and therapeutic aspects of the ingredients/products. Besides processing conditions to influence the yogurt constituents, overall acceptability, quality, and shelf-life, the analytical assays would help detect the hidden product constituents, toxins, and other storage-related changes. The therapeutic role of yogurt-a modern drug delivery system, would be demonstrated via the supplementation (of yogurt) either alone or with bioactive ingredients. The future of yogurt requires the collective action of stakeholders to formulate unique variants with different natural blends, where synthetic ingredients become completely replaced by the plant’s derivatives, which enhance the acidification rate and extend shelf life.

Casein phosphopeptide-calcium chelate: Preparation, calcium holding capacity and simulated digestion in vitro

In this work, CPP-Ca chelate was synthesized by chelating casein phosphopeptide (CPP) and calcium and characterized by Fourier transform infrared spectroscopy (FTIR), Scanning electron microscopy (SEM) Energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD). The antioxidant activity and calcium holding capacity of CPP-Ca were evaluated and its secondary structure transition was monitored during gastrointestinal digestion by in situ Raman spectroscopy. The results demonstrated that calcium chelating rate reached 40 % and calcium ion was bound to CPP mainly through the interaction of carboxyl and amino groups. The result of calcium holding capacity confirmed the formation of calcium phosphate precipitates could be delayed by 10-15 min with increasing CPP concentration. In vitro simulated digestion revealed CPP-Ca exhibited excellent calcium solubility and its secondary structural changes occurred, especially α-helix and β-sheet content. These findings provided significant insights into enhancing bioavailability of calcium supplements and developing of calcium functional foods for human and animals.

Synthetic amorphous calcium phosphates (ACPs): preparation, structure, properties, and biomedical applications

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 PO₄^3- 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.