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Ahmed SZ, Khan AS, Aljeshi NM, Md Sabri BA, Akhtar S, Abu Hassan MI. A Comparative In Vitro Physicochemical Analysis of Resin Infiltrants Doped With Bioactive Glasses. Cureus 2024; 16:e64500. [PMID: 39007016 PMCID: PMC11246546 DOI: 10.7759/cureus.64500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2024] [Indexed: 07/16/2024] Open
Abstract
Objective This study aimed to investigate the longevity and effectiveness of bioactive glass (BAG)-based dental resin infiltrants. Materials and methods The three types of BAG - 45S5 bioglass (RIS), boron-substituted (RIB), and fluoride-substituted (RIF) - were incorporated with photoinitiated dimethacrylate monomers to create experimental resin infiltrants. ICON® (CN; DMG-America, Ridgefield Park, NJ) and pure resin (PR) were used as control groups in this study. Disc-shaped samples were prepared for the experimental and control groups. The samples were challenged with the pH cycle and immersed in the artificial saliva for 30 days. On Day 0 and Day 30, the pH cycle and artificial saliva immersion, Vicker's microhardness, surface roughness, and surface morphology were investigated. Results The RIF group's disc samples showed the highest Vicker's microhardness values (78.20 ±0.06) on Day 30 of artificial saliva immersion, whereas the CN group's values were the lowest (55.99 ±0.24). Following the pH cycling, the RIF displayed the highest hardness (64.15 ±1.89) whereas the CN group's values were the lowest (33.47 ±1.28). Regarding surface roughness, on Day 30, the RIB resin group exhibited the highest (1.14 ±0.001 µm). In contrast, the CN resin showed the lowest (1.07 ±0.06 µm) values, while immersed in the artificial saliva solution. In the same duration of time, in the pH cycling solution, PR showed the least (0.85 ±0.89 µm), while RIF showed the highest roughness value (0.94 ±0.54 µm). Morphological analysis revealed that following the artificial saliva immersion, the RIB, CN, and PR exhibited smoother surfaces compared to the RIS and RIF groups. However, when immersed in the pH cycling solution, RIB and RIF showed more resistance against acid attack. Conclusions Our results revealed that the experimental resin groups performed much better than the commercial resin infiltrants following artificial saliva and pH cycling challenges.
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Affiliation(s)
- Syed Zubairuddin Ahmed
- Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Abdul S Khan
- Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Naemah M Aljeshi
- Dentistry, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Budi A Md Sabri
- Dentistry, College of Dentistry, University Teknologi Mara, Sungai Buloh, MYS
| | - Sultan Akhtar
- Department of Biophysics, Institute for Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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Predapramote V, Tantilertanant Y, Srisawasdi S. Evaluation of resin infiltration for inhibiting initial caries progression: An in vitro study using Micro-Computed Tomographic analysis. Saudi Dent J 2024; 36:745-750. [PMID: 38766302 PMCID: PMC11096623 DOI: 10.1016/j.sdentj.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 05/22/2024] Open
Abstract
Objective To evaluate the changes in lesion depth and mineral density of resin infiltration-treated white spot lesions against a simulated oral environment using thermal and acidic challenges in vitro. Materials and methods Two enamel slabs were prepared from each buccal surface of permanent human premolars, for a total of 56 slabs. Artificial white spot lesions were induced. One specimen was treated with resin infiltration, while the other was used as an untreated control. A micro-CT was used to assess the lesion depth and mineral density of each specimen. Subsequently, all specimens were subjected to 10,000 cycles of thermocycling and pH cycling for 10 days before being re-evaluated using the micro-CT. Lesion depth and mineral density were examined and compared between before and after aging procedures within each group by the paired sample t-test. The independent samples t-test was utilized to compare lesion depth progression and percentage change of mineral density between groups. Results After aging, there was both a significant lesion depth progression and a mineral loss in the control and resin infiltration groups. Mean lesion depth progression was 132.88 ± 4.18 µm for the control group and 52.31 ± 4.16 µm for resin infiltration group. Percentage mineral density loss as a percentage for the control and resin infiltration groups were 16.1 ± 0.64 % and 8.83 ± 0.30 %, respectively. The resin infiltration group demonstrated a significantly lower mean lesion depth progression and percentage changes in mineral loss compared to the control group. Conclusions The lesion depth and mineral density changes in the resin infiltrated-treated group were lower than untreated white spot lesions after aging procedures using thermal and acidic challenges. Clinical significance Resin infiltration is a promising approach to inhibit the progression of white spot lesions related to the initial stage of dental caries.
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Affiliation(s)
- Vongnart Predapramote
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand
| | - Yanee Tantilertanant
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand
| | - Sirivimol Srisawasdi
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand
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Meng Q, Wang Y, He J, Chen L, Meng J, Lyons K, Mei ML. The effect of combined use of resin infiltration with different bioactive calcium phosphate-based approaches on enamel white spot lesions: An in vitro study. J Dent 2024; 143:104909. [PMID: 38428717 DOI: 10.1016/j.jdent.2024.104909] [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: 11/27/2023] [Revised: 02/18/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES This in vitro study aimed to evaluate the effect of resin infiltration combined with casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) or bioactive glass (BAG) on the stability of enamel white spot lesions (WSLs) treatment. MATERIALS AND METHODS Eighty-four enamel blocks were prepared from the buccal surfaces of sound human premolars. All enamel blocks were placed in a demineralisation solution for 3 days to establish the artificial enamel WSLs. Enamel blocks with WSLs were randomly divided into three groups (n = 28 each group): RI/B: one-off resin infiltration followed by twice daily BAG treatment; RI/C: one-off resin infiltration followed by twice daily CPP-ACPF treatment; RI: one-off resin infiltration treatment only (as control) and subjected to pH cycling for 7 days. Surface morphology, elemental analysis, crystal characteristics, surface roughness and microhardness of enamel surfaces were investigated by scanning electron microscopy and energy-dispersive spectrometry observation, X-ray diffraction (XRD), atomic force microscope and Vickers' hardness testing, respectively. RESULTS Mean values of the surface roughness (mean±standard deviation (nm)) were 24.52±5.07, 27.39±5.87 and 34.36±4.55 for groups RI/B, RI/C and RI respectively (p = 0.003). The calcium to phosphate ratios were 1.32±0.16, 1.22±0.26 and 0.69±0.24 for groups RI/B, RI/C and RI respectively (p < 0.001). XRD revealed apatite formation in all three groups. The mean enamel surface microhardness (kg/mm2) of the groups were 353.93±28.49, 339.00±27.32 and 330.38±22.55 for groups RI/B, RI/C and RI respectively (p = 0.216). CONCLUSIONS Resin infiltration combined with CPP-ACPF or BAG remineralisation appears to improve the surface properties of WSLs. CLINICAL SIGNIFICANCE The combination of resin infiltration and CPP-ACPF/BAG remineralisation may be a potential treatment for the management of the WSLs.
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Affiliation(s)
- Qingfei Meng
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China; Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
| | - Yan Wang
- College of Stomatology, Bengbu Medical College, Bengbu, China
| | - Jingyu He
- Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
| | - Lijuan Chen
- Department of Stomatology, Xuzhou first People's Hospital, Xuzhou, China.
| | - Jian Meng
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China; Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China.
| | - Karl Lyons
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Liu G, Yang L, Gao L, Ma Y, Wu X, Wang X, Hao Z. Durability of infiltrated resin application on white spot lesions after different challenges: An ex vivo study. J Prosthet Dent 2024; 131:500-507. [PMID: 35256186 DOI: 10.1016/j.prosdent.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Infiltrated resin has been widely used as a minimally invasive approach to masking white spot lesions and reinforcing demineralized enamel. Recent evidence confirms its satisfactory effect in the short term, but studies focusing on its long-term performance are lacking. PURPOSE The purpose of this ex vivo study was to evaluate the durability of infiltrated resin on white spot lesions after pH cycling and long-term thermocycling, staining, and toothbrushing. MATERIAL AND METHODS Four axial surfaces of 25 extracted human molars were sectioned and fabricated as specimens. The enamel surface of each specimen was prepared in 3 areas: sound enamel, demineralized enamel (white spot lesions), and demineralized enamel treated by infiltrated resin. Then, 4 specimens of each molar were allocated to different challenges simulating a 10-year follow-up: pH cycling, thermocycling, staining, and toothbrushing. The surface roughness, microhardness, and CIELab color values were measured before and after different treatments. A scanning electron microscope (SEM) was used to observe representative specimens. Linear mixed models were used to evaluate the effect of different treatments on microhardness, roughness, and color differences (ΔE) (α=.05). RESULTS Resin infiltration reduced the surface roughness and increased the microhardness of demineralized lesions, (P<.001) but the values of sound enamel at baseline were not reached. The pH cycling led to the greatest roughness values (515.6 ±56.9 nm) on resin-infiltrated lesions, followed by thermocycling (450.7 ±64.7 nm), toothbrushing (291.2 ±43.5 nm), and staining (183.6 ±49.3 nm) (all P<.001). Only pH cycling significantly decreased the microhardness of resin-infiltrated lesions (81.6 ±14.8 HV 0.2) after progressive demineralization (P<.001). No clinically identified differences were found between resin-infiltrated white spot lesions and sound enamel (ΔE=3.4 ±2.0) at baseline. However, resin-infiltrated lesions demonstrated significantly greater discoloration after pH cycling (ΔE=8.0 ±4.5, P<.001), thermocycling (ΔE=5.4 ±2.0, P=.014), and staining treatments (ΔE=10.4 ±3.2, P<.001) than sound enamel. CONCLUSIONS Infiltrated resin application reduced surface roughness, improved microhardness, and masked white spot lesions immediately. However, it could not reestablish the characteristics of sound enamel completely and resist chemical and mechanical challenges over time.
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Affiliation(s)
- Gen Liu
- Postgraduate student, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Ling Yang
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Li Gao
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Yuanyuan Ma
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Xiangnan Wu
- Assistant Research Fellow, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Xiaodong Wang
- Associate Chief Physician, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Zhichao Hao
- Lecturer, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China.
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Ibrahim DFA, Hasmun NN, Liew YM, Venkiteswaran A. Effects of repeated etching cycles using 15% hydrochloric acid on enamel loss and relative attenuation coefficient in resin infiltration. Photodiagnosis Photodyn Ther 2024; 45:103989. [PMID: 38280674 DOI: 10.1016/j.pdpdt.2024.103989] [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: 09/24/2023] [Revised: 12/14/2023] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Resin infiltration is used to mask enamel opacities and the recommended etching cycles are three. However, anecdotal evidence suggests that favorable esthetics outcomes can be obtained by increasing the etching cycles. AIM To determine the incremental and total enamel loss when enamel surfaces are exposed to multiple etching cycles and to assess the relative attenuation coefficient after multiple etching cycles and resin infiltration treatment. METHODS Ninety extracted sound human premolars teeth were divided into 9 groups (n = 10); with each consecutive group having one additional etching cycle up to 9 cycles. The teeth were scanned with optical coherence tomography and enamel loss and attenuation coefficient were measured with MATLAB software. Enamel loss (one-way ANOVA, p ≤ 0.05) and attenuation coefficient (two-way ANOVA, p ≤ 0.05) were statistically analyzed. RESULTS There was a significant total enamel loss of more than 33% found at the 7th etching cycle and more. There was no statistically significant difference in the incremental mean depth of penetration of resin between various etching cycles (F(8, 134) = [2.016], one-way ANOVA, p = 0.185). CONCLUSION This study recommends that etching should not be repeated more than seven cycles to prevent excessive enamel loss. Following eight etching cycles, resin infiltration penetration appears approximately equal to that of healthy enamel.
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Affiliation(s)
- Dayang Fadzlina Abang Ibrahim
- Paediatric Dental Specialist Clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia; Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Noren Nor Hasmun
- Department of Oral Science, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Wilayah 50603, Persekutuan Kuala Lumpur, Malaysia
| | - Annapurny Venkiteswaran
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia.
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Bellocchio AM, Portelli M, Ciraolo L, Ciancio E, Militi A, Peditto M, Barbera S, Nucera R. Evaluation of the Clinical Variables Affecting Attachment Reproduction Accuracy during Clear Aligner Therapy. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6811. [PMID: 37895792 PMCID: PMC10607942 DOI: 10.3390/ma16206811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate some of the clinical variables that influence the accuracy of reproducing the planned attachment shape. The following clinical variables were considered: the template material, type of composite, and pressure application on the template during attachment curing. METHODS In this study, the evaluated materials for the thermoplastic transfer template construction are Erkolen 0.8 (polyethylene: PE) and Erkodur 0.8 (polyethylene terephthalate glycol-PET-G), and two types of composite resins: Enaflow (light-curing low-viscosity composite resin) and Enamel plus dentina HRI (light-curing high-viscosity composite resin). Two different light-curing lamps were used: Valo cordless color with no pressure and push light pressure (SCS). The 26 models included in the study were imported into the 3 Shape Ortho System 2022 (ver. 85.0.20 3 Shape, Denmark), and attachments were virtually placed on the dental elements of the first premolar and on both sides of the first upper molars. The accuracy of the attachment reproduction was evaluated through linear and angular evaluations against the reference model (MCAD). Three physical models were obtained: model A (MA), which was printed with attachments; model B (MB) with attachments made with a PE template; and model C (MC) with attachments made with a PET-G template. RESULTS The results showed statistically significant differences (p < 0.05) between the PE and PET-G templates with greater precision using the PET-G template. Statistically significant differences (p < 0.05) were found among the high-viscosity composite and low-viscosity composite with pressure curing. CONCLUSIONS In light of the obtained data, using a PET-G template is recommended. The pressure application during composite curing reduces the reproduction accuracy with a low-viscosity composite.
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Affiliation(s)
- Angela Mirea Bellocchio
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (M.P.); (L.C.); (E.C.); (A.M.); (M.P.); (S.B.); (R.N.)
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Chabuk MMG, Al-Shamma AMW. Surface roughness and microhardness of enamel white spot lesions treated with different treatment methods. Heliyon 2023; 9:e18283. [PMID: 37539286 PMCID: PMC10395522 DOI: 10.1016/j.heliyon.2023.e18283] [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] [Received: 04/04/2023] [Revised: 06/17/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Objective To analyse the surface roughness and microhardness of artificial enamel white spot lesions before and after WSL formation, after treatment (Opalsutre™ microabrasion, Sylc® bioactive glass, and ICON® resin infiltration), and after pH cycling with the help of the profilometer surface roughness tester and the digital Vickers microhardness tester. Materials and methods Seventy-five extracted molars were used to acquire one hundred specimens. 50 specimens were randomly assigned to five groups (n = 10) for the surface roughness study: 1) Sound group, 2) WSL group, 3) micro abrasion (MA; Opalustre, Ultradent, South Jordan, UT, USA), 4) bioactive glass 45S5 Sylc powder (Sylc; Denfotex Research Ltd, Inverkeithing, UK), and 5) ICON resin infiltration (ICON; DMG, Hamburg, Germany). An additional 25 specimens were used to obtain 50 enamel slabs for the surface microhardness study, which were also assigned to the same groups. All groups underwent a final stage of pH cycling. Surface roughness and surface microhardness measurements were performed at different stages for all groups. Results Regarding surface roughness, ICON significantly reduced the surface roughness compared to Opalustre and Sylc, with no significant difference between Opalustre and Sylc. In terms of surface microhardness, ICON showed the highest improvement, followed by Sylc and then Opalustre. Both surface roughness and microhardness were significantly affected by demineralization, partially improved after treatment, and then regressed significantly after pH cycling. Conclusion ICON resin infiltrant can be considered as a superior treatment option for improving surface roughness and microhardness, while Opalustre demonstrated relatively the poorest performance compared to the other treatment options. It is noteworthy that the pH cycling procedure had an adverse impact irrespective of the treatment option used.
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Affiliation(s)
- Mina MG. Chabuk
- Corresponding author. Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad. Al-Mansour, Baghdad, 10011, Iraq.
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Ibrahim DFA, Hasmun NN, Liew YM, Venkiteswaran A. Repeated Etching Cycles of Resin Infiltration up to Nine Cycles on Demineralized Enamel: Surface Roughness and Esthetic Outcomes-In Vitro Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1148. [PMID: 37508644 PMCID: PMC10378243 DOI: 10.3390/children10071148] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023]
Abstract
Resin infiltration (RI) is used to mask enamel opacities. There are three recommended etching cycles. However, anecdotal evidence suggests that favorable esthetics outcomes can be obtained by increasing the etching cycles. This study aimed to evaluate the effects of repeated etching cycles during RI application on esthetic changes and surface roughness of demineralized enamel at multiple treatment stages. Artificial demineralization was prepared on the buccal surface of ninety sound extracted premolars. The teeth were divided into nine groups (n = 10); with each consecutive group having one additional etching cycle up to nine etching cycles. Resin infiltrant was performed twice, first for 3 min (Resin 1) and again for 1 min (Resin 2). Surface roughness and esthetic changes were assessed using a profilometer (Ambios XP-200) and Minolta spectrophotometer, respectively, at baseline (sound enamel), etching, resin 1, resin 2, 7 days, and 28 days post resin applications. Data were analyzed with two-way ANOVA (p < 0.05). There was a significant interaction between the different stages and various groups of etching cycles on surface roughness, F(48, 126) = 3.48, p < 0.001. There was a significant interaction between the different stages and various groups of etching cycles on color changes, F(4, 126) = 1.177, p = 0.045. The surface roughness of demineralized enamel infiltrated with RI was less than that of sound enamel (baseline). There is a significant difference in color changes between resin 1 and resin 2 (p < 0.05). After five etching cycles, RI improved the esthetic of the color of teeth similar to the baseline. Surface roughness and color changes remained constant for 28 days. RI can be considered an effective and predictable treatment option for the restoration of early enamel lesions owing to its better surface characteristics and reliable masking effects. The color stability and surface roughness stay unaltered for up to 28 days.
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Affiliation(s)
- Dayang Fadzlina Abang Ibrahim
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Campus Sungai Buloh, Sungai Buloh 47000, Malaysia
| | - Noren Nor Hasmun
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Annapurny Venkiteswaran
- Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Campus Sungai Buloh, Sungai Buloh 47000, Malaysia
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de Cerqueira GA, Damasceno JE, Pedreira PR, Souza AF, Aguiar FHB, Marchi GM. Roughness and Microhardness of Demineralized Enamel Treated with Resinous Infiltrants and Subjected to an Acid Challenge: An in vitro Study. Open Dent J 2023. [DOI: 10.2174/18742106-v17-230223-2022-126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Background:
Resinous infiltrating has proven effective in arresting incipient caries lesions.
Objective:
This study aimed to assess the penetration depth of an experimental resin-infiltrant (75% - TEGDMA, 25% - Bis-EMA, 1% - EDAB, 0.5% camphorquinone), compare it with commercial infiltrant Icon®, and analyze the surface-roughness and microhardness of the resin-materials infiltrated into tooth specimens, before and after pH cycling.
Methods:
To assess penetration depth, sound third molar specimens were submitted to ten de-remineralization cycles for incipient carious lesion induction and were then randomly divided into 2 groups (n=3): (I) Experimental Infiltrant (EI) and (II) Commercial Infiltrant Icon (CI). After resin infiltration into specimens, qualitative Confocal Fluorescence Microscopy images were captured. For roughness and microhardness assessment, new specimens were demineralized, then randomly divided into two groups (n=20): (I) Experimental Infiltrant (EI) and (II) Commercial Infiltrant Icon (CI) and submitted to roughness and microhardness readouts at the following time-intervals: (T1) sound tooth, (T2) white-spot caries lesion, (T3) resin material that infiltrated, and (T4) resin material that infiltrated and was exposed to pH-cycling. In statistical analyses, generalized linear models of repeated measures in time were applied, with a significance level of 5%.
Results:
The experimental infiltrant penetrated the carious lesion and exhibited lower roughness values after its application, even after pH cycling, similar to the CI. The microhardness value of the EI group was significantly lower in the last three-time intervals evaluated compared to CI.
Conclusion:
Experimental resin infiltrant was efficient in penetrating white spot lesions and reducing surface roughness; however, it did not increase surface microhardness.
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Esteves-Oliveira M, Passos VF, Russi TMAZC, Fernandes ARR, Terto CNN, Mendonça JS, Campus G, Wierichs RJ, Meyer-Lueckel H, Lima JPM. Randomized in situ evaluation of surface polishing protocols on the caries-protective effect of resin Infiltrant. Sci Rep 2022; 12:20648. [PMID: 36450787 PMCID: PMC9712577 DOI: 10.1038/s41598-022-25091-8] [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] [Received: 09/26/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of this placebo-controlled randomized in situ study was to evaluate the effect of different surface polishing protocols on enamel roughness, bacterial adhesion and caries-protective effect of a resin infiltrant. Seventy-five bovine enamel samples having artificial caries lesions were treated with a resinous infiltrant and afterwards randomly dividided into five polishing protocols: aluminum oxide flexible disks (Al2O3-Disks), silicon carbide tips (SIC-Tips), silicon carbide brush (SIC-Brush), silicon carbide polyester strips (SIC-Strips) or no polishing [negative control (NC)]. Average surface roughness (Ra) was assessed by profilometry. Samples were mounted in palatal appliances under a mesh for biofilm accumulation. Fifteen volunteers wore the intraoral appliances (14-days) and cariogenic challenge was triggered by sucrose solutions. Biofilm formed was collected for microbiological analysis of caries-related bacteria (Streptococcus mutans, Lactobacillus acidophilus) and demineralization was assessed by cross-sectional microhardness. Mean Knoop hardness numbers (Kg/mm2) were plotted over lesion depth (µm) and area under the lesion curve was subtracted from sound enamel to determine demineralization (ΔS, Kg/mm2xµm). Data were analyzed by ANOVA and post-hoc comparisons (α = 0.05). NC resulted in significantly higher Ra means than Al2O3-Disks and SIC-Strips. Bacterial counts were not significantly different between the groups (p > 0.05). Regards ΔS means, however none of the groups were significantly different to NC (6983.3 kg/mm2xµm /CI 4246.1-9720.5, p > 0.05). Conclusions: Polishing protocols (Al2O3-Disks, SIC-Strips) significantly decreseased roughness of infiltrated-enamel, however none of the polishing protocols could signicantly decrease bacterial counts nor resulted in significant less demineralization.
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Affiliation(s)
- Marcella Esteves-Oliveira
- grid.5734.50000 0001 0726 5157Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland ,grid.8664.c0000 0001 2165 8627Department of Restorative Dentistry and Endodontology, Justus Liebig University Gießen, Gießen, Germany
| | - Vanara F. Passos
- grid.8395.70000 0001 2160 0329Department of Restorative Dentistry, Federal University of Ceara, Fortaleza, Ceara Brazil
| | | | | | - Caroline N. N. Terto
- grid.8395.70000 0001 2160 0329Department of Restorative Dentistry, Federal University of Ceara, Fortaleza, Ceara Brazil
| | - Juliano S. Mendonça
- grid.8395.70000 0001 2160 0329Department of Restorative Dentistry, Federal University of Ceara, Fortaleza, Ceara Brazil
| | - Guglielmo Campus
- grid.5734.50000 0001 0726 5157Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Richard J. Wierichs
- grid.5734.50000 0001 0726 5157Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Hendrik Meyer-Lueckel
- grid.5734.50000 0001 0726 5157Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland
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11
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Li M, Yang Z, Huang Y, Li Y, Zhou Z. In vitro effect of resin infiltrant on resistance of sound enamel surfaces in permanent teeth to demineralization. PeerJ 2022; 9:e12008. [PMID: 35047244 PMCID: PMC8759355 DOI: 10.7717/peerj.12008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 07/27/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate the effect of resin infiltrant on resistance of sound permanent enamel surfaces to demineralization. METHOD Eighty healthy premolars were sectioned to obtain enamel blocks from the buccal surface. Specimens with baseline surface microhardness values of 320-370 were selected. The experimental group were treated with resin infiltrant, while the control group was not. Specimens from each group were artificially demineralized and the surface microhardness values were measured again. Confocal laser scanning microscopy was used to measure the depth of demineralization and detect the penetration ability of the resin infiltrant. The specimens were subjected to a simulated toothbrushing abrasion test. Scanning electron microscopy was used to observe changes in the surface morphology of specimens after each of these procedures. RESULTS No significant differences between the experimental and control groups were observed in the baseline microhardness values or in the experimental group after resin infiltration compared with the baseline conditions. After artificial demineralization, the microhardness value in the control group was significantly lower than that in the experimental group (266.0 (±34.5) compared with 304.0 (±13.0), P = 0.017). Confocal laser scanning microscopy results showed that the demineralization depth in the control group was significantly deeper than that in the experimental group (97.9 (±22.8) µm vs. 50.4 (±14.3) µm, P < 0.001), and that resin infiltrant completely penetrated the acid-etched demineralized area of the tooth enamel with a mean penetration depth of 31.6 (±9.0) µm. Scanning electron microscopy showed that the surface morphology was more uniform and smoother after simulated toothbrushing. The enamel surface structure was more severely destroyed in the control group after artificial demineralization compared with that of the experimental group. CONCLUSION Resin infiltrant can completely penetrate an acid-etched demineralized enamel area and improve resistance of sound enamel surfaces to demineralization. Our findings provide an experimental basis for preventive application of resin infiltrant to sound enamel surfaces to protect tooth enamel against demineralization.
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Affiliation(s)
- Meng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zhengyan Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yajing Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yueheng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zhi Zhou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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12
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Chindane A, Patil A, Sandhyarani B. Effect of CPP-ACPF, resin infiltration, and colloidal silica infiltration on surface microhardness of artificial white spot lesions in primary teeth: An in vitro study. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.351340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Desai H, Stewart CA, Finer Y. Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review. Dent J (Basel) 2021; 9:dj9120147. [PMID: 34940044 PMCID: PMC8700643 DOI: 10.3390/dj9120147] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
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Affiliation(s)
- Hetal Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Correspondence:
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14
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Almulhim K, Khan AS, Alabdulghani H, Albasarah S, Al-Dulaijan Y, Al-Qarni FD. Effect of Ageing Process and Brushing on Color Stability and Surface Roughness of Treated White Spot Lesions: An in vitro Analysis. Clin Cosmet Investig Dent 2021; 13:413-419. [PMID: 34629906 PMCID: PMC8493663 DOI: 10.2147/ccide.s334633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/15/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the effect of ageing process and brushing on the color stability and surface roughness of white spot lesions treated with resin infiltration or remineralization. Patients and Methods Artificial white spot lesions were created on the facial surface of extracted bovine teeth. Specimens were divided into three main groups based on treatment received: resin infiltration (Icon), MI Paste Plus (MI) or no treatment (control). Specimens underwent pH cycling for 7 days, followed by brushing with toothbrush simulator. Specimens were then immersed in three different solutions (water, cranberry juice, or coffee) for 7 days. Surface roughness (SR) and color stability (CS) assessments were performed at baseline and after each test. One-way and two-way ANOVA were used to calculate the statistical comparisons between the groups and significance considered at P <0.05. Results Icon group had the least color change after pH cycling, while MI showed the least color change after brushing test. Immersion in coffee produced the highest color change in all groups, followed by cranberry juice. Icon group had the best color stability when immersed in cranberry juice or coffee. Control and the MI treated specimens showed gradual increase of SR after pH cycling and brushing test, while Icon group had improved surface properties. Brushing test alone produced less color change in comparison with immersion in cranberry juice and coffee; however, brushing increased SR. Conclusion Icon treatment showed superior color stability and surface roughness, compared to the control and the MI treated teeth. Brushing had less influence on color change compared to the immersion in cranberry juice or coffee.
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Affiliation(s)
- Khalid Almulhim
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdul Samad Khan
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hanan Alabdulghani
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sara Albasarah
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yousif Al-Dulaijan
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal D Al-Qarni
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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15
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Assessment of the Potential Ability to Penetrate into the Hard Tissues of the Root of an Experimental Preparation with the Characteristics of a Dental Infiltratant, Enriched with an Antimicrobial Component-Preliminary Study. MATERIALS 2021; 14:ma14195654. [PMID: 34640046 PMCID: PMC8510063 DOI: 10.3390/ma14195654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/26/2023]
Abstract
Infiltration is a method of penetration with a low viscosity resin that penetrates deep into demineralised tooth tissue and fills the intergranular spaces, hence reducing porosity. Carious lesions initially located at the enamel–cement junction are usually found in elderly patients. Those spots are predisposed to bacterial adhesion originating both from biofilm and from gingival pocket bacteria. The aim of this study was to evaluate the penetration of an experimental preparation, which has the characteristics of a dental infiltrant, enriched with an antibacterial component, into the decalcified root cement tissues of extracted human teeth in elderly patients. An experimental preparation with the characteristics of a dental infiltrant was prepared, applied, and polymerised on the surface of extracted, previously decalcified human teeth. The control sample was Icon (DMG, Hamburg, Germany). The ability of the preparations to penetrate deep into the root cement was evaluated using scanning electron and light microscopy. The study showed that an experimental preparation could potentially be used for treatment of early carious lesions within the tooth root in elderly patients, among others, as it penetrates deep into demineralised tissues. More research is needed.
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16
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Soveral M, Machado V, Botelho J, Mendes JJ, Manso C. Effect of Resin Infiltration on Enamel: A Systematic Review and Meta-Analysis. J Funct Biomater 2021; 12:jfb12030048. [PMID: 34449679 PMCID: PMC8395859 DOI: 10.3390/jfb12030048] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/28/2021] [Accepted: 08/12/2021] [Indexed: 12/30/2022] Open
Abstract
Subsurface enamel demineralization beneath an intact surface layer or white spots lesions (WSL) can and should be treated with non-invasive procedures to impede the development of a cavitated lesion. We aim to analyze if infiltrative resin improves enamel roughness, microhardness, shear bond strength, and penetration depth. MEDLINE [via Pubmed], Cochrane Central Register of Controlled Trials, Embase, Web of Science, Scholar, and LILACS were searched until May 2021. Methodological quality was assessed using the Joanna Briggs Institute Clinical Appraisal Checklist for Experimental Studies. Pairwise ratio of means (ROM) meta-analyses were carried out to compare the enamel properties after treatment with infiltrative resin on sound enamel and WSLs. From a total of 1604 articles, 48 studies were included. Enamel surface roughness decreased 35% in sound enamel (95%CI: 0.49–0.85, I2 = 98.2%) and 54% in WSLs (95%CI: 0.29–0.74, I2 = 98.5%). Microhardness reduced 24% in sound enamel (95%CI: 0.73–0.80, I2 = 99.1%) and increased by 68% in WSLs (95%CI: 1.51; 1.86, I2 = 99.8%). Shear bond strength reduced of 25% in sound enamel (95%CI: 0.60; 0.95, I2 = 96.9%) and increased by 89% in WSLs (95%CI: 1.28–2.79, I2 = 99.8%). Penetration depth was 65.39% of the WSLs (95%CI: 56.11–74.66, I2 = 100%). Infiltrative resins effectively promote evident changes in enamel properties in sound and WSLs. Future studies with long-term follow-ups are necessary to corroborate these results from experimental studies.
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Affiliation(s)
- Madalena Soveral
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal
- Correspondence:
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
| | - Cristina Manso
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal; (M.S.); (J.B.); (J.J.M.); (C.M.)
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17
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El Meligy OAES, Alamoudi NM, Eldin Ibrahim ST, Felemban OM, Al-Tuwirqi AA. Effect of resin infiltration application on early proximal caries lesions in vitro. J Dent Sci 2020; 16:296-303. [PMID: 33384812 PMCID: PMC7770447 DOI: 10.1016/j.jds.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background/purpose Resin infiltration (RI) material ICON is used in treating early proximal caries lesions, as it depends on a micro-invasive infiltration technology. This in vitro study aimed to evaluate the effect of ICON resin infiltration (RI) on early proximal caries by comparing surface roughness and hardness before and after treatment with RI using atomic force microscopy (AFM), automated microhardness testing system (AMHTS), and scanning electron microscopy (SEM) in vitro. Materials and methods Twenty seven premolars extracted for orthodontic reasons were sectioned buccolingually, creating 54 specimens. Each specimen was immersed in demineralizing solution to induce caries. Only teeth with "International Caries Detection and Assessment System" codes 1 and 2 were selected. The specimens were divided randomly into either AFM, AMHTS or SEM groups, which examined demineralized enamel before and after treatment with ICON. Results The mean average surface roughness and root mean square roughness values of demineralized enamel treated with ICON were significantly higher than untreated lesions (P < 0.001). The mean Vickers hardness values for demineralized enamel treated with ICON was significantly higher than untreated lesions (P < 0.001). SEM showed irregular, pitted and rough demineralized enamel surface with destruction of enamel rods and dissolution of enamel crystals. After ICON application, the surface showed complete blockage of enamel rods with RI and irregular, rough uneven topography. Conclusion RI application on proximal incipient caries increased surface roughness and hardness significantly.
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Affiliation(s)
- Omar Abd El Sadek El Meligy
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Najlaa Mohammed Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shimaa Tag Eldin Ibrahim
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama Mahmood Felemban
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amani Ahmed Al-Tuwirqi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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18
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Zakizade M, Davoudi A, Akhavan A, Shirban F. Effect of Resin Infiltration Technique on Improving Surface Hardness of Enamel Lesions: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101405. [PMID: 32473796 DOI: 10.1016/j.jebdp.2020.101405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 07/31/2019] [Accepted: 11/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE White spot lesion (WSL) is recognized as the first clinical sign of enamel caries; it is a very critical phase because it can be prevented from progression to frank caries by changing the surrounding destructive environment. The present study was undertaken to systematically review the effect of resin infiltration (RI) technique on surface hardness (SH) of WSL. METHODS Five electronic databases were searched with proper key words. Related titles and abstracts, up to October 2018, were screened, selected, and subjected to quality assessments. After collecting data, meta-analyses were carried out to compare the effect of RI with untreated WSL and sound enamel by using the STATA software. RESULTS A total of 4567 articles were included in the study after initial search. Finally, 10 studies were reliable enough in methodology to be included in the study. Metadata analyses, carried out on 7 studies that compared SH of RI group with untreated samples, showed a significant increase in SH with 3.66 mean difference (95% confidence interval = 2.56‒4.77, Q value = 36.07, I2 = 83.4%). However, meta-analysis on 4 studies that compared SH of RI with sound enamel showed a significant decrease in SH with -2.35 overall mean difference (95% confidence interval = -3.91-0.98, P = .00, Q value = 31.75, I2 = 90.6%). CONCLUSION The RI technique can enhance SH of WSL; however, regaining the SH of RI-treated WSLs similar to sound enamel is doubtful. Application of RI is more effective than other methods, including application of fluoride, enamel pro-varnish, adhesive, and colloidal silica infiltration for enhancing SH of WSLs.
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Affiliation(s)
- Mehrnaz Zakizade
- Department of Orthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Davoudi
- Dental Implants Research Center, Department of Prosthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ali Akhavan
- Dental Materials Research Center, Department of Endodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farinaz Shirban
- Dental Research Center, Department of Orthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
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Kielbassa AM, Leimer MR, Hartmann J, Harm S, Pasztorek M, Ulrich IB. Ex vivo investigation on internal tunnel approach/internal resin infiltration and external nanosilver-modified resin infiltration of proximal caries exceeding into dentin. PLoS One 2020; 15:e0228249. [PMID: 31990942 PMCID: PMC6986723 DOI: 10.1371/journal.pone.0228249] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/11/2020] [Indexed: 02/08/2023] Open
Abstract
This ex vivo proof-of-concept study aimed to investigate the effect of nanosilver particles (AgNP) added to a conventional infiltrant resin (Icon) on external penetration into natural proximal enamel caries exceeding into dentin after internal tunnel preparation and internal infiltration. Carious lesions (ICDAS codes 2/3) of extracted human (pre-)molars revealing proximal caries radiographically exceeding into dentin (E2/D1 lesions) were preselected. Then, 48 of those specimens showing demineralized areas transcending the enamel-dentin border as assessed by means of near-infrared light transillumination (DIAGNOcam) were deproteinized (NaOCl, 5%). Using an internal tunnel approach, occlusal cavities central to the marginal ridge were prepared. Excavation of carious dentin, total etch procedure (H3PO4, 40%), and internal resin infiltration (FITC-labeled) followed, along with final restorations (flowable composite resin). Outer lesion surfaces were etched (HCl, 15%) prior to external infiltration (RITC-labeled). Group 1 (control; n = 24) used non-modified infiltrant, while an infiltrant/AgNP mixture (20 nm; 5.5 wt%) was used with experimental Group 2 (n = 24). Non-infiltrated pores of cut lesions were stained (Berberine), and specimens were analyzed using confocal laser scanning microscopy. Compared to the non-filled infiltrant, incorporation of AgNP had no effect on the resin's external penetration. Between the groups, no significant differences regarding internal or external infiltration could be detected, and non-infiltrated lesion areas did not differ significantly (p>0.109; t-test). The internal tunnel preparation in combination with both an internal resin infiltration and an additional external infiltration approach using a nanosilver-modified infiltrant resin leads to increased infiltrated lesion areas, thus occluding and adhesively stabilizing the porous volume of the demineralized enamel. While exerting antimicrobial effects by the nanosilver particles, this approach should have the potential as a viable treatment alternative for proximal lesions extending into dentin, thus avoiding the sacrifice of sound enamel, postponing the frequently inevitable restoration/re-restoration cycle of conventional proximal caries treatment, and improving dental health.
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Affiliation(s)
- Andrej M. Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
- * E-mail:
| | - Marlene R. Leimer
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
| | - Jens Hartmann
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Stephan Harm
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Markus Pasztorek
- Department for Biomedical Research, Danube University, Krems, Austria
| | - Ina B. Ulrich
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria
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Ferreira JD, Flor-Ribeiro MD, Marchi GM, Pazinatto FB. The Use of Resinous Infiltrants for the Management of Incipient Carious Lesions: a Literature Review. JOURNAL OF HEALTH SCIENCES 2019. [DOI: 10.17921/2447-8938.2019v21n4p358-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractThe objective of this work was to analyze scientific evidence from a literature review pertaining to the effectiveness of resinous infiltrants for minimally invasive treatment of incipient carious lesions. Studies published between 2002 and 2019 were queried from the following databases: Capes, PubMed, Medline, BBO, Lilacs and SciELO. The search keywords included "Dental Caries", "Tooth Remineralization", "Dental Leakage". Most of the studies found resin-infiltrating treatment to be a viable option for the minimally invasive treatment of incipient carious lesions; this treatment was able to fulfill the primary expected effects: inhibition of carious progression and the lesions esthetic improvement. However, some issues need to be clarified to improve the safety of this treatment because it can be recommended in clinical practice. In conclusion, the use of resinous infiltrants has been reported as promising for the treatment of incipient carious lesions. However, there is a need for long-term studies to confirm the effectiveness of this treatment to determine its applicability for clinical use. Keywords: Dental Caries. Dental Leakage. Tooth Remineralization. ResumoO objetivo desse trabalho foi analisar evidências científicas, por meio de uma revisão de literatura, sobre a eficácia do uso de infiltrantes resinosos para o tratamento minimamente invasivo de lesões cariosas incipientes. A seleção do material literário utilizado foi realizada por pesquisa sobre o tema nas bases de dados: portal de periódicos Capes, PubMed, Medline, BBO, Lilacs e SciELO, abrangendo prioritariamente, o período de 2002 a 2019. Para busca nas bases de dados foram utilizadas palavras-chave como “Cárie Dentária”, “Remineralização Dentária”, “Infiltração Dentária”, assim como suas correspondentes na língua inglesa. A maioria dos estudos encontrados aponta o tratamento infiltrante resinoso como uma opção viável para o tratamento minimamente invasivo de lesões cariosas incipientes sendo capaz de cumprir os principais efeitos esperados: inibição da progressão cariosa e melhoria estética das lesões. Entretanto, alguns impasses necessitam ser esclarecidos para que o tratamento seja recomendado com mais segurança na prática clínica. Conclui-se que o uso de infiltrantes resinosos tem sido relatado como promissor para o tratamento de lesões cariosas incipientes, contudo há necessidade de novas pesquisas e estudos a longo prazo para confirmar sua eficácia em todos aspectos desejáveis para seu uso clínico. Palavras-chave: Cárie Dentária. Infiltração Dentária. Remineralização Dentária.
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21
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FLOR-RIBEIRO MD, GRAZIANO TS, AGUIAR FHB, STIPP RN, MARCHI GM. Effect of iodonium salt and chitosan on the physical and antibacterial properties of experimental infiltrants. Braz Oral Res 2019; 33:e075. [DOI: 10.1590/1807-3107bor-2019.vol33.0075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 05/25/2019] [Indexed: 11/22/2022] Open
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