1
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Alghanem S, Dziurkowska E, Ordyniec-Kwaśnica I, Sznitowska M. Intraoral medical devices for sustained drug delivery. Clin Oral Investig 2023; 27:7157-7169. [PMID: 37982874 PMCID: PMC10713785 DOI: 10.1007/s00784-023-05377-5] [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: 08/11/2023] [Accepted: 11/05/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES The oral cavity constitutes an attractive organ for the local and systemic application of drug substances. Oromucosal tablets, gels, or sprays are examples of the formulations applied. Due to the elution through the saliva, the residence time of the formulation at the application site is relatively short. Medical devices placed in the oral cavity, with a reservoir for an active substance, play an important role in solving this problem. MATERIALS AND METHODS In this review, we discuss the devices described in the literature that are designed to be used in the oral cavity, highlighting the advantages, disadvantages, and clinical applications of each of them. RESULTS Among the intraoral medical devices, special types are personalized 3D-printed devices, iontophoretic devices, and microneedle patches. CONCLUSION We anticipate that with the development of 3D printing and new polymers, the technology of flexible and comfortable devices for prolonged drug delivery in the oral cavity will develop intensively. CLINICAL RELEVANCE The presented review is therefore a useful summary of the current technological state, when in fact none of the existing devices has been widely accepted clinically.
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Affiliation(s)
- Suhail Alghanem
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland
| | - Ewelina Dziurkowska
- Department of Analytical Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland.
| | - Iwona Ordyniec-Kwaśnica
- Department of Dental Prosthetics, Faculty of Medicine, Medical University of Gdansk, Str. E. Orzeszkowej 18, 80-208, Gdansk, Poland
| | - Małgorzata Sznitowska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland
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2
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Tay N, Gan H, de Sousa FB, Shen L, Nóbrega DF, Peng C, Kilpatrick-Liverman L, Wang W, Lavender S, Pilch S, Han J. Improved mineralization of dental enamel by electrokinetic delivery of F - and Ca 2+ ions. Sci Rep 2023; 13:516. [PMID: 36627315 PMCID: PMC9832158 DOI: 10.1038/s41598-022-26423-4] [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: 07/26/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
This in vitro study evaluated the effects of the infiltration of F- and Ca2+ ions into human enamel by electrokinetic flow (EKF) on the enamel microhardness and F- content. Sound human enamel ground sections of unerupted third molars were infiltrated with de-ionized water by EKF and with F- ion by EKF respectively. All samples were submitted to two successive transverse acid-etch biopsies (etching times of 30 s and 20 min) to quantify F- ion infiltrated deep into enamel. Remarkably, sound enamel showed a large increase in microhardness (MH) after infiltration of NaF (p < 0.00001) and CaCl2 (p = 0.013) by EKF. Additionally, NaF-EKF increased the remineralization in the lesion body of artificial enamel caries lesions compared to controls (p < 0.01). With the enamel biopsy technique, at both etching times, more F- ions were found in the EKF-treated group than the control group (p << 0.05), and more fluoride was extracted from deeper biopsies in the NaF-EKF group. In conclusion, our results show that EKF treatment is superior in transporting Ca2+ and F- ions into sound enamel when compared to molecular diffusion, enhancing both the mineralization of sound enamel and the remineralization of artificial enamel caries.
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Affiliation(s)
- NamBeng Tay
- grid.486188.b0000 0004 1790 4399Engineering Cluster, Singapore Institute of Technology, 10 Dover Drive, Singapore, 138683 Singapore
| | - HiongYap Gan
- Engineering Cluster, Singapore Institute of Technology, 10 Dover Drive, Singapore, 138683, Singapore.
| | - Frederico Barbosa de Sousa
- grid.411216.10000 0004 0397 5145Department of Morphology and Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Cidade Universitaria, Paraíba, Brazil
| | - Lu Shen
- grid.486188.b0000 0004 1790 4399Engineering Cluster, Singapore Institute of Technology, 10 Dover Drive, Singapore, 138683 Singapore
| | | | - Chenhui Peng
- grid.56061.340000 0000 9560 654XDepartment of Physics and Materials Science, University of Memphis, Memphis, TN USA
| | | | - Wei Wang
- grid.418753.c0000 0004 4685 452XColgate-Palmolive Technology Center, Piscataway, NJ USA
| | - Stacey Lavender
- grid.418753.c0000 0004 4685 452XColgate-Palmolive Technology Center, Piscataway, NJ USA
| | - Shira Pilch
- grid.418753.c0000 0004 4685 452XColgate-Palmolive Technology Center, Piscataway, NJ USA
| | - Jongyoon Han
- Department of Electric Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
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3
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Martins Andrade JF, da Cunha Miranda T, Cunha-Filho M, Taveira SF, Gelfuso GM, Gratieri T. Iontophoresis application for drug delivery in high resistivity membranes: nails and teeth. Drug Deliv Transl Res 2022; 13:1272-1287. [PMID: 36209312 DOI: 10.1007/s13346-022-01244-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/03/2022]
Abstract
Iontophoresis has been vastly explored to improve drug permeation, mainly for transdermal delivery. Despite the skin's electrical resistance and barrier properties, it has a relatively high aqueous content and is permeable to many drugs. In contrast, nails and teeth are accessible structures for target drug delivery but possess low water content compared to the skin and impose significant barriers to drug permeation. Common diseases of these sites, such as nail onychomycosis and endodontic microbial infections that reach inaccessible regions for mechanical removal, often depend on time-consuming and ineffective treatments relying on drug's passive permeation. Iontophoresis application in nail and teeth structures may be a safe and effective way to improve drug transport across the nail and drug distribution through dental structures, making treatments more effective and comfortable for patients. Here, we provide an overview of iontophoresis applications in these "hard tissues," considering specificities such as their high electrical resistivity. Iontophoresis presents a promising option to enhance drug permeation through the nail and dental tissues, and further developments in these areas could lead to widespread clinical use.
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Affiliation(s)
| | - Thamires da Cunha Miranda
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil
| | - Marcílio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil
| | - Stephânia Fleury Taveira
- Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Federal University of Goias (UFG), Goiânia, GO, 74605-170, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil.
| | - Taís Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília, DF, 70910-900, Brazil.
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4
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Mohabatpour F, Chen X, Papagerakis S, Papagerakis P. Novel trends, challenges and new perspectives for enamel repair and regeneration to treat dental defects. Biomater Sci 2022; 10:3062-3087. [PMID: 35543379 DOI: 10.1039/d2bm00072e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Dental enamel is the hardest tissue in the human body, providing external protection for the tooth against masticatory forces, temperature changes and chemical stimuli. Once enamel is damaged/altered by genetic defects, dental caries, trauma, and/or dental wear, it cannot repair itself due to the loss of enamel producing cells following the tooth eruption. The current restorative dental materials are unable to replicate physico-mechanical, esthetic features and crystal structures of the native enamel. Thus, development of alternative approaches to repair and regenerate enamel defects is much needed but remains challenging due to the structural and functional complexities involved. This review paper summarizes the clinical aspects to be taken into consideration for the development of optimal therapeutic approaches to tackle dental enamel defects. It also provides a comprehensive overview of the emerging acellular and cellular approaches proposed for enamel remineralization and regeneration. Acellular approaches aim to artificially synthesize or re-mineralize enamel, whereas cell-based strategies aim to mimic the natural process of enamel development given that epithelial cells can be stimulated to produce enamel postnatally during the adult life. The key issues and current challenges are also discussed here, along with new perspectives for future research to advance the field of regenerative dentistry.
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Affiliation(s)
- Fatemeh Mohabatpour
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Dr., S7N 5A9, SK, Canada. .,College of Dentistry, University of Saskatchewan, 105 Wiggins Rd, Saskatoon, S7N 5E4, SK, Canada
| | - Xiongbiao Chen
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Dr., S7N 5A9, SK, Canada. .,Department of Mechanical Engineering, University of Saskatchewan, 57 Campus Dr., Saskatoon, S7N 5A9, SK, Canada
| | - Silvana Papagerakis
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Dr., S7N 5A9, SK, Canada. .,Department of Surgery, College of Medicine, University of Saskatchewan, 107 Wiggins Rd B419, S7N 0 W8, SK, Canada
| | - Petros Papagerakis
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Dr., S7N 5A9, SK, Canada. .,College of Dentistry, University of Saskatchewan, 105 Wiggins Rd, Saskatoon, S7N 5E4, SK, Canada
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5
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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: 18] [Impact Index Per Article: 6.0] [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
| | - 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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6
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Wang J, Liu Z, Ren B, Wang Q, Wu J, Yang N, Sui X, Li L, Li M, Zhang X, Li X, Wang B. Biomimetic mineralisation systems for in situ enamel restoration inspired by amelogenesis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:115. [PMID: 34455518 PMCID: PMC8403113 DOI: 10.1007/s10856-021-06583-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 07/05/2021] [Indexed: 05/28/2023]
Abstract
Caries and dental erosion are common oral diseases. Traditional treatments involve the mechanical removal of decay and filling but these methods are not suitable for cases involving large-scale enamel erosion, such as hypoplasia. To develop a noninvasive treatment, promoting remineralisation in the early stage of caries is of considerable clinical significance. Therefore, biomimetic mineralisation is an ideal approach for restoring enamel. Biomimetic mineralisation forms a new mineral layer that is tightly attached to the surface of the enamel. This review details the state-of-art achievements on the application of amelogenin and non-amelogenin, amorphous calcium phosphate, ions flow and other techniques in the biomimetic mineralisation of enamel. The ultimate goal of this review was to shed light on the requirements for enamel biomineralisation. Hence, herein, we summarise two strategies of biological minimisation systems for in situ enamel restoration inspired by amelogenesis that have been developed in recent years and compare their advantages and disadvantages.
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Affiliation(s)
- Jue Wang
- Department of Obsterics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin, China
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Zhihui Liu
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Bingyu Ren
- Department of Thyroid surgery, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Qian Wang
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Jia Wu
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Nan Yang
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Xin Sui
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Lingfeng Li
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Meihui Li
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Xiao Zhang
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Xinyue Li
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Bowei Wang
- Department of Obsterics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin, China.
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7
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Mok ZH, Proctor G, Thanou M. Emerging nanomaterials for dental treatments. Emerg Top Life Sci 2020; 4:613-625. [PMID: 33200780 PMCID: PMC7752085 DOI: 10.1042/etls20200195] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 01/08/2023]
Abstract
The emergence of nanomaterials for dental treatments is encouraged by the nanotopography of the tooth structure, together with the promising benefits of nanomedicine. The use of nanoparticles in dentistry, also termed as 'nanodentistry', has manifested in applications for remineralisation, antimicrobial activity, local anaesthesia, anti-inflammation, osteoconductivity and stem cell differentiation. Besides the applications on dental tissues, nanoparticles have been used to enhance the mechanical properties of dental composites, improving their bonding and anchorage and reducing friction. The small particle size allows for enhanced permeation into deeper lesions, and reduction in porosities of dental composites for higher mechanical strength. The large surface area to volume ratio allows for enhanced bioactivity such as bonding and integration, and more intense action towards microorganisms. Controlled release of encapsulated bioactive molecules such as drugs and growth factors enables them to be delivered more precisely, with site-targeted delivery for localised treatments. These properties have benefitted across multiple fields within dentistry, including periodontology and endodontics and reengineering of dental prosthetics and braces. This review summarises the current literature on the emerging field of nanomaterials for dental treatments.
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Affiliation(s)
- Zi Hong Mok
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, London, U.K
| | - Gordon Proctor
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, U.K
| | - Maya Thanou
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, London, U.K
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8
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Zhou W, Peng X, Zhou X, Bonavente A, Weir MD, Melo MAS, Imazato S, Oates TW, Cheng L, Xu HHK. Novel Nanocomposite Inhibiting Caries at the Enamel Restoration Margins in an In Vitro Saliva-Derived Biofilm Secondary Caries Model. Int J Mol Sci 2020; 21:ijms21176369. [PMID: 32887330 PMCID: PMC7503730 DOI: 10.3390/ijms21176369] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 12/14/2022] Open
Abstract
Secondary caries often occurs at the tooth-composite margins. This study developed a novel bioactive composite containing DMAHDM (dimethylaminohexadecyl methacrylate) and NACP (nanoparticles of amorphous calcium phosphate), inhibiting caries at the enamel restoration margins in an in vitro saliva-derived biofilm secondary caries model for the first time. Four composites were tested: (1) Heliomolar nanocomposite, (2) 0% DMAHDM + 0% NACP, (3) 3% DMAHDM + 0% NACP, (D) 3% DMAHDM + 30% NACP. Saliva-derived biofilms were tested for antibacterial effects of the composites. Bovine enamel restorations were cultured with biofilms, Ca and P ion release of nanocomposite and enamel hardness at the enamel restoration margins was measured. Incorporation of DMAHDM and NACP into composite did not affect the mechanical properties (p > 0.05). The biofilms’ CFU (colony-forming units) were reduced by 2 logs via DMAHDM (p < 0.05). Ca and P ion release of the nanocomposite was increased at cariogenic low pH. Enamel hardness at the margins for DMAHDM group was 25% higher than control (p < 0.05). With DMAHDM + NACP, the enamel hardness was the greatest and about 50% higher than control (p < 0.05). Therefore, the novel composite containing DMAHDM and NACP was strongly antibacterial and inhibited enamel demineralization, resulting in enamel hardness at the margins under biofilms that approached the hardness of healthy enamel.
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Affiliation(s)
- Wen Zhou
- State Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu 610041, China; (W.Z.); (X.P.); (X.Z.)
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD 21201, USA; (A.B.); (M.D.W.); (M.A.S.M.); (T.W.O.)
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Xinyu Peng
- State Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu 610041, China; (W.Z.); (X.P.); (X.Z.)
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu 610041, China; (W.Z.); (X.P.); (X.Z.)
| | - Andrea Bonavente
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD 21201, USA; (A.B.); (M.D.W.); (M.A.S.M.); (T.W.O.)
| | - Michael D. Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD 21201, USA; (A.B.); (M.D.W.); (M.A.S.M.); (T.W.O.)
| | - Mary Anne S. Melo
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD 21201, USA; (A.B.); (M.D.W.); (M.A.S.M.); (T.W.O.)
| | - Satoshi Imazato
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan;
| | - Thomas W. Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD 21201, USA; (A.B.); (M.D.W.); (M.A.S.M.); (T.W.O.)
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu 610041, China; (W.Z.); (X.P.); (X.Z.)
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD 21201, USA; (A.B.); (M.D.W.); (M.A.S.M.); (T.W.O.)
- Correspondence: (L.C.); (H.H.K.X.)
| | - Hockin H. K. Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD 21201, USA; (A.B.); (M.D.W.); (M.A.S.M.); (T.W.O.)
- Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Correspondence: (L.C.); (H.H.K.X.)
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9
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Chen H, Tang Y, Weir MD, Lei L, Masri R, Lynch CD, Oates TW, Zhang K, Hu T, Xu HHK. Effects of S. mutans gene-modification and antibacterial calcium phosphate nanocomposite on secondary caries and marginal enamel hardness. RSC Adv 2019; 9:41672-41683. [PMID: 35541571 PMCID: PMC9076473 DOI: 10.1039/c9ra09220j] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/10/2019] [Indexed: 02/05/2023] Open
Abstract
Secondary caries at the restoration-tooth margins is a main reason for dental restoration failures. Gene-modification for Streptococcus mutans (S. mutans) and composites containing dimethylaminohexadecyl methacrylate (DMAHDMA) and nanoparticles of amorphous calcium phosphate (NACP) all have the potential to suppress bacterial acids and promote remineralization. However, there has been no report of their effects on marginal caries-inhibition and enamel hardness. The objective of this study was to investigate the effects of gene-modification and DMAHDM-NACP composite restoration on enamel demineralization and hardness at the margins under biofilm acids for the first time. Parent S. mutans and rnc gene-deleted S. mutans were tested side by side. The bioactive composite contained 3% DMAHDM and 30% NACP. Mechanical properties and calcium (Ca) and phosphate (P) ion releases were measured. Colony-forming units (CFU), MTT, lactic acid and polysaccharide of biofilms were evaluated. Demineralization of bovine enamel with composite restorations was induced via biofilms, then enamel hardness was measured. The dual strategy of combining rnc-deletion with DMAHDM+30NACP: (1) achieved the strongest biofilm-inhibition, with the greatest reduction in biofilm CFU by 6 logs; (2) decreased biofilm lactic acid and polysaccharide production by more than 80%; (3) achieved enamel hardness that was 140% higher than that of a commercial fluoride-releasing composite under 30 days of biofilm acids. Therefore, the novel dual approach of rnc gene-deletion and DMAHDM+NACP nanocomposite is promising to inhibit secondary caries at the margins and increase the longevity of tooth restorations.
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Affiliation(s)
- Hong Chen
- State Key Laboratory of Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University Chengdu Sichuan 610041 China
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School Baltimore MD 21201 USA
| | - Yunhao Tang
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School Baltimore MD 21201 USA
- Second Affiliated Hospital of Chongqing Medical University Chongqing 400010 China
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School Baltimore MD 21201 USA
| | - Lei Lei
- State Key Laboratory of Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University Chengdu Sichuan 610041 China
| | - Radi Masri
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School Baltimore MD 21201 USA
| | - Christopher D Lynch
- Restorative Dentistry, University Dental School and Hospital, University College Cork Wilton Cork Ireland
| | - Thomas W Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School Baltimore MD 21201 USA
| | - Ke Zhang
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School Baltimore MD 21201 USA
- School of Stomatology, Capital Medical University Beijing China
| | - Tao Hu
- State Key Laboratory of Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University Chengdu Sichuan 610041 China
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School Baltimore MD 21201 USA
- Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine Baltimore MD 21201 USA
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine Baltimore MD 21201 USA
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10
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Gudkina J, Amaechi BT, Abrams SH, Brinkmane A, Jelisejeva I. Caries Increment and Oral Hygiene Changes in 6- and 12-Year-Old Children in Riga, Latvia: A 3-Year Follow-Up Report Using ICDAS II and RADKE Criteria. Eur J Dent 2019; 13:413-419. [PMID: 31795005 PMCID: PMC6890505 DOI: 10.1055/s-0039-1700250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives
The purpose of this study was to investigate the caries increment and oral hygiene changes over a 3-year period and also compare the sensitivity and specificity of Radke’s caries assessment method to ICDAS II among 6- and 12-year-old children in Riga, Latvia.
Materials and Methods
Thirty-eight 6 and thirty-nine 12-year-old children were examined visually and with bitewing (BW) radiographs for dental caries at baseline and after a 3-year period. Decayed, missing, and filled surfaces (dmfs/DMFS) in all teeth were scored by one calibrated examiner using the Radke’s caries scoring criteria. Oral hygiene level was determined using Green-Vermillion index (G-V ind.) at baseline and after 3 years. ICDAS II was used to assess all children only at the 3rd-year time point. The parents of the 6- and 12-year-old children responded to a questionnaire on oral hygiene at baseline and at the 3-year mark.
Statistical Analysis
The data were analyzed using
t
-test, Chi-square test, Wilcoxon test (α= 0.05), and sensitivity and specificity tests.
Results
The mean (SD) values of G–V ind. and caries experience at baseline/3-year period in 6- versus 12-year-old children were as follows. G-V ind.: 1.14(0.80) /1.48(0.89) [
p
= 0.4768] versus 0.99(0.45)/1.45(1.22) [
p
= 0.0337]. DMFS: 0.72(1.02)/ 3.13(3.13) [
p
= 0.0000] versus 6.79(5.14)/14.79(9.86)[
p
= 0.0000]; dmfs: 11.26(8.71)/7.74 (4.86) [
p
= 0.0780] versus 3.57 (2.03)/1.5(0.71)[
p
= 0.3173].The sensitivity and specificity of Radke to ICDAS II of caries-affected surfaces was: in proximal surfaces–0.57 and 0.98, on occlusal surfaces–0.83 and 0.98, on buccal/lingual surfaces–0.43 and 0.99.
Conclusions
The result of the present study suggests that the increased caries experience over a 3-year period among the 6- and 12-year-old children in Riga may be due to the concurrent decreased level of oral hygiene, suggesting that ICDAS II instead of Radke’s criteria should be used to detect and monitor dental caries.
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Affiliation(s)
- Jekaterina Gudkina
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | | | - Anda Brinkmane
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - Ieva Jelisejeva
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
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11
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Featherstone JD, Fontana M, Wolff M. Novel Anticaries and Remineralization Agents: Future Research Needs. J Dent Res 2019; 97:125-127. [PMID: 29355470 DOI: 10.1177/0022034517746371] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- J D Featherstone
- 1 Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, USA
| | - M Fontana
- 2 Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M Wolff
- 3 Cariology and Comprehensive Care, College of Dentistry, New York University, New York, NY, USA
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12
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Peng C, de Sousa FB, Gan HY, Kwon HJ, Park S, Kilpatrick-Liverman L, Wang W, Lavender S, Pilch S, Han J. Enhanced Delivery of F -, Ca 2+, K +, and Na + Ions into Enamel by Electrokinetic Flows. J Dent Res 2019; 98:430-436. [PMID: 30676839 DOI: 10.1177/0022034518818463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As the outermost layer of the tooth crown, dental enamel is the most mineralized tissue in mammals, consisting of hydroxyapatite crystallites separated by long and narrow nanochannels. A major challenge in dentistry is how various molecules can be infiltrated into these nanopores in an efficient and controlled way. Here we show a robust method to transport various ions of interest, such as fluoride (F-), potassium (K+), calcium (Ca++), and sodium (Na+), into these nanopores by electrokinetic flows. It is verified by fluorescence microscopy, laser-scanning confocal microscopy, mass spectrometry, and ion selective electrode technique. Different ions are demonstrated to infiltrate through the entire depth of the enamel layer (~1 mm), which is significantly enhanced penetration compared with diffusion-based infiltration. Meanwhile, transport depth and speed can be controlled by infiltration time and applied voltage. This is the first demonstration of reliably delivering both anions and cations into the enamel nanopores. This technique opens opportunities in caries prevention, remineralization, tooth whitening, and nanomedicine delivery in clinical dentistry, as well as other delivery challenges into various biomaterials such as bones.
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Affiliation(s)
- C Peng
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - F B de Sousa
- 2 Department of Morphology, Health Sciences Center, Fereral University of Paraiba, Joao Pessoa, Cidade Universitaria, Paraiba, Brazil
| | - H Y Gan
- 3 Engineering Cluster, Singapore Institute of Technology, Singapore
| | - H J Kwon
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S Park
- 4 Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | | | - W Wang
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Lavender
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Pilch
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - J Han
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.,6 Department of Electric Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,7 Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
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13
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Philip N. State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management. Caries Res 2018; 53:284-295. [PMID: 30296788 DOI: 10.1159/000493031] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/11/2018] [Indexed: 12/17/2022] Open
Abstract
The principles of minimally invasive dentistry clearly dictate the need for clinically effective measures to remineralize early enamel caries lesions. While fluoride-mediated remineralization is the cornerstone of current caries management philosophies, a number of new remineralization strategies have been commercialized or are under development that claim to promote deeper remineralization of lesions, reduce the potential risks associated with high-fluoride oral care products, and facilitate caries control over a lifetime. These non-fluoride remineralizing systems can be broadly categorized into biomimetic enamel regenerative technologies and the approaches that repair caries lesions by enhancing fluoride efficacy. This paper discusses the rationale for non-fluoride remineralization and the mechanism of action, challenges, and evidence behind some of the most promising advances in enamel remineralization therapies.
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Affiliation(s)
- Nebu Philip
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia,
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