The Effect of Copper on Demineralization of Dental Enamel

Copper Materials for Caries Management: A Scoping Review

This study comprehensively reviewed the types, properties and potential applications of copper materials for caries management. Two researchers independently searched English publications using PubMed, Scopus and Web of Science. They screened the titles and abstracts of publications presenting original studies for review. They included 34 publications on copper materials, which were categorized as copper and copper alloy materials (13/34, 38%), copper salt materials (13/34, 38%) and copper oxide materials (8/34, 24%). All reported copper materials inhibited the growth of cariogenic bacteria such as Streptococcus mutans and Candida albicans. The materials could be doped into topical agents, restorative fillers, dental adhesives, drinking water, dental implants, orthodontic appliances, mouthwash and sugar. Most publications (29/34, 83%) were laboratory studies, five (5/34, 14%) were animal studies and only one paper (1/34, 3%) was clinical research. In conclusion, copper and copper alloy materials, copper salt materials and copper oxide materials have an antimicrobial property that inhibits cariogenic bacteria and Candida albicans. These copper materials may be incorporated into dental materials and even drinking water and sugar for caries prevention. Most publications are laboratory studies. Further clinical studies are essential to validate the effectiveness of copper materials in caries prevention.

Characterization of Physical and Biological Properties of a Caries-Arresting Liquid Containing Copper Doped Bioglass Nanoparticles

Silver diamine fluoride (SDF) is an outstanding dental material for arresting and preventing caries, but some drawbacks, such as high flowability due to low viscosity and cytotoxicity to the pulp, have been reported. To overcome these problems, copper-doped bioactive glass nanoparticles (CuBGns) were combined with SDF. After synthesis, CuBGns were examined by physical analysis and added in SDF at different weight/volume% (SDF@CuBGn). After assessing physical properties (viscosity and flowability) of SDF@CuBGn, physicochemical properties (morphology before and after simulated body fluid (SBF) immersion and ion release) of SDF@CuBGn-applied hydroxyapatite (HA) discs were evaluated. Biological properties were further evaluated by cytotoxicity test to pulp stem cells and antibacterial effect on cariogenic organisms (Streptococcus mutans and Staphylococcus aureus). Combining CuBGns in SDF increased the viscosity up to 3 times while lowering the flowability. More CuBGns and functional elements in SDF (Ag and F) were deposited on the HA substrate, even after SBF immersion test for 14 days, and they showed higher Cu, Ca, and Si release without changing F and Ag release. Cell viability test suggested lower cytotoxicity in SDF@CuBGn-applied HA, while CuBGns in SDF boosted antibacterial effect against S. aureus, ~27% in diameter of agar diffusion test. In conclusion, the addition of CuBGn to SDF enhances viscosity, Ag and F deposition, and antibacterial effects while reducing cell toxicity, highlighting the role of bioactive CuBGns for regulating physical and biological effects of dental materials.

Effect of Galla Chinensis on Remineralization of Early Dentin Lesion

Objective  This study aimed to investigate the efficacy of the Galla chinensis extract (GCE) on early dentin lesion remineralization.

Materials and Methods  Seventy-two dentin specimens were divided into three groups according to the treatment solution. In group S1, specimens were treated with GCE; in group S2, the specimens were treated with sodium fluoride (NaF); meanwhile, specimens of group S3 were treated with distilled water (DW). Each group was further subdivided into two subgroups according to the treatment time (1 minute and 5 minutes). An in vitro pH-cycling model for 12 days was done. Subsequently, surface microhardness (SMH) of the specimens, elemental analysis, and their micromorphological appearance were evaluated.

Statistical Analysis  Data were statistically analyzed. One-way analysis of variance was used to compare numerical (parametric) data between more than two separate groups followed by post hoc Tukey.

Results  There was no significant difference between the mean SMH of dentin between NaF and GCE groups. Regarding the time, the 5-minute treatment with NaF and DW groups recorded higher mean SMH value of dentin than the 1-minute treatment group. Meanwhile, for GCE groups, the 1-minute immersion recorded higher mean SMH value than the 5-minute immersion without any significant difference between them. The microhardness results were confirmed by environmental scanning electron microscope and energy dispersive X-ray analysis results.

Conclusion  GCE could be used as an effective alternative for dentin remineralization.

The evaluation of zinc and copper content in tooth enamel without any pathological changes - an in vitro study

Objectives

The objectives of the study were to evaluate the content of copper and zinc in individual layers of tooth enamel and to analyze the relationships between the study minerals in individual layers of tooth enamel.

Patients and methods

Fifteen human permanent teeth were cut off every 150 μm alongside the labial surface. Acid biopsy of each layer was performed. The zinc content was determined using the air-acetylene flame method. The copper content was determined using the electrothermal technique with argon.

Results

The mean zinc concentrations increased significantly starting from the outer enamel surface, with the maximum concentration in the 150-300 μm layer. The mean copper concentrations increased substantially from the outer enamel surface to a depth of 150 μm, and then a slight downward trend of this mineral levels was seen, down to a depth of 450 μm. Strong positive correlation was found between the zinc and copper concentrations at depths of 150-300, 450-600 and 600-750 μm.

Conclusion

The levels of zinc and copper in the outer enamel layers may have an effect on the increased content of unipolar minerals at deeper enamel layers. The content of the study elements determined may reflect the process of mineralization and maturation of enamel in the pre-eruption period.

The Coordination Abilities of Three Novel Analogues of Saliva Peptides: The Influence of Structural Modification on the Copper Binding

Three novel analogues of salivary peptides as sialorphin (QHNPR) and opiorphin (QRFSR) were synthesized by the solid-phase method. The sequences of these ligands were following: AHNPR, QANPR and QRFPR. The aim of our work was investigation in what way some structural modifications may impact on coordination abilities of studied peptides. In this work we presented the interaction of pentapeptides with copper(II) ions in wide range of pH. To determine the coordination model of ligands there were carried out several studies by spectroscopy (UV–Vis, CD) methods and potentiometric measurements.

Copper deficit as a potential pathogenic factor of reduced bone mineral density and severe tooth wear

The study evaluated if men and women with severe tooth wear were at increased risk of general bone loss. Enamel biopsies obtained from 50 subjects aged 47.5 ± 5 years showed decreased copper content, which was associated with reduced spine bone mineral density, suggesting deficits of this trace element contributing to bone demineralization, enamel attrition, and deteriorated quality of mineralized tissues.

INTRODUCTION

The objective of this cross-sectional study was to assess associations between enamel trace minerals and bone mineral density (BMD) in severe tooth wear. We hypothesized that similar factors contributed to both the excessive abrasion of dental enamel and reduced BMD in subjects with tooth wear.

METHODS

Fifty patients aged 47.5 ± 5 years with severe tooth wear and 20 age-, sex-, and body mass index (BMI)-matched healthy volunteers with normal dental status were studied regarding dietary intakes of trace elements, serum and salivary copper (Cu), zinc (Zn), and calcium (Ca) concentrations, and serum PTH, osteocalcin, and hydroxyvitamin D levels. Tooth wear was determined using clinical examination based on standard protocol according to Smith and Knight. In all subjects, acid biopsies of the maxillary central incisors were carried out to assess mineral composition of the enamel. Atomic absorption spectroscopy with an air/acetylene flame was used to measure Ca and Zn, and graphite furnace atomic absorption spectroscopy was used to analyze Cu content. BMD was examined using dual energy X-ray absorptiometry.

RESULTS

Tooth wear patients had reduced lumbar spine, but not femoral, BMD relative to controls (p < 0.001). No differences were found in enamel Ca concentration and Zn content was slightly higher in tooth wear patients than in controls whereas Cu content was significantly decreased in the patients: 19.59 ± 16.4 vs 36.86 ± 26.1 μg/l (p = 0.01) despite similar levels of Cu in serum and saliva. The differences were independent of serum 25-OH-D, osteocalcin concentrations or PTH either.

CONCLUSION

Severe tooth wear is associated with reduced spinal BMD. Enamel in adult individuals with severe tooth wear is low in copper content. Therefore, further work is needed to determine whether copper plays a role in bone pathophysiology in these patients.

Zinc in the mouth, its interactions with dental enamel and possible effects on caries; a review of the literature

Zinc is an essential trace element. In the mouth, it is present naturally in plaque, saliva and enamel. Zinc is formulated into oral health products to control plaque, reduce malodour and inhibit calculus formation. It has good oral substantivity, and elevated concentrations can persist for many hours in plaque and saliva following delivery from mouthrinses and toothpastes. Although low concentrations of zinc can both reduce enamel demineralisation and modify remineralisation, during caries clinical trials, the addition of zinc to fluoride toothpastes has not affected their ability to reduce caries. Mechanistic studies may help explain this apparent contradiction. Zinc is readily desorbed from hydroxyapatite by calcium, which is plentiful in plaque and saliva. Where crystal-growth sites remain occupied by zinc despite this, they may simply be 'over-grown' by remineralisation initiated at unoccupied sites. Further, under certain conditions, low concentrations of zinc can enhance remineralisation of enamel lesions, by retarding lesion arrestment. Although this may help to explain the apparent lack of an overall zinc effect on caries, it seems unlikely that any negative effects would be countered exactly by positive effects. Further mechanistic studies, complementing well-designed in vitro and in situ caries studies, should lead to further understanding of the zinc-enamel interactions relevant to demineralisation and remineralisation.