Erosive effects of common beverages on extracted premolar teeth

Evaluation of effect of various drinks on tooth surface morphology under scanning electron microscope

Aim and Objectives

The study aimed to evaluate and compare the effect of various beverages carbonated drinks, i.e., thumps up, fresh fruit juice (apple and pomegranate) and packaged fruit juice (apple and pomegranate) on tooth surface morphology under scanning electron microscope.

Materials and Methods

Thirty recently extracted intact caries-free human permanent teeth were disinfected with 5.25% of sodium hypochlorite solution and autoclaved at 240°F, 20 psi pressure for 40 min. Each tooth was sectioned into 4 enamel sections yielding 120 sections which were embedded in resin using a prefabricated mold. Prepared samples were immersed as Group I - thumps up, Group II - fresh apple juice, Group III - packaged apple juice, Group IV - fresh pomegranate juice, Group V - packaged pomegranate juice, and Group VI - normal saline. Each immersion was done daily for 30 min over 14 days after which samples were scanned under scanning electron microscope (SEM). The data obtained were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS Version 23; Chicago Inc., IL, USA).

Results

The highest surface roughness was noted in the fresh pomegranate and packaged pomegranate groups with a mean of 2.9000 ± 0.30779 followed by thumbs up group. The greatest mean of cracks was noted in thumbs up group with a mean of 2.500 ± 0.51299 which was significant at P = 0.000. The greatest mean of score was noted in thumbs up group with a mean of 2.3000 ± 0.65695 which was significant at P = 0.000.

Conclusion

The present study demonstrated that all drinks were erosive in nature with thumps and pomegranate juice showing significantly higher erosiveness than apple juice (P < 0.01).

Examining enamel-surface demineralization upon exposure to acidic solutions and the remineralization potential of milk and artificial saliva

The enamel surface may undergo demineralization due to exposure to acidic substances and the remineralization of the etched enamel is crucial to regain or maintain integrity. This study aimed to investigate the erosive effect of 10 acidic solutions on tooth enamel and the remineralization capacity of milk and artificial saliva by measuring surface roughness (Ra), enamel depth, and microhardness. A total of 80 bovine incisor enamel specimens were immersed in 10 different acidic solutions, including four different acidic drinks, three different citric acid solutions, and three different citric acid buffer solutions, for 1 h. After demineralization, the specimens were immersed in milk and artificial saliva for 3 h. Surface roughness, enamel abraded depth, and microhardness were measured before demineralization, in-between time intervals and after remineralization. Data were analyzed using Friedman and Kruskal-Wallis tests (p < 0.05). The results indicate a significant difference in surface roughness between the measurements taken at different time intervals, particularly between the baseline and after 1 h demineralization. Also, the specimens immersed in CAB1 exhibited greatest increase in Ra among other acidic solutions (Δ: 0.18 ± 0.07). Moreover, only the microhardness increased after remineralization (p < 0.05). Enamel demineralization using various acidic solutions revealed increased Ra and enamel abraded depth, and decreased microhardness. The use of remineralization agents, milk and artificial saliva, demonstrated an increase in microhardness. This study provides insights into the effects of different acidic solutions and potential remineralization agents on tooth enamel.

Properties of SiCN Films Relevant to Dental Implant Applications

The application of surface coatings is a popular technique to improve the performance of materials used for medical and dental implants. Ternary silicon carbon nitride (SiCN), obtained by introducing nitrogen into SiC, has attracted significant interest due to its potential advantages. This study investigated the properties of SiCN films deposited via PECVD for dental implant coatings. Chemical composition, optical, and tribological properties were analyzed by adjusting the gas flow rates of NH3, CH4, and SiH4. The results indicated that an increase in the NH3 flow rate led to higher deposition rates, scaling from 5.7 nm/min at an NH3 flow rate of 2 sccm to 7 nm/min at an NH3 flow rate of 8 sccm. Concurrently, the formation of N-Si bonds was observed. The films with a higher nitrogen content exhibited lower refractive indices, diminishing from 2.5 to 2.3 as the NH3 flow rate increased from 2 sccm to 8 sccm. The contact angle of SiCN films had minimal differences, while the corrosion rate was dependent on the pH of the environment. These findings contribute to a better understanding of the properties and potential applications of SiCN films for use in dental implants.

Compressive strength evaluation of thin occlusal veneers from different CAD/CAM materials, before and after acidic saliva exposure

In the present study are depicted valuable observations for practitioners, obtained from an in vitro study which aims to evaluate the compressive strength of occlusal veneers fabricated from 3 type of restorative materials, before and after 1 month of acidic artificial saliva exposure (pH = 2.939). In this context, 90 extracted human molars were prepared to receive computer-aided design/computer-aided manufacturing (CAD/CAM) occlusal veneers. The restorative materials considered in this study were: Cerasmart; Straumann Nice and Tetric CAD. The occlusal veneers were designed, milled and cemented with an adhesive dual-cure resin cement. From all the extracted human molars, only sixty specimens were immersed in acidic artificial saliva, for 1 month, at 37 °C ± 1 °C and part of this specimens were also thermo-cycled, between 5 and 55 °C ± 2 °C, before compressive strength test. The results showed a lower compressive strength for both the samples exposed to acidic artificial saliva as well as for the samples exposed to acidic artificial saliva and thermo-cycled. Scanning electron microscopy (SEM) showed that after compressive strength, all the specimens non-exposed to acidic artificial saliva, present extensive cracks formation at the surface of the restorations, and after exposure to acidic artificial saliva for 1 month, the surface damage was characterized by longitudinal and profound fractures of the restoration, as well as the fracture of the tooth structure. Between CAD/CAM materials tested, nanoceramic resin shows more favorable fracture patterns, both before and after acidic artificial saliva exposure.

The dynamic interplay of dietary acid pH and concentration during early-stage human enamel and dentine erosion

Dental erosion continues to be a significant global health concern affecting nearly 30% of adults world-wide. With increasing soft drink consumption predominantly driving its prevalence, strategies for prevention and control are often implemented when erosion is severe, or rates are high in the populace. While factors affecting dental erosion such as pH on enamel has received much attention, the effect of dietary acid concentration when factored out to a commercially available pH has yet to be determined. Furthermore, understanding these effects on dentine, which is known to be more susceptible to erosion than enamel can unravel structure property relationships between acid characteristics and hard tissue types. This study aimed to develop structure-property relationships between dietary acid concentration, and pH, on the nano-textural and nano-mechanical properties of human enamel and dentine during short-term simulated drinking. To achieve this, a novel sample preparation methodology and analysis approach was developed by applying atomic force microscopy (AFM) in quantitative imaging mode. This enabled simultaneous measurement of enamel and dentine morphology and mechanical properties. Flow-cells were used to simulate drinking, exposing polished and smear layer free human enamel and dentine to 30 s repeated cycles of unbuffered citric acid 6% (pH = 1.88) and 1% (w/v) (pH = 2.55) and commercially available buffered pH = 3.8 states, for up to 180 s. The same 50 µm × 50 µm area of specimen morphology was analysed using in-house developed nanotextural analysis using the bearing area curve (BAC) with a focus on roughness (Ra), normalised peak (PA) and valley areas (VA). Mechanical properties were simultaneously measured for stiffness (N/m) after each 30 s. While all studies agree pH is a major factor in the erosion of enamel, here its dominance over the treatment time varied, with concentration surpassing the importance of pH after initial acid contact. Conversely, dentine erosion showed concentration-dependent changes in morpho-mechanical properties only. These results not only highlight the dynamic process of erosion, but how the interplay between acid characteristics and dental tissue type impact the progression of very early-stage erosion.

Improved pH stability, heat stability, and functionality of phycocyanin after PEGylation

Phycocyanin (PC), a spirulina-derived protein-chromophore complex, suffers from poor techno-functional properties and is highly susceptible to aggregation and color changes upon heating and pH fluctuations. We tackled these issues by modifying PC via PEGylation. Electrophoresis and Fourier transform infrared spectroscopy proved successful conjugation of methoxy PEG (mPEG) chains on PC after PEGylation. Circular dichroism indicated highly ordered folding states adopted by PEGylated PC, which we attributed to the mPEG chains on the protein surface that sterically stabilized the protein structure. Consequently, the mPEG-PC conjugates exhibited high blue color intensity and improved thermodynamic stability. Further, benefit from an electrostatic shielding effect of mPEG chains, surface charges of PEGylated PC were neutralized over pH 2-9 and the blue hue of PC was stabilized against pH variations. Additionally, the flexible and hydrophilic mPEG polymers on the PC surface promoted protein-protein and protein-water interactions. PEGylated PC thus gained increased protein solubility, techno-functionality (emulsifying, foaming, and gelling performance), and antioxidant activities, when compared to unmodified PC. Heat-induced gels formed by mPEG-PC conjugates exhibited increased stiffness, higher water retention, and weak gel-type rheological properties. After PEGylation, the improved functional properties, bioactivity, and color stability against heat and pH fluctuations will facilitate food and pharmaceutical applications of PC.

Evaluating the pH of Various Commercially Available Beverages in Pakistan: Impact of Highly Acidic Beverages on the Surface Hardness and Weight Loss of Human Teeth

The objectives of this study were to investigate the pH of common beverages and to evaluate the effects of common acidic beverages on the surface hardness and weight loss of human tooth specimens. A total of 106 beverages were conveniently purchased from supermarkets in Karachi, Pakistan. Prior to evaluation, beverages were refrigerated or stored at room temperature in accordance with the manufacturers’ recommendations. Beverages were categorized into six groups: ‘Sports and Energy drinks’, ‘Water’, ‘Fruit Juices and Drinks’, ‘Sodas’, ‘Milk and Flavored Milk’ and ‘Teas and Coffee’. Using a pH meter, the pH of each beverage was measured in triplicate at room temperature. In addition, the influence of five highly acidic beverages on the weight loss and surface hardness of human tooth specimens was evaluated using gravimetric analysis and the Vickers hardness tester, respectively. ‘Sports and Energy drinks’, ‘Fruits Juices and Drinks’ and ‘Sodas’ were the most acidic beverage categories, with a pH range of 3.00−5.00. A total of 33% of beverages tested in this study were highly acidic (pH less than 4.00), 29% of beverages were moderately acidic (pH 4.00−4.99) and 31% were mildly acidic (pH 5.00−6.99). Significant weight loss was observed in all immersed specimens compared to control counterparts (p < 0.05). Similarly, for surface hardness, five highly acidic beverages (Red Bull, Pepsi, Apple Cidra, Tang Mosambi and Tang Orange) significantly decreased the surface hardness of specimens (p < 0.05). The pH levels of commonly available beverages in Pakistan are highly acidic, which may encourage loss of minerals from teeth; hence, affecting their surface hardness.

Analysis of Erosive Nature of Fruit Beverages Fortified with Calcium Ions: An In Vitro Study Evaluating Dental Erosion in Primary Teeth

Background

Since children frequently consume acidic fruit beverages, dental erosion is common in children. The erosive effects on primary teeth are more profound due to the lesser thickness of enamel and dentin. This study evaluated if calcium fortification of fruit beverages could reduce their erosive potential. Methodology. Tropicana Orange Delight was the fruit beverage chosen and fortified with calcium carbonate. Forty noncarious extracted primary teeth were equally distributed into four groups. Samples in group A were exposed to calcium-fortified fruit beverages and group B to nonfortified fruit beverages for 1, 2, and 3 min. The pH and calcium ion concentration of both the fruit beverages were evaluated from baseline through the test period. Samples in groups C and D were then exposed to fortified and nonfortified fruit beverages for 10, 20, and 30 min. The surface roughness and microhardness of these samples were analysed.

Results

Due to fortification, the pH and calcium ion concentration of fortified beverages was higher compared to nonfortified beverages at baseline. The calcium ion concentration of fortified beverages decreased from baseline in contrast to an increase in the nonfortified beverage group. This indicates that fortified beverage is less erosive in nature. The surface roughness of samples in the fortified beverage group did not decrease significantly from baseline. In the nonfortified beverage group, surface roughness values at 20 and 30 min of exposure were higher than baseline, suggesting that significant erosive changes occur at the prolonged duration of exposure. The microhardness values of samples in the fortified beverage group increased from baseline through the test period, suggestive of resistance to erosion offered by calcium fortification. The microhardness values of samples in the nonfortified beverage group decreased through the test period, suggestive of erosion.

Conclusion

Calcium fortification of this fruit beverage significantly reduces its erosive potential on primary teeth.

Restorative Materials Exposed to Acid Challenge: Influence of Temperature on In Vitro Weight Loss

Consumption of acidic beverages and foods could provoke erosive damage, both for teeth and for restorative materials. Temperatures of consumption could influence the erosive effects of these products. The aim of this in vitro study is to assess the influence of an acidic challenge on the weight loss of different restorative materials. Resin composites and glass-ionomer cements (GIC) were tested. The medium of storage was Coca-Cola (Coca-Cola, Coca-Cola Company, Milano, Italy) at two different temperatures, 4 and 37 °C, respectively for Group A and Group B. For each group, nine specimens were prepared for each material tested. After 7 days, weight was assessed for each sample, and the percentage weight loss was calculated. For all the resin composites (Groups 1−13), no significant weight losses were noticed. (<1%). Conversely, GICs (Groups 14 and 15) showed significant weight loss during the acidic challenge, which was reduced in the case of these materials that included a protective layer applied above. Significant differences were registered with intra-group analysis; weight loss for specimens immersed in Coca Cola at 37 °C was significantly higher for almost all materials tested when compared to specimens exposed to a cooler medium. In conclusion, all the resin composites showed reliable behaviour when exposed to acidic erosion, whereas glass-ionomer cements generally tended to solubilize.

A time based objective evaluation of the erosive effects of various beverages on enamel and cementum of deciduous and permanent teeth

Background

Erosion of the teeth is a chronic irreversible process leading to loss of surface enamel and even the dentin, in turn causing sensitivity and pain. Increased consumption of carbonated beverages remains a major cause for dental erosion. However, many of the so called safe beverages that are consumed may also have sufficiently low pH to cause dental erosion. One of the parameters to measure the dental erosion is estimation of hardness and surface roughness. Thus, this study aims to evaluate the difference in hardness and surface roughness of enamel and cementum using three beverages namely (carbonated drink, lime soda, lime juice) in deciduous and permanent teeth.

Material and Methods

Ten permanent and three deciduous teeth samples each were kept in lime juice, lime soda, carbonated beverage and tap water. The VHN using Vickers hardness tester and Ra value using surface profilometer were assessed at baseline, 1 day and 10 days.

Results

At the end of 10 days the decrease in hardness of enamel of permanent teeth was maximum for teeth immersed in carbonated beverage followed by lime soda and lime juice. However, in the deciduous teeth it was observed that the VHN drop was maximum at 1 day in relation to teeth immersed in carbonated beverage followed by lime juice and lime soda. The hardness of cementum decreased significantly at the end of ten days both in deciduous as well as permanent teeth.

Conclusions

The present study shows that many of the most commonly used beverages like lime juice and lime soda have a sufficiently low pH to cause erosion of the enamel surface as well as that of cementum of both deciduous and permanent teeth. Though protective mechanisms do exist in the oral cavity to neutralize the acids present in these beverages, continuous usage of these beverages leads to irreversible damage to the tooth structure.

Key words:Dental erosion, hardness, surface roughness, permanent teeth, deciduous teeth.

Evaluation of colour change and surface roughness of two resin-based composites when exposed to beverages commonly used by children: an in-vitro study

AIM

To evaluate and compare the surface roughness and colour change of microhybrid and nanocomposite after exposure to beverages commonly used by children.

METHODS

Thirty discs were prepared using Filtek Z250 and Filtek Supreme composites. Discs were immersed in distilled water, orange juice and Coca-Cola. Colour and surface roughness were measured at baseline and on days 15 and 30.

RESULTS

Filtek Z250 and Filtek Supreme showed no significant difference in surface roughness and colour change at all measurement times. Immersion solution had a significant effect on surface roughness as well as colour change. Specimens immersed in Coca-Cola demonstrated the highest effect, followed by those immersed in orange juice, while specimens immersed in distilled water had the least effect. There was a significant increase in surface roughness and colour change over time. The change in colour was more evident in the period between baseline measurements and after 15 days. There was a significant interaction between media type and time.

CONCLUSIONS

Both composites showed no significant difference in roughness and colour change at all measurement times. There was a significant increase in surface roughness and colour change in all immersion solutions tested over time. Coca-Cola caused unacceptable colour change.

Influence of Toothpaste pH on Its Capacity to Prevent Enamel Demineralization

Aim:

This study evaluated in vitro the remineralization capacity of commercial toothpastes with different fluoride (F) concentrations and their effectiveness when they are acidified.

Materials and Methods:

One hundred and twelve caries-free teeth were used to prepare enamel specimens, and the specimens were divided into 16 groups (n = 7). Baseline surface Vickers microhardness was measured for all the specimens and all the tested groups were subjected to the pH-cycling regime involved five demineralization challenges each day for 10 days, and surface Vickers microhardness was then measured. Once daily, specimens were exposed for 30 min after last demineralization challenge of the day to the slurry of each toothpaste containing 1450 ppm F, 1000 ppm F, 450 ppm F, and 0 ppm F. The slurry was in original pH or acidulated on 6.5, 6.0, or 5.5 pH. The difference among tested group was assessed by analysis of variance and Newman–Keuls test (P < 0.05).

Results:

The highest increase in microhardness was detected after treatment with toothpaste containing 1450 ppm fluoride (percentage of increase in microhardness was 6.20%), and the biggest loss was detected after treatment with toothpaste containing no fluoride (percentage of decrease was 6.82%), but there was no significant difference between tested groups.

Conclusions:

The highest increase in microhardness was detected after treatment with toothpaste containing more fluorides (1450 ppm F) regardless of the acidity.

Do Dietary Habits Influence Trace Elements Release from Fixed Orthodontic Appliances?

The objective was to investigate the effect of dietary habits on the release of Cr and Ni ions from orthodontic appliances by hair mineral analysis. Patients (N = 47) underwent electronic questionnaire survey to investigate the effect of dietary habits on Cr and Ni levels in hair. The research was carried out on hair sampled at the beginning and in the 4th, 8th, and 12th months of the treatment. The content of Cr and Ni in the collected samples was determined by ICP-OES. The study showed that consumption of acidic dietary products may have the effect on increasing the release of Cr and Ni ions from orthodontic appliances. The release of Cr from orthodontic appliances in patients who consumed fruit juice, coffee, yoghurt, and vinegar was higher. The coefficients enabling comparison of metal ions release pattern at a given sampling points were defined. The comparison of the coefficients yielded the information on the possible magnification of metal ions released as the result of the additional factor consumption of acidic food or drink that intensifies metal ions release. The following magnification pattern was found for chromium: coffee (7.57 times) > yoghurt (2.53) > juice (1.86) > vinegar (1.08), and for nickel: vinegar (2.2) > coffee (1.22) > juice (1.05). Yoghurt did not intensify the release of nickel. Concluding, orthodontic patients should avoid drinking/eating coffee, yoghurt, fruit juices, and vinegar.

Role of enamel deminerlization and remineralization on microtensile bond strength of resin composite

Objective:

This study is aimed to establish the microtensile bond strength of enamel following exposure to an aerated drink at various time intervals with/without application of remineralization agent. In addition, degree of remineralization and demineralization of tooth enamel has been assessed using polarized light microscopy.

Materials and Methods:

Seventy extracted human incisors split into two halves were immersed in aerated beverage (cola drink) for 5 min and stored in saliva until the time of microtensile bond testing. Prepared specimens were divided randomly into two study groups; remineralizing group (n = 70): specimens were treated for remineralization using casein phosphopeptides and amorphous calcium phosphate (CPP-ACP) remineralization agent (Recaldent™; GC Europe) and control group (n = 70): no remineralization treatment; specimens were kept in artificial saliva. All specimens were tested for microtensile bond strength at regular intervals (1 h, 1 days, 2 days, 1 week, and 2 weeks) using a universal testing machine. The results statistically analyzed (P = 0.05) using two-way ANOVA test.

Results:

Results showed statistically significant increase in bond strength in CPP-ACP tested group (P < 0.05) at all-time intervals. The bond strength of remineralizing group samples at 2 days (~13.64 megapascals [MPa]) is comparable to that of control group after 1 week (~12.44 MPa).

Conclusions:

CPP-ACP treatment of teeth exposed to an aerated drink provided significant increase in bond strength at a shorter interval compared to teeth exposed to saliva alone.

Repeated exposure of acidic beverages on esthetic restorative materials: An in-vitro surface microhardness study

Background

A manifold increase in the consumption of aerated beverages has witnessed a twin increase in tooth wear and raised demand for esthetic restorative materials. This study aimed to evaluate the surface microhardness changes of esthetic restorative materials following treatment with aerated beverages in an in-vitro situation.

Material and Methods

The initial surface microhardness of the restorative materials GC Fuji II LC, GC Fuji IX, Nano Glass ionomer, Resin and Nano composite was recorded. These materials were studied under 3 groups that included those exposed to the acidic beverages daily, weekly once in a month and those that had no exposures at all. The final surface microhardness of the materials was recorded following experimentation and was subjected to statistical comparisons.

Results

The restorative materials were compared for their surface microhardness changes following respective treatments using the T-test and One-way ANOVA analysis. Inter-comparisons between the groups showed statistical significance (p<.05), when treated with both the beverages. The five restorative materials revealed surface microhardness loss; the maximum reduction noticed with the Nano glass ionomer cement tested (p<.0005).

Conclusions

The surface microhardness of restorative materials markedly reduced upon repeated exposures with acidic beverages; the product with phosphoric acid producing the maximum surface microhardness loss.

Key words:Restorative materials, acidic beverages, surface microhardness, resin composites, glass ionomers.

The pH of beverages in the United States

BACKGROUND

Dental erosion is the chemical dissolution of tooth structure in the absence of bacteria when the environment is acidic (pH < 4.0). Research indicates that low pH is the primary determinant of a beverage's erosive potential. In addition, citrate chelation of calcium ions may contribute to erosion at higher pH. The authors of this study determined the erosive potential measured by the pH of commercially available beverages in the United States.

METHODS

The authors purchased 379 beverages from stores in Birmingham, Alabama, and categorized them (for example, juices, sodas, flavored waters, teas, and energy drinks) and assessed their pH. They used a pH meter to measure the pH of each beverage in triplicate immediately after it was opened at a temperature of 25°C. The authors recorded the pH data as mean (standard deviation).

RESULTS

Most (93%, 354 of 379) beverages had a pH of less than 4.0, and 7% (25 of 379) had a pH of 4.0 or more. Relative beverage erosivity zones based on studies of apatite solubility in acid indicated that 39% (149 of 379) of the beverages tested in this study were considered extremely erosive (pH < 3.0), 54% (205 of 379) were considered erosive (pH 3.0 to 3.99), and 7% (25 of 379) were considered minimally erosive (pH ≥ 4.0).

CONCLUSIONS

This comprehensive pH assessment of commercially available beverages in the United States found that most are potentially erosive to the dentition.

PRACTICAL IMPLICATIONS

This study's findings provide dental clinicians and auxiliaries with information regarding the erosive potential of commercially available beverages. Specific dietary recommendations for the prevention of dental erosion may now be developed based on the patient's history of beverage consumption.

Amazonian delicacy tucupi is as erosive as a cola-based soft drink

OBJECTIVE

Acidic diets are advocated as main risk factor for tooth erosion, which could be prevented, or at least controlled, if patients were early advised. It is important to identify, hence, if possible dietary constituents regionally consumed on large scale, such as tucupi, a low-pH yellowish-green color and strong flavor delicacy made from the juice of a bitter cassava, may explain its occurrence in specific patient groups. This cross-over in situ/ex vivo study evaluated tucupi's ability to promote erosion of bovine enamel by assessing its percentage of surface microhardness change (%SMHC), taking a cola-based soft drink and human saliva as positive and negative controls.

DESIGN

For three 7-days spaced out legs of 7 days each, nine volunteers wore palatal devices with three bovine enamel blocks, which were challenged with one of the following solutions: TUC-tucupi (n=27); COL-cola-based soft drink (n=27); SAL-saliva (n=27). Erosive challenges were performed extra-orally (4×/day) by dropping TUC or COL at room temperature on specimens. After 5min, palatal devices were replaced into the mouth. SAL permanently acted as the negative control while volunteers solely wore the device. One-way ANOVA followed by Tukey's post-hoc tests (α=0.05) were applied.

RESULTS

TUC promoted an enamel %SMHC (-21.56±10.08(a)) similar than that promoted by COL (-18.19±12.99(a); p=0.275), which were both significantly higher than that promoted by SAL (-1.86±13.65(b); p<0.0001).

CONCLUSIONS

Besides the most worldwide appreciated cola-based soft drink, the greatly consumed Amazonian delicacy tucupi can be considered a potential risk factor for tooth erosion.

Effect of different pH solvents on micro-hardness and surface topography of dental nano-composite: An in vitro analysis

Objective:

Erosion of tooth surface is attributed to recent shift in diet pattern and frequent use of beverages. The aim of this research was to evaluate the effects of different beverages on surface topography and hardness of nano-filled composite material.

Methods:

Sixty flat disc shaped resin composite samples were fabricated and placed in distilled water for 24 hours. After 24 hours test samples were dried and divided into 4 groups. Group A (n=15) specimens were placed in tight amber bottle comprising 25 ml of artificial saliva. Similarly Group B, C and D were stored in equal amounts of orange juice, milk and coca cola drink respectively. Samples were checked for hardness and surface changes were evaluated with scanning electron microscopy.

Results:

There were strong significant difference observed in samples immersed in orange juice and artificial saliva. A strong significant difference was seen between Group D and Group A. Group A and Group C showed no significant difference. The micro-hardness test showed reduced values among all samples.

Conclusion:

Beverages consumed daily have a negative influence on hardness and surface degradation of nano-filled dental composite. Comparatively, nano-filled composites possess higher surface area to volume ratio of their fillers particle size may lead to higher surface roughness than other resin based dental biomaterials.

Effect on oral pH changes and taste perception in 10-14-year-old children, after calcium fortification of a fruit juice

AIM

The aim was to determine the effect of calcium fortification of a commercially available mixed-fruit juice on oral pH changes and taste perception in a group of 10 to 14 year-old Indian children.

METHOD

A controlled, blinded, non-randomised clinical trial was adopted, consisting of a sample of 100 healthy children (DMFT <3; age 10-14 years), who were exposed to three test juices one by one [Group A: original fruit juice (control group); Group B: calcium-fortified fruit juice and Group C: calcium + vitamin D fortified fruit juice]. Oral pH, collection of saliva and plaque sampling was undertaken, before and after the juice exposure by each subject at 0, 1, 5, 15, 30 and 45 min. The respective pH was measured with a digital pH meter. For taste perception, a scoring system was used after exposure of the juices to the subjects in a blind manner. The statistical evaluation was done using one-way ANOVA for salivary and plaque pH and Kruskal-Wallis test for buffer capacity and taste perception.

RESULTS

There was a smaller drop in salivary and plaque pH (p < 0.5) and a significant reduction in perceived taste (p < 0.001) by the subjects after calcium modification of fruit juice.

CONCLUSION

The calcium-modified mixed fruit juices was less acidogenic compared with the unfortified juice, and hence will be less cariogenic and erosive towards teeth.

An in-vitro assessment of erosive potential of a calcium-fortified fruit juice

AIM

To evaluate and compare the in vitro pH, buffer capacity and calcium loss from tooth enamel before and after calcium fortification of a packaged fruit juice.

METHODS

An approved brand of packaged mixed fruit juice was selected as a test drink on the basis of a pilot questionnaire. The test drink was fortified with 1,000 mg/l (0.1% w/v) of calcium citrate malate to obtain two test groups: Group 1: original beverage (serving as control) and Group 2: calcium-fortified drink. The pH and buffering capacity for the test drinks were measured before and after calcium fortification; 90 prepared enamel samples were divided and immersed into three test subgroups: (1) buffer solution pH 7 (positive control), (2) original fruit juice (negative control) and (3) calcium-fortified fruit juice for 3 min. Calcium loss from the enamel of immersed teeth was measured as a quantitative estimate of tooth mineral loss.

RESULTS

After calcium fortification of the fruit juice the mean pH raised from 3.4 to 4.0 (p = 0.029), the mean buffer capacity decreased from 9.73 to 9.16 (p < 0.001) and the mean calcium loss from enamel specimens decreased from 3.5 to 0.26 mg/dl (p < 0.001).

STATISTICS

To compare the change in mean pH and buffering capacity between the subject groups, t test was used, and to compare the calcium loss from enamel specimens, among the three subgroups, ANOVA was used.

CONCLUSION

Calcium fortification of packaged fruit juice in vitro, improves its pH and buffering capacity. Consequently, the fortified juice causes significantly less mineral loss from human enamel. Fortifying juice with calcium may exert a significant protective potential against dental erosion particularly due to frequent exposure of acidic drinks.

Developmental enamel defects in the primary dentition: aetiology and clinical management

Developmental enamel defects, presenting as enamel hypoplasia or opacities are caused by damage or disruption to the developing enamel organ as a result of inherited and acquired systemic conditions. The high prevalence of these defects in the primary dentition demonstrates the vulnerability of the teeth to changes in the pre- and postnatal environment. The presence of enamel hypoplasia increases the risk of primary teeth to early childhood caries and tooth wear as the defective enamel is thinner, more plaque retentive and less resistant to dissolution in acid compared to normal enamel. The purpose of this paper was to critically review the aetiology and clinical complications of developmental enamel defects in the primary dentition and propose recommendations for the clinical management of affected teeth.

Erosive potential of different types of grape juices

The purpose of the present study was to evaluate the erosive potential of different types (concentrated and powdered) and commercial brands of industrialised grape juices. The pH of all five fruit drinks was measured at two time points: immediately after preparation and 24 hours later. Sixty specimens of bovine enamel were randomly allocated and immersed in different types of grape juice (n = 10) for 10 minutes four times a day for fifteen days. The enamel alteration was analysed using surface Knoop microhardness (KHN) and surface roughness (Ra) tests at baseline and on the 5(th), 10(th) and 15(th) days of the experiment. Two way ANOVA, Tukey's post hoc and Pearson's correlation tests were used for statistical analysis (α = 5%). The grape juices presented pH values ranging from 2.9 to 3.5. All of the tested juices promoted significant enamel mineral loss (p < 0.05) on the first evaluation (5(th) day of immersion) and produced a significant increase in the mean roughness from the 10(th) day on when compared to the control group (p < 0.05). By the 15(th) day, all of the beverages had produced surface roughnesses that were significantly higher than that of the control group. The results suggest that all grape juices, regardless of their commercial presentation, present erosive potential.

In vitro long-term degradation of aesthetic restorative materials in food-simulating media

OBJECTIVE

The aim of this study was to evaluate the effect of long-term food-simulating media storage on degradation of restorative materials through roughness measurements.

MATERIALS AND METHODS

Sixty cylindrical specimens of each material (Filtek Z250, Esthet X, Filtek Flow, Dyract AP and Vitremer) were prepared, stored for 24 h, and polished. The surface roughness analysis was conducted using Surfcorder (SE1700) roughness-measuring instrument. Three traces were recorded on each specimen at three different locations. The specimens were randomly distributed into five groups (n = 12) according to the storage media: (water, ethanol, Coca-Cola®, citric acid and lactic acid). Roughness measurements were recorded after 1 week, 1, 3 and 6 months. The storage solutions were weekly changed. Data were submitted to ANOVA and Tukey test (p < 0.05).

RESULTS

There was no significant increase on roughness means for Filtek Z250, Filtek Flow and Vitremer over time, regardless the storage media. Significant increase on surface roughness was observed for Esthet X after 1 month of storage in Coca-Cola® and after 3 months of storage in citric acid and for Dyract AP after 6 months in water. There were no significant differences on surface roughness between resin composites and compomer. Resin-modified glass ionomer showed a significantly higher surface roughness mean than the other materials.

CONCLUSIONS

Food-simulating media affects the surface roughness of the materials. Biodegradation is material-, solution- and time-dependent.

A literature review of dental erosion in children

Dental erosion is increasingly recognized as a common condition in paediatric dentistry with complications of tooth sensitivity, altered aesthetics and loss of occlusal vertical dimension. The prevalence of erosion in children has been reported to range from 10% to over 80%. The primary dentition is thought to be more susceptible to erosion compared to the permanent dentition due to the thinner and less mineralized enamel. The aim of this paper was to critically review dental erosion in children with regards to its prevalence, aetiology, diagnosis and prevention. The associations between erosion and other common conditions in children such as caries and enamel hypoplasia are also discussed.

Short communication: In vitro assessment of erosive potential of energy drinks

AIM

This in vitro study was to evaluate the endogenous pH, titratable acidity, total soluble solids content (TSSC) and nonreducing sugars of energy drinks.

METHODS

Nine energy drinks (Bad Boy Power Drink, Red Bull, Red Bull Sugar Free, Flying Horse, Burn, Night Power, Flash Power, Flying Horse Light and 220V) were evaluated by a randomised experiment with 3 repetitions on each sample. pH analysis performed by potentiometry and buffering capacity was assessed by dilution of each drink. Increments of 0.1 N KOH were titrated until neutrality reached. TSSC readings were performed by Brix refractometry using an Abbé refractometer.

RESULTS

pH values ranged from 1.52 (Flash Power) to 3.20 (Red Bull) and all drinks showed pH 5.5. Titratable acidity values ranged from 0.56 (220V) to 1.04 (Bad Boy Power Drink). Flying Horse Light presented the lowest TSSC content (1.66%) and Flying Horse presented the highest (12.58%). Non-reducing sugars values ranged from 0.00% (Red Bull Sugar Free and Flying Horse Light) to 54.33% (Flying Horse).

CONCLUSION

The energy drinks evaluated have a high erosive potential, as they present low pH and a high non-reducing sugar content.

Does the amount of filler content in sealants used to prevent decalcification on smooth enamel surfaces really matter?

OBJECTIVE

To determine how filler content and an acidic environment affect the retention of sealants placed on smooth enamel surfaces.

MATERIALS AND METHODS

A sample of 120 teeth was randomly divided into six subsamples. Three experimental sealants with identical formulas, with the exception of the amount of filler content (18%, 30%, 50%), were applied according to manufacturers' recommendations. Half of the subsamples were exposed to an acid environment (pH of 2.5) for 96 hours. With the use of a tooth-brushing simulator, each tooth was exposed to 15,000 brushing strokes, while a slurry of 1 : 3 toothpaste/neutral sodium bicarbonate cycled through the machine. Initial and final photographs were analyzed subjectively and objectively. Scanning electron microscope photomicrographs were used to evaluate the tooth surface.

RESULTS

Subjective analyses showed significant (P < .05) filler effects, with the 18% filled sealant showing the least change, followed by the 30% sealant, then the 50% filled sealant, which showed the greatest loss. Objective analyses showed the same pattern of loss, but the differences between sealants were not statistically significant. Exposure to an acidic environment had no significant effect on sealant retention. SEMS showed a layer of sealant remaining on all of the sealed teeth evaluated.

CONCLUSIONS

Filler content of resin sealant material affects the retention of sealants on smooth enamel surfaces; exposure to an acid environment has no effect on sealant retention. Within the limits of this study, highly filled resin sealants once saturated have the ability to endure the oral environment and remain on a smooth enamel surface, regardless of the amount of filler content.

Safety issues associated with commercially available energy drinks

OBJECTIVE

To describe benefits and adverse effects associated with the consumption of energy drinks.

DATA SOURCES

Searches were conducted using Medline, IPA (International Pharmaceutical Abstracts), EMBASE, and MANTIS; databases such as Natural Medicines Comprehensive Database, Natural Standard, ALTMEDEX, and AltHealthWatch; and Google (range 1980 to September 2007). Search terms included energy drink, Red Bull, caffeine, glucose, ginseng, guarana, taurine, and bitter orange.

DATA SYNTHESIS

Most energy drinks contain natural products such as guarana, ginseng, and taurine. As much as 80 to 300 mg of caffeine and 35 grams of processed sugar per 8-ounce serving are commonly present in energy drinks such as Cocaine, Pimp Juice, Red Bull, and Spike Shooter. No reports were identified of negative effects associated with taurine, ginseng, and guarana used in the amounts found in most energy drinks. Commonly reported adverse effects seen with caffeine in the quantities present in most energy drinks are insomnia, nervousness, headache, and tachycardia. Four documented case reports of caffeine-associated deaths were found, as well as four separate cases of seizures associated with the consumption of energy drinks.

CONCLUSION

The amounts of guarana, taurine, and ginseng found in popular energy drinks are far below the amounts expected to deliver either therapeutic benefits or adverse events. However, caffeine and sugar are present in amounts known to cause a variety of adverse health effects.

Effect of titanium tetrafluoride and sodium fluoride on erosion progression in enamel and dentine in vitro

Our aim was to investigate the effect of TiF4 solutions on mineral loss on enamel and dentine in vitro. Samples were fluoridated 1 x 5 min per day with 1.64% w/v TiF4 or 2.2% w/v NaF solutions, each with a pH of 1.2, and then subjected to a cyclic de- and remineralization procedure for 5 days. Demineralization was performed for 6 x 10 min per day with citric acid (pH 2.3). In controls no fluoridation was performed. Mineral content was determined by longitudinal microradiography. Enamel mineral loss was markedly reduced by both fluoride solutions, but TiF4 was significantly more effective than NaF: cumulative mineral loss on day 3 was 61.7 +/- 15.0 microm in the NaF and 34.2 +/- 13.1 microm in the TiF4 group (p < or = 0.001) compared with 121.0 +/- 27.0 microm in the control group. Dentine mineral loss ceased after both TiF4 and NaF applications (cumulative mineral loss on day 5 in controls: 61.0 +/- 17.0 microm, in the TiF4 group: 15.4 +/- 13.4 microm and in the NaF group: 21.8 +/- 11.8 microm). Both TiF4 and NaF application reduced mineral loss both on enamel and dentine, which could open new possibilities for a symptomatic therapy of erosions.