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Zhong Y, Liu C, Yan X, Li X, Chen X, Mai S. Odontogenic and anti-inflammatory effects of magnesium-doped bioactive glass in vital pulp therapy. Biomed Mater 2024; 19:045026. [PMID: 38740053 DOI: 10.1088/1748-605x/ad4ada] [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: 03/14/2024] [Accepted: 05/13/2024] [Indexed: 05/16/2024]
Abstract
This study aimed to investigate the effects of magnesium-doped bioactive glass (Mg-BG) on the mineralization, odontogenesis, and anti-inflammatory abilities of human dental pulp stem cells (hDPSCs). Mg-BG powders with different Mg concentrations were successfully synthesized via the sol-gel method and evaluated using x-ray diffraction, Fourier-transform infrared spectroscopy, scanning electron microscopy, and transmission electron microscopy. Apatite formation was observed on the surfaces of the materials after soaking in simulated body fluid. hDPSCs were cultured with Mg-BG powder extracts in vitro, and no evident cytotoxicity was observed. Mg-BG induced alkaline phosphatase (ALP) expression and mineralization of hDPSCs and upregulated the expression of odontogenic genes, including those encoding dentin sialophosphoprotein, dentin matrix protein 1, ALP, osteocalcin, and runt-related transcription factor 2. Moreover, Mg-BG substantially suppressed the secretion of inflammatory cytokines (interleukin [IL]-4, IL-6, IL-8, and tumor necrosis factor-alpha). Collectively, the results of this study suggest that Mg-BG has excellent in vitro bioactivity and is a potential material for vital pulp therapy of inflamed pulps.
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Affiliation(s)
- Yewen Zhong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
| | - Cong Liu
- Department of Biomaterials, School of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong 510641, People's Republic of China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, Guangdong 510006, People's Republic of China
| | - Xin Yan
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
| | - Xiangdong Li
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
| | - Xiaofeng Chen
- Department of Biomaterials, School of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong 510641, People's Republic of China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, Guangdong 510006, People's Republic of China
| | - Sui Mai
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, People's Republic of China
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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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Luo X, Niu J, Su G, Zhou L, Zhang X, Liu Y, Wang Q, Sun N. Research progress of biomimetic materials in oral medicine. J Biol Eng 2023; 17:72. [PMID: 37996886 PMCID: PMC10668381 DOI: 10.1186/s13036-023-00382-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/02/2023] [Indexed: 11/25/2023] Open
Abstract
Biomimetic materials are able to mimic the structure and functional properties of native tissues especially natural oral tissues. They have attracted growing attention for their potential to achieve configurable and functional reconstruction in oral medicine. Though tremendous progress has been made regarding biomimetic materials, significant challenges still remain in terms of controversy on the mechanism of tooth tissue regeneration, lack of options for manufacturing such materials and insufficiency of in vivo experimental tests in related fields. In this review, the biomimetic materials used in oral medicine are summarized systematically, including tooth defect, tooth loss, periodontal diseases and maxillofacial bone defect. Various theoretical foundations of biomimetic materials research are reviewed, introducing the current and pertinent results. The benefits and limitations of these materials are summed up at the same time. Finally, challenges and potential of this field are discussed. This review provides the framework and support for further research in addition to giving a generally novel and fundamental basis for the utilization of biomimetic materials in the future.
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Affiliation(s)
- Xinyu Luo
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Jiayue Niu
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Guanyu Su
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Linxi Zhou
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China.
- National Center for Stomatology, Shanghai, 200011, China.
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China.
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
| | - Xue Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Ying Liu
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Qiang Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Ningning Sun
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
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Almarsomy DH, Al-khayat FA, Al-Taee LA. The preventive/therapeutic effect of CO 2 laser and MI Paste Plus® on intact and demineralized enamel against Streptococcus mutans (In Vitro Study). Heliyon 2023; 9:e20310. [PMID: 37790956 PMCID: PMC10543189 DOI: 10.1016/j.heliyon.2023.e20310] [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: 03/09/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023] Open
Abstract
Background To evaluate the preventive and therapeutic effects of CO2 laser and MI paste plus on intact and demineralized enamel surfaces and their impact on bacterial adhesion. Methods: 160 enamel slabs were prepared and randomly allocated into two main groups; sound and demineralized enamel (n = 80 per group), in which specimens were immersed in a demineralizing solution (50 mM acetic acid, pH 4.5) for 72 h at 37 °C. Each group was further divided into four subgroups (n = 20); the control (un treated surfaces), surfaces treated by CO2 laser, MI paste plus (Recaldent™, GC corporation/Germany), and those received a combination of CO2 and MI paste plus. Streptococcus Mutans biofilm was isolated, quantified, and then applied on treated enamel surfaces and incubated anaerobically for 24 h and then quantified by colony-forming unit (CFU). Meanwhile, surface changes were assessed by Vickers microhardness and Scanning Electron Microscope combined with Energy-Dispersive X-Ray Spectroscopy (SEM-EDX). Results: The combined use of CO2 laser followed by MI paste plus significantly (p < 0.000) enhanced surface microhardness of sound and demineralized enamel with a significant reduction in bacterial counts. However, each technique alone was beneficial as they exhibited higher microhardness with lower bacterial viability in comparison to the control. The treatment of demineralized enamel surfaces with MI paste significantly reduced the number of bacterial colonies with the presence of dispersed mineral deposits over the surface. Conclusions The combined use of CO2 laser and MI paste plus was effective as a preventive and/or therapeutic measures in enhancing surface properties of enamel and reducing the bacterial viability.
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Affiliation(s)
- Dhuha H. Almarsomy
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Fadia A. Al-khayat
- Department of Basic Sciences, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Lamis A. Al-Taee
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
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Li Y, Liu M, Xue M, Kang Y, Liu D, Wen Y, Zhao D, Guan B. Engineered Biomaterials Trigger Remineralization and Antimicrobial Effects for Dental Caries Restoration. Molecules 2023; 28:6373. [PMID: 37687202 PMCID: PMC10489995 DOI: 10.3390/molecules28176373] [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: 06/19/2023] [Revised: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 09/10/2023] Open
Abstract
Dental caries is the most prevalent chronic disease globally, significantly impacting individuals' quality of life. A key reason behind the failure of implanted restorations is their biological inactivity, meaning they are unable to form crosslinks with the surrounding tooth structures, thus making patients susceptible to implant loss and recurrent tooth decay. For the treatment of caries, antibacterial medicine and remineralization are effective means of treating the recurrence of caries. Owing to the rapid progression in the biomaterials field, several biomaterials have been reported to display antimicrobial properties and aid in dentin remineralization. Bioactive materials hold considerable potential in diminishing biofilm accumulation, inhibiting the process of demineralization, enabling dentin remineralization, and combating bacteria related to caries. Bioactive materials, such as fluoride, amorphous calcium phosphate, bioactive glass, collagen, and resin-based materials, have demonstrated their effectiveness in promoting dentin remineralization and exerting antibacterial effects on dental caries. However, the concentration of fluoride needs to be strictly controlled. Although amorphous calcium phosphate can provide the necessary calcium and phosphorus ions for remineralization, it falls short in delivering the mechanical strength required for oral mastication. Resin-based materials also offer different advantages due to the complexity of their design. In this review, we delve into the application of advanced bioactive materials for enhancing dentin remineralization and antibacterial properties. We eagerly anticipate future developments in bioactive materials for the treatment of dental caries.
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Affiliation(s)
- Yuexiao Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Shenyang 110022, China
| | - Minda Liu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Shenyang 110022, China
| | - Mingyu Xue
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Yuanyuan Kang
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Dongjuan Liu
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Yan Wen
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
| | - Duoyi Zhao
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
| | - Boyu Guan
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Shenyang 110022, China
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
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Shah Y, Deshpande A, Jain A, Jaiswal V, Andharia M. Effectiveness of resin infiltration (ICON) and microabrasion-remineralization technique with two remineralizing agents (Tooth Mousse and Toothmin) on permanent incisor hypoplasia - A randomized clinical trial. J Indian Soc Pedod Prev Dent 2023; 41:204-215. [PMID: 37861634 DOI: 10.4103/jisppd.jisppd_245_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Aims The study aims to compare the effect of resin infiltration and microabrasion-remineralization (MAb-Re) with Tooth Mousse and Toothmin on permanent incisor hypoplasia. Materials and Methods The study included children with permanent incisor hypoplasia above 9 years of age, 171 teeth divided randomly into four groups: Group A - ICON, Group B - MAb-Re using Tooth Mousse, Group C - MAb-Re using Toothmin, and Group D - control group. Process involved taking standardized photographs at T1 - before intervention, T2 - immediately after treatment, and T3 - 6-month follow-up. Color evaluation, area calculation, participant and expert opinion using a Likert scale, treatment time, and cost-effectiveness were all taken into consideration during the assessment. Statistical Analysis Used Data were collected, entered into a computer, and analyzed; one-way ANOVA was used for intergroup assessment. Results Overall color change was evident immediately after treatment in the ICON group compared to other groups (P < 0.05). However, no significant difference in color change was visible between the groups after 6 months. Reduction in hypoplastic area was seen in all the groups. The mean time was similar for all the groups. Toothmin was found to be the most cost-effective in comparison with the other two interventions. Conclusions ICON proved to be more effective immediately after treatment for masking incisor hypoplasia. However, at 6-month follow-up interval, all the groups gave similar results.
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Affiliation(s)
- Yash Shah
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Anshula Deshpande
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Aishwarya Jain
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Vidhi Jaiswal
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Mudra Andharia
- Department of Periodontology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
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Zhang OL, Niu JY, Yin IX, Yu OY, Mei ML, Chu CH. Bioactive Materials for Caries Management: A Literature Review. Dent J (Basel) 2023; 11:dj11030059. [PMID: 36975556 PMCID: PMC10047026 DOI: 10.3390/dj11030059] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Researchers have developed novel bioactive materials for caries management. Many clinicians also favour these materials, which fit their contemporary practice philosophy of using the medical model of caries management and minimally invasive dentistry. Although there is no consensus on the definition of bioactive materials, bioactive materials in cariology are generally considered to be those that can form hydroxyapatite crystals on the tooth surface. Common bioactive materials include fluoride-based materials, calcium- and phosphate-based materials, graphene-based materials, metal and metal-oxide nanomaterials and peptide-based materials. Silver diamine fluoride (SDF) is a fluoride-based material containing silver; silver is antibacterial and fluoride promotes remineralisation. Casein phosphopeptide-amorphous calcium phosphate is a calcium- and phosphate-based material that can be added to toothpaste and chewing gum for caries prevention. Researchers use graphene-based materials and metal or metal-oxide nanomaterials as anticaries agents. Graphene-based materials, such as graphene oxide-silver, have antibacterial and mineralising properties. Metal and metal-oxide nanomaterials, such as silver and copper oxide, are antimicrobial. Incorporating mineralising materials could introduce remineralising properties to metallic nanoparticles. Researchers have also developed antimicrobial peptides with mineralising properties for caries prevention. The purpose of this literature review is to provide an overview of current bioactive materials for caries management.
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Affiliation(s)
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Iris Xiaoxue Yin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - 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
- Faculty of Dentistry, The University of Otago, Dunedin 9054, New Zealand
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Correspondence:
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Red Marine Algae Lithothamnion calcareum Supports Dental Enamel Mineralization. Mar Drugs 2023; 21:md21020109. [PMID: 36827150 PMCID: PMC9963885 DOI: 10.3390/md21020109] [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: 11/27/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
The current management of oral conditions such as dental caries and erosion mostly relies on fluoride-based formulations. Herein, we proposed the use of the remaining skeleton of Lithothamnion calcareum (LC) as an alternative to fluorides. LC is a red macroalgae of the Corallinales order, occurring in the northeast coast of Brazil, whose unique feature is the abundant presence of calcium carbonates in its cell walls. Two experimental approaches tested the general hypothesis that LC could mediate enamel de-remineralization dynamics as efficiently as fluorides. Firstly, the effect of LC on enamel de-mineralization was determined in vitro by microhardness and gravimetric measurements to test the hypothesis that LC could either prevent calcium/phosphate release from intact enamel or facilitate calcium/phosphate reprecipitation on an artificially demineralized enamel surface. Subsequently, an in situ/ex vivo co-twin control study measured the effect of LC on the remineralization of chemical-demineralized enamel using microhardness and quantitative light-induced fluorescence. With this second experiment, we wanted to test whether outcomes obtained in experiment 1 would be confirmed by an in situ/ex vivo co-twin control model. Both experiments showed that LC exhibited equivalent or superior ability to modulate enamel de-remineralization when compared to fluoride solution. LC should be explored as an alternative to manage oral conditions involving the enamel demineralization.
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Comparative Efficacy of Novel Biomimetic Remineralising Technologies. Biomimetics (Basel) 2023; 8:biomimetics8010017. [PMID: 36648803 PMCID: PMC9844379 DOI: 10.3390/biomimetics8010017] [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: 12/05/2022] [Revised: 12/21/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
Biomimetic technologies for the remineralisation of enamel subsurface lesions (ESLs) have been developed and include: fluorocalcium phosphosilicate bioglass (BG/F); casein phosphopeptide-amorphous calcium phosphate (CPP−ACP) and with fluoride (CPP−ACFP); and self-assembling oligopeptide P11-4 (SAP). The aim of this study was to compare the remineralisation of ESLs in vitro using these technologies. Human enamel slabs with ESLs were cut into two half-slabs; one half-slab was untreated (control), and the other half was treated by exposure to one of the four technologies with artificial saliva (AS) or AS alone for 14 days at 37 °C. The technologies were applied to the ESL surface according to the manufacturer’s instructions. At the completion of each treatment, the treated half-slabs and their paired control half-slabs were embedded, sectioned and the mineral content was determined using transverse microradiography. The change in mineral content (remineralisation) between treatments was statistically analysed using one-way ANOVA. The order from highest to lowest remineralisation was CPP−ACFP (52.6 ± 2.6%) > CPP−ACP (43.0 ± 4.9%) > BG/F (13.2 ± 2.5%) > SAP (5.8 ± 1.6%) > AS (2.1 ± 0.5%). Only CPP−ACFP and CPP−ACP produced remineralisation throughout the body of the lesions. All four biomimetic technologies had some effect on the remineralisation of ESLs; however, CPP−ACFP with calcium, phosphate and fluoride ions stabilised by CPP was superior in the level and pattern of remineralisation obtained.
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Resin Infiltration of Non-Cavitated Enamel Lesions in Paediatric Dentistry: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121893. [PMID: 36553336 PMCID: PMC9776437 DOI: 10.3390/children9121893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
The resin infiltration (RI) technique was introduced as one of the minimal intervention dentistry strategies in addressing dental caries among the paediatric population. This technique used the low-viscosity resin monomer to infiltrate the non-cavitated carious lesion and other developmental enamel porosities, thus allowing the conservation of the tooth structure. This narrative review aims to explore the value of RI in Paediatric Dentistry. Through our search of the literature, the development of the material, their clinical applications and shortcomings, as well as the innovation that has been carried out to improve the current RI, were discussed. There are number of high-level evidence supporting the use of RI in arresting non-cavitated proximal caries lesions in primary and permanent teeth, but its efficacy in managing anterior white spot lesions is still unclear. Limited penetration depth, not radiopaque and questionable long-term colour and material stability were among the limitation of the material. Various laboratory-based studies have been conducted to improve the current properties of RI. Nevertheless, RI has emerged as one of the important micro-invasive techniques in addressing non-cavitated and anterior white-spot enamel lesions in children and adolescents with great success.
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Evaluation of the Efficacy of CPP-ACP Remineralizing Mousse in MIH White and Yellow Opacities-In Vitro Vickers Microhardness Analysis. Dent J (Basel) 2022; 10:dj10100186. [PMID: 36285996 PMCID: PMC9600031 DOI: 10.3390/dj10100186] [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: 07/28/2022] [Revised: 09/09/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Remineralization of tooth enamel can be partially achieved by the application of a casein phosphopeptides and amorphous phosphate (CPP-ACP) complex. However, evidence to support its effectiveness in Molar-incisor-hypomineralization (MIH)-affected teeth is scarce. The study’s aim is to evaluate the efficacy of CPP-ACP mousse in remineralizing MIH-affected enamel using a Vickers microhardness test. Two groups of enamel opacities of hypomineralized permanent teeth, white (group A) and yellow (group B) lesions (n = 14), went through a 28-day treatment protocol with GC Tooth Mousse. Before and after treatment, microhardness was measured in three different areas of each tooth (hypomineralized, transition, and outside the hypomineralized area). Data were analyzed using parametric and non-parametric tests with a significance of p < 0.05. The mean microhardness values increased in the hypomineralized and transition areas in both groups after the treatment protocol (in group A, 105.38 ± 11.70 to 158.26 ± 37.34; 123.04 ± 22.84 to 156.33 ± 35.70; in group B, 108.63 ± 14.66 to 143.06 ± 22.81; 132.55 ± 20.66 to 146.00 ± 12.88) and the differences pre/post-treatment were statistically significant within each group (p < 0.001 for both groups). Between groups, there was a statistically significant difference in the same areas (hypomineralized: p = 0.003; transition: p = 0.008) with a higher improvement in enamel hardness in group A. Topical application of CPP-ACP showed an increase in the physical strength of the hypomineralized and transition areas of MIH-affected enamel, likely due to an increase in mineral content.
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Molaasadolah F, Hosseinipour ZS, Afzali F, Parhizkar A, Poorzandpoush K. The effect of two calcium phosphate-containing agents on the enamel resistance of permanent molars to demineralization: An experimental study. Clin Exp Dent Res 2022; 8:1533-1539. [PMID: 35993588 PMCID: PMC9760130 DOI: 10.1002/cre2.649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The main purpose of this experimental study was to determine the in vitro effects of two calcium phosphate-containing agents (Remin Pro® and GC Tooth mousse™) on the enamel resistance of permanent molars to demineralization. METHODS Fifty extracted human third molars were randomly divided into four groups; that is the control group and three case groups treated with Remin Pro®, GC Tooth mousse™, and sodium fluoride gel. The three case groups were treated with 0.25 ml of the paste associated with each experimental group for 5 min, kept in fluoride-free artificial saliva, and incubated at 37°C for 28 days. After the treatment regimen, 10 samples of each case group were subjected to demineralization using an acetic acid-containing solution, and remineralization using a remineralizing solution. The morphology of enamel was observed via scanning electron microscopy and their enamel calcium/phosphorus (Ca/P) ratios were measured before/after the demineralization cycle with energy-dispersive X-ray analysis. Data were statistically analyzed using one-way analysis of variance and post hoc Tukey tests. RESULTS The enamel Ca/P ratios in the case study groups were significantly higher than that of the control group before/after the demineralization regimen (p < .0001). However, the ratios were not significantly different between the case study groups after the treatment regimen and demineralization cycle (p > .05). CONCLUSION The outcomes of the current study indicated that all three agents seemed to increase the enamel resistance of permanent molar teeth to demineralization.
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Affiliation(s)
- Fatemeh Molaasadolah
- Department of Pediatric Dentistry, School of DentistryShahid Beheshti University of Medical SciencesTehranIran
| | - Zohre Sadat Hosseinipour
- Department of Pediatric Dentistry, School of DentistryAJA University of Medical SciencesTehranIran
| | | | - Ardavan Parhizkar
- Iranian Centre for Endodontic Research, Research Institute for Dental SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Kiana Poorzandpoush
- Department of Pediatric Dentistry, School of DentistryShahid Beheshti University of Medical SciencesTehranIran
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Effect of Over-The-Counter Tooth-Whitening Products on Enamel Surface Roughness and Microhardness. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12146930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: To evaluate the efficacy of new over-the-counter tooth-whitening products on enamel surface roughness and microhardness. Methods: A total of 120 enamel specimens were prepared and randomly allocated into six groups. Group A was treated with 10% carbamide peroxide; Group B was immersed in distilled water; Group C was treated with hydrated silica, sodium hexametaphosphate toothpaste; Group D was treated with sodium bicarbonate; Group E was treated with 0.25% citric acid; and Group F was treated with hydrated silica, charcoal powder. Results: A, B, and D demonstrated decreased Ra, whereas Groups C, E, and F showed an increased Ra after whitening. The changes in Ra from T0 to T1 in each group was statistically significant (p < 0.001) except for Group B (p = 0.85). The groups showed decreased KHN after whitening, except for specimens in Group B (distilled water). The KHN from T0 to T1 decreased significantly for groups A, C, E, and F (p = 0.001). Significant difference was observed at T1 (p < 0.0001). Conclusion: Within the limitations of this study, it could be demonstrated that surface roughness and enamel microhardness changes were influenced by the type, composition, and exposure time of the whitening product.
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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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15
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Aref NS, Alrasheed MK. Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: an in-vitro study. Prog Orthod 2022; 23:10. [PMID: 35307802 PMCID: PMC8934900 DOI: 10.1186/s40510-022-00404-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background White spot lesion (WSL) is the most common consequence during and after orthodontic treatment. This study was conducted to investigate the ability of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) coupled with universal adhesive resin to treat white spot lesions. Material and methods Forty-five extracted premolars were sectioned to create 90 specimens. Seventy-five specimens were demineralized to generate artificially created WSLs. Different strategies have been applied for the management of the artificially created WSLs. Six experimental groups were employed: Group I: sound enamel (control), Group II: demineralized enamel (artificially-created WSLs), Group III: ICON resin-treated WSLs, Group IV: CPP-ACP-treated WSLs, Group V: universal adhesive resin-treated WSLs, and Group VI: CPP-ACP followed by universal adhesive resin-treated WSLs. Assessment of color stability using a spectrophotometer, surface microhardness using a Vickers tester, and surface roughness using a profilometer was done. The surface topography of representative specimens from each experimental group was inspected using a scanning electron microscope. Collected data were analyzed using one-way ANOVA followed by Tukey’s post hoc test at p ≤ 0.05. Results White spot lesions treated with CPP-ACP and subsequently coated with universal adhesive resin (Group VI) exhibited a significantly lower ΔE than both CPP-ACP (Group IV) and universal adhesive resin-treated (Group V) groups (p ≤ 0.05), but it was not significantly different from the ICON resin-treated group (Group III). For surface microhardness, WSLs treated with CPP-ACP and consequently coated with universal adhesive resin (Group VI) recorded the highest mean that was significantly different from both ICON resin (Group III) and universal adhesive resin-treated (Group V) groups (p ≤ 0.05). All the tested strategies (ICON resin, CPP-ACP, universal adhesive resin, and CPP-ACP followed by universal adhesive resin) significantly lowered the surface roughness of the WSLs (p ≤ 0.05), while no significant difference was detected among them. Conclusions Combining a considerable caries remineralizing program using CPP-ACP with subsequent universal adhesive resin infiltration could be a promising approach to manage WSLs efficiently through increasing surface microhardness and restoring esthetic while developing a smoother surface.
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Sezer B, Tuğcu N, Calışkan C, Durmuş B, Kupets T, Bekiroğlu N, Kargül B, Bourgeois D. Effect of casein phosphopeptide amorphous calcium fluoride phosphate and calcium glycerophosphate on incisors with molar-incisor hypomineralization: A cross-over, randomized clinical trial. Biomed Mater Eng 2022; 33:325-335. [DOI: 10.3233/bme-211371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Within the scope of minimally invasive dentistry, the use of different biocompatible remineralization agents on incisors affected by molar-incisor hypomineralization (MIH) gains importance. OBJECTIVE: To evaluate the effect of casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) and calcium glycerophosphate (CaGP) in mineral density (MD) of white/creamy and yellow/brown demarcated opacities on incisors affected by MIH by means laser fluorescence (LF). METHODS: As a cross-over, randomized trial, twenty-two children with 167 incisors affected by MIH were recruited and randomly assigned to one of the two different agents and crossed over to other agents with two weeks washout in between. Incisors were examined by using LF at all before and after three months periods. RESULTS: The results of the paired t-tests for determining the period effect between the baseline findings showed significant difference in white/creamy and yellow/brown demarcated opacities of LF values for both groups (p < 0.05). The difference between both groups according to after categorization of 20% increasing in MD in the percent of change before and after application on LF values; was not found statistically significant in white/creamy (p = 0.970) and yellow/brown (p = 0.948) opacities. CONCLUSIONS: The primary outcome was CPP-ACFP and CaGP had a positive effect in decreasing hypomineralization on MIH-affected enamel for three months period.
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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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18
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Shirani F, Malekipoor M, Mousavinasab S, Jafari N, Sharifinejad N. Spectrophotometric Evaluation of the Color Change of Artificial White Spot Lesions Treated with Three Different Commercially Available Remineralizing Agents: An In Vitro Study. DENTAL HYPOTHESES 2022. [DOI: 10.4103/denthyp.denthyp_129_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Escalante-Otárola WG, Castro-Núñez GM, Leandrim TP, Alencar CM, de Albuquerque Jassé FF, Kuga MC. Effects of Remineralizing Agents Based on Calcium Phosphate, Sodium Phosphate, or Sodium Fluoride on Eroded Cervical Dentin. Oper Dent 2021; 46:E296-E306. [PMID: 34919731 DOI: 10.2341/20-209-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate the effect of remineralizing agents on collagen matrix pattern, precipitate formation, and dentinal tubule obliteration in eroded cervical dentin. METHODS AND MATERIALS One hundred bovine cervical dentin specimens were previously eroded (0.6% hydrochloric acid, pH 2.3, 5 minutes) and then randomized into five groups (n=20): G1, control (without treatment); G2, Desensibilize Nano P (FGM); G3, MI Paste Plus (Recaldent); G4, Regenerate (NR-5); and G5, Desensibilize KF 2% (FGM). These treatments were applied in four sessions with 7-day intervals. During this period, the samples were subjected to an erosive challenge with orange juice (pH 3.8, 5 minutes). The specimens were analyzed by polarized light microscopy with picrosirius red staining, scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). RESULTS The G3 showed a higher concentration of type I collagen than G2 and G5 (p<0.05). The G3 showed greater formation of surface precipitates than that of G1 and G5 (p<0.05). In addition, G4 and G5 showed a greater number of open dentinal tubules than that of G3 (p<0.05). CONCLUSIONS Calcium phosphate-based remineralizing agents have shown to be a promising alternative treatment for preventing deleterious effects on the eroded dentin collagen matrix. In addition, they promoted precipitate formation and dentinal tubule obliteration on the eroded dentin.
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Affiliation(s)
- W G Escalante-Otárola
- Wilfredo Gustavo Escalante-Otárola, DDS, MS, PhD, NCCL Research Group, School of Dentistry, Faculty of Health Sciences, Jorge Basadre Grohmann National University - UNJBG, Tacna, Perú; Department of Restorative Dentistry, Araraquara School of Dentistry, Paulista State University - UNESP, Araraquara, SP, Brazil
| | - G M Castro-Núñez
- Gabriela Mariana Castro-Núñez DDS, MS, PhD, School of Dentistry, Faculty of Health Sciences, Jorge Basadre Grohmann National University - UNJBG, Tacna, Perú
| | - T P Leandrim
- Thaís Piragine Leandrim DDS, MS, PhD student, Department of Restorative Dentistry, Araraquara School of Dentistry, Paulista State University - UNESP, Araraquara, SP, Brazil
| | - C M Alencar
- Cristiane de Melo Alencar DDS, MS, PhD student, Department of Restorative Dentistry, Araraquara School of Dentistry, Paulista State University - UNESP, Araraquara, SP, Brazil
| | - F F de Albuquerque Jassé
- Fernanda Ferreira de Albuquerque Jassé DDS, MS, PhD, School of Dentistry, Federal University of Para, Belém, PA, Brazil
| | - M C Kuga
- *Milton Carlos Kuga DDS, MS, PhD, Department of Restorative Dentistry, Araraquara School of Dentistry, Paulista State University - UNESP, Araraquara, SP, Brazil
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20
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Grohe B, Mittler S. Advanced non-fluoride approaches to dental enamel remineralization: The next level in enamel repair management. BIOMATERIALS AND BIOSYSTEMS 2021; 4:100029. [PMID: 36824571 PMCID: PMC9934497 DOI: 10.1016/j.bbiosy.2021.100029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/22/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
In modern dentistry, a minimally invasive management of early caries lesions or early-stage erosive tooth wear (ETW) with synthetic remineralization systems has become indispensable. In addition to fluoride, which is still the non-plus-ultra in these early caries/ETW treatments, a number of new developments are in the test phase or have already been commercialized. Some of these systems claim that they are comparable or even superior to fluoride in terms of their ability to remineralize enamel. Besides, their use can help avoid some of the risks associated with fluoride and support treatments of patients with a high risk of caries. Two individual non-fluoride systems can be distinguished; intrinsic and extrinsic remineralization approaches. Intrinsic (protein/peptide) systems adsorb to hydroxyapatite crystals/organics located within enamel prisms and accumulate endogenous calcium and phosphate ions from saliva, which ultimately leads to the re-growth of enamel crystals. Extrinsic remineralization systems function on the basis of the external (non-saliva) supply of calcium and phosphate to the crystals to be re-grown. This article, following an introduction into enamel (re)mineralization and fluoride-assisted remineralization, discusses the requirements for non-fluoride remineralization systems, particularly their mechanisms and challenges, and summarizes the findings that underpin the most promising advances in enamel remineralization therapy.
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Affiliation(s)
- Bernd Grohe
- Lawson Health Research Institute, St. Joseph's Hospital, London, ON, N6A 4V2 Canada,Corresponding author at: 268 Grosvenor Street, London, ON, N6A 4V2, Canada.
| | - Silvia Mittler
- Department of Physics & Astronomy, University of Western Ontario, London, ON, N6A 3K7 Canada,Department of Chemical and Biochemical Engineering, University of Western Ontario, London, ON, N6A 5B9 Canada
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21
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Sleibi A, Tappuni AR, Baysan A. Reversal of Root Caries with Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Varnish in Xerostomia. Caries Res 2021; 55:475-484. [PMID: 34352792 DOI: 10.1159/000516176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/28/2021] [Indexed: 11/19/2022] Open
Abstract
Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45-92 years) with primary root caries (n = 184 root carious lesions) and unstimulated salivary flow rate of <0.2 mL/min were randomly allocated to receive either dental varnish containing CPP-ACP and 5% fluoride (group 1: MI varnish; GC, Japan) (n = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (n = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (n = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (n = 35) in group 2 (p < 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, n = 60, 83.3%) (group 2, n = 66, 74.2%) (p = 0.36), and (group 1, n = 60, 89.6%) (group 2, n = 67, 81.7%, n = 1 soft, 1.2%) (p = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (p < 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.
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Affiliation(s)
- Ahmed Sleibi
- Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, UK,
| | - Anwar R Tappuni
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Aylin Baysan
- Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, UK
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Kilic M, Gurbuz T. Evaluation of the effects of different remineralisation agents on initial enamel lesions by scanning electron microscope and energy-distributed X-ray analysis. Int J Clin Pract 2021; 75:e14299. [PMID: 33930242 DOI: 10.1111/ijcp.14299] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study compared the ability of four remineralization agents to restore demineralised enamel lesions in permanent human incisors. METHODS In total, 40 teeth were included in the study. Two samples were obtained from each tooth. The 80 samples were divided into 10 groups (n = 8 per group). The right halves of the teeth were controls solely subjected to demineralisation and stored in artificial saliva for the duration of the experiment. The left halves of the teeth were remineralised using a 5% NaF-containing fluoride varnish (GC MI varnish; GC Corp.), a toothpaste containing casein phosphopeptide and amorphous calcium (GC tooth mousse; GC Corp.), a water-soluble remineralisation paste containing fluoride, hydroxyapatite, xylitol (Remin Pro; Voco), and ROCS remineralising gel containing Ca, magnesium(Mg) and phosphate (P). After 21 days of remineralisation, scanning electron microscopy and energy-dispersive X-ray (EDX) assessments were performed, and the results were analysed using one-way analysis of variance. RESULTS EDX analysis showed that the ROCS medical remineralising gel had the lowest Ca/P ratio among the groups (P = .04). Compared with the control groups, the Remin Pro and ROCS medical remineralising gel treatments produced significantly higher Ca/P ratios (P = .014 and P = .025). These results were statistically significant, and P-value <.05 was accepted for statistical significance. CONCLUSIONS The group treated with a fluoride-free, xylitol-containing ROCS medical remineralising gel had the lowest Ca/P ratio. Compared with the control groups, Remin Pro and ROCS remineralising gel appeared effective for repairing initial enamel lesions.
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Affiliation(s)
- Munevver Kilic
- Department of Pediatric Dentistry, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Taskin Gurbuz
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Saglik ve Teknolojileri University, İstanbul, Turkey
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Comparative Study of Technologies for Tubule Occlusion and Treatment of Dentin Hypersensitivity. J Funct Biomater 2021; 12:jfb12020027. [PMID: 33925548 PMCID: PMC8167718 DOI: 10.3390/jfb12020027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to evaluate the occluding/remineralization performance and resistance to acid attacks of the mineralization layer formed by a tooth-desensitizing gel containing amorphous calcium magnesium phosphate (ACMP) particles and compare it to six other desensitizing products available on the market. Similar comprehensive studies are few and there is especially a lack of studies that are up to date. A dentin-disc model was used for in vitro evaluation of the desensitizing toothpastes/gels. Application of the products was performed twice daily for seven days. One set of specimens were evaluated using scanning electron microscopy (SEM) directly after the final treatment and another set was evaluated after an acid challenge, exposing specimens to 2 wt% citric acid. The ACMP desensitizing gel was the only product resulting in complete occlusion by the formation of mineralized material on the dentin surface and inside the tubules. Particle deposition was dominant after treatment with the other desensitizing products, with little or no mineralization, resulting in partial occlusion only. Sensodyne Repair & Protect and Oral-B Pro-Expert showed the highest resistance toward acid attacks. Material inside the tubules remained relatively unaffected by acid attacks in all specimens. The results in this study indicated a great variability among the occluding agents in terms of occlusion and acid resistance of the mineralization layer. The high degree of occlusion and intra-tubular mineralization that could mitigate the effect of acid solubilization indicate that the ACMP desensitizing gel may be a superior option for the treatment of dentin hypersensitivity.
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Shen P, Fernando JR, Yuan Y, Walker GD, Reynolds C, Reynolds EC. Bioavailable fluoride in calcium-containing dentifrices. Sci Rep 2021; 11:146. [PMID: 33420297 PMCID: PMC7794534 DOI: 10.1038/s41598-020-80503-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/16/2020] [Indexed: 11/14/2022] Open
Abstract
Calcium added to dentifrices can complex with fluoride ions to reduce intra-oral bioavailability and therefore efficacy in preventing dental caries. Six commercially available dentifrices containing different types of calcium and fluoride were analyzed for total and bioavailable fluoride levels by adding 10 g of dentifrice to 30 mL of distilled deionized water and mixing vigorously for 1 min to simulate toothbrushing. One milliliter of the dentifrice/water slurry was immediately centrifuged and the supernatant removed for bioavailable fluoride analysis and the mixed slurry prior to centrifugation used for total fluoride analysis using a modified microdiffusion method. The concentration of fluoride was determined using a fluoride ion-selective electrode calibrated with internal fluoride standards. All the dentifrices had similar total fluoride concentrations to those indicated on their labels (94% to 105%). However, only one dentifrice that contained calcium in the form of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) had almost 100% (97%) of fluoride in bioavailable form. The other dentifrices contained calcium carbonate and they exhibited significantly (p < 0.001) lower bioavailable fluoride levels (27% to 61%), through the generation of poorly soluble fluoride phases. The saliva biomimetic CPP, as CPP-ACP, in a dentifrice stabilised calcium and fluoride ions to maintain fluoride's bioavailability.
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Affiliation(s)
- Peiyan Shen
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, 720 Swanston Street, Carlton, Melbourne, VIC, 3010, Australia
| | - James R Fernando
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, 720 Swanston Street, Carlton, Melbourne, VIC, 3010, Australia
| | - Yi Yuan
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, 720 Swanston Street, Carlton, Melbourne, VIC, 3010, Australia
| | - Glenn D Walker
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, 720 Swanston Street, Carlton, Melbourne, VIC, 3010, Australia
| | - Coralie Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, 720 Swanston Street, Carlton, Melbourne, VIC, 3010, Australia
| | - Eric C Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, 720 Swanston Street, Carlton, Melbourne, VIC, 3010, Australia.
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Kozhuharova P, Diaconescu AO, Allen P. Reduced cortical GABA and glutamate in high schizotypy. Psychopharmacology (Berl) 2021; 238:2459-2470. [PMID: 34146134 PMCID: PMC8373725 DOI: 10.1007/s00213-021-05867-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/02/2021] [Indexed: 12/04/2022]
Abstract
RATIONALE Abnormal functioning of the inhibitory gamma-aminobutyric acid (GABA) and excitatory (glutamate) systems is proposed to play a role in the development of schizophrenia spectrum disorder. Although results are mixed, previous 1H-magnetic resonance spectroscopy (MRS) studies in schizophrenia and clinical high-risk samples report these metabolites are altered in comparison to healthy controls. Currently, however, there are few studies of these metabolites in schizotypy samples, a personality dimension associated with the experience of schizophrenia and psychosis-like symptoms. OBJECTIVES We investigated if GABA and glutamate metabolite concentrations are altered in people with high schizotypy. We also explored the relationship between resilience to stress, GABA metabolite concentrations and schizotypy. METHODS We used MRS to examine GABA and glutamate levels in the medial prefrontal cortex in people with low and high schizotypy traits as assessed with the Schizotypal Personality Questionnaire. Resilience to stress was assessed using the Connor-Davidson Resilience Scale. RESULTS Compared to individuals with low schizotypy traits, high schizotypy individuals showed lower cortical prefrontal GABA (F (1,38) = 5.18, p = 0.03, η2 = 0.09) and glutamate metabolite levels (F (1, 49) = 6.25, p = 0.02, η2 = 0.02). Furthermore, participants with high GABA and high resilience levels were significantly more likely to be in the low schizotypy group than participants with low GABA and high resilience or high GABA and low resilience (95% CI 1.07-1.34, p < .001). CONCLUSIONS These findings demonstrate that subclinical schizotypal traits are associated with abnormal functioning of both inhibitory and excitatory systems and suggest that these transmitters are implicated in a personality trait believed to be on a continuum with psychosis.
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Affiliation(s)
- Petya Kozhuharova
- Centre for Cognition, Neuroscience and Neuroimaging, Department of Psychology, University of Roehampton, Holybourne Ave, Roehampton, London, SW15 4JD, UK.
| | - Andreea O Diaconescu
- Department of Psychiatry, Brain and Therapeutics, Krembil Centre for Neuroinformatics, CAMH, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Paul Allen
- Centre for Cognition, Neuroscience and Neuroimaging, Department of Psychology, University of Roehampton, Holybourne Ave, Roehampton, London, SW15 4JD, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Shen P, Zalizniak I, Palamara JE, Burrow MF, Walker GD, Yuan Y, Reynolds C, Fernando JR, Reynolds EC. Recharge and increase in hardness of GIC with CPP-ACP/F. Dent Mater 2020; 36:1608-1614. [DOI: 10.1016/j.dental.2020.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/29/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022]
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Kensche A, Pötschke S, Hannig C, Dürasch A, Henle T, Hannig M. Efficacy of mouthrinses with bovine milk and milk protein isolates to accumulate casein in the in situ pellicle. Clin Oral Investig 2020; 24:3871-3880. [DOI: 10.1007/s00784-020-03253-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
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Shen P, Fernando JR, Walker GD, Yuan Y, Reynolds C, Reynolds EC. Addition of CPP-ACP to yogurt inhibits enamel subsurface demineralization. J Dent 2020; 103:103506. [PMID: 33115668 DOI: 10.1016/j.jdent.2020.103506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/28/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the capacity of an approved food additive with anticariogenic properties, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), when added to a processed, sugar-containing yogurt with added lactic-acid bacteria (probiotics), to prevent demineralization of enamel subsurface lesions in vitro. METHODS Enamel subsurface demineralised lesions were created in thirty extracted human third molars. These were then exposed to artificial saliva (AS) with: 1) Danone yogurt alone; 2) Danone yogurt with 0.2 % w/w CPP-ACP; or 3) Danone yogurt with 0.5 % w/w CPP-ACP at 37 °C for two weeks. The yogurt/AS was replaced with fresh preparations each day. At the completion of each treatment the enamel slabs were embedded, sectioned and analyzed using transverse microradiography to measure changes in enamel lesion depths and subsurface mineral content. Yogurt samples were analysed for soluble calcium (Ca) and inorganic phosphate (Pi) levels and pH. RESULTS Yogurt alone demineralized enamel subsurface lesions to produce significantly larger lesions. However, the addition of 0.2 % CPP-ACP to the yogurt resulted in significant reduction in demineralization compared with yogurt alone (p < 0.0001). The addition of 0.5 % CPP-ACP to the yogurt produced a net remineralization effect with a significant increase in lesion mineral content (p < 0.0001). The addition of CPP-ACP resulted in a significant (p < 0.0001) dose-related increase in Ca, Pi and pH. CONCLUSIONS The addition of CPP-ACP to a commercial yogurt exhibited a dose related protective effect with 0.5 % CPP-ACP producing remineralization of existing enamel subsurface lesions under the in vitro experimental conditions. CLINICAL SIGNIfiCANCE: The results of this study suggest that some processed yogurts with added sugar could result in enamel demineralization when frequently consumed by individuals with poor oral hygiene. The addition of CPP-ACP to these yogurts may help prevent demineralization and promote enamel subsurface lesion remineralization, and therefore, make them safer for teeth.
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Affiliation(s)
- Peiyan Shen
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - James R Fernando
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Glenn D Walker
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yi Yuan
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Coralie Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eric C Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia.
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Gonçalves FMC, Delbem ACB, Gomes LF, Emerenciano NG, Dos Passos Silva M, Cannon ML, Danelon M. Combined effect of casein phosphopeptide-amorphous calcium phosphate and sodium trimetaphosphate on the prevention of enamel demineralization and dental caries: an in vitro study. Clin Oral Investig 2020; 25:2811-2820. [PMID: 32995976 DOI: 10.1007/s00784-020-03597-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effect of treatment with fluoridated toothpaste supplemented with a combination of sodium trimetaphosphate (TMP) and casein phosphopeptide-amorphous calcium phosphate (MI Paste Plus®) on the demineralization of dental enamel. METHODS Bovine enamel blocks selected by initial surface hardness (SHi) were randomly allocated into six groups (n = 12), according to the test toothpastes: (1) without F-TMP-MI Paste Plus® (Placebo); (2) 1100 ppm F (1100F); (3) MI Paste Plus®; (4) 1100F + MI Paste Plus® (1100F-MI Paste Plus), (5) 1100F + 3 % TMP (1100F-TMP); and (6) 1100F-TMP + MI Paste Plus® (1100F-TMP-MI Paste Plus). Blocks were treated two times per day with slurries of toothpaste (1 min), and groups 4 and 6 received an application of MI Paste Plus (3 min). Next, the samples were subjected to five pH cycles (demineralizing/remineralizing solutions) at 37 °C, to produce subsurface enamel lesions.Thereafter, the blocks were maintained for 2 days in fresh remineralizing solution. After pH cycling, the following were obtained: percentage of surface hardness loss (%SH); integrated loss of subsurface hardness (ΔKHN); profile analysis and lesion depth subsurface through polarized light microscopy (PLM); scanning electron microscopy (SEM); and fluoride (F), calcium (Ca), and phosphorus (P) in the enamel. The data were subjected to ANOVA (1-criterion), followed by the Student-Newman-Keuls test (p < 0.001). RESULTS The 1100F-TMP-MI Paste Plus group showed better results for SHR, ΔKHN, and PLM (p < 0.001). The F concentration was similar among all groups (p > 0.001). The 1100F-TMP-MI Paste Plus group showed the highest concentration of Ca and P in the enamel (p < 0.001). CONCLUSION The application of 1100F-TMP-MI Paste Plus promoted a higher inhibitory effect against enamel demineralization. CLINICAL SIGNIFICANCE The combination of treatments with F, TMP, and MI Paste Plus® can be an effective alternative to improve the oral health of individuals, especially those with high activity of dental caries and at high risk for its development.
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Affiliation(s)
- Francyenne Maira Castro Gonçalves
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Cep 16015-050, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Cep 16015-050, Brazil
| | - Leonardo Fernandes Gomes
- Department of Materials Engineering, Federal University of São Carlos - UFSCar, São Carlos, SP, Cep 13565-905, Brazil
| | - Nayara Gonçalves Emerenciano
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Cep 16015-050, Brazil
| | - Matheus Dos Passos Silva
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Cep 16015-050, Brazil
| | - Mark L Cannon
- Feinberg School of Medicine, Ann and Robert Lurie Children's Hospital, Northwestern University, Chicago, IL, USA
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Cep 16015-050, Brazil.
- School of Dentistry, University of Ribeirão Preto-UNAERP, Ribeirão Preto, SP, Cep 14096-900, Brazil.
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Eslamian L, Borzabadi-Farahani A, Karimi S, Saadat S, Badiee MR. Evaluation of the Shear Bond Strength and Antibacterial Activity of Orthodontic Adhesive Containing Silver Nanoparticle, an In-Vitro Study. NANOMATERIALS 2020; 10:nano10081466. [PMID: 32727028 PMCID: PMC7466539 DOI: 10.3390/nano10081466] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 01/12/2023]
Abstract
This study evaluated the effect of incorporating silver nanoparticles (AgNPs) into conventional orthodontic adhesive on its antibacterial activity and the shear bond strength (SBS) to stainless steel orthodontic brackets. Thirty-four extracted premolars were randomly allocated into two groups (n = 17). Orthodontic adhesive (Transbond XT, 3M Unitek) was blended with AgNPs (50 nm, 0.3% w/w) to form a nano-adhesive. In order to bond stainless steel twin brackets (0.022-inch, American Orthodontics), Transbond XT (n = 17) and nano-adhesive (n = 17) were used in each group, respectively, after acid etching (37% phosphoric acid, 30 s) and rinsing with water (15 s). SBS and the adhesive remnant index (ARI) scores were recorded. Antibacterial activity against Streptococcus mutans in both groups after 24 h and 30 days was assessed (Disc agar diffusion test) and the inhibition zone diameter around each specimen was measured and recorded. Adding AgNPs significantly (p = 0.009) reduced the mean (SD) SBS in the nano-adhesive group [10.51(7.15) MPa] compared to Transbond XT [17.72(10.55) MPa]. The ARI scores on the Transbond XT and nano-adhesive showed no statistically significant difference (p = 0.322). Nano-adhesive with AgNPs showed significant antibacterial activity against Streptococcus mutans at 24 h and 30 days (p < 0.001). In both groups, no significant decline in the zones of inhibition was detected after 30 days (p = 0.907). The findings suggest that SBS decreased after incorporation of AgNPs [0.3% (w/w)], but was still above the recommended SBS of 5.9–7.8 MPa. The nano-adhesive showed significant antibacterial activity which did not change much after 30 days.
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Affiliation(s)
- Ladan Eslamian
- Dentofacial Deformities Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran;
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran;
| | - Ali Borzabadi-Farahani
- Orthodontics, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00183 Rome, Italy
- Private Practice, Finchley Orthodontics, North Finchley, London N12 9EN, UK
- Correspondence:
| | - Shahedeh Karimi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran; (S.K.); (S.S.)
| | - Sepideh Saadat
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran; (S.K.); (S.S.)
| | - Mohammad Reza Badiee
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran;
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Shen P, McKeever A, Walker GD, Yuan Y, Reynolds C, Fernando JR, Chen YY, MacRae CM, Schneider P, Reynolds EC. Remineralization and fluoride uptake of white spot lesions under dental varnishes. Aust Dent J 2020; 65:278-285. [PMID: 32678914 DOI: 10.1111/adj.12787] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs in vitro. METHODS MI varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and 2.26% fluoride and Duraphat varnish containing 2.26% fluoride (no added calcium) were compared with a placebo varnish (no added calcium or fluoride). Two WSLs were prepared in enamel slabs and varnish applied to cover one of the two lesions. Each slab was immersed in artificial saliva for 14 days at 37°C. Mineral content was determined using transverse microradiography and fluoride uptake using electron probe microanalysis. The data were statistically analysed using a linear mixed model. RESULTS Both MI and Duraphat varnishes significantly remineralized the covered and uncovered WSLs when compared with the placebo varnish (P < 0.001). The WSLs covered with varnish showed greater remineralization than those uncovered. MI varnish produced the highest level of remineralization and significantly greater fluoride uptake (0.44 ± 0.08 wt%) compared with Duraphat (0.24 ± 0.03 wt%) and the placebo varnish (0.06 ± 0.05 wt%). CONCLUSION Varnish containing fluoride and CPP-ACP was superior to varnish containing fluoride alone in promoting WSL remineralization and fluoride uptake.
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Affiliation(s)
- P Shen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - A McKeever
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - G D Walker
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Y Yuan
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - J R Fernando
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Y-Y Chen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C M MacRae
- Microbeam Laboratory, CSIRO Mineral Resources, Clayton, Victoria, Australia
| | - P Schneider
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - E C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
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Wang Y, Hua F, Jiang H. CPP-ACP May be effective, but not Significantly Greater than using Fluorides Alone, in Preventing and Treating white Spot Lesions Around Orthodontic Brackets. J Evid Based Dent Pract 2020; 20:101416. [PMID: 32381413 DOI: 10.1016/j.jebdp.2020.101416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Effectiveness of casein phosphopeptide-amorphous calcium phosphate-containing products in the prevention and treatment of white spot lesions in orthodontic patients: A systematic review. Pithon MM, Baião FS, Sant'Anna LID, Tanaka OM, Cople-Maia L. J Invest Clin Dent 2019;e12391. SOURCE OF FUNDING No financial support was reported. TYPE OF STUDY/DESIGN Systematic review.
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Berg C, Unosson E, Engqvist H, Xia W. Amorphous Calcium Magnesium Phosphate Particles for Treatment of Dentin Hypersensitivity: A Mode of Action Study. ACS Biomater Sci Eng 2020; 6:3599-3607. [PMID: 33463162 DOI: 10.1021/acsbiomaterials.0c00262] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Occlusion of exposed dentin tubules may eliminate or reduce dentin hypersensitivity by hindering fluid movements within the tubules. In this study, the mode of action of spherical particles of amorphous calcium magnesium phosphate (180-440 nm in diameter) was studied. A degradation study of the particles in Tris-HCl buffer showed that the particles continuously released Ca2+, Mg2+, and phosphate, and XRD analysis revealed the formation of hydroxyapatite (HA) after 1 week. The occluding effect and efficacy of the spherical particles as an occluding agent were evaluated in an in vitro study. The ACMP particles were incorporated in a gel intended for at-home use and tested on extracted human molars. Application of the particles followed by incubation in artificial saliva resulted in occlusion of exposed tubules, and examination with SEM showed that the particles could penetrate the tubules down to 100 μm from the dentin surface. Transformation of the particles into nanocrystalline HA-structures (nanoHA) was initiated at the dentin surface within 12 h of application, and tubule penetration of the particles, accompanied by further ion release and diffusion of ions, resulted in deep intratubular occlusion in the majority of the tubules within 3 days from application. NanoHA was tightly adhered to the tubule walls, filling the entire tubule volume after 7 days. The results of this study demonstrate the mode of action of the amorphous calcium magnesium phosphate particles in occluding exposed dentin tubules. Interaction with saliva and transformation of the particles within the tubules inducing further mineralization indicate that the particles may be used as an effective treatment to reduce dentin hypersensitivity.
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Affiliation(s)
- Camilla Berg
- Division of Applied Materials Science, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden, 75121
| | - Erik Unosson
- Division of Applied Materials Science, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden, 75121
| | - Håkan Engqvist
- Division of Applied Materials Science, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden, 75121
| | - Wei Xia
- Division of Applied Materials Science, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden, 75121
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Geeta RD, Vallabhaneni S, Fatima K. Comparative evaluation of remineralization potential of nanohydroxyapatite crystals, bioactive glass, casein phosphopeptide-amorphous calcium phosphate, and fluoride on initial enamel lesion (scanning electron microscope analysis) - An in vitro study. J Conserv Dent 2020; 23:275-279. [PMID: 33551599 PMCID: PMC7861088 DOI: 10.4103/jcd.jcd_62_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 01/24/2023] Open
Abstract
Aim: The aim of this in vitro study was to evaluate and compare the remineralization potential of four different remineralizing agents, i.e., nanohydroxyapatite crystals, bioactive glass, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride on initial enamel lesion. Materials and Methods: Sixty human maxillary central incisors were used in the present study. Samples were randomly divided into four groups (n = 15). Group 1: nanohydroxyapatite-containing dentifrice (Acclaim); Group 2: bioactive glass containing-dentifrice (SHY-NM); Group 3: CPP-ACP-containing dentifrice; and Group 4: fluoride-containing dentifrice. Baseline microhardness was checked, followed by immersion of teeth samples in demineralizing and remineralizing solution. This was followed by a pH cycle of 10 days. Data were analyzed using ANOVA and Bonferroni method. After this, scanning electron microscopic analysis was done to evaluate remineralization. Results: Statistical analysis of data was conducted using ANOVA, and multiple comparisons within groups were done using the Bonferroni method (post hoc tests). The decision criterion was to reject the null hypothesis if P < 0.05. If there was a significant difference between the groups, multiple comparisons (post hoc test) using the Bonferroni test were carried out. Conclusion: There is a significant difference in mean microhardness between the groups after remineralization. The mean value was found to be highest for nanohydroxyapatite, bioactive glass, CPP-ACP, and fluoride in descending order.
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Affiliation(s)
- R D Geeta
- Conservative Dentistry and Endodontics, ITS Dental College and Hospital, Muradnagar, Uttar Pradesh, India
| | - Saritha Vallabhaneni
- Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Kainath Fatima
- Conservative Dentistry and Endodontics, SB Patil Dental College and Hospital, Bidar, Karnataka, India
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Reddy SP, Prasad MG, Radhakrishna AN, Sandeep RV, Divya DV, Santosh Kumar KVK. Clinical Comparison of Eggshell Derived Calcium Hydroxyapatite with Dycal® as Indirect Pulp Capping Agents in Primary Molars. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Justino IBDS, Alexandria AK, Canto FMT, Leite KLDF, Vieira TI, Cabral LM, Silva RFD, Maia LC. Comparative Effect of Calcium Mesoporous Silica Versus Calcium and/or Fluoride Products on the Reduction of Erosive Tooth Wear and Abrasive Enamel Lesion. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Zeitouny M, Fayyad-Kazan H, Tassery H, Fayyad-Kazan H. In Vitro Influence of Prophylaxis Cleaning on Enamel Remineralization with Casein Phosphopeptide-Amorphous Calcium Phosphate. J Oral Maxillofac Res 2020; 11:e4. [PMID: 32377328 PMCID: PMC7191381 DOI: 10.5037/jomr.2020.11104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 03/11/2020] [Indexed: 01/03/2023]
Abstract
Objectives This randomized controlled in vitro 4-arm trial study aimed to study the remineralization potential of Recaldent™ and assess the effects of prophylaxis cleaning and MI Varnish® on enhancing this remineralization potential. Material and Methods Sixty human teeth were randomly assigned into equal samples (A/B). Sample A was prophylactically cleaned, randomly divided into equal samples (1/2). Sample A1 received treatment with MI Varnish® and Recaldent™ for 30 days. Sample A2 was treated similarly but without MI Varnish®. Sample B did not receive prophylaxis cleaning and was divided into equal samples (1/2). Sample B1 was treated as A1 and sample B2 as A2. The teeth were examined for mineral composition at baseline, after the interventions (T1), and after prophylaxis cleaning (T2). Study outcomes were mineral content (% weight of carbon [C], phosphorus [P], calcium [Ca], oxygen [O], chlorine [Cl], sodium [Na] and silicon [Si]) and calcium-phosphorus ratio (Ca/P). Results All groups had similar mineral composition at baseline. At T1, sample B2 exhibited least P, Ca and Ca/P content. Samples A1 and B1 showed higher content of P and Ca, compared to B2 (A1 only exhibited higher Ca/P). Sample A2 exhibited lowest Cl and Na content. At T2, sample A1 exhibited lowest C, P, O and Si content (highest Ca/P). Sample A2 showed least Ca/P, and highest Na content. Conclusions Teeth treated by Recaldent™ proceeded by prophylaxis cleaning or MI Varnish® showed remineralization, especially when receiving both interventions. This superior effect persisted even after a second cleaning. Further trials are necessary to provide conclusive evidence in humans.
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Affiliation(s)
- Mona Zeitouny
- Department of Restorative and Esthetic, Faculty of dentistry, Lebanese University, HadathLebanon
| | | | - Herve Tassery
- Laboratoire Bioingénierie et Nanoisciences, Montpellier University, MontpellierFrance.,Aix Marseille University, MarseilleFrance
| | - Hussein Fayyad-Kazan
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences I, Lebanese University, HadathLebanon
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Guanipa Ortiz MI, Alencar CDM, Freitas De Paula BL, Alves EB, Nogueira Araújo JL, Silva CM. Effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) on dental hypersensitivity: A randomized controlled clinical trial. PLoS One 2019; 14:e0225501. [PMID: 31790452 PMCID: PMC6886796 DOI: 10.1371/journal.pone.0225501] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 11/04/2019] [Indexed: 12/29/2022] Open
Abstract
Objective This randomized controlled clinical trial aimed to evaluate the effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH), and the impact of this on the health-related quality of life (HRQL). Methods Eighty teeth with DH were randomized into four groups and received three treatment sessions: PLACEBO = placebo + LASER application mimicking; CPP-ACPF = CPP-ACPF + LASER application mimicking; PBM = placebo + LASER active application; CPP-ACPF+PBM = CPP-ACPF + LASER active application. Tactile (exploratory probe) and evaporative (triple syringe) stimuli were used to measure DH and were recorded with the aid of a visual analogue scale (VAS) after the 1st, 2nd and 3rd treatment sessions and one-month follow-up. The HRQL was recorded in the DH experience questionnaire (DHEQ). Results The intragroup comparison showed a significant reduction in DH (p < 0.05) with both stimuli after one-month follow-up. The intergroup comparison with the evaporative stimulus showed that CPP-ACPF+PBM significantly reduced DH when compared to the rest of treatments, after one-month follow-up. CPP-ACPF+PBM group statistically differed from the other treatment groups in the DHEQ evaluation after one-month follow-up. Conclusion After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of this study.
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Affiliation(s)
| | | | | | | | | | - Cecy Martins Silva
- School of Dentistry, Federal University of Pará, Belém, Pará, Brazil
- * E-mail:
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Fernando JR, Butler CA, Adams GG, Mitchell HL, Dashper SG, Escobar K, Hoffmann B, Shen P, Walker GD, Yuan Y, Reynolds C, Reynolds EC. The prebiotic effect of CPP-ACP sugar-free chewing gum. J Dent 2019; 91:103225. [DOI: 10.1016/j.jdent.2019.103225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 11/26/2022] Open
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Effect of CPP-ACP on Streptococcus mutans in saliva of high caries-risk preschool children: a randomized clinical trial. Eur Arch Paediatr Dent 2019; 21:339-346. [PMID: 31732883 DOI: 10.1007/s40368-019-00490-0] [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] [Received: 04/24/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to assess the efficacy of CPP-ACP in reducing salivary S. mutans levels and compare its effect as a dentifrice to use of a fluoride dentifrice alone, or with the sequential use of a combination of both agents (fluoride, then CPP-ACP) in three groups of preschool children over a 6-month period. METHODS This was a double-blinded clinical trial, the sample (n = 127, age 4.6 ± 0.47 years), with high caries risk, was randomized into three groups which applied different agents twice daily; fluoride toothpaste (500 ppm, n = 50), CPP-ACP (10% w/v, n = 38), and combination group (n = 39) applied fluoride, then CPP-ACP. S. mutans salivary levels were measured by GC Saliva-Check Mutans™. RESULTS Within groups, a significant decrease in S. mutans-positive children (SMPC) occurred in fluoride and combination groups at 3-months, (P < 0.05), and in all groups at 6-months, (P < 0.05). The highest reduction in SMPC occurred in the CPP-ACP group, however, there were no significant differences in SMPC between groups at all study intervals, (P > 0.05). CONCLUSION Although all agents were effective, CPP-ACP showed the highest reduction in SMPC over 6-months.
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Tham J, Calache H, Hallett KB. "Setting the scene in early childhood" - an MID approach for life. Aust Dent J 2019; 64 Suppl 1:S10-S21. [PMID: 31144324 DOI: 10.1111/adj.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article presents a discussion paper for both consideration and implementation of Minimal Intervention Dentistry (MID) principles by the general dental practitioner. It argues that if these concepts can be adopted in early childhood by both the community and the profession, "Teeth for Life" can become a reality for all. Oral Health promoting behaviours can be nurtured and supported from infancy and developed into everyday living practice for a lifetime thereby maintaining an optimal quality of life. MID techniques have become more refined and supported by scientific research in the recent times and should be considered an essential clinical guideline for the future disease management.
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Affiliation(s)
- J Tham
- Department of Dentistry, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
| | - H Calache
- Deakin Health Economics, Faculty of Health, Centre for Population Health Research, Melbourne, Victoria, Australia
| | - K B Hallett
- Department of Dentistry, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
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Kensche A, Dürasch A, König B, Henle T, Hannig C, Hannig M. Characterization of the in situ pellicle ultrastructure formed under the influence of bovine milk and milk protein isolates. Arch Oral Biol 2019; 104:133-140. [PMID: 31202148 DOI: 10.1016/j.archoralbio.2019.05.021] [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: 12/13/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The present study aimed to investigate if bovine milk or milk protein isolates, respectively, alter the ultrastructure of thein situ pellicle and might therefore have an influence on oral health. METHODS In situ pellicle samples were formed on bovine enamel slabs exposed in the oral cavity of three subjects for 6, 30, 60 or 120 min. After 3 min of pellicle formation, mouthrinses were performed for 3 min with (non-)homogenized UHT- or fresh milk (0.3% or 3.8% fat), 30% UHT-treated cream or different types of casein- or milk protein isolates containing preparations. The specimens were removed after the exposure times and transmission electron microscopy (TEM) was performed. Native pellicle samples served as controls. RESULTS Topical ultrastructural pellicle modifications were detected after mouthrinses with all types of homogenized UHT- or fresh milk and after the application of a 3% native casein micelles containing experimental solution. Atypical globular protein structures, identified as casein micelles, were temporarily adsorbed onto the pellicle. They were closely associated with lipid droplets. Furthermore, the mouthrinses occasionally affected the morphology of salivary bacteria. However, no notable ultrastructural alterations remained after 120 min of pellicle formation. CONCLUSION For the first time, bovine milk- and micellar casein-induced pellicle modifications were revealed by TEM. The adsorption of micellar casein is possibly due to its molecular interactions. CLINICAL SIGNIFICANCE Bovine milk or micellar caseins provide some potential for the development of preventive strategies against bacterial biofilm formation or erosive processes at the tooth surface.
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Affiliation(s)
- A Kensche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307 Dresden, Germany.
| | - A Dürasch
- Chair of Food Chemistry, TU Dresden, Dresden, Germany
| | - B König
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D- 66421 Homburg/Saar, Germany
| | - T Henle
- Chair of Food Chemistry, TU Dresden, Dresden, Germany
| | - C Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307 Dresden, Germany
| | - M Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D- 66421 Homburg/Saar, Germany
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Thierens LAM, Moerman S, Elst CV, Vercruysse C, Maes P, Temmerman L, Roo NMCD, Verbeeck RMH, Pauw GAMD. The in vitro remineralizing effect of CPP-ACP and CPP-ACPF after 6 and 12 weeks on initial caries lesion. J Appl Oral Sci 2019; 27:e20180589. [PMID: 31116280 PMCID: PMC6534368 DOI: 10.1590/1678-7757-2018-0589] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/24/2019] [Indexed: 11/29/2022] Open
Abstract
Objective: The aim of this in vitro study was to determine the effects of remineralization promoting agents containing casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP), or CPP-ACP in combination with fluoride (CPP-ACPF) on artificial white spot lesions (WSLs) after 6 and 12 weeks. Methodology: White spot lesions were created on 123 sectioned premolars (246 specimens) with a demineralization solution during a 96 hours pH-cycling regime. Two experimental groups were created: a CPP-ACP group (Tooth Mousse™), and a CPP-ACPF group (Mi Paste Plus™). Additionally, two control groups were created, one using only a conventional toothpaste (1450 ppm fluoride) and another one without any working agents. All teeth were also daily brushed with the conventional toothpaste except the second control group. Tooth Mousse™ and Mi Paste Plus™ were applied for 180 seconds every day. The volume of demineralization was measured with transverse microradiography. Six lesion characteristics regarding the lesion depth and mineral content of WSLs were also determined. Results: The application of CPP-ACP and CPP-ACPF had a significant regenerative effect on the WSLs. Compared to Control group 1 and 2 the volume of demineralization after 6 weeks decreased significantly for CPP-ACP (respectively p<0.001 and p<0.001) and CPP-ACPF (respectively p=0.001 and p=0.003). The same trend was observed after 12 weeks. For the CPP-ACPF group, WSL dimensions decreased significantly between 6 and 12 weeks follow-up (p=0.012). The lesion depth reduced significantly after application of CPP-ACP and CPP-ACPF but increased significantly in the Control groups. Mineral content increased for CPP-ACP and CPP-ACPF after an application period of 12 weeks, but this was only significant for CPP-ACP. Conclusions: Long-term use of CPP-ACP and CPP-ACPF in combination with a conventional tooth paste shows beneficial effects in the recovery of in vitro subsurface caries lesions.
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Affiliation(s)
- Laurent A M Thierens
- Ghent University, Department of Orthodontics, Oral Health Sciences, Ghent, Belgium
| | - Sophie Moerman
- Ghent University, Department of Orthodontics, Oral Health Sciences, Ghent, Belgium
| | - Charlotte van Elst
- Ghent University, Department of Orthodontics, Oral Health Sciences, Ghent, Belgium
| | - Chris Vercruysse
- Ghent University, Department of Basic Medical Sciences, Biomaterials Group, Ghent, Belgium
| | - Petra Maes
- Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Brussels, Belgium
| | - Liesbeth Temmerman
- Ghent University, Department of Orthodontics, Oral Health Sciences, Ghent, Belgium
| | - Noëmi M C de Roo
- Ghent University, Department of Orthodontics, Oral Health Sciences, Ghent, Belgium
| | - Ronald M H Verbeeck
- Ghent University, Department of Basic Medical Sciences, Biomaterials Group, Ghent, Belgium
| | - Guy A M de Pauw
- Ghent University, Department of Orthodontics, Oral Health Sciences, Ghent, Belgium
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Kijsamanmith K, Banomyong D, Burrow MF, Kanchanasantikul P, Wipawiwat S, Srikam S, Laojarungphesatchakorn S. Effect of Conventional and Acid-modified Casein Phosphopeptide-Amorphous Calcium Phosphate Crèmes on Dentin Permeability Before and After Acid Challenge. Oper Dent 2019; 44:530-535. [PMID: 30951440 DOI: 10.2341/17-382-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigated the effect of conventional and acidified casein phosphopeptide-amorphous calcium phosphate-containing crèmes (CPP-ACP and ACPP-ACP) on dentin permeability (DP) before and after acid challenge, using a fluid-flow measuring device and scanning electron microscopic (SEM) examination. Fifty dentin discs were prepared from intact human third molars. Each tooth was sectioned 3 mm above and below the cementoenamel junction. The smear layer was removed to expose the dentin and dentinal tubules. For fluid-flow measurement, 20 specimens were used and divided into two groups: (a) CPP-ACP (pH=7) and (b) ACPP-ACP (pH=2). The dentin surfaces were treated with the crème for five minutes daily for two weeks, and then an acid challenge was performed using 6% citric acid. Under simulated pulpal pressure, DP was measured at baseline, five minutes, two weeks, and after acid challenge. The remaining specimens were prepared and examined using SEM to investigate dentinal tubule occlusion. DP was not significantly different between the two CPP-ACP-containing crèmes at any test period (p≥0.05). DP after two weeks or acid challenge was significantly lower than that at five minutes (p<0.05). The results were consistent with the SEM micrographs that presented patent dentinal tubules after a five-minute application and partial blockage of dentinal tubules after the two-week application. The dentinal tubules remained partially occluded after acid challenge. Using conventional and acid-modified CPP-ACP-containing crèmes for two weeks decreased DP and partially occluded the dentinal tubules, which resisted acid challenge.
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Vijayasankari V, Asokan S, GeethaPriya PR. Evaluation of remineralisation potential of experimental nano hydroxyapatite pastes using scanning electron microscope with energy dispersive X-ray analysis: an in-vitro trial. Eur Arch Paediatr Dent 2019; 20:529-536. [DOI: 10.1007/s40368-018-00411-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
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Carious lesion remineralizing potential of fluoride- and calcium-containing toothpastes: A laboratory study. J Am Dent Assoc 2019; 150:345-351. [PMID: 30902337 DOI: 10.1016/j.adaj.2018.11.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND The authors conducted a laboratory study to determine the carious lesion remineralization and fluoridation potential of fluoride (F)- and calcium-containing toothpastes. METHODS The authors created early carious lesions in bovine enamel specimens and assigned them to 7 treatment groups on the basis of their surface Vickers microhardness: Clinpro Tooth Crème (Clinpro) (3M ESPE), CTx4 Gel 1100 (CTx4) (Oral Biotech), Enamelon Fluoride Toothpaste (Enamelon) (Premier Dental), MI Paste ONE (MI-One) (GC America), Crest Cavity Protection Toothpaste (Crest) (Procter & Gamble), and 2 F-dose controls (low F, high F). The authors pH cycled the specimens for 10 days by using an established model, determined changes in surface microhardness, calculated percentage of surface microhardness recovery (%SMHr; primary outcome variable), and measured enamel F uptake (EFU). The authors used a 1-way analysis of variance for data analysis. RESULTS Study results showed an F-dose response for both %SMHr (low-F control: mean, 9.8; 95% confidence interval [CI], 5.7 to 13.8); Crest: mean, 26.2; CI, 21.8 to 30.6; high-F control: mean, 33.5; CI, 29.4 to 37.5) and EFU (low-F control: mean, 47; CI, 12 to 83; Crest: mean, 225; CI, 189 to 260; high-F control: mean, 307; CI, 271 to 342; all micrograms of F per cubic centimeter). For %SMHr, Clinpro (mean, 26.5; CI, 22.5 to 30.6) and CTx4 (mean, 27.3; CI, 23.1 to 31.5) were similar to Crest, all being superior to Enamelon (mean, 15.6; CI, 11.6 to 19.7), which was superior to MI-One (mean, 4.3; CI, 0.3 to 8.3). For EFU, there were no differences between Clinpro (mean, 189; CI, 153 to 224), CTx4 (mean, 177; CI, 142 to 213), Enamelon (mean, 196; CI, 161 to 232), and Crest, all being superior to MI-One (mean, 66; CI, 30 to 102). CONCLUSIONS This study's results failed to show superior remineralizing efficacy of any of the toothpastes compared with those of a calcium-free F toothpaste, with 2 of the 4 toothpastes being inferior. Clinical testing will be required to establish conclusive evidence. PRACTICAL IMPLICATIONS Clinicians should be aware of the remineralizing potential of new anticaries products.
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Bayne S, Ferracane J, Marshall G, Marshall S, van Noort R. The Evolution of Dental Materials over the Past Century: Silver and Gold to Tooth Color and Beyond. J Dent Res 2019; 98:257-265. [DOI: 10.1177/0022034518822808] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The field of dental materials has undergone more of a revolution than an evolution over the past 100 y. The development of new products, especially in the past half century, has occurred at a staggering pace, and their introduction to the market has been equally impressive. The movement has mostly come in the area of improved esthetics, marked by the gradual replacement of dental amalgam with dental composite and all-metal and porcelain-fused-to-metal indirect restorations with reinforced dental ceramics, all made possible by the rapid improvements in dental adhesive materials. This article covers the time course of dental materials development over the past century in which the Journal of Dental Research has been published. While there have been advances in nearly all materials used in the field, this article focuses on several areas, including dental amalgam, dental composites and light curing, dental adhesives and dental cements, ceramics, and new functional repair materials. A few short statements on future advances will be included at the end.
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Affiliation(s)
- S.C. Bayne
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J.L. Ferracane
- School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - G.W. Marshall
- School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
| | - S.J. Marshall
- School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
| | - R. van Noort
- Academic Unit of Restorative Dentistry, University of Sheffield, Sheffield, UK
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Fernando JR, Shen P, Sim CPC, Chen YY, Walker GD, Yuan Y, Reynolds C, Stanton DP, MacRae CM, Reynolds EC. Self-assembly of dental surface nanofilaments and remineralisation by SnF 2 and CPP-ACP nanocomplexes. Sci Rep 2019; 9:1285. [PMID: 30718577 PMCID: PMC6362116 DOI: 10.1038/s41598-018-37580-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/07/2018] [Indexed: 11/09/2022] Open
Abstract
Dental caries, erosion and hypersensitivity are major public health problems. SnF2 is used widely in oral care products to help prevent/treat these conditions. Casein phosphopeptide-stabilised amorphous calcium phosphate nanocomplexes (CPP-ACP) are a biomimetic nanotechnology of salivary phosphopeptide-ACP complexes that deliver bioavailable calcium and phosphate ions to promote dental remineralisation (repair). We show here using in vitro studies and a double-blind, randomised controlled, cross-over design in situ clinical trial that SnF2 and CPP-ACP interact to form a nanofilament coating on the tooth surface and that together they are superior in their ability to promote dental remineralisation. Sn(II) by cross-linking the CPP-ACP helps to stabilise the complexes which improves delivery to the tooth surface and enhances binding and ion incorporation into tooth mineral. The combination of SnF2 and CPP-ACP in oral care products may significantly improve their efficacy in prevention/treatment of dental caries/erosion and hypersensitivity.
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Affiliation(s)
- James R Fernando
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peiyan Shen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christina P C Sim
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yu-Yen Chen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Glenn D Walker
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yi Yuan
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Coralie Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - David P Stanton
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Colin M MacRae
- Microbeam Laboratory, CSIRO Mineral Resources, Clayton, Victoria, Australia
| | - Eric C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia.
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Beerens MW, Ten Cate JM, Buijs MJ, van der Veen MH. Long-term remineralizing effect of MI Paste Plus on regression of early caries after orthodontic fixed appliance treatment: a 12-month follow-up randomized controlled trial. Eur J Orthod 2019; 40:457-464. [PMID: 29161371 PMCID: PMC6160597 DOI: 10.1093/ejo/cjx085] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Casein-phosphopeptide-amorphous-calcium-fluoride-phosphate (CPP-ACFP) can remineralize subsurface lesions. It is the active ingredient of MI-Paste-Plus® (MPP). The long-term remineralization efficacy is unknown. Objective To evaluate the long-term effect of MPP versus a placebo paste on remineralization of enamel after fixed orthodontic treatment over a 12-month period. Design This trial was designed as a prospective, double-blinded, placebo-controlled RCT. Methods Patients with subsurface lesions scheduled for removal of the appliance were included. They applied either MPP or control paste once a day at bedtime for 12 months, complementary to normal oral hygiene. Main outcome measures Changes in enamel lesions (primary outcome) were fluorescence loss and lesion area determined by quantitative light-induced fluorescence (QLF). Secondary outcomes were Microbial composition, by conventional plating, and acidogenicity of plaque, by capillary ion analysis (CIA), and lesion changes scored visually on clinical photographs. Randomization Participants [age = 15.5 years (SD = 1.6)] were randomly assigned to either the MPP or the control group, as determined by a computer-randomization scheme, created and locked before the start of the study. Participants received neutral-coloured concealed toothpaste tubes marked A or B. Blinding The patients and the observers were blinded with respect to the content of tube A or B. Results A total of 51 patients were analysed; MPP (n = 25) versus control group (n = 26); data loss (n = 14). There was no significant difference between the groups over time for all the used outcome measures. There was a significant improvement in enamel lesions (fluorescence loss) over time in both groups (P < 0.001 and P < 0.001), with no differences between groups. Limitations Being an in vivo study, non-compliance of the subjects could have influenced the result. Conclusion The additional use of MPP in patients with subsurface enamel lesions after orthodontic fixed appliance treatment did not improve these lesions during the 1 year following debonding. Registration This trial is registered at the medical ethical committee of the VU Medical Centre in Amsterdam (NL.199226.029.07).
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Affiliation(s)
- Moniek W Beerens
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Jacob M Ten Cate
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Mark J Buijs
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Monique H van der Veen
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
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Zabokova-Bilbilova E, Sotirivska-Ivkovska A, Igić M, Mijoska A, Stavreva N, Spirov V, Evrosimovska B, Pecakov K. In vitro assessment of caseein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in prevention of white spot lesions. ACTA STOMATOLOGICA NAISSI 2019. [DOI: 10.5937/asn1979909z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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