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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 2024:105141. [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] [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) (ClinproTM White) or tricalcium phosphate (TCP) (MI Varnish TM) 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 (ClinproTM White) (n= 193) and 5% NaF varnish with CPP-ACP (MI Varnish TM) (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 TM group (n= 125), 65.1% in the ClinproTM 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, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Pei Liu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Divesh Sardana
- Pediatric Dentistry, The University of Oklahoma College of Dentistry, Oklahoma, USA
| | - Simin Peng
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Edward Cm Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Cynthia Ky Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R.
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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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Nath SJC, Fu Y, Li KC, Loho T, Loch C, Ekambaram M. A Comparison of the Enamel Remineralisation Potential of Self-Assembling Peptides. Int Dent J 2024; 74:187-194. [PMID: 37743135 PMCID: PMC10988264 DOI: 10.1016/j.identj.2023.07.003] [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: 03/23/2023] [Revised: 06/19/2023] [Accepted: 07/04/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The aim of this research was to compare the efficacy of the remineralising potential of self-assembling peptides (SAPs): Curodont Repair (P11-4), P26, and leucine-rich amelogenin peptides (LRAP) with the standard 5% NaF varnish (Duraphat) on early enamel caries lesions (EECLs). METHODS A demineralising solution (DS) was used to create artificial EECLs in human dental enamel specimens, which were randomly allocated to treatment groups: P11-4; P26 solution; LRAP solution; 5% NaF varnish; and deionised water (DIW). Each specimen was subjected to 8 days of pH cycling. Specimens from each test group were subjected to microcomputed tomography (micro-CT) and nanomechanical testing to assess mineral density (MD), hardness (H), and elastic modulus (EM) properties of sound, demineralised, and treated enamel. RESULTS The mean MD percentage gain was highest in the P26 and P11-4 groups, followed by the LRAP, 5% NaF varnish, and DIW groups. There were statistically significant differences amongst groups. In the outer layer of EECLs, the EM and H were highest in P26 and P11-4 groups, followed by the LRAP and 5% NaF varnish. In the inner layer of EECLs, the EM and H were highest in P11-4 and P26 groups, indicative of enhanced penetration and remineralisation of the deeper parts of the artificial EECLs. CONCLUSIONS P26 and P11-4 SAPs are more effective than 5% NaF varnish in remineralising the depth of EECLs.
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Affiliation(s)
- Suneil Jason Chand Nath
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yipeng Fu
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand; The Fifth Outpatient Department, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Kai Chun Li
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Thomas Loho
- Faculty of Engineering, Chemical and Materials Engineering, University of Auckland, New Zealand
| | - Carolina Loch
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Manikandan Ekambaram
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
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Rahmath Meeral P, Doraikannan S, Indiran MA. Efficiency of casein phosphopeptide amorphous calcium phosphate versus topical fluorides on remineralizing early enamel carious lesions - A systematic review and meta analysis. Saudi Dent J 2024; 36:521-527. [PMID: 38690375 PMCID: PMC11056415 DOI: 10.1016/j.sdentj.2024.01.014] [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: 10/14/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 05/02/2024] Open
Abstract
Objective To assess the remineralizing efficiency of caesin phosphopepdide amorphous calcium phosphate (CPP-ACP) versus topical fluorides on early enamel lesions in vivo. Data sources PubMed, Web of Science, Scopus, EBSCO were searched based on the PICOS criteria up to December 2022 with English language restriction. All relevant studies were subjected to two separate reviews before being included at the title, abstract, and full text levels. Study selection 41 studies were reviewed and 11 selected for inclusion in the final sample for the review. All were randomized clinical trials with the follow-up period of the studies ranging from 3 to 12 months. Out of the 11 studies, only two are with low risk of bias on assessment with Cochrane risk of bias assessment tool, while the other nine articles were with the moderate and high risk of bias. Conclusions Conflicting evidence exists on the clinical efficacy of CPP-ACP compared to the various fluoride forms tested, and no adverse effect associated with CPP-ACP use was discovered in comparison to fluorides that had certain detrimental health impacts. Although, the review results in favor of both fluorides and CPP-ACP with similar clinical efficiency, when ill effects are considered the CPP-ACP can be a choice of remineralizing early enamel lesions. However, before concrete suggestions can be given, high-quality, well-designed clinical research in this area are still necessary. Clinical significance A considerable remineralizing impact has been shown in both in vitro and in vivo experiments, making CPP-ACP/CPP-ACPF a more promising remineralizing agent than fluorides. Therefore, this can be applied clinically to early enamel carious lesion.
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Affiliation(s)
- P. Rahmath Meeral
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai 600077, India
| | - Srisakthi Doraikannan
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai 600077, India
| | - Meignana Arumugham Indiran
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai 600077, India
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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 2023. [PMID: 37831601 DOI: 10.1111/idh.12778] [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: 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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Matar MA, Darwish SS, Salma RS, Lotfy WA. Evaluation of the antibacterial activity of Enamelast® and Fluor defender® fluoride varnishes against Streptococcus mutans biofilm: an in vitro study in primary teeth. Eur Arch Paediatr Dent 2023; 24:549-558. [PMID: 37525011 PMCID: PMC10600041 DOI: 10.1007/s40368-023-00811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 06/02/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE The aim of the current work was to compare the antibacterial activity of Enamelast® and Fluor defender® fluoride varnish on biofilm generation by Streptococcus mutans on extracted primary teeth. METHODS Thirty-six primary molars were collected and sliced into seventy-two test model disks. All specimens were examined, and the cracked or broken ones were discarded. A total number of specimens (n = 54) were divided into two experimental analyses viz; biofilm formation (n = 27) and microscopic examination (n = 27). Specimens of each analysis were tested under different experimental conditions: a negative control group (n = 9), Fluor defender group (n = 9), and Enamelast group (n = 9). Following treatment, biofilms were generated by adherent Streptococcus mutans on the test model disks on three time intervals: 24 h (n = 3), 48 h (n = 3), and 72 h (n = 3) for each analysis. Then, for biofilm formation analysis, the biofilm was detected spectrophotometrically at 620 nm after being stained by crystal violet. For microscopical analysis, the surfaces of the test model disks were visualized by scanning electron microscopy (SEM), and each image was processed and analyzed using ImageJ software. RESULTS At 48 and 72 h, Enamelast® and Fluor defender®-treated group showed significantly (p < 0.001) slight adhered bacterial cells when compared with the negative control group as revealed by the absorbance and SEM. Compared with the Fluor defender®-treated group, the absorbance of the Enamelast®-treated group showed a significant (p < 0.001) increase by approximately 7- and 16.5-fold at 48 and 72 h, respectively. Similarly, SEM showed that the number of bacterial cells adhered to enamel surfaces in the Fluor defender®-treated group was significantly (p < 0.001) fewer than the Enamelast®-treated group by approximately 36.55% and 20.62% at 48 and 72 h after exposure, respectively. CONCLUSION We conclude that the anti-biofilm activity of Fluor defender® against Streptococcus mutans was significantly (p < 0.001) greater than Enamelast® fluoride varnish. The use of Fluor defender® is encouraged as a preventive measure in children with the high risk of developing dental caries.
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Affiliation(s)
- M A Matar
- Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - S S Darwish
- Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - R S Salma
- Pediatric Dentistry Department, College of Dentistry El Alamein, Arab Academy for Science, Technology and Maritime Transport (AAST), Alamein, Egypt.
| | - W A Lotfy
- Microbiology Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
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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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Evaluation of Resin Infiltration, Fluoride and the Biomimetic Mineralization of CPP-ACP in Protecting Enamel after Orthodontic Inter-Proximal Enamel Reduction. Biomimetics (Basel) 2023; 8:biomimetics8010082. [PMID: 36810413 PMCID: PMC9944074 DOI: 10.3390/biomimetics8010082] [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: 01/04/2023] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND This study investigated the effect of using different agents for protecting enamel proximal surfaces against acidic attack after interproximal reduction (IPR) using the trans micro radiography technique. METHODS Seventy-five sound-proximal surfaces were obtained from extracted premolars for orthodontic reasons. All teeth were measured miso-distally and mounted before being stripped. The proximal surfaces of all teeth were hand stripped with single-sided diamond strips (OrthoTechnology, West Columbia, SC, USA) followed by polishing via Sof-Lex polishing strips (3M, Maplewood, MN, USA). Three-hundred micrometers of enamel thickness was reduced from each proximal surface. The teeth were randomly divided into 5 groups: group 1 (control un-demineralized) received no treatment, group 2 (control demineralized) had their surfaces demineralized after the IPR procedure, group 3 (fluoride) specimens were treated with fluoride gel (NUPRO, DENTSPLY, Charlotte, NC, USA) after the IPR, group 4 (Icon) resin infiltration material (Icon Proximal Mini Kit, DMG, Bielefeld, Germany) was applied after IPR, group 5 (MI varnish) specimens were treated with Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing varnish (MI Varnish, G.C, USA, St. Alsip, IL, USA) after the IPR. The specimens in (groups 2-5) were stored in a 4.5 pH demineralization solution for 4 days. The trans-micro-radiography (TMR) technique was conducted to evaluate the mineral loss (∆Z) and lesion depth of all specimens after the acid challenge. The obtained results were analyzed statistically using a one-way ANOVA at a significance level of α = 0.05. RESULTS The MI varnish recorded significant ∆Z and lesion depth values compared to the other groups p > 0.05. There was no significant difference in ∆Z and lesion depth between the control demineralized, Icon, and fluoride groups p < 0.05. CONCLUSION The MI varnish increased the enamel resistance to acidic attack, and thus can be considered an agent capable of protecting the proximal enamel surface after IPR.
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Effect of fluoride varnish in combination with simulated oral environment on enamel-bracket shear bond strength. Odontology 2023; 111:85-92. [PMID: 35771340 DOI: 10.1007/s10266-022-00724-6] [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: 12/20/2021] [Accepted: 06/07/2022] [Indexed: 01/06/2023]
Abstract
To determine the effect of fluoride varnish application combined with a simulated oral environment prior to bracket bonding on the shear bond strength (SBS) between brackets and tooth enamel. Sixty de-identified, extracted teeth were grouped to either receive or not receive fluoride varnish and then stored for 7 days at 37 °C in phosphate-buffered saline (PBS) solution or PBS combined with three 15-min cycles/day in a demineralizing solution to simulate pH variation following meals. Subsequently, brackets were bonded and after 24-h dark cure at 37 °C, debonded using shear forces in a simulated oral environment. The maximum shear force was used to calculate SBS, and the adhesive remnant index (ARI) was determined by image analysis of photos of the bracket mesh pad after debonding. A statistically higher SBS (10.16 MPa) was observed when fluoride varnish was applied prior to storage in PBS + demineralizing solution compared to SBS (6.38 MPa) following storage in the same solution without varnish application. Based on 37% effect size, this difference is also clinically relevant. In contrast, no significant differences in SBS were observed with varnish application combined with PBS with no demineralizing solution or between storage solution alone. Moreover, there was no significant difference in ARI due to varnish combined with either storage method or storage solution only. Results suggest varnish application prior to bracket bonding in combination with simulated oral environment that included acid exposure is beneficial in maintaining higher SBS between bracket and enamel. Despite higher SBS, adhesive remaining on enamel did not increase.
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Sardana D, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Caries-preventive effectiveness of two different fluoride varnishes: A randomised clinical trial in patients with multi-bracketed fixed orthodontic appliances. Int J Paediatr Dent 2023; 33:50-62. [PMID: 35737872 DOI: 10.1111/ipd.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/28/2022] [Accepted: 05/05/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients with multi-bracketed fixed orthodontic appliances are at a higher risk of developing enamel demineralisation. AIM To compare the efficacy of the quarterly application of two varnishes in preventing white spot lesions (WSLs) during multi-bracketed fixed orthodontic treatment. DESIGN Ninety-nine patients were randomly allocated into three intervention groups: Group A-standard oral hygiene instructions (OHI); Group B-5% sodium fluoride (NaF) varnish with standard OHI; and Group C-NaF plus tricalcium phosphate varnish with standard OHI. The outcome was assessed at 6-monthly intervals using a quantitative laser fluorescence device, clinical evaluation and photographic evaluation on six maxillary anterior teeth. A logistic regression model using generalised estimating equations with the intervention group, time and their interaction was used to compare the occurrence of WSLs, whereas the independent-samples Kruskal-Wallis test was used to compare the means of fluorescent values among different groups at p = .05. RESULTS Generalised estimating equations (with intervention and time as predictors) showed that only the effect of time was found to be significant (p < .001), whereas there was no significant difference among the three intervention groups (p = .305) using clinical assessment or photographic assessment (p = .599). At the 18-month follow-up, sodium fluoride (NaF) varnish with standard OHI was shown to reduce the odds of WSLs by 55% (p = .200), and NaF plus tricalcium phosphate varnish with standard OHI by 42% (p = .327). CONCLUSION The study failed to demonstrate that the quarterly application of both the study varnishes with OHI provided additional benefits compared with standard OHI alone in preventing WSLs, taking the effect of time of follow-up into consideration. There were higher odds of developing WSLs with an increased duration of orthodontic treatment.
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Affiliation(s)
- Divesh Sardana
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.,Division of Pediatric Dentistry, The University of Oklahoma College of Dentistry, Oklahoma city, USA
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yanqi Yang
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Colman P McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Cynthia K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Liu Z, Lu J, Chen X, Xiu P, Zhang Y, Lv X, Jiang X, Wang K, Zhang L. A novel amelogenesis-inspired hydrogel composite for the remineralization of enamel non-cavitated lesions. J Mater Chem B 2022; 10:10150-10161. [PMID: 36472307 DOI: 10.1039/d2tb01711c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Enamel non-cavitated lesions (NCLs) are subsurface enamel porosity from carious demineralization. The developed enamel cannot repair itself once NCLs occurs. The regeneration of mineral crystals in a biomimetic environment is an effective way to repair enamel subsurface defects. Previously, an amelogenin-derived peptide named QP5 was proven to repair demineralized enamel. In this work, inspired by amelogenesis, a novel biomimetic hydrogel composite containing the QP5 peptide and bioactive glass (BG) was designed, in which QP5 could promote enamel remineralization by guiding the calcium and phosphorus ions provided by BG. Also, BG could adjust the mineralization micro-environment to alkalinity, simulating the pH regulation of ameloblasts during enamel maturity. The BQ hydrogel composite showed biosafety and possessed capacity for enamel binding, ion release and pH buffering. Enamel NCLs treated with the BQ hydrogel composite showed a higher reduction in lesion depth and mineral loss both in vitro and in vivo. Moreover, compared to the hydrogels containing only BG or QP5, groups treated with the BQ hydrogel composite attained more surface microhardness recovery and color recovery, exhibiting resistance to erosion and abrasion of the remineralization layer. We envision that the BQ hydrogel composite can provide a biomimetic micro-environment to favor enamel remineralization, thus reducing the lesion depth and increasing the mineral content as a promising biomimetic material for enamel NCLs.
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Affiliation(s)
- Zhenqi Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Junzhuo Lu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Xiangshu Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Peng Xiu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Yinmo Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Xiaohui Lv
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Xinyi Jiang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Kun Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Linglin Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
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12
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Eissa NM, Elshourbagy EM, Gomaa NE. Effect of sodium fluoride plus tricalcium phosphate with and without CO2 laser on remineralization of white spot lesions. Heliyon 2022; 8:e10752. [PMID: 36212006 PMCID: PMC9535291 DOI: 10.1016/j.heliyon.2022.e10752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/19/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives The aim of this in vitro study was to evaluate the effect of NaF plus TCP with and without CO2 laser irradiation on management of demineralized enamel using microhardness test and digital microscopy. Methods Eighty intact extracted human premolar teeth were randomly divided into 4 groups (20/each). Each group was subjected to a demineralizing solution to create white spot lesion. Group 1 was treated with 3M Vanish™. Group 2 was irradiated with CO2 laser. Group 3 was subjected to CO2 laser followed by 3M Vanish™. Group 4 was treated by 3M Vanish™ then CO2 laser. The teeth were immersed in artificial saliva. Surface microhardness was measured for each tooth before demineralization at base line (M1 as a control), after demineralization (M2) and after management (M3). Comparison of microhardness values between groups was performed using one way ANOVA test with significant level (0.05) followed by multiple comparisons post-hoc Tukey test between groups. Enamel surface was photographed by digital microscope. Results All intervention methods used in the current study significantly increased microhardness values of demineralized enamel (P < 0.001). Little improvement of enamel appearance was observed in all groups meanwhile using CO2 laser on demineralized enamel directly led to signs of white and black dots affecting the appearance of enamel surface. Significance The most effective intervention regarding microhardness was group 2 followed by group 3, group 4 and group 1. Coating the enamel surface with 3M Vanish™ before CO2 laser irradiation acted as a protective layer from the undesirable effects of laser on the teeth with increasing enamel microhardness values more than using Vanish alone. So the promising intervention method regarding both microhardness and appearance was group 4.
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Fernando JR, Walker GD, Park TKS, Shen P, Yuan Y, Reynolds C, Reynolds EC. Comparison of calcium-based technologies to remineralise enamel subsurface lesions using microradiography and microhardness. Sci Rep 2022; 12:9888. [PMID: 35701508 PMCID: PMC9197824 DOI: 10.1038/s41598-022-13905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Assessment of enamel subsurface lesion remineralisation is essential for the evaluation of novel remineralisation technologies. The gold standard to assess subsurface mineral gain of enamel lesions is transverse microradiography (TMR). However, some studies have utilised surface microhardness (SMH) to evaluate efficacy of remineralisation agents. The aim of this study was to assess remineralisation of enamel subsurface lesions using TMR and SMH after in vitro treatment with calcium-containing technologies, and to test correlation between the TMR and SMH measurements. The parameters obtained from the TMR and SMH analyses of enamel subsurface remineralisation were not significantly correlated. Furthermore, the enamel subsurface remineralisation as measured by TMR was significantly correlated with the water-soluble calcium concentration of the remineralisation products. Scanning electron microscopy revealed surface precipitates formed by specific remineralisation treatments obfuscated accurate assessment of remineralisation by SMH. It was concluded that TMR is a more appropriate method for analysis of enamel subsurface remineralisation, and that SMH values of remineralised enamel should be interpreted with caution. Using TMR the level of remineralisation (%R) by the different technologies was CPP-ACP/F (31.3 ± 1.4%); CPP-ACP (24.2 ± 1.4%); CaSO4/K2HPO4/F (21.3 ± 1.4%); f-TCP/F (20.9 ± 1.0%); Nano-HA/F (16.3 ± 0.3%); Nano-HA (15.3 ± 0.6%) and F alone control (15.4 ± 1.3%).
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Affiliation(s)
- James R Fernando
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Glenn D Walker
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Thomas Kwan-Soo Park
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Peiyan Shen
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Yi Yuan
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Coralie Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Australia
| | - Eric C Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Australia.
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Bezerra SJC, Viana ÍEL, Aoki IV, Duarte S, Hara AT, Scaramucci T. In-vitro evaluation of the anti-cariogenic effect of a hybrid coating associated with encapsulated sodium fluoride and stannous chloride in nanoclays on enamel. J Appl Oral Sci 2022; 30:e20210643. [PMID: 35507984 PMCID: PMC9064272 DOI: 10.1590/1678-7757-2021-0643] [Citation(s) in RCA: 3] [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: 11/08/2021] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study is to test, in vitro, the anti-cariogenic effect of experimental hybrid coatings, with nano clays of halloysite or bentonite, loaded with sodium fluoride or with a combination of sodium fluoride and stannous chloride, respectively. METHODOLOGY The varnish Fluor Protector (1,000 ppm of F-) was used as positive control and no treatment was the negative control. Enamel specimens (5 mm × 5 mm) were obtained from bovine teeth. The specimens (n=10) had their surfaces divided into two halves (5 mm × 2.5 mm each), in which one half received one of the treatments (Hybrid; Hybrid + NaF; Hybrid + NaF + SnCl2; Hybrid + NaF Loaded; Hybrid + NaF + SnCl2 Loaded). The specimens were submitted to a cariogenic challenge using a biofilm model (S. mutans UA159, for 5 days). Enamel surfaces both under and adjacent to the treated area were analyzed for mineral loss and lesion depth, by transverse microradiography. The pH of the medium was measured twice a day, and the fluoride release was analyzed. Additional specimens were submitted to confocal analysis. RESULTS Data were statistically analyzed by two-way ANOVA followed by Tukey test (α=0.05). None of hybrid groups were able to reduce the lesion depth; the Hybrid + NaF group, however, was able to reduce mineral loss differing from the negative control (p=0.008). The groups showed no significant difference in the pH measurement and fluoride release. Confocal analysis confirmed that for all groups the biofilm growth was similar. CONCLUSION None of the hybrid groups reduced lesion depth, but the Hybrid + NaF group was able to promote protection against mineral loss.
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Affiliation(s)
- Sávio José Cardoso Bezerra
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, Brasil
- Indiana University School of Dentistry, Operative Dentistry and Dental Public Health, Department of Cariology, Indianapolis, United States
| | - Ítallo Emídio Lira Viana
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, Brasil
| | - Idalina Vieira Aoki
- Universidade de São Paulo, Escola Politécnica, Departamento de Engenharia Química, São Paulo, Brasil
| | - Simone Duarte
- Indiana University School of Dentistry, Operative Dentistry and Dental Public Health, Department of Cariology, Indianapolis, United States
| | - Anderson Takeo Hara
- Indiana University School of Dentistry, Operative Dentistry and Dental Public Health, Department of Cariology, Indianapolis, United States
| | - Taís Scaramucci
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Dentística, São Paulo, Brasil
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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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Effectiveness of Visual-Tactile Examination and DIAGNOdent Pen in Detecting Early Enamel Caries and Its Remineralisation: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1263750. [PMID: 35059458 PMCID: PMC8766177 DOI: 10.1155/2022/1263750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022]
Abstract
Background The caries preventive effect of Colgate Duraphat® and GC Tooth Mousse Plus® has been widely studied, but the remineralisation potential of initial occlusal caries using these two remineralisation materials remains unclear. Aim This study is aimed at evaluating and comparing the remineralisation of early enamel caries on the occlusal surface of permanent posterior teeth using ICDAS II caries scoring system and DIAGNOdent Pen (DDPen) after remineralisation with Colgate Duraphat® and GC Tooth Mousse Plus®. Materials and Methods Extracted posterior teeth (N = 120) with incipient occlusal caries were included in this study. The occlusal surface of each tooth was scored using DDPen and ICDAS II scoring before remineralisation. Then, remineralisation of the teeth of the experimental group was carried out using either CPP-ACP-F or fluoride varnish. After the remineralisation procedures, the occlusal surface of each tooth was again scored using DDPen and ICDAS II scoring. The teeth were then fixed in dental stone blocks and sectioned longitudinally for histological examination using a stereomicroscope. Statistical analysis was performed to calculate the sensitivity and specificity of DDPen and ICDAS II to detect remineralisation and compare with the gold standard histological examination. Results According to ICDAS-II scores, a significant difference was noted in GC Tooth Mousse Plus® and Duraphat® study samples, whereas the difference between the pre-and post-remineralisation of the control group was not significant. According to the DDPen score criteria, a statistically significant difference was noted among all study groups; however, a greater significance level was noted in the GC Tooth Mousse Plus® and Duraphat® study samples compared with the control group. The Spearman's rank correlation of ICDAS-II and DDPen with Downer's histological score (gold standard) revealed a higher association of DDPen score (.738) as compared to ICDAS-II scores (.430). Conclusion The study concluded that both ICDAS II and DDPen could detect remineralisation of early enamel occlusal caries. DDPen was more sensitive than ICDAS-II to detect remineralisation compared with the Downers histological scores.
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González-Sotelo A, Contreras-Bulnes R, Rodríguez-Vilchis LE, de Los Angeles Moyaho-Bernal M, Rubio-Rosas E, Teutle-Coyotecatl B, Mézquita-Rodrigo I. Morphological and porosity changes in primary enamel surface after an in vitro demineralization model. Microsc Res Tech 2022; 85:1956-1963. [PMID: 35005814 DOI: 10.1002/jemt.24058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/29/2021] [Accepted: 01/02/2022] [Indexed: 11/06/2022]
Abstract
In vitro models are very useful in dentistry, especially to evaluate preventive methods against dental caries. Although they have been used for more than 30 years, specific demineralization models have not been established for primary enamel, which is more prone to demineralization than permanent enamel. This study evaluates porosity changes in primary enamel surface after a demineralization model through a scientifically validated analytical tool. Nine healthy human anterior primary teeth extracted for therapeutic reasons were included in this study, previous informed consent. The samples were randomly assigned to three groups n = 3: G1_2D, G2_4D, and G3_7D. Scanning electron microscopy (SEM) images at ×200 and ×1000 were taken during two stages: before demineralization (BD) and after demineralization (AD). Morphological characterization was observed at ×1000, while porosity (pore count and perimeter) was analyzed by the ImageJ program, using ×200 SEM images previously converted. Several statistical analyses were used to determine differences (p ≤ .05). Morphological characterization AD revealed new pits and cracks on the enamel surface in G1_2D and G2_4D groups. Localized eroded enamel areas were observed in G3_7D. Pore count of enamel surface BD ranged from 64.26 ± 37.62 to 97.93 ± 34.25 and AD ranged from 150.06 ± 64.86 to 256 ± 58.14. AD, G_4D exhibited a decrease in pore perimeter contrary to G_2D and G_7D. Significant differences were observed. Finally, morphological changes were more evident as days of demineralization increased; 7 days of immersion could be employed as an enamel erosive model. The pore count increased after the demineralization model, BD pores perimeter was heterogeneous, and AD varied according to the immersion period.
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Affiliation(s)
- Arlete González-Sotelo
- Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Universidad Autónoma del Estado de México, Toluca, Mexico
| | - Rosalía Contreras-Bulnes
- Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Universidad Autónoma del Estado de México, Toluca, Mexico
| | - Laura Emma Rodríguez-Vilchis
- Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Universidad Autónoma del Estado de México, Toluca, Mexico
| | | | - Efraín Rubio-Rosas
- Dirección de Innovación y Transferencia de Conocimiento, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Bernardo Teutle-Coyotecatl
- Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Universidad Autónoma del Estado de México, Toluca, Mexico
| | - Irina Mézquita-Rodrigo
- Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Universidad Autónoma del Estado de México, Toluca, Mexico
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Nadar B, Yavagal P, Velangi C, Yavagal C, Basavaraj S. Efficacy of casein phosphopeptide-amorphous calcium phosphate varnish in remineralizing white spot lesions: A systematic review and meta-analysis. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.346406] [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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A novel sustained release fluoride strip based Poly(propylene carbonate) for preventing caries. Eur J Pharm Sci 2022; 171:106128. [DOI: 10.1016/j.ejps.2022.106128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 11/18/2022]
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Alqahtani MA, Almosa NA, Alsaif KA, Alsaif NM, Aljaser YJ. Effect of topical fluoride application and diode laser-irradiation on white spot lesions of human enamel. Saudi Dent J 2021; 33:937-943. [PMID: 34938035 PMCID: PMC8665184 DOI: 10.1016/j.sdentj.2021.08.007] [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: 01/08/2021] [Revised: 07/02/2021] [Accepted: 08/16/2021] [Indexed: 12/01/2022] Open
Abstract
Objectives This study aims to evaluate the effectiveness of topical fluoride application and diode laser-irradiation on the hardness of demineralized enamel and to evaluate the esthetic improvement of the white spot lesions (WSLs) using a visual analog scale (VAS). Materials and Methods Artificial WSLs (3x3 mm) were created on the enamel surface of 45 human third molars. The teeth were randomly assigned into three groups (n = 15): group A, fluoride only; group B, combined therapy of fluoride and diode laser; and group C, control. Vicker’s hardness number (VHN) was measured at baseline, after demineralization and after treatment. To evaluate the esthetic improvement after treatment, 14 raters evaluated each group’s photographs using a 100-millimeter VAS. A one-way ANOVA or Brown-Forsythe and Games-Howell post hoc procedure were performed for statistical analysis. The level of significance was set at α = 0.05 for all tests. Results Group A mean VHN was significantly higher than groups B and C, and group B was significantly higher than group C (P < 0.05). However, the mean VAS rating for the combined therapy group (B) was significantly higher than that for groups A and C (P < 0.05). Conclusion Combination therapy significantly improved the esthetic appearance of WSLs compared to the fluoride only group. However, there was less enamel hardness versus treatment with fluoride only.
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Affiliation(s)
- Mohammad A Alqahtani
- Department of Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
| | - Naif A Almosa
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Khalid A Alsaif
- Prosthodontics Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Naif M Alsaif
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Yazeed J Aljaser
- Orthodontic Resident, College of Dentistry, Taibah University, Madina, Saudi Arabia
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Wierichs RJ, Mester J, Wolf TG, Meyer-Lueckel H, Esteves-Oliveira M. Effects of the association of high fluoride- and calcium-containing caries-preventive agents with regular or high fluoride toothpaste on enamel: an in vitro study. Clin Oral Investig 2021; 26:3167-3178. [PMID: 34816310 DOI: 10.1007/s00784-021-04299-4] [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: 09/21/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this in vitro study was to compare the caries-preventive effect of various high fluoride- and calcium-containing caries-preventive agents (> 22.000 ppm F- [ppm]) in adjunct to use of regular (1450 ppm) or high (5000 ppm) fluoride toothpaste on sound as well as demineralized enamel. MATERIALS AND METHODS Bovine enamel specimens (n = 276; 5 mm × 3.5 mm × 3 mm) having one sound surface [ST] and one artificial caries lesion [DT] were randomly allocated to 12 groups. Interventions before pH-cycling were no intervention ([SC1/SC5]), application of varnishes/solutions containing NaF (22,600 ppm; Duraphat [NaF1/NaF5]); NaF + tricalcium phosphate (22,600 ppm; Clinpro White Varnish [TCP1/TCP5]); NaF + CPP-ACP (22,600 ppm; MI Varnish [CPP1/CPP5]); silver diammine fluoride (35,400 ppm; Cariestop 30%[SDF1/SDF5]); and NaF + calcium fluoride (45,200 ppm; Biophat[CaF1/CaF5]). During pH-cycling (28 days, 6 × 120 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 × /day) with either 1,450 (NaF; named, e.g., TCP1) or 5,000 ppm (NaF; e.g., TCP5) dentifrice slurry. Differences in integrated mineral loss (∆∆Z) and lesion depth (∆LD) were calculated between values after initial demineralization and after pH-cycling using transversal microradiography. RESULTS After pH-cycling, SC1/SC5 showed significantly increased ∆ZDT/LDDT values, indicating further demineralization (p < 0.05; paired t-test). Decreased ∆ZDT values, indicating non-significant remineralization, could only be observed in CaF1/CaF5 (p > 0.05; paired t-test). Additional use of all varnishes/solutions significantly decreased ∆∆ZDT/∆∆ZST and ∆LDDT/∆LDST compared to SC1/SC5 (p < 0.05;ANCOVA). Between 1450 and 5000 ppm dentifrices, a significant difference in ∆∆ZDT/∆∆ZST and ∆LDDT/∆LDST could only be observed for SC1/SC5 (p < 0.05; ANCOVA). CONCLUSION Under the conditions chosen, all fluoride varnishes/solutions significantly reduced demineralization. Furthermore, a significant dose-response characteristic for fluoride varnishes could be revealed. However, no additional benefit could be observed, when varnishes were combined with high fluoride instead of regular fluoride dentifrices. CLINICAL RELEVANCE For children and adolescents with high caries risks varnishes containing more than 22,600 ppm should be further investigated, as they offered higher caries-preventive effects in vitro. Furthermore, there seems to be no difference in the demineralization-inhibitory capacity of fluoride varnishes when used in combination with either standard or highly fluoridated dentifrices.
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Affiliation(s)
- Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland. .,Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, 52074, Aachen, Germany.
| | - Judith Mester
- Department of CariologyEndodontology and Periodontology, University of Leipzig, Liebigstraße 12, 04103, Leipzig, Germany
| | - Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Marcella Esteves-Oliveira
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.,Department of CariologyEndodontology and Periodontology, University of Leipzig, Liebigstraße 12, 04103, Leipzig, Germany
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22
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Magalhães TC, Teixeira NM, França RS, Denadai ÂML, Santos RLD, Carlo HL, Munchow EA, Carvalho FGD. Synthesis of a chitosan nanoparticle suspension and its protective effects against enamel demineralization after an in vitro cariogenic challenge. J Appl Oral Sci 2021; 29:e20210120. [PMID: 34644779 PMCID: PMC8523102 DOI: 10.1590/1678-7757-2021-0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/26/2021] [Indexed: 11/22/2022] Open
Abstract
Objective Our study aims to synthesize, characterize, and determine the effects of a ChNPs suspension on human enamel after cariogenic challenge via pH-cycling. Methodology ChNPs were synthesized by ion gelation and characterized by Transmission Electron Microscopy (TEM) and Dynamic Light Scattering. Forty enamel blocks were divided into four groups (n=10/group): (i) ChNPs suspension; (ii) chitosan solution; (iii) 0.05% sodium fluoride (NaF) solution; and (iv) distilled water. Specimens were exposed to cariogenic challenge by cycling in demineralization solution (3 h) and then remineralized (21h) for 7 days. Before each demineralization cycle, the corresponding solutions were passively applied for 90 s. After 7 days, specimens were examined for surface roughness (Ra) and Knoop hardness (KHN) before and after the cariogenic challenge; % KHN change (variation between initial and final hardness), and surface topography by an optical profilometer. The data were analyzed by repeated-measures ANOVA, One-way ANOVA, and Tukey tests (α=0.05). Results TEM images showed small spherical particles with diameter and zeta potential values of 79.3 nm and +47.9 mV, respectively. After the challenge, all groups showed an increase in Ra and a decrease in KHN values. Optical profilometry indicated that ChNPs- and NaF-treated specimens showed uneven roughness interspersed with smooth areas and the lowest %KHN values. Conclusion The ChNPs suspension was successfully synthesized and minimized human enamel demineralization after a cariogenic challenge, showing an interesting potential for use as an oral formulation for caries prevention.
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Affiliation(s)
- Taís Chaves Magalhães
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Departamento de Odontologia, Governador Valadares, Minas Gerais, Brasil
| | - Natália Moreira Teixeira
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Departamento de Odontologia, Governador Valadares, Minas Gerais, Brasil
| | - Renata Sobreira França
- Universidade Federal da Paraíba, Departamento de Odontologia Restauradora, Paraíba, João Pessoa, Brasil
| | - Ângelo Márcio Leite Denadai
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Departamento de Farmácia, Governador Valadares, Minas Gerais, Brasil
| | - Rogério Lacerda Dos Santos
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Departamento de Odontologia, Governador Valadares, Minas Gerais, Brasil
| | - Hugo Lemes Carlo
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Departamento de Odontologia, Governador Valadares, Minas Gerais, Brasil
| | - Eliseu Aldrighi Munchow
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Departamento de Odontologia, Governador Valadares, Minas Gerais, Brasil
| | - Fabíola Galbiatti de Carvalho
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Departamento de Odontologia, Governador Valadares, Minas Gerais, Brasil
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23
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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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24
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Gutiérrez-Prieto SJ, Sequeda-Castañeda LG, Penedo-Jaramillo GM, Chacín-Nieto AV, Contreras-Cáceres DR, Moreno-Abello GC, Galvis-Rincón MP, Gamboa-Jaimes FO, Luengas-Caicedo PE. In vitro mineral apposition analysis of two Colombian plant extracts on Amelogenesis imperfecta teeth. Clin Exp Dent Res 2021; 8:336-349. [PMID: 34498426 PMCID: PMC8874054 DOI: 10.1002/cre2.485] [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: 02/09/2021] [Revised: 07/30/2021] [Accepted: 08/08/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To determine if native Colombian Piper marginatum Jacq. and Ilex guayusa Loes plant extracts have a remineralizing effect on teeth with Amelogenesis imperfecta in comparison with the commercial products Clinpro-3M and Recaldent™. MATERIAL AND METHODS An in vitro study was carried out with 128 human teeth slices (64 healthy and 64 with Amelogenesis imperfecta) on which an initial Raman spectroscopy was performed followed by Raman spectroscopies at 0, 24, 48, and 72 h to determine possible remineralization by observing mineral increase or decrease as a result of P. marginatum Jacq. and I. guayusa Loes extract application in comparison to control substance (Clinpro and Recaldent™) application. Obtained data were analyzed using a bivariate method with a t unidirectional test. Significant differences among groups were determined by an ANOVA with Dunnett post hoc tests. RESULTS Native I. guayusa Loes and P. marginatum Jacq. Colombian plants extracts exhibited phosphate and orthophosphate mineral apposition, where P. marginatum Jacq. presented better results. CONCLUSIONS Native Colombian I. guayusa Loes and P. marginatum Jacq plant extract might in the future be useful for dental tissue remineralization, as they induced phosphate and orthophosphate mineral apposition, main components of tooth enamel. These types of natural compounds can become an alternative to fluorine, whose ingestion is harmful to the human body.
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Affiliation(s)
- Sandra J Gutiérrez-Prieto
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luis G Sequeda-Castañeda
- Department of Chemistry, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia.,Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Gabriela M Penedo-Jaramillo
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Andrea V Chacín-Nieto
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Daniel R Contreras-Cáceres
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Gloria C Moreno-Abello
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María P Galvis-Rincón
- Department of Periodontal Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Fredy O Gamboa-Jaimes
- Department of Microbiology, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Pilar E Luengas-Caicedo
- Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá, Colombia
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25
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González-Sotelo A, Contreras-Bulnes R, Rodríguez-Vilchis LE, Moyaho-Bernal MDLA, Rubio-Rosas E, Cerna-Cortez JR. Enamel demineralization model in primary teeth: Micro-CT and SEM assessments of artificial incipient lesion. Microsc Res Tech 2021; 84:1577-1585. [PMID: 33527566 DOI: 10.1002/jemt.23718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/24/2020] [Accepted: 01/16/2021] [Indexed: 11/06/2022]
Abstract
Many studies have analyzed different tooth demineralization models, which generate artificial incipient lesions; however, most of them are complex, slow, not clear and results could not be employed in both primary and permanent teeth because of chemical content differences among them. This study evaluates a demineralization model on primary enamel, under three incubation periods; quantifying artificial incipient lesions formation, and depth by micro-CT, complementing with SEM for morphological characterization. Sixteen healthy human anterior primary teeth extracted for prolonged retention and orthopedic/orthodontic reasons were included in this study, previous informed consent. The sample was randomly assigned to four groups n = 4: G_Control, G_2D, G_4D, and G_7D. Micro-CT and SEM were performed during two stages: before demineralization (BD) and after demineralization (AD). A t-student test was carried out to determine differences among groups (p ≤ .05). No incipient lesions were observed in control group. Artificial lesion depth was similar among experimental groups; values were from 38.16 ± 05.40 μm to 42.61 ± 04.75 μm. An amount of 14 to 17 artificial incipient lesions were formed per group, the extension and distribution were different for each incubation period. Five erosive lesions were produced in G_7D. All experimental groups were able to form incipient artificial lesions in primary enamel. SEM characterization revealed more pronounced changes on the enamel surface, as the days of immersion in the demineralization solution increased. The 4-day incubation period is the most recommended for the demineralization model, due to the formation of incipient lesions only and its extension, which facilitates their assessment.
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Affiliation(s)
- Arlete González-Sotelo
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Jesús Carranza esq. Paseo Tollocan, Col. Universidad, Toluca, Estado de México, C.P. 50130, México
| | - Rosalía Contreras-Bulnes
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Jesús Carranza esq. Paseo Tollocan, Col. Universidad, Toluca, Estado de México, C.P. 50130, México
| | - Laura E Rodríguez-Vilchis
- Universidad Autónoma del Estado de México, Facultad de Odontología, Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Jesús Carranza esq. Paseo Tollocan, Col. Universidad, Toluca, Estado de México, C.P. 50130, México
| | - Maria de Los Angeles Moyaho-Bernal
- Benemérita Universidad Autónoma de Puebla, Facultad de Estomatología, Av. Manuel Espinosa Yglesias 31 Pte. 1304, Col. Los Volcanes, Puebla, Puebla, C.P. 72570, México
| | - Efraín Rubio-Rosas
- Benemérita Universidad Autónoma de Puebla, Dirección de Innovación y Transferencia de Conocimiento, Prolongación de la 24 Sur y Av. San Claudio, Ciudad Universitaria, Col. San Manuel, Puebla, Puebla, C.P. 72570, México
| | - Jorge R Cerna-Cortez
- Benemérita Universidad Autónoma de Puebla, Facultad de Ciencias Químicas, Centro Avanzado de Pruebas Analíticas No Destructivas, Blvd Valsequillo y esquina Blvd Municipio libre S/N, Cd Universitaria, Col. San Manuel, Puebla, C.P. 72570, Mexico
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26
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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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YILMAZ N, OCAK M, ÖKTE Z. REMINERALIZATION OF PRIMARY MOLAR DENTINE WITH SILVER DIAMINE FLUORIDE AND SODIUM FLUORIDE : AN IN VITRO STUDY. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.796823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bijle MN, Ekambaram M, Lo ECM, Yiu CKY. The enamel remineralization potential of fluoride varnishes containing arginine. J Dent 2020; 99:103411. [DOI: 10.1016/j.jdent.2020.103411] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 10/24/2022] Open
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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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Kamal D, Hassanein H, Elkassas D, Hamza H. Complementary remineralizing effect of self-assembling peptide (P11-4) with CPP-ACPF or fluoride: An in vitro study. J Clin Exp Dent 2020; 12:e161-e168. [PMID: 32071698 PMCID: PMC7018478 DOI: 10.4317/jced.56295] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/08/2019] [Indexed: 11/21/2022] Open
Abstract
Background Self-assembling peptide has been recently introduced to promote hard tissue regeneration for treating early non-cavitated carious lesions. This study investigates the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization combined with CPP-ACPF or fluoride.
Material and Methods Artificial enamel lesions were created on buccal surface of 60 specimens and were randomly assigned to six groups according to the remineralizing agent: G1-(Control, artificial saliva), G2-(Fluoride varnish), G3-(CPP-ACPF varnish), G4-(Self-assembling peptide), G5-(Self-assembling peptide+fluoride varnish), G6-(Self-assembling peptide+CPP-ACPF varnish). All products were applied according to manufacturer’s instructions and specimens were stored in a daily renewed artificial saliva. Surface microhardness (SMH) and scanning electron microscope (SEM) were assessed at baseline, after demineralization, 1 week and 4 weeks storage. SMH values were analyzed using ANOVA and Tukey’s post-hoc test.
Results The highest statistically significant SMH values were found in G6 followed by G5, G4, G2 and G3 while the lowest values were found in G1. No statistically significant difference was found between G5 and G6. Also, no statistically significant difference was found between G2 and G3. SEM showed that G4, G5, G6 resulted in more pronounced remineralization, reversing the demineralized enamel fish scale pattern compared to G2 and G3 after 1 week and 4 week remineralization.
Conclusions Complementary effect was obtained after combining self-assembling peptide with CPP-ACPF or fluoride showing the highest remineralizing potential early after 1 week and even after 4 weeks compared to when each agent used alone. Added benefits can be obtained through combining self-assembling peptide with other remineralzing agents allowing faster and enhanced regeneration of non-cavitated caries lesions. Key words:Enamel regeneration, biomimetic remineralization, self-assembling peptide, CPP-ACPF, fluoride.
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Affiliation(s)
- Dina Kamal
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | | | - Dina Elkassas
- Operative Dentistry Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Heba Hamza
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Wierichs RJ, Rupp K, Meyer-Lueckel H, Apel C, Esteves-Oliveira M. Effects of Dentifrices Differing in Fluoride Content on Remineralization Characteristics of Dentin in vitro. Caries Res 2019; 54:75-86. [PMID: 31775152 DOI: 10.1159/000504165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 10/14/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the caries preventive effect of highly fluoridated dentifrices and gels on sound dentin as well as on artificial dentin caries-like lesions. METHODS Bovine dentin specimens (n = 240), with 2 different surfaces each (1 sound surface [sound treatment (ST)] and one caries lesion [demineralized treatment (DT)]), were prepared and randomly allocated to one highly (6 × 120 min demineralization/day [H]) and one lowly cariogenic (6 × 60 min demineralization/day [L]) pH-cycling model. Treatments during pH-cycling (28 days) were: brushing 2×/day with: 0 ppm F [H0/L0], 1,450 ppm F [H1,450/L1,450], 2,800 ppm F [H2,800/L2,800], 5,000 ppm F [H5,000/L5,000], 5,000 ppm F plus TCP [H5,000+TCP/L5,000+TCP], and 12,500 ppm F [H12,500/L12,500] containing dentifrices/gels. Dentifrice/gel slurries were prepared with deionized water (1:2 wt/wt). Differences in integrated mineral loss (∆∆Z) and ∆ lesion depth were calculated between values before and after pH-cycling using transversal microradiography. RESULTS The correlation between ΔΔZDT and F- was strong for the highly (rH = 0.691; p < 0.001) and moderate (rL = 0.500; p < 0.001) for the lowly cariogenic model, indicating a fluoride dose-response for both. Significant differences for ΔΔZDT and ΔΔZST could be found between H0, H1,450, H5,000, and H12,500 as well as L0, L5,000, and L125,000 (p ≤ 0.046; analysis of covariance [ANCOVA]). Except for 0 ppm F-, no significant difference in ΔΔZST and ΔΔZDT could be found between the highly and lowly cariogenic model (p ≥ 0.056; ANCOVA). CONCLUSION For both pH-cycling conditions a dose-response for fluoride could be revealed. For elderly people with exposed root surfaces, the use of gels containing 12,500 ppm F instead of regularly (1,450 ppm F) or highly (5,000 ppm F) fluoridated dentifrices should be further investigated, as it offered higher caries-preventive effects in vitro.
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Affiliation(s)
- Richard J Wierichs
- Department of Biohybrid and Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany, .,Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany,
| | - Katharina Rupp
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany
| | - Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, zmk Bern, University of Bern, Bern, Switzerland
| | - Christian Apel
- Department of Biohybrid and Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Marcella Esteves-Oliveira
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany.,Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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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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Alafifi A, Yassen AA, Hassanein OE. Effectiveness of polyacrylic acid-bioactive glass air abrasion preconditioning with NovaMin remineralization on the microhardness of incipient enamel-like lesion. J Conserv Dent 2019; 22:548-553. [PMID: 33088063 PMCID: PMC7542074 DOI: 10.4103/jcd.jcd_195_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/09/2020] [Accepted: 06/25/2020] [Indexed: 12/05/2022] Open
Abstract
Background: Bioactive glass (BAG) remineralization is a promising method for dental hard tissue regeneration. The aim of this study was to evaluate the microhardness of incipient enamel-like lesions with or without preconditioning by air abrasion using polyacrylic acid (PAA)-BAG before application of NovaMin remineralizing agent. Materials and Methods: Forty extracted human molars were selected, sectioned mesiodistally obtaining buccal and lingual halves, and embedded in resin molds. Specimens were randomly assigned to four groups (n = 10) according to the remineralization protocol: G1 (control, artificial saliva), G2 (preconditioning), G3 (NovaMin), and G4 (preconditioning and NovaMin). Enamel windows 4 mm × 4 mm were done on the buccal and lingual surfaces. Specimens were immersed in a daily renewed demineralizing solution to create white spot lesions. Remineralizing agents were applied according to the manufacturer's instructions, and specimens were stored in a daily renewed artificial saliva. Microhardness was assessed using Vickers hardness number (VHN) at baseline (positive control), after demineralization (negative control), and after 24-h and 1-month remineralization. Results: The preconditioning/NovaMin group after 1 month showed a statistically significant high VHN, with no statistically significant difference between it and the positive control. This was followed by the NovaMin group after 1 month, while the lowest VHN was found in the demineralized group, with no statistically significant difference between it and the preconditioning group, whether after 24 h or 1 month. Conclusions: Enamel preconditioning with PAA-BAG air abrasion play a major role in enhancement of remineralization when it is accompanied with NovaMin. Furthermore, an extended period of time had helped to attain more benefits from NovaMin remineralization. Clinical Significance: Enamel remineralization with NovaMin after conditioning by bioactive glass air abrasion, provides the patients with a fast and durable treatment of incipient enamel lesions, which would reduce the possibility of future progression of demineralization and caries occurrence.
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Affiliation(s)
- Abdullah Alafifi
- Department of Operative Dentistry, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Asmaa Aly Yassen
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Giza, Egypt
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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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Godoi FAD, Carlos NR, Bridi EC, Amaral FLBD, França FMG, Turssi CP, Kantovitz KR, Basting RT. Remineralizing effect of commercial fluoride varnishes on artificial enamel lesions. Braz Oral Res 2019; 33:e044. [PMID: 31141037 DOI: 10.1590/1807-3107bor-2019.vol33.0044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 04/26/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate soluble and insoluble fluoride concentrations in commercial varnishes, and their remineralization effect on artificial caries enamel lesions using surface and cross-sectional microhardness evaluations. Forty bovine enamel blocks were separated into four groups (n=10): control (no treatment), Enamelast (Ultradent Products), Duraphat (Colgate-Palmolive) and Clinpro White Varnish (3M ESPE). Surface enamel microhardness evaluations were obtained, artificial enamel caries lesions were developed by dynamic pH-cycling, and the varnishes were then applied every 6 days, after which the enamel blocks were submitted to dynamic remineralization by pH cycles. After removal of the varnishes, the enamel surfaces were reassessed for microhardness. The blocks were sectioned longitudinally, and cross-sectional microhardness measurements were performed at different surface depths (up to 300 μm depth). Polarized light microscopy images (PLMI) were made to analyze subsurface caries lesions. The fluoride concentration in whole (soluble and insoluble fluoride) and centrifuged (soluble fluoride) varnishes was determined using an extraction method with acetone. The data were analyzed to evaluate the surface microhardness, making adjustments for generalized linear models. There was a significant decrease in enamel surface microhardness after performing all the treatments (p<0.0001). Enamelast and Duraphat showed significantly higher enamel microhardness values than the control and the Clinpro groups (p = 0.0002). Microhardness loss percentage was significantly lower for Enamelast (p = 0.071; One-way ANOVA). PLMI showed that subsurface caries lesions were not remineralized with the varnish treatments. No significant differences in the in-depth microhardness levels (p = 0.7536; ANOVA) were observed among the treatments. Enamelast presented higher soluble and insoluble fluoride concentrations than the other varnishes (p < 0.0001; Kruskal-Wallis and Dunn tests). Enamelast and Duraphat varnishes promoted enamel surface remineralization, but no varnish remineralized the subsurface lesion body. Although insoluble and soluble fluoride concentration values did not correspond to those declared by the manufacturer, Enamelast presented higher fluoride concentration than the others.
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Üstün N, Aktören O. Analysis of efficacy of the self‐assembling peptide‐based remineralization agent on artificial enamel lesions. Microsc Res Tech 2019; 82:1065-1072. [DOI: 10.1002/jemt.23254] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/04/2019] [Accepted: 02/28/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Nilüfer Üstün
- Department of Pediatric DentistryIstanbul University Faculty of Dentistry Istanbul Turkey
| | - Oya Aktören
- Department of Pediatric DentistryIstanbul University Faculty of Dentistry Istanbul Turkey
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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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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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Jafari K, Hekmatfar S, Fereydunzadeh M. In vitro Comparison of Antimicrobial Activity of Conventional Fluoride Varnishes Containing Xylitol and Casein Phosphopeptide-Amorphous Calcium Phosphate. J Int Soc Prev Community Dent 2018; 8:309-313. [PMID: 30123762 PMCID: PMC6071361 DOI: 10.4103/jispcd.jispcd_67_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/23/2018] [Indexed: 11/04/2022] Open
Abstract
Objective Different fluoride varnishes are used for the prevention of dental caries. The aim of this study was to compare the antimicrobial effect of different fluoride varnishes, containing xylitol and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), on Streptococcus mutans. Materials and Methods In this in vitro study, the antibacterial effects of four varnishes, namely Polimo and V-varnish (containing xylitol), MI varnish (containing CPP-ACP), and Preventa, were evaluated against S. mutans. The disc diffusion method was used for testing the bacterial sensitivity. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U-tests. Results According to the results, Polimo showed the highest antibacterial effects, compared to the other three varnishes (P ≤ 0.05). Growth inhibition zones were not observed in V-varnish and Preventa. The mean diameter of inhibition zone around the MI varnish was significantly higher, compared to those of the V varnish and Preventa (P ≤ 0.05). Conclusion As the findings indicated, the fluoride varnish containing xylitol and CPP-ACP could be more effective iAQ1n the prevention of dental caries.
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Affiliation(s)
- Karim Jafari
- Department of Prosthodontics, Dental Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Somayeh Hekmatfar
- Department of Pedodontics, Dental Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Maryam Fereydunzadeh
- Dental Research Committee, Dental Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
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Yu OY, Zhao IS, Mei ML, Lo ECM, Chu CH. Effect of Silver Nitrate and Sodium Fluoride with Tri-Calcium Phosphate on Streptococcus mutans and Demineralised Dentine. Int J Mol Sci 2018; 19:ijms19051288. [PMID: 29693627 PMCID: PMC5983598 DOI: 10.3390/ijms19051288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/19/2018] [Accepted: 04/24/2018] [Indexed: 12/01/2022] Open
Abstract
This study investigated the effect of 25% silver nitrate (AgNO3) and 5% sodium fluoride (NaF) varnish with functionalized tri-calcium phosphate (fTCP) on a Streptococcus mutans (S. mutans) biofilm and dentine caries lesion. Demineralised dentine specimens were treated with 25% AgNO3 and 5% NaF + fTCP (Group 1), 25% AgNO3 and 5% NaF (Group 2), 25% AgNO3 (Group 3), or water (Group 4). The specimens were subjected to a S. mutans biofilm challenge after treatment. The biofilm was then studied via scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), and colony forming units (CFU). The specimens were assessed by micro-computed tomography, X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). SEM and CLSM revealed less biofilm in Groups 1 to 3. The log10 CFU of Groups 1 to 4 were 4.5 ± 0.7, 4.4 ± 0.9, 4.4 ± 0.9, and 6.7 ± 1.0, respectively (Groups 1, 2, 3 < 4, p < 0.001). The lesion depths of Groups 1 to 4 were 212.6 ± 20.1 µm, 280.8 ± 51.6 µm, 402.5 ± 61.7 µm, and 497.4 ± 67.2 µm, respectively (Groups 1 < 2 < 3 < 4, p < 0.001). XRD demonstrated silver chloride formation in Groups 1, 2, and 3. FTIR found the amide I: HPO42− values of the four groups were 0.22 ± 0.05, 0.25 ± 0.05, 0.41 ± 0.12, and 0.64 ± 0.14, respectively (Groups 1, 2 < 3 < 4; p < 0.001). In conclusion, this study revealed that AgNO3 and NaF + fTCP reduced the damage of dentine caries by cariogenic biofilm.
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Affiliation(s)
- Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | | | - May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | | | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Wierichs RJ, Stausberg S, Lausch J, Meyer-Lueckel H, Esteves-Oliveira M. Caries-Preventive Effect of NaF, NaF plus TCP, NaF plus CPP-ACP, and SDF Varnishes on Sound Dentin and Artificial Dentin Caries in vitro. Caries Res 2018; 52:199-211. [DOI: 10.1159/000484483] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/16/2017] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to compare the caries-preventive effect of different fluoride varnishes on sound dentin as well as on artificial dentin caries-like lesions. Bovine dentin specimens (n = 220) with one sound surface (ST) and one artificial caries lesion (DT) were prepared and randomly allocated to 11 groups. The interventions before pH cycling were as follows: application of a varnish containing NaF (22,600 ppm F-; Duraphat [NaF0/NaF1]), NaF plus tricalcium phosphate (22,600 ppm F-; Clinpro White Varnish Mint [TCP0/TCP1]), NaF plus casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP; 22,600 ppm F-; MI Varnish [CPP0/CPP1]), or silver diamine fluoride (SDF; 35,400 ppm F-; Cariestop 30% [SDF0/SDF1]) and no intervention (NNB/N0/N1). During pH cycling (14 days, 6 × 120 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 times/day) with either fluoride-free (“0”; e.g., TCP0) or 1,100 ppm F- (“1”; e.g., TCP1) dentifrice slurry. In another subgroup, the specimens were pH cycled but not brushed (NNB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between the values after initial demineralization and those after pH cycling, using transversal microradiography and photographic images. After pH cycling, no discoloration could be observed. Furthermore, NNB, N0, and N1 showed significantly increased ΔZDT/LDDT and ΔZST/LDST values, indicating further demineralization. In contrast, CPP0, CPP1, SDF0, and SDF1 showed significantly decreased ΔZDT/LDDT values, indicating remineralization (p ≤ 0.004; paired t test). CPP0, CPP1, SDF0, and SDF1 showed significantly higher changes in ΔΔZDT/ΔLDDT and ΔΔZST/ΔLDST than NNB, N0, and N1 (p < 0.001; Bonferroni post hoc test). In conclusion, under the conditions chosen, all fluoride varnishes prevented further demineralization. However, only NaF plus CPP-ACP and SDF could remineralize artificial dentin caries-like lesions under net-demineralizing conditions, thereby indicating that NaF plus CPP-ACP and SDF may be helpful to high-caries-risk patients.
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Influence of highly concentrated fluoride dentifrices on remineralization characteristics of enamel in vitro. Clin Oral Investig 2018; 22:2325-2334. [PMID: 29344804 DOI: 10.1007/s00784-018-2333-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 01/02/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the role of highly fluoridated dentifrice on remineralization characteristics of lowly and highly pre-demineralized enamel artificial caries lesions. METHODS Bovine enamel specimens were prepared (pH 4.95; 21 days) and discriminated in either lowly [L] or highly [H] pre-demineralized artificial caries lesions. Specimens with a mean ΔZbaseline,L (95% CI) of 5120 (4995; 5245) vol.% × μm and a mean ΔZbaseline,H of 8187 (8036; 8339) vol.% × μm were selected and randomly allocated to 12 groups (n = 20). Treatments during pH-cycling (28 days; 6 × 60 min demineralization/day) were brushing 2×/day with fluoride-free (0 ppm F- [L0/H0]), 1100 ppm F- [L1100/H1100], 2800 ppm F- [L2800/H2800], 5000 ppm F- [L5000/H5000], 5000 ppm F- + glycerin [L5000 + glycerin/H5000 + glycerin], and 5000 ppm F- + TCP [L5000 + TCP/H5000 + TCP] containing dentifrices. Dentifrice slurries were prepared with deionized water (1:3wt/wt). After cycling specimens presenting lesion surface loss were discarded and for the remaining 202 specimens, transversal microradiographic (TMR) analyses (ΔZpH-cycle/LDpH-cycle) were performed again. Changes in mineral loss (ΔΔZ = ΔZbaseline - ΔZpH-cycle) and lesion depth (ΔLD = LDbaseline - LDpH-cycle) were calculated. RESULTS Significant differences for ΔΔZ could be found between L0, L1100, and L5000 as well as H0, H1100, and H2800/H5000 (p ≤ 0.01; ANCOVA). Except for 0 ppm F-, higher ΔΔZ could be found in highly compared with lowly demineralized specimens (p ≤ 0.004; ANCOVA). After pH-cycling, a second lesion front could only be observed in H5000 and H5000 + TCP. The correlation between ΔΔZ and F- was moderate for lowly and highly demineralized lesions (rL = 0.591; pL < 0.001; rH = 0.746; pH < 0.001), indicating a fluoride dose response for both. CONCLUSION For both baseline substrate conditions, a dose response for fluoride could be revealed. CLINICAL SIGNIFICANCE Remineralization characteristics of enamel directly depended on baseline mineral loss.
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Razmakhnina EM, Kiseleva EA. [Rationale for caries prevention in young adults based on caries resistance rates]. STOMATOLOGIIA 2018; 97:34-36. [PMID: 29795103 DOI: 10.17116/stomat201897234-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of the study was to evaluate the effectiveness of caries prevention in young adults with different caries resistance rates. Sixty-seven patients aged 18-20 with low (n=32) and high (n=35) dmft were enrolled in the study. Caries prevention efficacy was assessed by laboratory tests: enamel resistance test (ERT), clinical enamel remineralization speed test (CERST), estimation of calcium and inorganic phosphorus in oral fluid. Patients with high caries activity in addition to conventional prevention program received prophylaxis procedure with Clinpro White Varnish (3M ESPE). ERT and CERST were significantly higher in high dmft (>13) subgroup. Statistically significant difference in ERT and CERST was observed between subgroups at 3 and 6 months evaluation after prevention program.
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Affiliation(s)
| | - E A Kiseleva
- Kemerovo State Medical University, Kemerovo, Russia, 650029
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Kamal D, Hassanein H, Elkassas D, Hamza H. Comparative evaluation of remineralizing efficacy of biomimetic self-assembling peptide on artificially induced enamel lesions: An in vitro study. J Conserv Dent 2018; 21:536-541. [PMID: 30294117 PMCID: PMC6161534 DOI: 10.4103/jcd.jcd_123_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The biomimetic self-assembling peptide technology is a paradigm for dental hard tissue regeneration. Aim To investigate the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization compared to casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and fluoride-based delivery systems. Materials and Methods Artificial enamel lesions were created on buccal surfaces of 40 extracted human molars. Specimens were randomly assigned to four groups (n = 10) according to the remineralizing agent used: G1 - control: artificial saliva, G2 - fluoride varnish, G3 - CPP-ACPF varnish, G4 - self-assembling peptide agent. All products were applied according to the manufacturer's instructions and the specimens were stored in daily renewed artificial saliva. Surface microhardness (SMH) was assessed at baseline, after demineralization, after 1 week and after 4 weeks storage. SMH values were analyzed using ANOVA and Tukey's post hoc test. Results Self-assembling peptide showed the highest statistically significant mean SMH followed by fluoride and CPP-ACPF while the lowest mean SMH was found in artificial saliva. However, no statistically significant difference was found between fluoride and CPP-ACPF. Higher statistically significant mean SMH was found after 4 weeks compared to 1 week remineralization in all groups. Conclusions Self-assembling peptide confers the highest remineralizing efficacy compared to fluoride and CPP-ACPF, showing a promising, noninvasive regeneration potential. Furthermore, extended period of time helped attain more benefits from the remineralizing regimens applied.
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Affiliation(s)
- Dina Kamal
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | | | - Dina Elkassas
- Department of Operative Dentistry, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Heba Hamza
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Efficacy of Fluoride Varnishes with Added Calcium Phosphate in the Protection of the Structural and Mechanical Properties of Enamel. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7834905. [PMID: 29362716 PMCID: PMC5738627 DOI: 10.1155/2017/7834905] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/29/2017] [Indexed: 11/17/2022]
Abstract
The aim of this study was to investigate the efficacy of various fluoride varnishes in the protection of the structural and nanomechanical properties of dental enamel. Demineralized enamel specimens were imaged using a high-resolution micro-CT system and lesion parameters including mineral density and lesion depth were extracted from mineral density profiles. Nanoindentation elastic modulus and hardness were calculated as a function of penetration depth from the load-displacement curves. The average depth of the lesion in specimens with no prior fluoride varnish treatment was 86 ± 7.19 μm whereas the varnish treated specimens had an average depth of 67 ± 7.03 μm (P < 0.05). The mineral density of enamel lesions with no fluoride varnish treatment had an average of 1.85 gr/cm3 which was 25% lower than the corresponding value in varnish treated enamel and 37% lower than sound enamel. While, in the varnish treated group, elastic modulus and hardness values had decreased by 18% and 23%, respectively, the corresponding values in the non-varnish treated specimens had a reduction of 43% and 54% compared to the sound enamel. The findings from this study highlight the preventive role of fluoride varnishes. Addition of calcium and phosphate does not seem to enhance or inhibit the prevention or remineralization performance of fluoride varnishes.
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