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Singh DK, Goyal S, Bhola L, Shivkumar AT, Manningal A, Reddy U, Moothedath M, Mishra D. Influence of Different Mouthwashes on the Efficacy of Fluoridated Dentifrices in Prevention of Enamel Erosion: An In Vitro Study. J Contemp Dent Pract 2023; 24:739-742. [PMID: 38152905 DOI: 10.5005/jp-journals-10024-3539] [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] [Indexed: 12/29/2023]
Abstract
AIM The purpose of the current study was to evaluate the impact of three various mouthwashes on the effectiveness of fluoride dentifrices in preventing enamel erosion. MATERIALS AND METHODS A total of 120 sound intact human premolar teeth which were extracted for orthodontic treatment were selected for the study. A 3 × 3 mm window section was positioned in the middle of the coronal surface of the tooth in order to define the study area. Each sample was placed in a solution of 1% citric acid (pH 3.5) for 10 minutes in order to produce an eroded surface. All samples were divided into two main groups (60 samples each) as follows: Group A for sodium fluoride dentifrices and group B for stannous fluoride dentifrices, again it is subdivided into: CHX: Chlohex ADS®, EO: Listerine®, CPC: Colgate® Plax (20 samples in each subgroup). After that, samples underwent the pH cycling model for 5 days. Samples were examined for surface loss using a scanning electron microscope. RESULTS In sodium fluoride dentifrices group, before intervention, the surface loss was 3.12 ± 1.03 in CHX group, 3.08 ± 1.20 in EO group, and 3.09 ± 0.96 in CPC group. After intervention, the less surface loss found with CHX group (2.18 ± 0.84), followed by CPC (2.34 ± 0.74) and EO group (2.46 ± 0.97). In stannous fluoride dentifrices group, before intervention, the surface loss in CHX group was 3.26 ± 1.19, in EO group, it was 3.18 ± 1.31, and in CPC group, it was 3.22 ± 1.06. After intervention, the less surface loss found with CHX: group (1.90 ± 0.54), followed by CPC (2.24 ± 0.28) and EO group (2.38 ± 0.20). CONCLUSION The present study concluded that the fluoride dentifrices' preventive effects against tooth surface loss were unaffected by a different mouthwashes with varying compositions and major constituents. In terms of erosion, fluoridated toothpaste containing stannous fluoride was found to provide better surface loss protection than sodium fluoride. CLINICAL SIGNIFICANCE Primary prevention and the eradication of contributing causes are the greatest strategies for preventing erosion. Simultaneously, antibacterial agent in the mouthwashes may help in enhancing the effect of fluoride in the enamel, owing to their high affinity for teeth structures. Therefore, in addition to cause-related treatment, further efforts to reduce tooth tissue loss are also necessary.
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Affiliation(s)
- Dhirendra Kumar Singh
- Department of Periodontics, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Srishty Goyal
- Department of Periodontics, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India, Phone: +07060128287, e-mail:
| | - Lucy Bhola
- Department of Periodontics, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Ashwini Tumukur Shivkumar
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka, India
| | - Aparna Manningal
- Department of Public Health Dentistry, KMCT Dental College, Kozhikode, Kerala, India
| | - Upasana Reddy
- Department of Conservative Dentistry and Endodontics, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Muhamood Moothedath
- Department of Oral and Dental Health, College of Applied Health Sciences in Arrass, Qassim University, Al Qassim, Kingdom of Saudi Arabia
| | - Debasish Mishra
- Department of Periodontics, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
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Huang Y, Liu Y, Pandey NK, Shah S, Simon-Soro A, Hsu JC, Ren Z, Xiang Z, Kim D, Ito T, Oh MJ, Buckley C, Alawi F, Li Y, Smeets PJM, Boyer S, Zhao X, Joester D, Zero DT, Cormode DP, Koo H. Iron oxide nanozymes stabilize stannous fluoride for targeted biofilm killing and synergistic oral disease prevention. Nat Commun 2023; 14:6087. [PMID: 37773239 PMCID: PMC10541875 DOI: 10.1038/s41467-023-41687-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023] Open
Abstract
Dental caries is the most common human disease caused by oral biofilms despite the widespread use of fluoride as the primary anticaries agent. Recently, an FDA-approved iron oxide nanoparticle (ferumoxytol, Fer) has shown to kill and degrade caries-causing biofilms through catalytic activation of hydrogen peroxide. However, Fer cannot interfere with enamel acid demineralization. Here, we show notable synergy when Fer is combined with stannous fluoride (SnF2), markedly inhibiting both biofilm accumulation and enamel damage more effectively than either alone. Unexpectedly, we discover that the stability of SnF2 is enhanced when mixed with Fer in aqueous solutions while increasing catalytic activity of Fer without any additives. Notably, Fer in combination with SnF2 is exceptionally effective in controlling dental caries in vivo, even at four times lower concentrations, without adverse effects on host tissues or oral microbiome. Our results reveal a potent therapeutic synergism using approved agents while providing facile SnF2 stabilization, to prevent a widespread oral disease with reduced fluoride exposure.
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Affiliation(s)
- Yue Huang
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuan Liu
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nil Kanatha Pandey
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shrey Shah
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Aurea Simon-Soro
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Stomatology, Dental School, University of Seville, Seville, Spain
| | - Jessica C Hsu
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhi Ren
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Innovation and Precision Dentistry, School of Dental Medicine, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhenting Xiang
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dongyeop Kim
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Preventive Dentistry, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea
| | - Tatsuro Ito
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatric Dentistry, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Min Jun Oh
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Chemical and Biomolecular Engineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Christine Buckley
- Department of Cariology, Operative Dentistry and Dental Public Health and Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Faizan Alawi
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yong Li
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paul J M Smeets
- Northwestern University Atomic and Nanoscale Characterization Experimental Center, Northwestern University, Evanston, IL, USA
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Sarah Boyer
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Xingchen Zhao
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Derk Joester
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Domenick T Zero
- Department of Cariology, Operative Dentistry and Dental Public Health and Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - David P Cormode
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA.
| | - Hyun Koo
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Center for Innovation and Precision Dentistry, School of Dental Medicine, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA.
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Jiemkim A, Tharapiwattananon T, Songsiripradubboon S. Combined use of stannous fluoride-containing mouth rinse and toothpaste prevents enamel erosion in vitro. Clin Oral Investig 2023; 27:5189-5201. [PMID: 37432505 PMCID: PMC10492772 DOI: 10.1007/s00784-023-05138-4] [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: 05/04/2023] [Accepted: 07/02/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE To compare the protective effect of commercial stannous-containing mouth rinses on enamel erosion in a simulated 5-day in vitro cycling model. MATERIALS AND METHODS 81 human enamel specimens were embedded in resin blocks and divided into nine groups as follows; group 1: stannous fluoride (1000SnF2) toothpaste; groups 2,3, and 4 were the same as group 1 plus Elmex®, PerioMed™, and Meridol®, respectively, group 5: stannous fluoride (1450SnF2) toothpaste, groups 6, 7, and 8 were the same as group 5 plus Elmex®, PerioMed™, and Meridol®, respectively, group 9: negative control. An erosive challenge was induced with a 1 min hydrochloric acid (0.01 M, pH 2.2) treatment 3 times per day. Each cycle included immersing in the toothpaste slurry twice for two minutes and a one-minute rinse. The enamel slabs were immersed in artificial saliva between each erosive cycle and incubated overnight at 37 °C. Surface hardness loss and enamel loss were determined by Knoop surface hardness and non-contact profilometry, respectively. Finally, enamel surfaces were analyzed by scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDS). RESULTS All three mouth rinses had similar protective effects against erosion when using adjunct with 1000 SnF2 toothpaste (p > 0.05). With 1450 SnF2 toothpaste, Elmex® presented significantly lower surface hardness loss than Meridol® (p < 0.05). The combined use of Elmex® or PerioMed™ with toothpaste provided significantly better erosion protection than toothpaste alone, either 1000 or 1450 SnF2. In addition, 1000SnF2 toothpaste adjunct with mouth rinse is comparable to 1450 SnF2 toothpaste alone in preventing enamel erosion. CONCLUSION All three mouth rinses reduced enamel erosion. The additional use of a high concentration stannous containing mouth rinse with 1450 SnF2 toothpaste increases the protective effect against enamel erosion in vitro. CLINICAL SIGNIFICANCE To date, no standard protocol for preventing dental erosion is available. There are three stannous-containing mouth rinses on the market; however, no study compared their efficacy or indicated whether using adjuncts with anti-erosion toothpaste provides additional benefits. This study found that adding stannous mouth rinse to twice-daily toothpaste increases erosion protection.
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Affiliation(s)
- Apichaya Jiemkim
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant, Road, Pathumwan, Bangkok, 10330, Thailand
| | - Thipawan Tharapiwattananon
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant, Road, Pathumwan, Bangkok, 10330, Thailand
| | - Siriporn Songsiripradubboon
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant, Road, Pathumwan, Bangkok, 10330, Thailand.
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Huang Y, Liu Y, Pandey N, Shah S, Simon-Soro A, Hsu J, Ren Z, Xiang Z, Kim D, Ito T, Oh MJ, Buckley C, Alawi F, Li Y, Smeets P, Boyer S, Zhao X, Joester D, Zero D, Cormode D, Koo H. Iron oxide nanozymes stabilize stannous fluoride for targeted biofilm killing and synergistic oral disease prevention. RESEARCH SQUARE 2023:rs.3.rs-2723097. [PMID: 37066293 PMCID: PMC10104273 DOI: 10.21203/rs.3.rs-2723097/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Dental caries (tooth decay) is the most prevalent human disease caused by oral biofilms, affecting nearly half of the global population despite increased use of fluoride, the mainstay anticaries (tooth-enamel protective) agent. Recently, an FDA-approved iron oxide nanozyme formulation (ferumoxytol, Fer) has been shown to disrupt caries-causing biofilms with high specificity via catalytic activation of hydrogen peroxide, but it is incapable of interfering with enamel acid demineralization. Here, we find notable synergy when Fer is combined with stannous fluoride (SnF 2 ), markedly inhibiting both biofilm accumulation and enamel damage more effectively than either alone. Unexpectedly, our data show that SnF 2 enhances the catalytic activity of Fer, significantly increasing reactive oxygen species (ROS) generation and antibiofilm activity. We discover that the stability of SnF 2 (unstable in water) is markedly enhanced when mixed with Fer in aqueous solutions without any additives. Further analyses reveal that Sn 2+ is bound by carboxylate groups in the carboxymethyl-dextran coating of Fer, thus stabilizing SnF 2 and boosting the catalytic activity. Notably, Fer in combination with SnF 2 is exceptionally effective in controlling dental caries in vivo , preventing enamel demineralization and cavitation altogether without adverse effects on the host tissues or causing changes in the oral microbiome diversity. The efficacy of SnF 2 is also enhanced when combined with Fer, showing comparable therapeutic effects at four times lower fluoride concentration. Enamel ultrastructure examination shows that fluoride, iron, and tin are detected in the outer layers of the enamel forming a polyion-rich film, indicating co-delivery onto the tooth surface. Overall, our results reveal a unique therapeutic synergism using approved agents that target complementary biological and physicochemical traits, while providing facile SnF 2 stabilization, to prevent a widespread oral disease more effectively with reduced fluoride exposure.
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Affiliation(s)
| | - Yuan Liu
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Tatsuro Ito
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Faizan Alawi
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, USA
| | - Yong Li
- Biofilm Research Labs, Levy Center for Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | - Domenick Zero
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, USA
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Flemming J, Hannig C, Hannig M. Caries Management-The Role of Surface Interactions in De- and Remineralization-Processes. J Clin Med 2022; 11:jcm11237044. [PMID: 36498618 PMCID: PMC9737279 DOI: 10.3390/jcm11237044] [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: 09/28/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Bioadhesion and surface interactions on enamel are of essential relevance for initiation, progression and prevention of caries and erosions. Salivary proteins on and within initial carious and erosive lesions can facilitate or aggravate de- and remineralization. This applies for the pellicle layer, the subsurface pellicle and for proteins within initial carious lesions. Little is known about these proteinaceous structures related to initial caries and erosion. Accordingly, there is a considerable demand for an understanding of the underlying processes occurring at the interface between the tooth surface and the oral cavity in order to develop novel agents that limit and modulate caries and erosion. Objectives and findings: The present paper depicts the current knowledge of the processes occurring at the interface of the tooth surface and the oral fluids. Proteinaceous layers on dental hard tissues can prevent or aggravate demineralization processes, whereas proteins within initial erosive or carious lesions might hinder remineralization considerably and restrict the entry of ions into lesions. CONCLUSIONS Despite the fact that organic-inorganic surface interactions are of essential relevance for de- and remineralization processes at the tooth surface, there is limited knowledge on these clinically relevant phenomena. Accordingly, intensive research is necessary to develop new approaches in preventive dentistry.
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Affiliation(s)
- Jasmin Flemming
- Clinic of Operative Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, D-01307 Dresden, Germany
- Correspondence:
| | - Christian Hannig
- Clinic of Operative Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, D-01307 Dresden, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, D-66424 Homburg, Germany
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Francisconi-Dos-Rios LF, Dantas LM, Calabria MP, Pereira JC, Mosquim V, Wang L. Obliterating potential of active products for dentin hypersensitivity treatment under an erosive challenge. J Dent 2021; 112:103745. [PMID: 34252489 DOI: 10.1016/j.jdent.2021.103745] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To compare the effect of 5 desensitizing agents on the hydraulic conductance (Lp) of dentin and to analyze its surface under a Laser Scanning Confocal Microscope (LSCM) before and after an erosive challenge. METHODS Lp was analyzed in the following sequence: in the presence of smear layer (pMin), after a 15-second acid etching (pMax), after treatment with a desensitizing agent (pTreat) and after a 1-minute erosive challenge (6% citric acid - pEro). Fifty 1.0 ± 0.2 mm-thick dentin disks were prepared from sound human third molars and were randomly distributed into 5 groups (n = 10): FG-Fluoride gel (control), SA-Sensiactive, PR-Sensitive Pro-Relief, NP-Desensibilize Nano-P and EV-Enamel Pro Varnish. Data were analyzed by two-way ANOVA and Tukey tests (α<0.05). Additional specimens were analyzed under a Laser Scanning Confocal Microscope (LSCM) and by Energy Dispersive X-ray Spectroscopy (EDS). RESULTS All materials reduced the Lp in some extent, except for FG and EV. After the erosive challenge, SA was the only material effectively able to keep the same Lp of the post-treatment phase, while the other products showed lower resistance upon an erosive challenge. Under the LSCM, the SA and NP materials were more effective to obliterate the opened dentin tubules and demonstrated higher resistance upon an erosive challenge. The EDS analysis evidenced levels of Ca, O, P, Si, Na and S. CONCLUSIONS Product containing potassium oxalate was the most effective in reducing Lp of dentin samples before and after an erosive challenge. Under a LSCM, products containing potassium oxalate or hydroxyapatite crystals seemed to be occluding the dentin tubules after an erosive challenge.
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Affiliation(s)
| | | | | | - José Carlos Pereira
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Victor Mosquim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
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Moser C, Baumann T, Lussi A, Carvalho TS. Is the Erosion-Protective Effect Still Maintained when Tin Concentrations Are Reduced in Mouth Rinse Solutions? Caries Res 2021; 55:108-113. [PMID: 33556950 DOI: 10.1159/000513059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 11/15/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE As a preventive measure, tin (Sn2+)-containing products have a great potential to prevent enamel surface loss during erosive challenges, but adverse effects of high Sn2+ concentrations, such as astringent feeling of the teeth, are reported. Therefore, the main aim of this in vitro study was to develop a solution with lower Sn2+ concentrations that can still prevent dental erosion. METHODS A total of 162 enamel specimens were prepared from human premolars, which were selected from a pool of extracted teeth. The specimens were randomly distributed to 9 groups (each group n = 18 enamel specimens) according to the different test treatments: a humid chamber (no treatment) as the negative control, the commercial Elmex® Erosion Protection mouth rinse as the positive control, and 7 solutions either with lower Sn2+ concentrations and/or containing flavoring. The experiment included 4 cycles, consisting of pellicle formation by incubating the specimens with 200 μL of human saliva at 37°C for 1 h, then placing the specimens in the treatment for 2 min (60 mL, 30°C, shaking at 70 rpm), and later submitting them to an erosive challenge for 1 min in citric acid (60 mL 1%, pH 3.6, 30°C). Surface hardness was measured with a Vickers diamond and surface reflection intensity was measured with a reflectometer. RESULTS The control group performed significantly worse than all other solutions containing Sn2+. In general, there were no significant differences among the Sn2+-containing groups, and they presented similar protective effects on the enamel even when Sn2+ concentrations were reduced and flavorings were added. CONCLUSION Sn2+ concentrations in mouth rinses may be lowered to 200 ppm without compromising the anti-erosive properties of the solution.
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Affiliation(s)
- Corina Moser
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Adrian Lussi
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland,
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Lucchese A, Bertacci A, Lo Giudice A, Polizzi E, Gherlone E, Manuelli M, Chersoni S, Moro D, Valdrè G. Stannous Fluoride Preventive Effect on Enamel Erosion: An In Vitro Study. J Clin Med 2020; 9:jcm9092755. [PMID: 32858829 PMCID: PMC7563875 DOI: 10.3390/jcm9092755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/12/2020] [Accepted: 08/18/2020] [Indexed: 01/25/2023] Open
Abstract
The aim of this in vitro study was to evaluate the effects of a single dose application of two daily toothpastes on enamel exposed to acid attack. The research was conducted on human molars enamel fragments (n = 72). The two different toothpastes active ingredients were sodium fluoride (NaF) and stannous fluoride (SnF2). They were compared in protecting the surface of the enamel exposed to three acids: citric acid, lactic acid and hydrochloric acid. A spectrophotometer was used to measure the calcium ions and phosphate released in the solutions by the enamel specimens. Afterward, ionic concentrations were analyzed through the t-Student test, in order to estimate the significance level (p < 0.05) of the solubility differences obtained between the treatment and control groups. Finally, sample surfaces were analyzed with scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDX). The two analyzed toothpastes did not reveal any statistically significant variation in the release of calcium and phosphate (p > 0.05). Nevertheless, acid-resistant deposits were detected in samples treated with stannous fluoride and exposed to lactic acid, though the presence of tin ion deposits on samples treated with stannous fluoride was not shown. A single dose of a fluoride-based toothpaste before different acids attack, in simulated oral cavity conditions, did not show a significant preventive effect.
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Affiliation(s)
- Alessandra Lucchese
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital Vita Salute San Raffaele University, 20123 Milan, Italy; (E.G.); (M.M.)
- Unit of Dentistry, Research Center for Oral Pathology and Implantology, IRCCS San Raffaele Scientific Institute, 20123 Milan, Italy
- Correspondence: ; Tel.: +39-338-2533-113
| | - Angelica Bertacci
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), School of Dentistry, University of Bologna, 40126 Bologna, Italy; (A.B.); (S.C.)
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy;
| | - Elisabetta Polizzi
- Center for Oral Hygiene and Prevention, Dental School, Vita-Salute San Raffaele University and IRCCS San Raffaele, 20123 Milan, Italy;
| | - Enrico Gherlone
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital Vita Salute San Raffaele University, 20123 Milan, Italy; (E.G.); (M.M.)
- Unit of Dentistry, Research Center for Oral Pathology and Implantology, IRCCS San Raffaele Scientific Institute, 20123 Milan, Italy
| | - Maurizio Manuelli
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital Vita Salute San Raffaele University, 20123 Milan, Italy; (E.G.); (M.M.)
- Unit of Dentistry, Research Center for Oral Pathology and Implantology, IRCCS San Raffaele Scientific Institute, 20123 Milan, Italy
| | - Stefano Chersoni
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), School of Dentistry, University of Bologna, 40126 Bologna, Italy; (A.B.); (S.C.)
| | - Daniele Moro
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, 40126 Bologna, Italy; (D.M.); (G.V.)
| | - Giovanni Valdrè
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, 40126 Bologna, Italy; (D.M.); (G.V.)
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Ibrahim AI, Thompson VP, Deb S. A Novel Etchant System for Orthodontic Bracket Bonding. Sci Rep 2019; 9:9579. [PMID: 31270352 PMCID: PMC6610079 DOI: 10.1038/s41598-019-45980-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 06/17/2019] [Indexed: 02/07/2023] Open
Abstract
Orthodontic treatment is widely used to correct irregular teeth and/or jaw discrepancies to improve oral function and facial aesthetics. However, it is frequently associated with enamel damage that include chipping, demineralisation, and white spot formation. So far, current bonding systems that can maintain shear bond strengths (SBS) suitable for clinical performance are unable to limit enamel demineralisation, adhesive remnants and damage caused on removal of brackets after treatment. This study reports a novel "safe enamel etch" clinically viable procedure that was accomplished via application of novel etchant pastes developed with β-tricalcium phosphate and monocalcium phosphate monohydrate powders mixed with citric acid (5 M) or phosphoric acid (37% PA) to yield BCA and BPA etchants respectively. Although enamel etched with clinically used PA gel yielded higher SBS than the BCA/BPA etchants, it exhibited greater adhesive remnants with evidence of enamel damage. In contrast, the experimental etchants resulted in unblemished enamel surfaces with zero or minimal adhesive residue and clinically acceptable SBS. Furthermore, the BPA etchant caused lower enamel decalcification with extensive calcium-phosphate precipitation. The study conclusively showed that BPA facilitated in vitro enamel adhesion without detrimental effects of the aggressive PA gel with potential for remineralisation and saving time at the post-debonding step.
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Affiliation(s)
- A I Ibrahim
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - V P Thompson
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - S Deb
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
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Kensche A, Buschbeck E, König B, Koch M, Kirsch J, Hannig C, Hannig M. Effect of fluoride mouthrinses and stannous ions on the erosion protective properties of the in situ pellicle. Sci Rep 2019; 9:5336. [PMID: 30926846 PMCID: PMC6441001 DOI: 10.1038/s41598-019-41736-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 03/13/2019] [Indexed: 12/19/2022] Open
Abstract
The particular feature of this study is the investigation of effects of pure fluoride- or stannous ions based mouthrinses on the erosion protective properties and the ultrastructure of the in situ pellicle (12 volunteers). Experimental solutions were prepared either from 500 ppm NaF, SMFP, AmF or SnF2 or 1563 ppm SnCl2, respectively. After 1 min of in situ pellicle formation on bovine enamel slabs, rinses with one of the preparations were performed for 1 min and intraoral specimens’ exposure was continued for 28 min. Native enamel slabs and rinses with bidestilled water served as controls. After oral exposure, slabs were incubated in HCl (pH 2; 2.3; 3) for 120 s and kinetics of calcium- and phosphate release were measured photometrically; representative samples were analysed by TEM and EDX. All mouthrinses reduced mineral loss compared to the native 30-min pellicle. The effect was pH-dependent and significant at all pH values only for the tin-containing mouthrinses. No significant differences were observed between the SnF2- and the SnCl2-containing solutions. TEM/EDX confirmed ultrastructural pellicle modifications. SnF2 appears to be the most effective type of fluoride to prevent erosive enamel demineralisation. The observed effects primarily have to be attributed to the stannous ions’ content.
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Affiliation(s)
- A Kensche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany.
| | - E Buschbeck
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - B König
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D-66421, Homburg/Saar, Germany
| | - M Koch
- Physical Analytics, INM - Leibnitz Institute for New Materials, D-66123, Saarbrücken, Germany
| | - J Kirsch
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - C Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - M Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D-66421, Homburg/Saar, Germany
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11
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Ebrahimi N, Soleimani AA, Rashidiani J, Malekafzali B, Abedini F, Hosseinkhani H. Chitosan/Fluoride Nanoparticles for Preventing Dental Caries. ACTA ACUST UNITED AC 2019. [DOI: 10.2174/2542579x01666190212150457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
<P>Background: Dental caries is still a major public health problem. The use of fluoride is
one of the most effective ways to prevent tooth decay.
</P><P>
Objective: The purpose of this research was to investigate the effectiveness of fluoride entrapped in
chitosan nanoparticles in vivo.
</P><P>
Methods: Sodium fluoride was loaded in chitosan via ionic gelation of tripolyphosphate nanoparticles.
Characterization of nanoparticles was investigated by using the zeta potential, size of particles,
loading capacities, encapsulation efficiency, and Fourier Transforms Infrared Spectroscopy. Chitosan/
fluoride nanoparticles were fabricated by a method of fluoride/chitosan cross-linking with
tripolyphosphate.
</P><P>
Results: The size of nanoparticles was 219 nm. According to the zeta potential results, by adding
sodium fluoride to chitosan/tripolyphosphate nanoparticles reducing the number of positive charges
of chitosan, the result was diminished zeta potential from +30.8 mV to +14.9 mV. The optimum
drug loading and percentage of entrapment efficiency were 70% and 30% respectively. Fourier
transform infrared spectroscopy confirmed linked among tripolyphosphate, chitosan and fluoride
nanoparticles. In vitro characterization of nanoparticles demonstrated higher fluoride uptake ability
and smooth releasing profile.
</P><P>
Conclusion: It is suggested that fluoride/chitosan nanoparticles synthesized in our study may be a
promising means of delivering fluoride for the early prevention of tooth decay.</P>
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Affiliation(s)
- Niousha Ebrahimi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Soleimani
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jamal Rashidiani
- Nanobiotechnology Research Centre, Baqhiatollah University of Medical Science, Molla Sadra, Tehran, 1435916471, Iran
| | | | - Fatemeh Abedini
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Hesarak, Karaj, Alborz, Iran
| | - Hossein Hosseinkhani
- Innovation Center for Advanced Technology, Matrix, Inc., New York, NY 10029, United States
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12
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In vitro evaluation of the early erosive lesion in polished and natural human enamel. Dent Mater 2018; 34:1391-1400. [DOI: 10.1016/j.dental.2018.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/12/2018] [Accepted: 06/07/2018] [Indexed: 12/29/2022]
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13
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Scandiffio P, Mantilla T, Amaral F, França F, Basting R, Turssi C. Anti-erosive effect of calcium carbonate suspensions. J Clin Exp Dent 2018; 10:e776-e780. [PMID: 30305876 PMCID: PMC6174013 DOI: 10.4317/jced.54994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/05/2018] [Indexed: 11/05/2022] Open
Abstract
Background This study aimed to investigate the ability of different concentrations of calcium carbonate (CaCO3) suspensions to control enamel surface loss. Material and Methods Seventy-five enamel slabs were embedded, ground and polished in a pneumatic grinder-polisher machine. Reference areas were created with UPVC tape and the specimens were randomly allocated into five groups (n = 15) for exposure to hydrochloric acid solution to simulate gastric juice (0.01 M, pH 2) for 2 minutes. The samples were then exposed to suspensions containing 0.0001, 0.001, 0.01 or 0.1 mmol/L CaCO3 for 1 minute. Artificial saliva was used as control. The samples were subjected to a total of five erosive cycles followed by treatment with CaCO3 suspension. Surface loss was measured (in µm) using optical profilometry. Results One-way ANOVA (p = 0.009) and Tukey's test showed a significant reduction in surface loss when compared to the group not exposed to CaCO3 (0.74, +/- 0.23 µm), and the 0.01 mmol/L (0.40; +/- 0.23 µm) and 0.1 mmol/L suspensions (0.37; +/- 0.26 µm). Conclusions The lower concentrated suspensions were incapable of significantly reducing enamel surface loss. Rinsing with 0.01 and 0.1 mmol/L calcium carbonate suspensions was revealed as a potentially promising strategy to prevent enamel erosion. Key words:Tooth erosion, gastric acid, calcium carbonate, prevention and control.
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Affiliation(s)
- Priscila Scandiffio
- DDS, São Leopoldo Mandic Institute and Dental Research Center, Rua José Rocha Junqueira, 13, Campinas, SP, Brazil
| | - Tais Mantilla
- DDS, MSc, PhD student, School of Dentistry, University of São Paulo, Av. Professor Lineu Prestes 2227, São Paulo, SP, Brazil
| | - Flávia Amaral
- DDS, MSc, PhD, Assistant Professor, São Leopoldo Mandic Institute and Dental Research Center, Rua José Rocha Junqueira, 13, Campinas, SP, Brazil
| | - Fabiana França
- DDS, MSc, PhD, Assistant Professor, São Leopoldo Mandic Institute and Dental Research Center, Rua José Rocha Junqueira, 13, Campinas, SP, Brazil
| | - Roberta Basting
- DDS, MSc, PhD, Assistant Professor, São Leopoldo Mandic Institute and Dental Research Center, Rua José Rocha Junqueira, 13, Campinas, SP, Brazil
| | - Cecilia Turssi
- DDS, MSc, PhD, Assistant Professor, São Leopoldo Mandic Institute and Dental Research Center, Rua José Rocha Junqueira, 13, Campinas, SP, Brazil
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14
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15
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Nandakumar M, Nasim I. Comparative evaluation of grape seed and cranberry extracts in preventing enamel erosion: An optical emission spectrometric analysis. J Conserv Dent 2018; 21:516-520. [PMID: 30294113 PMCID: PMC6161533 DOI: 10.4103/jcd.jcd_110_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Dental erosion is defined as the loss of tooth structure due to chemical process that does not involve bacteria. The management of such a condition calls for a comprehensive approach to identifying the cause and treating it. Aim: The aim of this study is to comparatively evaluate the role of grape seed extract (GSE) and cranberry extract (CE) in preventing dental erosion using optical emission spectrometry. Materials and Methods: Prepared enamel specimens were subjected to the erosive challenge using HCl for 10 s, followed by immersion in experimental natural groups and control fluoride group for 30 s and artificial saliva for 60 min. This cycle was repeated three times. The amounts of calcium and phosphorous present in the acid solution after 1st, 2nd, and 3rd erosive challenges were determined for each group using induced coupled plasma-optical emission spectrometry. Results: The cumulative calcium and phosphorous release after the 1st, 2nd, and 3rd erosive challenges were found to be the least in SnF2 group, followed by GSE group and then in CE group. Conclusion: The protective of GSE and CE was inferior to the gold standard control group of stannous fluoride role, against enamel erosion. GSE showed better remineralizing effect; however, there was no statistically significant difference between the two groups.
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Affiliation(s)
- Mahalakshmi Nandakumar
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Iffat Nasim
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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16
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Kensche A, Kirsch J, Mintert S, Enders F, Pötschke S, Basche S, König B, Hannig C, Hannig M. Impact of customary fluoride rinsing solutions on the pellicle's protective properties and bioadhesion in situ. Sci Rep 2017; 7:16584. [PMID: 29185495 PMCID: PMC5707358 DOI: 10.1038/s41598-017-16677-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/10/2017] [Indexed: 01/20/2023] Open
Abstract
This study investigated the impact of customary fluoride based mouthrinses on the ultrastructure and the functional properties of the in situ pellicle, considering the prevention of erosion (8 volunteers) and initial biofilm formation (12 volunteers). Bovine enamel slabs were carried intraorally. After 1 min of pellicle formation, the subjects rinsed with elmex Kariesschutz (A), Dontodent Med Care (B), meridol (C) or elmex Zahnschmelzschutz Professional (D) for 1 min. In situ pellicle formation was continued up to 30 min/8 h before processing the slabs in vitro. Erosion was simulated by incubating the specimens in HCl (pH 3.0, 2.3, 2.0) for 120 s, measuring the kinetics of calcium/phosphate release photometrically; representative samples were evaluated by TEM and EDX. Bacterial adhesion was visualized fluorescence microscopically (DAPI/BacLight). Native enamel slabs or physiological pellicle samples served as controls. All investigated mouthrinses enhanced the erosion preventive pellicle effect in dependence of the pH-value. A significant decrease of Ca/P release at all pH values was achieved after rinsing with D; TEM/EDX confirmed ultrastructural pellicle modifications. All mouthrinses tendentially reduced bacterial adherence, however not significantly. The mouthrinse containing NaF/AmF/SnCl2 (D) offers an effective oral hygiene supplement to prevent caries and erosion.
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Affiliation(s)
- A Kensche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany.
| | - J Kirsch
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - S Mintert
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - F Enders
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - S Pötschke
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - S Basche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - B König
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D- 66421, Homburg/Saar, Germany
| | - C Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - M Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D- 66421, Homburg/Saar, Germany
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17
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O’Toole S, Bernabé E, Moazzez R, Bartlett D. Timing of dietary acid intake and erosive tooth wear: A case-control study. J Dent 2017; 56:99-104. [DOI: 10.1016/j.jdent.2016.11.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022] Open
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