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Erkmen Almaz M, Ulusoy NB, Akbay Oba A, Dokumacı A. Remineralization effect of NaF, NaF with TCP, NaF with CPP-ACP and NaF with CXP varnishes on newly erupted first permanent molars: A randomized controlled trial. Int J Dent Hyg 2024; 22:703-710. [PMID: 37831601 DOI: 10.1111/idh.12778] [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: 03/24/2023] [Revised: 06/23/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the remineralization effect of NaF, NaF with TCP, NaF with CPP-ACP and NaF with CXP varnishes on newly erupted first permanent molars using laser fluorescence (LF) method. The study was a randomized, double-blind, controlled trial with four parallel groups. METHODS The study was carried out in 48 high caries-risk children (DMFS >8), aged 6-7 years with newly erupted permanent first molars (initial lesion with 13 < LF value<30). A total of 140 teeth were divided randomly into four groups (n = 35): G1.Duraphat Varnish containing 5% NaF, G2. Clinpro™ White Varnish containing 5% NaF with TCP, G3.Embrace™ Varnish containing 5% NaF with CXP, G4. MI Varnish containing 5% NaF with CPP-ACP. All dental treatments of the patients were completed before the varnish application. The varnishes were applied to the targeted teeth at baseline, 1 and 3 months. Patients were called for follow-up appointments at 1, 3 and 6 months, and LF scanning was used to monitor mineralization changes. Data were analysed statistically by Wilcoxon signed-rank and Mann-Whitney U-tests. RESULTS In total, 40 children (122 teeth) completed the trial. At the end of 6 months, the amount of reduction in LF values (indicating remineralization) are as follows: NaF with CXP(6.87 ± 4.32) < NaF with TCP(7.36 ± 7.05) < NaF(7.40 ± 7.03) < NaF with CPP-ACP(8.33 ± 4.90). All of the varnishes resulted in significant decrease in LF measurements and there was no significant difference between control (NaF alone) group and other groups. Only MI varnish had a significantly greater remineralization effect than Embrace™ Varnish (p < 0.05). CONCLUSION As a non-invasive approach, CPP-ACP, TCP and CXP containing NaF varnishes have the potential to remineralize initial caries lesions on permanent first molars in high caries-risk children.
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Manchanda S, Liu P, Sardana D, Peng S, Lo EC, Yiu CK. Randomized clinical trial to compare three fluoride varnishes in preventing early childhood caries. J Dent 2024; 147:105141. [PMID: 38901821 DOI: 10.1016/j.jdent.2024.105141] [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: 05/18/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVES To compare the effectiveness of two 5% sodium fluoride (NaF) varnishes containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) (MI VarnishTM) or tricalcium phosphate (TCP) (ClinproTM White) to the conventional 5% NaF varnish (Duraphat®) in preventing early childhood caries (ECC) in high-risk preschool children. METHODS A double-blinded, randomized controlled trial recruited healthy 3-4-year-old children (N = 582) having at least one carious lesion (pre-cavitated or cavitated) after obtaining written informed consent from parents. Using a computer-generated random-number table, children were assigned to one of the 3 groups: Control group (n = 196): 5% NaF varnish (Duraphat®) or two test groups: 5% NaF with TCP (Clinpro™ White) (n = 193) and 5% NaF varnish with CPP-ACP (MI Varnish™) (n = 193) to receive quarterly (every 3 months) application over 24 months. RESULTS Incidence of new caries over 2 years was 59.2% in MI Varnish™ group (n = 125), 65.1% in the Clinpro™ White group (n = 129) and 66.1% in the Duraphat® group (n = 127) (p = 0.466). The mean cavitated lesions increment was not significant among the 3 groups (p = 0.714), as was the mean increment in non-cavitated carious lesions (p = 0.223). There was no significant difference (p = 0.630) in the distribution of total fluoride varnish applications among the three groups. Also, no significant difference was found in comparison of outcomes among the different number of fluoride varnish applications received by children in each group. CONCLUSIONS Both calcium- and phosphate-containing NaF varnishes showed similar efficacy against cavitated and non-cavitated carious lesions as compared to conventional NaF varnish in high-risk preschool children. CLINICAL SIGNIFICANCE Randomized trial provided a crucial opportunity to advance the understanding of the clinical effectiveness of different fluoride varnishes in preventing early childhood caries. Varnishes containing tricalcium phosphate or casein phosphopeptide amorphous calcium phosphate when compared to sodium fluoride varnish, demonstrated a similar efficacy against early childhood caries in high caries-risk preschool children.
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Affiliation(s)
- Sheetal Manchanda
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China
| | - Pei Liu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China
| | - Divesh Sardana
- Pediatric Dentistry, The University of Oklahoma College of Dentistry, Oklahoma, USA
| | - Simin Peng
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China
| | - Edward Cm Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Cynthia Ky Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China.
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Hamed S, Abd El Latief MH, El-Wassefy NA, Montasser MA. Fluoride-amorphous calcium phosphate and biomimetic nano-hydroxyapatite for enamel remineralization: An in-vitro study of surface microhardness and composition. Int Orthod 2024; 22:100865. [PMID: 38457899 DOI: 10.1016/j.ortho.2024.100865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/10/2024]
Abstract
AIM Fluoride-Amorphous Calcium Phosphate and Biomimetic Nano-Hydroxyapatite for Enamel Remineralization; An In-Vitro Study of Surface Microhardness and Composition. MATERIAL AND METHODS Ninety-six extracted human premolars with sound buccal surface were divided using a randomization computer-generating software into four groups; Group I (control) sound untreated enamel, Group II (demineralized) demineralized to create white spot lesions, Group III (biom-n-HA) demineralized and then treated with biomimetic nanohydroxyapatite cream, and Group IV (F-ACP) demineralized and then treated using Fluoride-Amorphous Calcium Phosphate varnish. Each group was divided into two subgroups; subgroup "A" evaluated for mineral content using energy dispersive x-ray spectroscopy (EDX) and for surface microhardness using the Vickers microhardness test and Subgroup "B" evaluated for white spot lesion depth using a polarized light microscope (PLM). RESULTS The highest microhardness (VHN) was found in the (F-ACP) group (mean=428.61±54.43) and then in the (Biom-n-HA) group (mean=408.11±70.16) followed by the (Control) group (mean=402.13±53.40) with no significant difference between them and finally in the significantly different (Demineralized) group (mean=256.99±45.83). The weight percentage of Ca (30.29±1.04 and 33.44±1.07) and Ca/P ratio (1.87±0.06 and 2.03±0.05) were significantly different between Group III and Group IV respectively. PLM measurements in Group II (198.83μm), Group III (60.17μm), and Group IV (26.33μm) were significantly different. CONCLUSIONS Both the (Biom-n-HA) cream and the (F-ACP) varnish showed promising results for enamel remineralization. The increased enamel surface microhardness was consistent with the mineral content and the changes in the birefringence.
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Affiliation(s)
- Sameh Hamed
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt
| | | | - Noha A El-Wassefy
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt
| | - Mona A Montasser
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt.
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Mainente MP, Naves PA, de Campos PH, Rodrigues MC, Diniz MB, Zaroni WCDS, Cardoso CDAB. Inhibition of incipient caries lesion progression by different fluoridated varnishes. Braz Dent J 2024; 35:e245616. [PMID: 38775592 PMCID: PMC11086610 DOI: 10.1590/0103-6440202405616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/19/2024] [Indexed: 05/25/2024] Open
Abstract
The aim of this in vitro study was to evaluate the potential of different fluoridated varnishes to inhibit the progression of incipient caries lesions after cariogenic challenge. Seventy-five enamel specimens of bovine teeth were prepared and selected based on the initial surface microhardness (SMH). The specimens were first subjected to artificial demineralization (in buffer solution) after which SMH was re-analyzed (SM1). They were then randomly assigned to five experimental groups: 1- CONTROL (pH cycling), 2 - MI VAR (MI Varnish with RECALDENTTM - CPP-ACP), 3 - PROFL (Profluorid®), 4 - CLIN (ClinproTM White Varnish with TCP), and 5 - DUR (Duraphat®) (n=15). The varnishes were applied in a thin layer and the specimens were then subjected to pH cycling for eight days. The SMH and cross-sectional microhardness (CSMH) were then analyzed (SM2). The fluoride and calcium ion concentrations in the solution were analyzed by the indirect method and atomic absorption spectrophotometry, respectively. Data were statistically analyzed by Student's t-test, ANOVA/Tukey-Kramer, or Kruskall-Wallis/Dunn tests for individual comparisons (p˂0.05). All varnishes led to significantly higher surface and subsurface remineralization compared with the control group but did not differ from each other. The varnishes with the highest fluoride release were: PROFL and CLIN, followed by MI VAR and DUR. The varnishes with significantly higher release of calcium were: DUR, CLIN, and PROFL. In conclusion, all commercial fluoridated varnishes tested have good potential to inhibit the progression of demineralization, regardless of the ion release mechanisms.
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Affiliation(s)
| | - Paula Andery Naves
- Graduate Program in Dentistry, Cruzeiro do Sul University. São Paulo-SP, Brazil
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Alazmah A. Assessment of Remineralization Ability of Different Fluoride Varnishes on Artificial Enamel Lesion of Primary Teeth - A Comparative Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1594-S1597. [PMID: 38882862 PMCID: PMC11174162 DOI: 10.4103/jpbs.jpbs_1090_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 06/18/2024] Open
Abstract
Aim The current study's aim was to evaluate the potential of various fluoride varnishes to remineralize artificial enamel lesions on primary teeth. Materials and Methods For the study, 90 deciduous molar teeth that were implicated for extraction were taken. A window region with a size of 3 × 3 mm was located in the middle of the tooth's coronal surface. The remaining portion was given a coat of nail polish and given time to dry. A demineralizing solution was used to create the artificial enamel lesion. The samples were randomized into three experimental groups at random, with 30 samples in each group. Group 1: Application of Clinpro White Varnish, Group 2: Application of Duraphat Varnish, and Group 3: Application of MI Varnish. After 14 days, samples from each group were examined under scanning electron microscopy at a magnification of 1000× to determine whether remineralization had occurred. Microhardness was also determined using a microhardness tester. Result Before the intervention, the mean demineralized enamel lesion in the Clinpro White Varnish group was 134.44 ± 0.04, in the Duraphat Varnish group was 133.76 ± 0.12, and in the MI Varnish group was 133.89 ± 0.08. After intervention, the maximum remineralized area was found in the MI Varnish group (82.74 ± 0.18) followed by the Clinpro White Varnish group (101.43 ± 0.16) and the Duraphat Varnish group (104.11 ± 0.10). After the intervention, there was a statistically significant difference found between the groups. After the intervention, the maximum microhardness mean value improved in the MI Varnish group (257.03 ± 1.09 to 261.18 ± 1.20) followed by Clinpro White Varnish (258.78 ± 1.64 to 260.10 ± 1.22) and Duraphat Varnish group (255.24 ± 1.51 to 258.02 ± 0.89). Conclusion According to the findings of the current investigation, all of the varnishes utilized in this in vitro experiment are capable of correcting early enamel defects on primary teeth. However, MI Varnish group was very effective compared to the Clinpro White Varnish group and the Duraphat Varnish group.
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Affiliation(s)
- Abdulfatah Alazmah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
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Juntavee A, Juntavee N, Pongpanatnukul C, Kruemai K, Limrachtamorn T. Remineralization potential of apacider mangosteen adhesive pastes on artificial carious lesions. J Dent Sci 2024; 19:978-989. [PMID: 38618135 PMCID: PMC11010799 DOI: 10.1016/j.jds.2023.07.012] [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: 06/24/2023] [Revised: 07/08/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Attention to caries administration has altered toward an early finding of lesions and targeted to noninvasive management with a remineralizing agent. This study compared the remineralization potential of apacider mangosteen adhesive pastes (AMAP), 500-ppm fluoride toothpaste (FT500), and 1000-ppm fluoride toothpaste (FT1000) on artificial caries. Materials and methods Artificial caries were generated to enamel of eighty extracted human premolars. The specimens were allocated to four groups and subjected to pH-cycling with the application of testing agents (2 min each, for 10 days): (1) AMAP, dairy, (2) FT500, twice a day, (3) FT1000, twice a day, and (4) no treatment (NT). The surface microhardness was determined before demineralization, after demineralization, and after application of pH-cycling. The hardness, percent of hardness recovery (%HR), and percent of remineralization potential (%RP) were analyzed with ANOVA and Bonferroni's test (α = 0.05). Polarized light microscopy (PLM) was assessed for lesion depth. Results Significant differences in remineralization were observed upon various agents compared to NT (P < 0.05). A significant difference in remineralization was found among AMAP, FT1000, and FT500 (P < 0.05). No significant difference in %HR and %RP was observed between AMAP and FT1000 (P > 0.05). PLM signified greater decrease in depth for AMAP, compared to FT1000 and FT500, but no depth reduction for NT. Conclusion AMAP possesses comparable remineralization ability to FT1000. However, decreasing in depth of carious lesions was evinced with using AMAP more than FT1000 and FT500. AMAP was recommended as a potential remineralization material for handling initial caries.
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Affiliation(s)
- Apa Juntavee
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Niwut Juntavee
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Chanamon Pongpanatnukul
- Division of Biomaterials and Pediatric Dentistry Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Kiraleen Kruemai
- Division of Biomaterials and Pediatric Dentistry Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Thaviporn Limrachtamorn
- Division of Biomaterials and Pediatric Dentistry Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Jiang W, Wang G, Wu W, Shao C, Pan H, Chen Z, Tang R, Chen Z, Xie Z. The effect of calcium phosphate ion clusters in enhancing enamel conditions versus Duraphat and Icon. AUST ENDOD J 2023; 49 Suppl 1:46-57. [PMID: 36127810 DOI: 10.1111/aej.12689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 07/25/2022] [Accepted: 09/03/2022] [Indexed: 12/14/2022]
Abstract
This study aimed to evaluate and compare the remineralisation, mechanical, anti-aging, acid resistance and antibacterial properties of calcium phosphate ion clusters (CPICs) materials with those of Duraphat and Icon. The remineralisation and mechanical properties were investigated using scanning electron microscopy, Fourier-transform infrared (FTIR) spectroscopy and nanoindentation. CPICs induced epitaxial crystal growth on the enamel surface, where the regrown enamel-like apatite layers had a similar hardness and elastic modulus to natural enamel (p > 0.05). Acid resistance and anti-aging properties were tested based on ion dissolution and surface roughness. CPICs exhibited similar calcium and phosphate ion dissolution to the control (p > 0.05), and its roughness decreased after thermocycling (p < 0.05), thereby decreasing the risk of enamel surface demineralisation. The minimum inhibitory concentration was 0.1 mg/ml, and the minimum bactericidal concentration ranged from 0.05 to 0.1 mg/ml. Overall, this biomimetic CPICs is a promising alternative to dental demineralisation.
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Affiliation(s)
- Wen Jiang
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Diseases of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Gang Wang
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Diseases of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenzhi Wu
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Diseases of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Changyu Shao
- Department of Chemistry, Center for Biomaterials and Biopathways, Zhejiang University, Hangzhou, Zhejiang, China
| | - Haihua Pan
- Department of Chemistry, Center for Biomaterials and Biopathways, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Ruikang Tang
- Department of Chemistry, Center for Biomaterials and Biopathways, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhuo Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Diseases of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhijian Xie
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Diseases of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
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Mashhour A, Allam G, Wassel M. Comparative evaluation of prevention of demineralization of artificial enamel caries treated with two fluoride varnishes and 38% SDF in primary teeth: an in vitro study. BMC Oral Health 2023; 23:110. [PMID: 36803462 PMCID: PMC9938617 DOI: 10.1186/s12903-023-02799-1] [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: 09/10/2022] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND This study aimed to compare the effect of Clinpro™ White varnish containing 5% sodium fluoride (NaF) and functionalized tricalcium phosphate, MI varnish containing 5% NaF and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 38% Silver diamine fluoride (SDF) in preventing demineralization of treated white spot lesions (WSLs) in enamel of primary teeth. METHODS Forty-eight primary molars with artificial WSLs were allocated into four groups as follows: Group 1: Clinpro white varnish, Group 2: MI varnish, Group 3: SDF, and Group 4: control (no treatment). The three surface treatments were applied for 24 h and then enamel specimens were subjected to pH cycling. Thereafter, the mineral content of specimens was evaluated by Energy Dispersive X-ray Spectrometer and the lesion depth was assessed via Polarized Light Microscope. One-way ANOVA followed by Tukey's post hoc test were used at p ≤ 0.05 to identify significant differences. RESULTS Insignificant difference in mineral content was observed among treatment groups. Treatment groups exhibited significantly higher mineral content compared to control except for Fluoride (F). MI varnish showed the highest mean calcium (Ca) ion content (66.57 ± 0.63), and Ca/P (2.19 ± 0.11), followed by Clinpro white varnish, and SDF. MI varnish also displayed the highest phosphate (P) ion content (31.46 ± 0.56), followed by SDF (30.93 ± 1.02), and Clinpro white varnish (30.53 ± 2.19). Fluoride content was highest in SDF (0.93 ± 1.18), followed by MI (0.89 ± 0.34) and Clinpro (0.66 ± 0.68) varnishes. Significant difference in lesion depth was observed among all groups (p < 0.001). The lowest mean lesion depth (µm) was found in MI varnish (226.23 ± 44.25) which was significantly lower than Clinpro white varnish (285.43 ± 44.70), SDF (293.32 ± 46.82), and control (576.69 ± 42.66). Insignificant difference in lesion depth was found between SDF and Clinpro varnish. CONCLUSIONS In primary teeth, WSLs treated with MI varnish displayed better resistance to demineralization compared to WSLs treated with Clinpro white varnish and SDF.
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Affiliation(s)
- Alshaimaa Mashhour
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566, Egypt.
| | - Gehan Allam
- grid.7269.a0000 0004 0621 1570Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566 Egypt
| | - Mariem Wassel
- grid.7269.a0000 0004 0621 1570Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566 Egypt
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Sköld UM, Birkhed D, Xu JZ, Lien KH, Stensson M, Liu JF. Risk factors for and prevention of caries and dental erosion in children and adolescents with asthma. J Dent Sci 2022; 17:1387-1400. [PMID: 35784121 PMCID: PMC9236939 DOI: 10.1016/j.jds.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/16/2022] [Indexed: 11/07/2022] Open
Abstract
There are many studies and reviews of the relationship between the asthma disease in young individuals on the one hand and caries and dental erosion on the other. The causes of caries and dental erosion might be related to the asthmatic drugs, low pH and the sweeteners that the inhaled drug contains and perhaps even the lifestyle of children and adolescents with asthma. The main focus of this review is therefore to describe various preventive strategies, based on long experience of preventive dental care in Sweden. Two fact boxes are presented, one on fluoride toothpaste as a population-based intervention for different ages and one on diet counselling in children and adolescents with asthma. The most important thing is to introduce fluoride toothpaste early in the child's life and that the parents brush the child's teeth twice a day, in the morning after breakfast and at night before bedtime, up to the age of 10. Moreover, a high-risk approach with an additional fluoride supply at home is presented, together with the application of fluoride varnish at the clinic. Regarding diet counselling, it is important to make sure that the child has regular meals during the day, maximum five to six times a day, to allow the teeth to rest between meals and restrict sweets and soft drinks to once a week. It is important to identify children and adolescents with asthma as early as possible and to refer them to a dental team for preventive treatment.
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Affiliation(s)
| | - Dowen Birkhed
- Former: Department of Cariology, University of Gothenburg, Göteborg, Sweden
| | - Jian-Zhi Xu
- Pediatric Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kai-Hua Lien
- Pediatric Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Malin Stensson
- Centre of Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Jeng-Fen Liu
- Pediatric Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Shetty RS, Bhat SS, Hegde SK, Bhat VS. Effect of Fluoride-based Varnishes with Added Calcium and Phosphate on Microhardness of Esthetic Restorative Materials: An In Vitro Study. Int J Clin Pediatr Dent 2022; 15:187-193. [PMID: 37457210 PMCID: PMC10338949 DOI: 10.5005/jp-journals-10005-2367] [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] [Indexed: 11/02/2023] Open
Abstract
Background and objectives Fluoride varnishes are being used to prevent caries in children. The high concentration of fluoride in varnishes apart from caries prevention may cause changes in surface properties of esthetic restorations. The study aims to evaluate and compare the effect of four commercially available fluoride varnishes with added calcium and phosphate on microhardness of three esthetic materials namely conventional GIC (Fuji II), high viscosity GIC (Fuji IX), and nanocomposite (Filtek Z350). Materials and methods A total of 28 pellets were made of each material and stored in distilled water at 37 °C for 48 hours. The microhardness of the pellets was tested which served as a baseline. These were then randomly divided into four subgroups. In one subgroup Profluorid varnish was applied, second subgroup MI varnish was applied, third subgroup Embrace varnish was applied, and in the fourth subgroup Enamel Pro varnish was applied as per protocol. Thereafter, all the pellets were subjected to microhardness testing (load = 100 g for 15 seconds). Results The fluoride varnishes increased the microhardness of conventional GIC (Fuji II) whereas in case of high viscosity GIC (Fuji IX) the application of varnishes reduced the microhardness. In case of nanocomposite restorative material (Filtek Z350) only Profluorid varnish increased its microhardness. Conclusion Fluoride varnish and calcium-phosphate containing fluoride varnish effect on the microhardness of restorative material is material dependent. So, the choice of fluoride varnish with or without proprietary additives depends on the nature and composition of the restorative material. How to cite this article Shetty RS, Bhat SS, HK Sundeep, et al. Effect of Fluoride-based Varnishes with Added Calcium and Phosphate on Microhardness of Esthetic Restorative Materials: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(2):187-193.
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Affiliation(s)
- Raksha S Shetty
- Department of Pediatric and Preventive Dentistry, Yenepoya Dental College, Mangaluru, Karnataka, India
| | - Sham S Bhat
- Department of Pediatric and Preventive Dentistry, Yenepoya Dental College, Mangaluru, Karnataka, India
| | - Sundeep K Hegde
- Department of Pediatric and Preventive Dentistry, Yenepoya Dental College, Mangaluru, Karnataka, India
| | - Vidya S Bhat
- Department of Prosthodontics, Yenepoya Dental College, Mangaluru, Karnataka, India
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Fluoride and calcium release from peppermint-flavored fluoride varnish containing dicalcium-phosphate-dihydrate coated with xylitol. Saudi Dent J 2022; 34:68-73. [PMID: 35068901 PMCID: PMC8767249 DOI: 10.1016/j.sdentj.2021.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/22/2022] Open
Abstract
Bakground: Fluoride varnish with high initial fluoride and calcium release can help patients with high-risk caries. Ample quantities of free fluoride and calcium ions in the oral cavity can enhance enamel remineralization. This study aimed to investigate the effect of dicalcium phosphate dihydrate coated with xylitol (DCPD-xylitol), in fluoride varnish, on the release of fluoride and calcium ions in the oral cavity. Materials and methods DCPD powder with xylitol was synthesized by preparing a 60% xylitol solution and mixed it with DCPD solution. The mixture was stirred for 1 h at room temperature and dried at 80 °C for 18 h to reduce the water content. Then, the powder was used in the formulation of peppermint-flavored fluoride varnish as an active agent. The amounts of fluoride and calcium ion released in deionized water at 37 °C for 6 h were assessed with an ion-selective electrode. The cumulative fluoride and calcium ion release data were analyzed using one-way analysis of variance (ANOVA) and the post hoc Tukey test with α = 0.05. Results The results showed that the addition of DCPD coated with xylitol provided better bioavailability of the ions than DCPD without coating. Peppermint-flavored fluoride varnish (PFFV) with DCPD-xylitol 1% gave the highest fluoride ion release (296.90 mg/L) compared to the varnishes with other xylitol concentrations and the positive control. In contrast, PFFV DCPD-xylitol 5% afforded the highest calcium ion release at 111.20 mg/L. Conclusions This study concluded that xylitol affects the bioavailability of free fluoride and calcium ions in varnishes. However, the efficacy of fluoride and calcium uptake in enamel and under different in vitro media conditions requires further investigation.
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Machado AC, Maximiano V, Yoshida ML, Freitas JG, Mendes FM, Aranha ACC, Scaramucci T. Efficacy of a calcium-phosphate/fluoride varnish and ionomeric sealant on cervical dentin hypersensitivity: A randomized, double-blind, placebo-controlled clinical study. J Oral Rehabil 2021; 49:62-70. [PMID: 34676918 DOI: 10.1111/joor.13270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/06/2021] [Accepted: 10/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dentin hypersensitivity (DH) is a common problem in the population that can have a significant impact on the quality of life of those who suffer from the condition. OBJECTIVES Compare the efficacy of two treatments for DH: Ca/PO4 - /F- varnish (Clinpro White Varnish) and ionomeric sealant (IS) (Clinpro XT Varnish) with a placebo. METHODS Participants (121) with at least one tooth with visual analogue scale (VAS) score of 4 and above were randomly and blindly allocated to the groups. Treatments were performed by a trained researcher. DH was evaluated by another blind researcher after the treatment and after 1 week, 4 weeks, 3 months and 6 months. After 4 weeks, placebo received the DH treatment with IS; thus, the participants were not assessed after 3 and 6 months. Primary outcome was DH reduction after 4 weeks. Differences in VAS scores in the other time intervals and entire values of VAS were considered secondary outcomes. Comparisons were made among the groups (α = 0.05). RESULTS IS showed the highest VAS value difference between baseline and 4 weeks (mean ± SD: 3.7 ± 2.2), differing significantly from placebo (2.3 ± 1.7) and Ca/PO4/F- varnish (2.6 ± 2.0). Ca/PO4- /F- varnish did not differ from placebo. In all time intervals, VAS values of all groups were significantly lower than the baseline value, without differences among groups. For the long-term differences in VAS values (3 and 6 months), the IS exhibited significantly higher values than Ca/PO4- /F- varnish. CONCLUSIONS The IS was the most efficacious product for reducing DH, whereas Ca/PO4- /F- varnish did not differ from placebo. Registered in ClinicalTrials.gov (NCT04591444).
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Affiliation(s)
- Alana Cristina Machado
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vinícius Maximiano
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mirian Lumi Yoshida
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Julia Gomes Freitas
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ana Cecilia Corrêa Aranha
- Special Laboratory of Lasers (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Taís Scaramucci
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Abufarwa M, Noureldin A, Dziak R, Covell D. Efficacy of CPP-ACP fluoride varnish applied with and without acid etching in preventing enamel demineralization compared to light-curable fluoride varnish. Angle Orthod 2021; 92:213-219. [DOI: 10.2319/050121-345.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/01/2021] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
Objectives
To compare efficacy of casein phosphopeptide (CPP)–amorphous calcium phosphate (ACP) fluoride varnish and light-curable resin modified glass ionomer fluoride varnish (FV) in preventing white spot lesions and evaluating acid etching prior to CPP-ACPFV application on its efficacy.
Materials and Methods
Molars and premolars were transected and halves divided into four groups (n = 18/group): (1) resin-modified glass ionomer FV: etched and Clinpro-XT varnish (3M ESPE, Pymble, New South Wales, Australia) application; (2) CPP-ACPFV: MI varnish (GC America, Alsip, IL) application; (3) Etch+CPP-ACPFV: etched and MI varnish application; (4) Control: etched and no surface treatment. To simulate 12 weeks in an intraoral environment, samples were subjected to thermocycling, brushing, and pH cycling. Enamel surface microhardness was evaluated at baseline and after the simulated 12 weeks. Representative samples were also assessed using scanning electron microscopy (SEM).
Results
At baseline there was no significant difference in microhardness among groups. After the simulated 12 weeks, all groups showed significant within-group differences (P < .001). Control showed the highest percentage loss of surface microhardness (89%), followed by CPP-ACPFV (58%), RMGIFV (51%), and Etch+CPP-ACPFV (24%). The control group had a significant decrease in microhardness compared to all experimental groups (P < .001). No difference was found between the RMGIFV and CPP-ACPFV varnish groups. The Etch+CPP-ACPFV group had significantly less decrease in microhardness compared to the RMGIFV (P < .001) and CPP-ACPFV groups (P < .001). With SEM, control samples showed signs of enamel surface damage, while experimental groups showed spherical particles on a relatively intact surface.
Conclusions
RMGIFV and CPP-ACPFV are effective in reducing enamel demineralization. Acid etching the enamel surface prior to CPP-ACPFV varnish application increased its efficacy.
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Poza-Pascual A, Serna-Muñoz C, Pérez-Silva A, Martínez-Beneyto Y, Cabello I, Ortiz-Ruiz AJ. Effects of Fluoride and Calcium Phosphate-Based Varnishes in Children at High Risk of Tooth Decay: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910049. [PMID: 34639351 PMCID: PMC8508447 DOI: 10.3390/ijerph181910049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effect of the application of two varnishes-MI Varnish (5% sodium fluoride with CPP-ACP) and Clinpro White Varnish (5% sodium fluoride with fTCP)-applied every three months in children with high caries risk for 12 months on plaque indexes, salivary pH, salivary lactic acid and chemical elements concentrations. METHODS We included 58 children aged 4-12 years, assigned to control (placebo), Clinpro and MI groups. Baseline and three-month saliva samples were taken. We assessed changes in pH, lactic acid concentrations and chemical elements in saliva. RESULTS At 12 months, all groups showed a nonsignificant increase in pH levels and a reduction in lactic acid, which was greatest in the placebo group. There was a significant reduction in 24Mg (p = <0.001), 31P (p = 0.033) and 66Zn (p = 0.005) levels in the placebo group (p ≤ 0.05), but not in the other elements studied: 23Na, 27Al, 39K, 44Ca, 52Cr, 55Mn, 57Fe, 59Co, 63Cu, 75As, 111Cd, 137Ba, 208Pb and 19F. CONCLUSIONS Neither pH, lactic acid concentrations or most salivary chemical elements were useful in defining patients at high risk of caries or in monitoring the effect of MI Varnish and Clinpro White Varnish after three-month application for 12 months. However, the appearance of new cavities was stopped, and the hygiene index improved, probably due to hygienic and dietary measures and the use of fluoridated toothpaste. TRIAL REGISTRATION ISRCTN registry, ISRCTN13681286.
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Affiliation(s)
- Andrea Poza-Pascual
- Department of Stomatology I, School of Dentistry, University of the Basque Country, 48940 Lejona, Spain;
| | - Clara Serna-Muñoz
- Department of Integrated Pediatric Dentistry, School of Dentistry, University of Murcia, Biomedical Research Institute of Murcia, 30008 Murcia, Spain; (C.S.-M.); (A.P.-S.); (I.C.); (A.J.O.-R.)
| | - Amparo Pérez-Silva
- Department of Integrated Pediatric Dentistry, School of Dentistry, University of Murcia, Biomedical Research Institute of Murcia, 30008 Murcia, Spain; (C.S.-M.); (A.P.-S.); (I.C.); (A.J.O.-R.)
| | - Yolanda Martínez-Beneyto
- Department of Integrated Pediatric Dentistry, School of Dentistry, University of Murcia, Biomedical Research Institute of Murcia, 30008 Murcia, Spain; (C.S.-M.); (A.P.-S.); (I.C.); (A.J.O.-R.)
- Correspondence:
| | - Inmaculada Cabello
- Department of Integrated Pediatric Dentistry, School of Dentistry, University of Murcia, Biomedical Research Institute of Murcia, 30008 Murcia, Spain; (C.S.-M.); (A.P.-S.); (I.C.); (A.J.O.-R.)
| | - Antonio José Ortiz-Ruiz
- Department of Integrated Pediatric Dentistry, School of Dentistry, University of Murcia, Biomedical Research Institute of Murcia, 30008 Murcia, Spain; (C.S.-M.); (A.P.-S.); (I.C.); (A.J.O.-R.)
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The effect of new anti-adhesive and antibacterial dental resin filling materials on gingival fibroblasts. Dent Mater 2021; 37:1416-1424. [PMID: 34253351 DOI: 10.1016/j.dental.2021.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/14/2021] [Accepted: 06/19/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Aim of this study was to evaluate the biocompatibility of four experimental antiadhesive and antibacterial dental filling composites on human gingival fibroblasts (HGFs). METHODS For these experimental resin composites a delivery system based on novel polymeric hollow beads, loaded with Tego Protect (Aa1), Dimethicone (Aa2), Irgasan (Ab1) and methacrylated polymerizable Irgasan (Ab2) as active agents was used. The cultured HGFs' cell integrity, proliferation, viability, collagen synthesis and cytokine release were measured. For this purpose, human gingival fibroblasts were treated with eluates from all four composites and compared with an experimental standard composite (ST). Eluate extraction times 24 h and 168 h were chosen. RESULTS Statistical analysis was conducted via a mixed model. Both antibacterial composites reduced proliferation, collagen and cytokine synthesis significantly (p < 0.05), increasing with time of elution. Ab1 did also have a damaging effect on the membrane and on cell viability. SIGNIFICANCE Overall, it can be concluded that the antiadhesive composites showed clear advantages over the antibacterial composites in terms of biocompatibility. This study also continues to show the potential of the new poly-pore system, as it can be used for a variety of other applications in future composite mixtures.
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How different time intervals between repeated applications of CPP-ACP fluoride varnish effect smooth surface enamel demineralization? J Dent 2021; 112:103742. [PMID: 34224791 DOI: 10.1016/j.jdent.2021.103742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the preventive effects of different time intervals between repeated applications of the CPP-ACP fluoride varnish on enamel demineralization. METHODS Human teeth were sectioned and randomly allocated to three groups: 4-week, 6-week, and 12-week (N = 22/group). Baseline images of the enamel surfaces were obtained using the FluoreCam recording the area, intensity, and impact of baseline enamel demineralization. All groups received fluoride varnish applications at the beginning of the experiment. The varnish was reapplied every 4 or 6 weeks in the 4-week and 6-week groups, respectively. Following each application, the groups underwent thermo-cycling, tooth brushing and pH cycling to simulate the time effect. After 12 weeks, the enamel surfaces were reimaged using the FluoreCam. Within and between-group differences in the area, intensity and impact of demineralization were evaluated. RESULTS At baseline, there were no significant between-group differences for area, intensity, or impact. Statistically significant (p<0.001) enamel demineralization occurred over time within each group. There were significant between-group differences in the changes that occurred in area (P = 0.004), impact (P = 0.022), but not intensity. The 12-week had significantly larger areas of demineralization than the 6-week (P = 0.041) and 4-week (P = 0.001) groups. Changes in impact was significantly (P = 0.007) greater in the 12-week group than 4-week group, but not greater than the 6-week group. There were no statistically significant differences between 4- and 6-week groups in the changes of area, intensity, or impact. CONCLUSION Reapplication of the CPP-ACP fluoride varnish every 4-6 weeks, is more effective in reducing enamel demineralization compared to every 12 weeks.
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Remineralization Potential of Nanohydroxyapatite Toothpaste Compared with Tricalcium Phosphate and Fluoride Toothpaste on Artificial Carious Lesions. Int J Dent 2021; 2021:5588832. [PMID: 33824661 PMCID: PMC8007336 DOI: 10.1155/2021/5588832] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/08/2021] [Accepted: 03/10/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Nanohydroxyapatite (nano-HA) has been utilized as an alternative agent for dental enamel remineralization. This study compared remineralization potential of nano-HA toothpaste (NHT), functionalized tricalcium phosphate toothpaste (TCPT), and fluoride toothpaste (FT) on carious lesions. Materials and Methods Sixty extracted human premolars were prepared for artificial carious lesions with synthetic polymer gel. Samples were divided into four groups according to testing agents: NHT, TCPT, FT, and one group with no treatment (NT). Each group was subjected to pH-cycling with the application of toothpaste in slurry form twice a day (2-min each) for 10 days. Surface microhardness was measured before demineralization, after demineralization, and after pH-cycling. Hardness at different periods, percentage of hardness recovery (% HR), and percentage of remineralization potential (%RP) were determined and statistically analyzed with ANOVA and Tukey comparisons (α = 0.05). Polarized light microscopy (PLM) was utilized to assess lesion depth. Results Significant remineralization of carious lesions was observed among different toothpastes compared to NT (p < 0.05). No significant difference in remineralization potential was found among NHT, TCPT, and FT (p > 0.05). No significant difference in % HR and % RP was seen among NHT, TCPT, and FT (p > 0.05). PLM indicated a greater decrease in carious depth upon using NHT compared to TCPT and FT, with minimal increase in depth for NT. Conclusions NHT has comparable capability to TCPT and FT in hardness recovery. However, decrease in carious depth was evidenced with PLM for NHT more than TCPT and FT. Thus, NHT was suggested as a potential remineralization product for treating initial carious lesions. Clinical Significance. The study showed that NHT had the potential to remineralize artificial carious lesion. It was confirmed in potential in the lesion depth reduction and forming a new enamel layer. NHT showed its capability as an alternative for dental caries therapeutic.
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18
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Kamath KA, Nasim I, Rajeshkumar S. Evaluation of the re-mineralization capacity of a gold nanoparticle-based dental varnish: An in vitro study. J Conserv Dent 2021; 23:390-394. [PMID: 33623242 PMCID: PMC7883789 DOI: 10.4103/jcd.jcd_315_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/28/2020] [Accepted: 09/19/2020] [Indexed: 11/04/2022] Open
Abstract
Background Dental caries is an infectious microbial disease caused by acidogenic bacteria. It leads to the dissolution of enamel, dentin, and cementum. Enamel demineralization is often appreciated as' 'White Chalky lesions or Chalky enamel''. Standard procedures for protection of these teeth are fissure sealing and topical fluoride application. A varnish is generally a material in which a resin such as copal is dissolved within an organic solvent such as ethanol. Gold is one of the most biocompatible dental materials. Gold nanoparticles were biosynthesised using aspartic acid in previous studies. Aim and Objectives To prepare a gold nanoparticle based dental varnish and to evaluate its re-mineralizing capacity. Materials and Methods Gold nanoparticle dental varnish was prepared using all the necessary constituents. This newly prepared dental varnish was compared with G.C Fuji/SnF2 dental varnish. Demineralizing capacity of the dental varnishes were analysed. The tooth specimens were prepared according to methodology and mounted on resin blocks. They were subjected to demineralization remineralization cycles. ICP-OES and Knoop Hardness tests were performed. Results AuNP dental varnish had a satisfactory remineralization effect on demineralised enamel. For calcium analysis, the AuNP group showed significantly more total calcium loss when compared to the SnF2 group (P < 0.05) and was statistically significant. For phosphorus analysis, AuNP group showed significantly greater net phosphorus loss compared to the SnF2 group (P < 0.05) and was statistically significant. It was also observed that the KHN increased more significantly in Group A (SnF2) as compared to Group B (AuNP) and was also statistically significant (P < 0.05). Conclusion AuNP dental varnish showed considerable re mineralizing property; however, it was not superior to dental varnishes like SnF2 dental varnish. Further research needs to be done in vitro to better modify the AuNP dental varnish before proceeding to in vivo studies.
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Affiliation(s)
- K Ajith Kamath
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India
| | - Iffat Nasim
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India
| | - S Rajeshkumar
- Department of Pharmacology and Nanomedicine, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India
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Subramaniam P, Raj N S, Papulwar S. Levels of Streptococcus Mutans in mother–child pairs following application of fluoride varnish containing casein phosphopeptide: Amorphous calcium phosphate. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2021. [DOI: 10.4103/jiaphd.jiaphd_146_20] [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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20
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Karlinsey R. Fluoride Plus Calcium Phosphate Varnishes: A Possible Link between Mineral Phase Formations and Observed Clinical Outcomes. DENTAL HYPOTHESES 2021. [DOI: 10.4103/denthyp.denthyp_117_21] [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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Soares-Yoshikawa AL, Varanda T, Iwamoto AS, Kantovitz KR, Puppin-Rontani RM, Pascon FM. Fluoride release and remineralizing potential of varnishes in early caries lesions in primary teeth. Microsc Res Tech 2020; 84:1012-1021. [PMID: 33278320 DOI: 10.1002/jemt.23662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/25/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022]
Abstract
This study evaluated the fluoride (F) release and remineralizing potential of varnishes containing sodium fluoride (5% NaF), 5% NaF with CPP-ACP and 5% NaF with TCP in early caries lesions in primary teeth. To determine the F release at 1, 4, 6, 24, 72, and 168 hr, strips were covered with the varnishes and immersed in purified water (n = 7). The varnishes and purified water (negative control) were applied on enamel blocks with early caries lesions (n = 16). Enamel blocks were stored in artificial saliva and submitted to a pH-cycling. The area of enamel hardness loss (ΔS) was analyzed by microhardness, lesion depth by polarized light microscopy (PLM) and the chemical analysis by Energy-dispersive X-ray spectroscopy. Data were submitted to Shapiro-Wilk, two-way and one-way ANOVA, Tukey and paired t-tests (α = 5%). All varnishes released F, but 5% NaF with CPP-ACP had the highest release at 4, 6, 24, and 72 hr (p < .05) followed by 5% NaF with TCP and 5% NaF. No significant difference in ΔS was observed among varnishes (5% NaF = 4,098.4 ± 1,407.9; 5% NaF with CPP-ACP = 4,164.0 ± 1,019.3; 5% NaF with TCP = 4,183.2 ± 1,527.2; p = .999), but all of them differed from the negative control group (6,757.8 ± 2,274.7; p < .001). Lesion depth was lower in varnishes groups compared to negative control (% reduction: 5% NaF = 41.8%, 5% NaF with CPP-ACP = 38.8%, and 5% NaF with TCP = 36.3%; p < .001). Similar Ca, P, and Ca/P ratio percentages among groups and F was not detected after the treatments. All fluoride varnishes showed potential to enhance remineralization of early caries lesions in primary teeth.
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Affiliation(s)
- Aline Laignier Soares-Yoshikawa
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Thais Varanda
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alexsandra Shizue Iwamoto
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Kamila Rosamilia Kantovitz
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.,Dental Materials Area, Faculdade São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Regina Maria Puppin-Rontani
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Fernanda Miori Pascon
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Cai J, Burrow MF, Manton DJ, Hardiman R, Palamara JEA. Remineralising effects of fluoride varnishes containing calcium phosphate on artificial root caries lesions with adjunctive application of proanthocyanidin. Dent Mater 2020; 37:143-157. [PMID: 33267974 DOI: 10.1016/j.dental.2020.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/13/2020] [Accepted: 10/24/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate the remineralising effects of fluoride (F) varnishes containing bioavailable calcium-phosphate compound (Ca-P) based remineralisation systems and 5000 ppm F toothpaste (FTP) on root caries lesions (RCLs) and the potential effects of proanthocyanidin (PA) for the treatments of RCLs when used as an adjunct to F regimens. METHODS Demineralised root dentine and a pH-cycling model were used to mimic RCLs and the oral environment. Remineralising effects of MI VarnishTM (MIV) containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and Clinpro™ White Varnish (CPWV) containing tri-calcium phosphate (TCP) along with FTP and PA were evaluated regarding the birefringence, elemental composition, mechanical properties and mineral density of remineralised dentine with DuraphatTM as a comparison. RESULTS MIV, CPWV and DuraphatTM promoted the incorporation of F into RCLs and increased mineral density but did not change microhardness of root dentine significantly. Surface microhardness increased significantly when MIV or CPWV was used with 5000 ppm FTP. Application of PA with F regimens significantly increased subsurface mineral density. When PA was applied with MIV or CPWV along with FTP, the highest ion uptake and relative mineral gain (%ΔZ) was achieved, and significant increase of microhardness was up to 30 μm depth. Generally, MIV was associated with a higher mineral content gain than CPWV. SIGNIFICANCE Treatment of carious root surfaces remains challenging due to the complex pathological processes and difficulty in restoring the highly organised structure of root dentine. Treatment strategies targeting both remineralisation and preservation of the dentinal organic matrix have the potential to improve the fluoride-mediated remineralisation approaches.
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Affiliation(s)
- Jing Cai
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Michael F Burrow
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; Faculty of Dentistry, the University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong SAR, China
| | - David J Manton
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, The Netherlands
| | - Rita Hardiman
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Joseph E A Palamara
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
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Radha S, Kayalvizhi G, Adimoulame S, Prathima GS, Muthusamy K, Ezhumalai G, Jagadesaan N. Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020; 13:311-317. [PMID: 33149400 PMCID: PMC7586479 DOI: 10.5005/jp-journals-10005-1673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim The aim of the study was to assess the remineralizing efficacy of fluoride and its combination varnishes on white spot lesion (WSL) in children with early childhood caries (ECC). Materials and methods Sixty children with active WSL on primary maxillary anterior teeth were randomly selected. At baseline, the WSL activity was evaluated using ICDAS II [lesion activity assessment (LAA)] and its dimensions through photographic method. They were allocated to group I (GI) (5% NaF), group II (GII) [5% NaF with amorphous calcium phosphate (ACP)], and group III (GIII) [5% NaF with casein phosphopeptides - amorphous calcium phosphate (CPP -ACP)]. First, oral hygiene instructions and diet counseling were given followed by application of fluoride varnishes in their respective groups. The same parameters were recorded at follow-up of 2, 4, 12, and 24 weeks intervals. Data were collected and subjected to statistical analysis using Friedman Chi-square and Mann-Whitney tests. Results Overall, the active WSL changed to inactive over a period of 24 weeks in GI was 90%, GII was 95%, and 100% in GIII. There was a significant reduction in dimension of WSL in GI from 4.119 to 2.525 (p = 0.0001). Likewise, there was a significant reduction in dimension of WSL in GII and GIII from 4.586 to 3.258 and 4.696 to 1.2155, respectively (p = 0.0001, p = 0.0001). Comparatively, group III (MI varnish) showed statistically significant reduction in the dimension of WSL from baseline to 24 weeks (p = 0.002). But the results were statistically insignificant with change of active lesions to its inactivity (p = 0.349). Conclusion Fluoride varnish with CPP-ACP was found to be an effective preventive strategy in reversing WSL in children with ECC. Clinical relevance These combination varnishes could prove to be a promising preventive measure for pediatric dentists in reversing white spot lesions of ECC. Clinical trial registry NCT03360266. How to cite this article Radha S, Kayalvizhi G, Adimoulame S, et al. Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13(4):311-317.
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Affiliation(s)
- Sarangapani Radha
- Department of Pedodontics and Preventive Dentistry, JKK Nattraja Dental College and Hospital, Komarapalayam, Namakkal, Tamil Nadu, India
| | - Gurusamy Kayalvizhi
- Department of Pedodontics and Preventive Dentistry, Dr Syamala Reddy Dental College and Hospital, Bengaluru, Karnataka, India
| | - Sanguida Adimoulame
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India
| | - Gajula S Prathima
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India
| | - Kirthika Muthusamy
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - G Ezhumalai
- Department of Statistics, Mahatma Gandhi Medical College and Research Institute, SBV, Puducherry, India
| | - Nagendrababu Jagadesaan
- Department of Prosthodontics and Crown and Bridge, JKK Nattraja Dental College and Hospital, Komarapalayam, Namakkal, Tamil Nadu, India
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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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Shen P, McKeever A, Walker GD, Yuan Y, Reynolds C, Fernando JR, Chen YY, MacRae CM, Schneider P, Reynolds EC. Remineralization and fluoride uptake of white spot lesions under dental varnishes. Aust Dent J 2020; 65:278-285. [PMID: 32678914 DOI: 10.1111/adj.12787] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs in vitro. METHODS MI varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and 2.26% fluoride and Duraphat varnish containing 2.26% fluoride (no added calcium) were compared with a placebo varnish (no added calcium or fluoride). Two WSLs were prepared in enamel slabs and varnish applied to cover one of the two lesions. Each slab was immersed in artificial saliva for 14 days at 37°C. Mineral content was determined using transverse microradiography and fluoride uptake using electron probe microanalysis. The data were statistically analysed using a linear mixed model. RESULTS Both MI and Duraphat varnishes significantly remineralized the covered and uncovered WSLs when compared with the placebo varnish (P < 0.001). The WSLs covered with varnish showed greater remineralization than those uncovered. MI varnish produced the highest level of remineralization and significantly greater fluoride uptake (0.44 ± 0.08 wt%) compared with Duraphat (0.24 ± 0.03 wt%) and the placebo varnish (0.06 ± 0.05 wt%). CONCLUSION Varnish containing fluoride and CPP-ACP was superior to varnish containing fluoride alone in promoting WSL remineralization and fluoride uptake.
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Affiliation(s)
- P Shen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - A McKeever
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - G D Walker
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Y Yuan
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - J R Fernando
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Y-Y Chen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C M MacRae
- Microbeam Laboratory, CSIRO Mineral Resources, Clayton, Victoria, Australia
| | - P Schneider
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - E C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
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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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In Vitro Comparison of Fluoride, Magnesium, and Calcium Phosphate Materials on Prevention of White Spot Lesions around Orthodontic Brackets. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1989817. [PMID: 32337230 PMCID: PMC7152941 DOI: 10.1155/2020/1989817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/20/2020] [Indexed: 11/24/2022]
Abstract
One common negative side effect of orthodontic treatment with fixed appliances is the development of white spot lesions (WSLs) around brackets. This study is aimed at comparing the efficacy of various oral hygiene practices in preventing enamel demineralization around orthodontic brackets under similar in vitro conditions. The study included 90 extracted bovine incisors, which were randomized into six groups: fluoride toothpaste (FT), nonfluoride toothpaste (NFT), fluoride varnish plus fluoride toothpaste (FV+FT), CPP-ACP varnish plus fluoride toothpaste (CPP-ACP+FT), medical minerals gel plus nonfluoride toothpaste (MMG+NFT), and no intervention (control). All groups were subjected to demineralization and remineralization cycles. Visual appraisals were used to evaluate the changes in the enamel surface appearance at the beginning and end of the experiment. The changes in the demineralization degree were evaluated by measuring the Ca+2 concentration in the demineralization solution at different time points. The majority of teeth in the CPP-ACP+FT group exhibited no shift in appearance, whereas in the other groups, a slight change in enamel translucency was observed. At all the time points, the Ca+2 concentration in the demineralization solution in the CPP-ACP+FT group was the least among all other groups. At day 5, MMG+NFT's preventive efficacy was significantly higher than FV+FT's, but at days 10, 15, and 19, their efficacy was similar. However, at all the time points, MMG+NFT's efficacy was significantly higher than that of control, whereas FV+FT's efficacy was decreased at days 10, 15, and 19 and was close to the efficacy of control. To fight WSLs, early diagnosis was of great importance and examination of the tooth surface after air-drying for 5 s was recommended.
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Subramaniam P, Babu KLG, Teleti S. Effect of varnish containing casein phosphopeptides-amorphous calcium phosphate and fluoride on surface microhardness of enamel – An in vitro study. SAUDI JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.4103/sjos.sjoralsci_43_19] [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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Justino IBDS, Alexandria AK, Canto FMT, Leite KLDF, Vieira TI, Cabral LM, Silva RFD, Maia LC. Comparative Effect of Calcium Mesoporous Silica Versus Calcium and/or Fluoride Products on the Reduction of Erosive Tooth Wear and Abrasive Enamel Lesion. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Varma V, Hegde KS, Bhat SS, Sargod SS, Rao HA. Comparative Evaluation of Remineralization Potential of Two Varnishes Containing CPP-ACP and Tricalcium Phosphate: An In Vitro Study. Int J Clin Pediatr Dent 2019; 12:233-236. [PMID: 31708621 PMCID: PMC6811951 DOI: 10.5005/jp-journals-10005-1629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim The aim of this study is to evaluate the remineralization potential of Clinpro XT varnish containing tricalcium phosphate (TCP) and MI varnish containing casein phosphopeptide (casein phosphopeptide–amorphous calcium phosphate, CPP–ACP). Materials and methods Thirty premolar teeth were taken and divided into three groups. Samples were sliced mesiodistally into buccal and lingual halves using a diamond disk bur. The buccal halves of the teeth were used for the study. Artificial caries like lesions were produced and evaluated with Diagnodent. The samples in each group were treated with the respective remineralizing agent (except for the control group) at every 24 hours for 7 days and the surfaces were assessed using Diagnodent to record the values after the remineralization procedure. The Diagnodent values obtained were tabulated and statistically analyzed using one-way ANOVA and Tukey's multiple comparison tests. Results There was a significant difference between the values calculated before and after remineralization in all the three groups. Conclusion The study findings showed that MI varnish containing CPP–ACP had the highest release of fluoride as compared to the Clinpro fluoride releasing varnish. Clinical significance MI varnish is a 5% NaF varnish containing CPP–ACP to give an exceptional fluoride varnish that releases more bioavailable fluoride, calcium, and phosphate, hence, can be used successfully in remineralization of early carious lesions. CPP–ACP can be used in the clinical practice for reversing or arresting the early carious lesions. How to cite this article Varma V, Hegde KS, et al. Comparative Evaluation of Remineralization Potential of Two Varnishes Containing CPP–ACP and Tricalcium Phosphate: An In Vitro Study. Int J Clin Pediatr Dent 2019;12(3):233–236.
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Affiliation(s)
- Venu Varma
- Department of Pedodontics and Preventive Dentistry, Yenepoya Dental College, Yenepoya University, Mangaluru, Karnataka, India
| | - K Sundeep Hegde
- Department of Pedodontics and Preventive Dentistry, Yenepoya Dental College, Yenepoya University, Mangaluru, Karnataka, India
| | - Sham S Bhat
- Department of Pedodontics and Preventive Dentistry, Yenepoya Dental College, Yenepoya University, Mangaluru, Karnataka, India
| | - Sharan S Sargod
- Department of Pedodontics and Preventive Dentistry, Yenepoya Dental College, Yenepoya University, Mangaluru, Karnataka, India
| | - Ht Ajay Rao
- Department of Pedodontics and Preventive Dentistry, Yenepoya Dental College, Yenepoya University, Mangaluru, Karnataka, India
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de Amoêdo Campos Velo MM, Agulhari MAS, Rios D, Magalhães AC, Honório HM, Wang L. Root caries lesions inhibition and repair using commercial high-fluoride toothpastes with or without tri-calcium phosphate and conventional toothpastes containing or not 1.5% arginine CaCO3: an in situ investigation. Clin Oral Investig 2019; 24:2295-2304. [DOI: 10.1007/s00784-019-03084-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 09/22/2019] [Indexed: 01/23/2023]
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Sleibi A, Tappuni AR, Karpukhina NG, Hill RG, Baysan A. A comparative evaluation of ion release characteristics of three different dental varnishes containing fluoride either with CPP-ACP or bioactive glass. Dent Mater 2019; 35:1695-1705. [PMID: 31563405 DOI: 10.1016/j.dental.2019.08.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/13/2019] [Accepted: 08/31/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To compare ion release characteristics of three different dental varnishes either containing CPP-ACP and fluoride (CPP-ACPF, MI Varnish GC, Japan), bioactive glass and fluoride (BGAF, Dentsply Sirona USA) or fluoride alone (NUPRO White, Dentsply Sirona USA) using fluoride-Ion Selective Electrode (F-ISE), Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES), X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), 19F and 31P Magic Angle Spinning-Nuclear Magnetic Resonance (MAS-NMR). METHODS A thin layer (0.0674±0.0005g) of each varnish (20×25mm in area) was spread on a roughened glass slide (n=7). They were separately immersed in 10ml Tris buffer (0.06M, pH=7.30), and changed after 1, 2, 4, 6, 24 and 48h. Fluoride-ion concentration at each time using the F-ISE, whilst calcium and phosphate release were investigated using ICP-OES. XRD, FTIR. MAS-NMR analyses were also performed before and after immersion. RESULTS The cumulative F-ion release was significantly higher in CPP-ACPF (1.113mmol/g)>BGAF(0.638)>F(0.112) (p<0.001). The cumulative calcium and phosphorus were higher in the CPP-ACPF (0.137mmol/g, 0.119) than BGAF (0.067, 0.015) (p<0.001) respectively. The XRD and 19F MAS-NMR confirmed the presence of NaF peaks in all cases before immersion. There were less prominent signal and appearance of fluorapatite crystals after immersion. 19F MAS-NMR revealed CaF2 formation after immersion in both CPP-ACPF and BGAF. 31P MAS-NMR showed phosphate signals in both CPP-ACPF and BGAF before immersion. FTIR failed to show any signs of apatite formation. SIGNIFICANCE Both CPP-ACP and bioactive glass enhanced ion release without compromising the bioavailability of fluoride. The CPP-ACPF varnish had the most promising ion release.
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Affiliation(s)
- Ahmed Sleibi
- Institute of Dentistry, Queen Mary University of London, Turner Street, EI 2AD, London, United Kingdom; College of Dentistry, Mustansiriyah University, Baghdad, Iraq.
| | - A R Tappuni
- Institute of Dentistry, Queen Mary University of London, Turner Street, EI 2AD, London, United Kingdom
| | - Natalia G Karpukhina
- Dental Physical Sciences Unit, Institute of Dentistry, Queen Mary University of London, Mile End Road, EI 4NS, London, United Kingdom
| | - Robert G Hill
- Dental Physical Sciences Unit, Institute of Dentistry, Queen Mary University of London, Mile End Road, EI 4NS, London, United Kingdom
| | - A Baysan
- Institute of Dentistry, Queen Mary University of London, Turner Street, EI 2AD, London, United Kingdom
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Machado AC, Rabelo FEM, Maximiano V, Lopes RM, Aranha ACC, Scaramucci T. Effect of in-office desensitizers containing calcium and phosphate on dentin permeability and tubule occlusion. J Dent 2019; 86:53-59. [DOI: 10.1016/j.jdent.2019.05.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 11/24/2022] Open
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Soltanimehr E, Bahrampour E, Yousefvand Z. Efficacy of diode and CO 2 lasers along with calcium and fluoride-containing compounds for the remineralization of primary teeth. BMC Oral Health 2019; 19:121. [PMID: 31217005 PMCID: PMC6585004 DOI: 10.1186/s12903-019-0813-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/03/2019] [Indexed: 11/30/2022] Open
Abstract
Background This study aimed to assess the efficacy of a 980-nm diode and 10.6-μm CO2 laser accompanied by tricalcium phosphate-5% sodium fluoride (fTCP) and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) for the remineralization of primary teeth. Methods In total, 117 extracted primary anterior teeth were randomly divided into eight experimental and one control group: (I) control (polished enamel), (II) fTCP varnish, (III) fTCP + diode laser, (IV) fTCP + CO2 laser, (V) CPP-ACP, (VI) CPP-ACP + diode laser, (VII) CPP-ACP + CO2 laser, (VIII) diode laser, and (IX) CO2 laser. The microhardness of 12 samples in each group and the enamel porosity of one sample in each group were assessed before and after demineralization and 28 days after remineralization. Data were analysed using two-way ANOVA. Results Significant differences existed in microhardness (P = 0.004) and percentage of remineralization (P < 0.001) after remineralization among the material groups such that the highest mean was noted in the CPP-ACP group. No significant difference was noted in microhardness (P = 0.052) or percentage of remineralization (P = 0.981) after remineralization among the laser groups. In all groups, porosities increased after demineralization and slightly decreased after remineralization; the greatest reduction in porosity of the material groups was noted in the fTCP group, and the CO2 group among the laser groups. The interaction effect of materials and lasers was not significant (P > 0.05). Conclusion The highest microhardness was achieved after remineralization with CPP-ACP. The efficacy of the diode and CO2 lasers was the same. No synergistic effect was found between materials and lasers. Trial registration This is not a human subject research.
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Affiliation(s)
- Elham Soltanimehr
- Department of Pediatric Dentistry, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Bahrampour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kermanshah University of Medical Sciences, Building No. 1, Shahid Beheshti Boulevard, Kermanshah, 6715847141, Iran.
| | - Zeynab Yousefvand
- School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Effects of Fluoride and Calcium Phosphate Materials on Remineralization of Mild and Severe White Spot Lesions. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1271523. [PMID: 31317022 PMCID: PMC6601497 DOI: 10.1155/2019/1271523] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/27/2019] [Indexed: 11/17/2022]
Abstract
Fixed orthodontic treatments often lead to enamel demineralization and cause white spot lesions (WSLs). The aim of this study was to evaluate the mineralization degree of 2 types of WSLs based on ICDAS index and compare the remineralizing efficacy of 3 oral hygiene practices after 1 month and 3 months. 80 mild demineralized and 80 severe demineralized enamel specimens were randomized into three treatments: fluoride toothpaste (FT), fluoride varnish plus fluoride toothpaste (FV+FT), and CPP-ACP plus fluoride toothpaste (CPP-ACP+FT). Microhardness tester, DIAGNODent Pen 2190, and scanning electron microscope were used to evaluate the changes of mineralization degree. Both qualitative and quantitative indicators suggested that the mild and severe white spot lesions were different in the degree of mineralization. Severe WSLs demineralized much more seriously than mild lesions even after 3 months of treatment. Despite the variation in severity, both lesions had the same variation trend after each measure was applied: FT had weak therapeutic effect, FV + FT and CPP-ACP + FT were effective for remineralization. Their remineralizing efficacy was similar after 1 month, and combined use of CPP-ACP plus F toothpaste was more effective after 3 months. In order to fight WSLs, early diagnosis was of great importance, and examination of the tooth surface after air-dry for 5 seconds was recommended. Also, when WSLs were found, added remineralizing treatments were required.
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Dehailan LA, Martinez-Mier EA, Eckert GJ, Lippert F. An In Vitro Investigation of Anticaries Efficacy of Fluoride Varnishes. Oper Dent 2019; 44:E234-E243. [PMID: 31172870 DOI: 10.2341/18-040-l] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Most currently marketed fluoride varnishes (FVs) have not been evaluated for their effectiveness in preventing dental caries. The objective of this study was to investigate the anticaries efficacy, measured as fluoride release into artificial saliva (AS); change in surface microhardness of early enamel caries lesions; and enamel fluoride uptake (EFU) of 14 commercially available FVs and two control groups. Bovine enamel specimens (5×5 mm) were prepared and assigned to 18 groups (n=12). Early caries lesions were created in the specimens and characterized using Vickers microhardness (VHNlesion). FV was applied to each group of specimens. Immediately afterward, specimens were incubated in 4 mL of AS for 18 hours, which were collected and renewed every hour for the first six hours. AS samples were analyzed for fluoride using an ion-specific electrode. Specimens were then brushed for 20 seconds with toothpaste slurry and subjected to pH cycling consisting of a four-hour/day acid challenge and one-minute treatments with 1100 ppm F dentifrice for five days. Microhardness was measured following pH cycling (VHNpost). EFU was determined using microbiopsy. Acid resistance (eight-hour demin challenge) was performed after pH cycling, and microhardness was measured (VHNart) and compared with baseline values to test the FV impact after pH cycling. One-way analysis of variance was used for data analysis (α=0.05). FVs differed in their release characteristics (mean ± SD ranged from 14.97 ± 2.38 μg/mL to 0.50 ± 0.15 μg/mL), rehardening capability (mean ± SD ranged from 24.3 ± 15.1 to 11.7 ± 12.7), and ability to deliver fluoride to demineralized lesions (mean ± SD ranged from 3303 ± 789 μg/cm3 to 707 ± 238 μg/cm3). Statistically significant but weak linear associations were found between ΔVHN(post - lesion), EFU, and fluoride release (correlations 0.21-0.36). The results of this study demonstrated that differences in FV composition can affect their efficacy in in vitro conditions.
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Abufarwa M, Noureldin A, Azimaie T, Campbell PM, Buschang PH. Preventive effects of carbon dioxide laser and casein phosphopeptide amorphous calcium phosphate fluoride varnish on enamel demineralization: A comparative, in vitro study. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2019; 10:e12400. [PMID: 30693660 DOI: 10.1111/jicd.12400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
AIM The aim of the present study was to compare the effects of carbon dioxide (CO2 ) laser and casein phosphopeptide amorphous calcium phosphate (CPP-ACP)fluoride varnish on enamel demineralization. METHODS Human teeth were randomly assigned to three groups. The enamel was treated with fluoride varnish, 10.6 μm CO2 laser, or no treatment (control), followed by 9 days of pH cycling. Baseline and final FluoreCam images were used to quantify the area, intensity, and impact of demineralization; cross-sectional microhardness was used to measure the mechanical properties of the enamel. RESULTS There were statistically-significant changes in the area, intensity and impact of demineralization in the control and laser groups (P < 0.05), but not in the fluoride group. The control group showed a significantly greater area and impact of enamel demineralization compared to the fluoride group. The area of demineralization in the laser group was significantly greater than that of the fluoride group. Enamel demineralization of the laser and control groups was comparable. The fluoride group showed statistically-significant harder enamel than the control at 20, 40, and 60 μm depths; the laser group enamel was significantly harder than the control at 20 and 40 μm depths. The fluoride group showed statistically-significant harder enamel than the laser group at 20 μm depth. CONCLUSIONS CPP-ACP fluoride varnish is more effective than CO2 in preventing enamel demineralization.
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Affiliation(s)
- Moufida Abufarwa
- Department of Biomedical Science, Texas A&M University College of Dentistry, Dallas, Texas
| | - Amal Noureldin
- Department of Public Health Sciences, Texas A&M University College of Dentistry, Dallas, Texas
| | - Taha Azimaie
- Rutgers School of Dental Medicine, Newark, New Jersey
| | - Phillip M Campbell
- Department of Orthodontics, Texas A&M University College of Dentistry, Dallas, Texas
| | - Peter H Buschang
- Department of Orthodontics, Texas A&M University College of Dentistry, Dallas, Texas
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Wassel MO, Sherief DI. Ion release and enamel remineralizing potential of miswak, propolis and chitosan nano-particles based dental varnishes. PEDIATRIC DENTAL JOURNAL 2019. [DOI: 10.1016/j.pdj.2018.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Salman NR, ElTekeya M, Bakry N, Omar SS, El Tantawi M. Comparison of remineralization by fluoride varnishes with and without casein phosphopeptide amorphous calcium phosphate in primary teeth. Acta Odontol Scand 2019; 77:9-14. [PMID: 30045657 DOI: 10.1080/00016357.2018.1490967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To compare MI (5% NaF with 2% CPP-ACP) and Prevident (5% NaF) varnishes in remineralizing caries-like lesions in primary teeth regarding calcium and phosphate enamel content and lesion depth. MATERIAL AND METHODS Caries-like lesions were created in 48 primary teeth which were divided into 2 halves; one left untreated (control) and the other half treated with MI or Prevident varnishes. Calcium and phosphate content was assessed using energy dispersive X-ray spectrometer and reduction in lesion depth was assessed using polarized light microscopy. Demineralization and remineralization values in each group were compared using paired t test and percentage change between groups was compared using t test and Mann Whitney U test. RESULTS A greater percentage increase of calcium was observed in MI than Prevident specimens (median = 8.97 and 2.67, p < .0001), with greater calcium phosphate ratio percentage increase (median = 28.96 and 7.40) and phosphate percentage reduction (median = 15.5 and 4.51). The mean (SD) percentages reduction in lesion depth in the MI varnish was significantly greater than in Prevident varnish (44.41 (7.12) and 22.73 (9.35), p < .0001). CONCLUSIONS MI varnish had better remineralization effect in primary teeth than Prevident varnish in terms of higher mineral content and shallower lesion depth.
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Affiliation(s)
- Nehal Raid Salman
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Pharos University, Alexandria, Egypt
| | - Magda ElTekeya
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Niveen Bakry
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Samia Soliman Omar
- Department of Oral Biology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Abstract
Aims The aim of this study is to evaluate and compare the demineralization inhibitory effect, fluoride release at varying time intervals, and antibacterial property of MI varnish and fluor protector varnish. Materials and methods Twenty-four extracted human premolars were sectioned mesiodistally. The buccal and the lingual halves of the teeth were utilized to evaluate the demineralization inhibitory effect and fluoride release of MI varnish and fluor protector varnish, respectively. To evaluate the demineralization inhibitory effect, 150-μm axial longitudinal section was obtained that was photographed and evaluated under a polarized light microscope. To evaluate the fluoride release, a fluoride-specific ion electrode was used. To evaluate the antibacterial susceptibility, the disk diffusion test (Kirby–Bauer method) was done. Results Statistical analysis was done using the Students unpaired t test for intergroup comparison and the p value <0.01 was obtained for all the three parameters, i.e., demineralization inhibitory effect, antimicrobial property, and fluoride releasing property at different time intervals. Conclusion A combination of casein phosphopeptide (CPP)–amorphous calcium phosphate (ACP) in fluoride varnish seems to enhance the caries preventive potential of fluoride varnish and antibacterial activity against Streptococcus mutans. Clinical significance MI varnish, a combination of CPP–ACP and fluoride varnish could be the future of minimally invasive dentistry as it is minimally invasive yet an effective modality for caries prevention. How to cite this article Attiguppe P, Malik N, et al. CPP–ACP and Fluoride: A Synergism to Combat Caries. Int J Clin Pediatr Dent 2019;12(2):120–125.
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Affiliation(s)
- Prabhakar Attiguppe
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Neetu Malik
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Shivani Ballal
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Saraswathi V Naik
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Sleibi A, Tappuni A, Mills D, Davis GR, Baysan A. Comparison of the Efficacy of Different Fluoride Varnishes on Dentin Remineralization During a Critical pH Exposure Using Quantitative X-Ray Microtomography. Oper Dent 2018; 43:E308-E316. [PMID: 30457948 DOI: 10.2341/18-014-l] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES: The objective of this in vitro study was to quantify the amount of mineral change in demineralized dentin at pH 5.5 after the application of dental varnishes containing fluoride with casein phosphopeptide-amorphous calcium phosphate, fluoride and bioglass, or fluoride alone. METHODS AND MATERIALS: A total of 12 extracted human sound mandibular premolar root samples were coated with an acid-resistant varnish, leaving a 2 × 3 mm window at the outer root surface. These root specimens were then randomly divided into four groups and separately subjected to the demineralizing cycle at a pH of 4.8 for five days to create artificial caries-like lesions in dentin. Subsequently, each sample was imaged using quantitative x-ray microtomography (XMT) at a 15-μm voxel size. Each test group then received one of the following treatments: dental varnish containing casein phosphopeptide-amorphous calcium phosphate and fluoride (CPP-ACP, MI varnish, GC Europe), bioglass and fluoride (BGA, Experimental, Dentsply Sirona), or fluoride alone (NUPRO, Dentsply Sirona), as well as a control group, which received no treatment. These samples were kept in deionized water for 12 hours. The thin layer of varnish was then removed. All samples including the nonvarnish group were subjected to the second demineralizing cycle at pH 5.5 for five days. The final XMT imaging was then carried out following the second demineralizing cycle. XMT scan was also carried out to varnish samples at 25 μm voxel size. The change in mineral concentration in the demineralized teeth was assessed using both qualitative and quantitative image analysis. RESULTS: There was an increase in radiopacity in the subtracted images of all varnish groups; a significant increase in mineral content, 12% for the CPP-ACP and fluoride ( p≤0.05 and p≤0.001), 25% BGA ( p≤0.001), and 104% fluoride alone varnish ( p≤0.001). There was an increase in the size of radiolucency in the lesion area with a significant decrease in mineral content in the nonvarnish group, 10% ( p≤0.05 and p≤0.001). CONCLUSIONS: There was encouraging evidence of a remineralization effect following the application of dental varnish on dentin and also an observed resistance to demineralization during the acidic challenge in all cases. However, a dental varnish containing fluoride alone appeared to have a much greater effect on dentin remineralization when compared with CPP-ACP with fluoride and bioglass with fluoride.
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Bou Chebel F, Zogheib CM, Baba NZ, Corbani KA. Clinical Comparative Evaluation of Nd:YAG Laser and a New Varnish Containing Casein Phosphopeptides-Amorphous Calcium Phosphate for the Treatment of Dentin Hypersensitivity: A Prospective Study. J Prosthodont 2018; 27:860-867. [DOI: 10.1111/jopr.12984] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Fady Bou Chebel
- Department of Esthetic and Restorative Dentistry; St-Joseph University, School of Dentistry; Beirut Lebanon
| | - Carina Mehanna Zogheib
- Advanced Specialty Education Program in Prosthodontics; Loma Linda University, School of Dentistry; Loma Linda CA
| | - Nadim Z. Baba
- Advanced Specialty Education Program in Prosthodontics; Loma Linda University, School of Dentistry; Loma Linda CA
| | - Karim A. Corbani
- Department of Esthetic and Restorative Dentistry; St-Joseph University, School of Dentistry; Beirut Lebanon
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Abufarwa M, Noureldin A, Campbell PM, Buschang PH. The longevity of casein phosphopeptide-amorphous calcium phosphate fluoride varnish's preventative effects: Assessment of white spot lesion formation. Angle Orthod 2018; 89:10-15. [PMID: 30207486 DOI: 10.2319/021718-127.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To test how long casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) fluoride varnish prevents enamel demineralization in vitro. MATERIALS AND METHODS Human molars and premolars were sectioned buccolingually and randomly assigned to two groups. Standardized pretreatment images of enamel surfaces were obtained using FluoreCam. The control group received no treatment, and the experimental group received an application of CPP-ACP fluoride varnish. Over simulated periods of 2, 4, 8, and 12 weeks, specimens were placed in a toothbrushing simulator, thermocycled, subjected to 9 days of pH cycling, and imaged with FluoreCam. Samples were sectioned and polished for polarized light microscope (PLM) evaluation. RESULTS There were statistically significant time ( P < .001) and varnish ( P < .001) effects on area, intensity, and impact of enamel demineralization. The control group showed significant and progressive demineralization over the 12 weeks ( P < .001). The experimental group revealed no significant demineralization during the first 4 weeks ( P > .05) and significant ( P < .001) increases thereafter. Experimental demineralization after 12 weeks was comparable to 2-week demineralization in the controls, with significant between-group differences ( P < .001) in enamel demineralization at all time points. PLM of the control and experimental groups revealed lesion depths of 90 ± 34 μm and 37 ± 9 μm, respectively. CONCLUSIONS Within the limitations of this in vitro study, CPP-ACP fluoride varnish prevents enamel demineralization for at least 4 weeks and limits demineralization up to 12 weeks.
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Increasing the efficiency of CPP-ACP to remineralize enamel white spot lesions. J Dent 2018; 76:52-57. [PMID: 29933004 DOI: 10.1016/j.jdent.2018.06.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 06/13/2018] [Accepted: 06/18/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare the remineralization efficacy of using the MI paste plus according to manufacturer's instructions to MI varnish and to using a modified method of MI-paste plus application. MATERIALS AND METHODS 100 enamel specimens were obtained from the buccal and lingual surfaces of 50 extracted human non-caries third molars. All specimens were challenged by a buffered demineralization solution for 4 days, and were divided in 4 groups with 25 specimens in each group. 25 demineralized specimens had MI paste plus applied for 4 min and then wiped out (MI), 25 specimens had MI paste applied followed by application of SE-bonding agent (MI + Bond), 25 specimens had MI Varnish applied according to manufacturer instructions (MI Varnish) the rest of specimens served as controls (C). All specimens were stored for 7 days in artificial saliva. All specimens had their surface hardness (SH) measured by micro-hardness tester before/after the acidic challenge and after the treatment procedures. After the SH test all specimens were crosssectioned to obtain 100-150 micron thickness specimens to observe the lesion depth before/after treatment by the TMR (Transverse Micro Radiography) technique. RESULTS TMR experiment showed that (MI + Bond) and (MI varnish) groups recorded significant decrease in lesion depth and mineral loss of the tested subsurface lesion p < 0.05. (MI + Bond) group scored the highest significant regain of surface micro hardness results p < 0.05. CONCLUSION (MI varnish) and the modified application of MI paste are methods that can increase the efficacy of CPP-ACP in remineralizing the enamel surface lesions.
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Comparison of efficacy of dental varnish containing fluoride either with CPP-ACP or bioglass on root caries: Ex vivo study. J Dent 2018; 73:91-96. [DOI: 10.1016/j.jdent.2018.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 04/12/2018] [Indexed: 01/05/2023] Open
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Lockner F, Twetman S, Stecksén-Blicks C. Urinary fluoride excretion after application of fluoride varnish and use of fluoride toothpaste in young children. Int J Paediatr Dent 2017; 27:463-468. [PMID: 28105705 DOI: 10.1111/ipd.12284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The efficacy and safety of combined use of topical fluoride products are essential issues that must be monitored. AIM To assess urinary excretion of fluoride after application of two different dental varnishes containing 2.26% fluoride in 3- to 4-year-old children and to compare the levels with and without parallel use of fluoride toothpaste. DESIGN Fifteen healthy children were enrolled to a randomized crossover trial that was performed in two parts: Part I with twice-daily tooth brushing with fluoride toothpaste and Part II with twice-daily brushing with a non-fluoride toothpaste. After a 1-week run-in period, 0.1 mL of the two fluoride varnishes (Duraphat and Profluorid Varnish) was topically applied in a randomized order. Baseline and experimental urine was collected during 6-h periods. The fluoride content was determined with an ion-sensitive electrode. RESULTS There was a statistically significant increase in the 6-h fluoride excretion after application of both experimental varnishes, with and without parallel use of fluoride toothpaste (P < 0.01). When fluoridated toothpaste was used, the mean fluoride excretion was 0.20 mg/6 h after application of Duraphat and 0.29 mg/6 h after application of Profluorid Varnish (P = 0.18). CONCLUSIONS Topical applications of 0.1 mL of fluoride varnish significantly increased the 6-h fluoride excretion. As some individuals displayed excretion levels exceeding the optimal fluoride exposure, a restricted use of fluoride toothpaste in connection with the varnish applications would decrease fluoride exposure.
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Affiliation(s)
- Frida Lockner
- Department of Odontology, Pediatric Dentistry, Umeå University, Umeå, Sweden
| | - Svante Twetman
- Department of Odontology, Cariology and Endodontics, University of Copenhagen, Copenhagen, Denmark
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Hasnamudhia F, Bachtiar EW, Sahlan M, Soekanto SA. The effect of CPP-ACP-propolis chewing gum on calcium and phosphate ion release on caries-active subjects’ saliva and the formation of Streptococcus mutans biofilm. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/884/1/012137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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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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Mohd Said SNB, Ekambaram M, Yiu CKY. Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions. Int J Paediatr Dent 2017; 27:163-173. [PMID: 27348852 DOI: 10.1111/ipd.12243] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare remineralization potential of topical fluoride varnishes with added calcium phosphate-based delivery systems on artificial enamel caries. METHODS Human enamel specimens (n = 60) were randomly divided into six groups: Group 0: Control (no varnish), Group 1: Duraphat® , Group 2: MI Varnish™ , Group 3: Embrace™ Varnish, Group 4: Enamel Pro® Varnish, and Group 5: Clinpro™ White Varnish. Specimens were immersed in demineralizing solution for 96 h to create artificial caries lesion. Each specimen was then immersed in artificial saliva for 6 h after fluoride varnish application and pH cycling was performed for 8 days. Specimens were evaluated using Knoop surface microhardness (KHN) and transverse microradiography (TMR). One-way anova test was performed to examine the effect of fluoride varnishes on change in percentage of surface hardness recovery (%SHR), change in lesion depth (ΔLD), and change in mineral loss (ΔΔZ) with the significance limit set at 5%. RESULTS %SHR of enamel following treatment with Group 1 was significantly higher than Group 3 and Group 4. Conversely, ΔLD and ΔΔZ of Group 1 were significantly higher than Group 2, Group 3, and Group 4. No significant differences in %SHR, ΔLD, and ΔΔZ were found between Group 1 and Group 5. CONCLUSIONS Duraphat® alone achieves significant remineralization of enamel carious lesions. Clinpro™ White Varnish had similar enamel remineralization effect as Duraphat® .
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Affiliation(s)
- Siti N B Mohd Said
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong (SAR), China
| | - Manikandan Ekambaram
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong (SAR), China
| | - Cynthia K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong (SAR), China
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Al Dehailan L, Lippert F, González-Cabezas C, Eckert G, Martinez-Mier E. Fluoride concentration in saliva and biofilm fluid following the application of three fluoride varnishes. J Dent 2017; 60:87-93. [DOI: 10.1016/j.jdent.2017.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/18/2017] [Accepted: 03/14/2017] [Indexed: 11/25/2022] Open
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