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Amend S, Stork S, Lücker S, Seipp A, Gärtner U, Frankenberger R, Krämer N. Influence of different pre-treatments on the resin infiltration depth into enamel of teeth affected by molar-incisor hypomineralization (MIH). Dent Mater 2024; 40:1015-1024. [PMID: 38744567 DOI: 10.1016/j.dental.2024.05.010] [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: 12/25/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This in vitro pilot study aimed to evaluate whether different pre-treatments (demineralization, deproteinization, (chemo-)mechanical reduction of the surface layer) influence the penetration depth of a resin infiltrant into MIH-affected enamel compared to initial carious lesions. METHODS Thirty extracted human permanent molars with non-cavitated initial carious lesions (n = 5) or MIH (n = 25) were chosen and randomly assigned to six experimental groups: IC: initial caries; M: MIH; MN: MIH, 5.25% sodium hypochlorite; MM: MIH, microabrasion; MA: MIH, air abrasion; MAN: MIH, air abrasion and 5.25% sodium hypochlorite. A modified indirect dual fluorescence staining method was adopted to assess the penetration depth (PD) of the resin infiltrant and the lesion depth (LD) by confocal laser scanning microscopy (CLSM). Exemplarily, scanning electron microscopic (SEM) images were captured. The relationship between group assignment and penetration/lesion depth was estimated using a linear mixed model incorporating the tooth as random effect (two observations/tooth). The significance level was set at p < 0.05. RESULTS For MIH-affected molars, the mean PD (in µm; median, [minimum-maximum]) were M (178.2 [32.5-748.9]), MN (275.6 [105.3-1131.0]), MM (48.7 [0.0-334.4]), MA (287.7 [239.4-491.7]), and MAN (245.4 [76.1-313.5]). Despite the observed differences in PD between the groups, these could not be statistically verified (Bonferroni, p = 0.322). The percentage penetration was significantly higher for IC than for MIH groups (Bonferroni, p < 0.05). SIGNIFICANCE Compared to IC, resin infiltration into MIH-affected enamel ist more variable. Different pre-treatments influence the resin penetration into developmentally hypomineralized enamel to a fluctuating level.
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Affiliation(s)
- Stefanie Amend
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Stephan Stork
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Susanne Lücker
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Anika Seipp
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Ulrich Gärtner
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Marburg), Philipps-University Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany.
| | - Norbert Krämer
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
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Kielbassa AM, Summer S, Frank W, Lynch E, Batzer JS. Equivalence study of the resin-dentine interface of internal tunnel restorations when using an enamel infiltrant resin with ethanol-wet dentine bonding. Sci Rep 2024; 14:12444. [PMID: 38816512 PMCID: PMC11139992 DOI: 10.1038/s41598-024-63289-0] [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: 02/18/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024] Open
Abstract
This preregistered ex vivo investigation examined the dentinal hybrid layer formation of a resinous infiltrant (Icon), with reference to both thickness (HLT) and homogeneity when combined with modified tunnel preparation (occlusal cavity only) and internal/external caries infiltration. The adhesives Syntac and Scotchbond MP were used as controls (Groups 1 and 3) or in combination with Icon (Groups 2 and 4). A split-tooth design using healthy third molars from 20 donors resulted in 20 prepared dentine cavities per experimental group. The cavity surfaces (n = 80) were etched (37% H3PO4), rinsed, and air-dried. Rewetting with ethanol was followed by application of the respective primers. After labeling with fluorescent dyes, either Syntac Adhesive/Heliobond or Scotchbond MP Adhesive was used alone or supplemented with Icon. HLT, as evaluated by scanning electron microscopy, did not significantly differ (P > 0.05), and confocal laser scanning microscopy revealed homogeneously mixed/polymerized resin-dentine interdiffusion zones in all groups. Icon can be successfully integrated into an ethanol-wet dentine bonding strategy, and will result in compact and homogeneous hybrid layers of comparable thickness considered equivalent to the non-Icon controls, thus allowing for preservation of the tooth's marginal ridge and interdental space in the case of internal/external infiltration of proximal caries.
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Affiliation(s)
- Andrej M Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems an der Donau, Austria.
| | - Sabrina Summer
- Department for Biomedical Research, Centre of Experimental Medicine, University for Continuing Education Krems, Krems an der Donau, Austria
| | - Wilhelm Frank
- Centre for Health Sciences, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University (DPU), Krems an der Donau, Austria
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Leicester, UK
| | - Julia-Susanne Batzer
- Centre for Operative Dentistry, Periodontology, and Endodontology, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems an der Donau, Austria
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Sinanovic AL, Messer-Hannemann P, Samadi M, Schwendicke F, Effenberger S. Effect of Bleaching on Resin-Infiltration-Masked Artificial White Spots In Vitro. J Funct Biomater 2024; 15:125. [PMID: 38786636 PMCID: PMC11122313 DOI: 10.3390/jfb15050125] [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: 04/10/2024] [Revised: 04/30/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel.
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Affiliation(s)
- Alan Leon Sinanovic
- Clinical Research, DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
- Department Biotechnology, University of Applied Sciences Hamburg, 21033 Hamburg, Germany
| | | | - Mariam Samadi
- Clinical Research, DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians University Munich, 80336 Munich, Germany
| | - Susanne Effenberger
- Clinical Research, DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians University Munich, 80336 Munich, Germany
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Park H, Hong S, Chrzan B, Al-Talib T, Abubakr NH. Resin infiltration for white spot lesions: An in vitro experimental trial. J Orthod 2024:14653125241244806. [PMID: 38587302 DOI: 10.1177/14653125241244806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To evaluate the aesthetic outcome by varying the duration allowed for infiltrant penetration when treating white spot lesions with resin infiltration. DESIGN An in vitro, experimental randomised study. METHODS Artificially created white spot lesions (WSLs) were induced on 100 extracted anterior teeth (T1). Teeth were divided into enamel and dentine groups depending on the extent of the lesion and then randomly assigned into different treatment protocol groups: penetration times of 3, 6 and 9 min. Resin infiltration treatment was applied according to the treatment protocol assigned (T2). Samples were thermocycled for 10,000 cycles (1 clinical year) (T3). The samples from the 3-min enamel and dentine groups were then randomly assigned into either a repeat treatment or no additional treatment group (T4). Samples were then thermocycled for an additional 10,000 cycles (T5). Spectrophotometric analysis was measured colour change (ΔE) for all groups. RESULTS Mean ΔE values equal to or greater than the critical value (3.7) indicate a detectable clinical difference in colour of the treated WSL when compared to before WSL formation. Mean ΔE values, for the enamel groups, were slightly above or significantly below the critical value, and for the dentine groups, were significantly above the critical value. Mean ΔE values within the enamel and dentine groups both demonstrated a downward trend with increasing time allowed for resin infiltrant penetration (P < 0.05). No significant mean ΔE difference (P = 0.53) was found between groups that received a single or repeat treatment. After the first thermocycling event, no significant difference in colour change was observed in all groups except for the deep dentine lesion treated for 3 min. There was a significant difference in colour change for all groups except the enamel group that received a single treatment following thermocycling after a single or repeat treatment. CONCLUSION Increasing the resin infiltrant penetration time to at least 9 min is advised as the most optimised treatment protocol. Resin infiltration treatment should be done only once to treat a particular white spot lesion as subsequent treatment for the same lesion results in marginal colour improvement. The colour improvement of WSLs resulting from the resin infiltration treatment can be expected to last for at least 1 year. Resin infiltration treatment of shallow lesions with a single and optimised infiltration technique can be expected to last an additional year.
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Affiliation(s)
- Hahnnah Park
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Sandy Hong
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Brian Chrzan
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Tanya Al-Talib
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
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Zago JLG, de Cerqueira GA, Ferreira RDS, Aguiar FHB, Tabchoury CPM, Marchi GM. Evaluation of experimental resin infiltrant containing nanohydroxyapatite on color stability and microhardness in demineralized enamel. Clin Oral Investig 2023; 27:6835-6845. [PMID: 37798534 DOI: 10.1007/s00784-023-05298-3] [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: 06/28/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the effect of the addition of 10% nanohydroxyapatite in an experimental resin infiltrant on color stability and mineral loss. MATERIAL AND METHODS Bovine enamel blocks were randomized into five groups (n = 27/group): SE (sound enamel); ICL (initial caries lesion); I (Icon®); E (experimental infiltrant); EH (experimental infiltrant containing 10% nanohydroxyapatite). Color evaluation (n = 15) was performed and CIEL*a*b* values were obtained at points T0 (baseline), T1 (14 days immersed on coffee solution), and T2 (28 days immersed) and data were calculated ∆E00, ∆WID, ∆L*, ∆a*, and ∆b*. Cross-sectional microhardness (n = 12) was performed and lesion area (∆S) was calculated. Images were obtained with polarized light optical microscopy at 40 × magnification (n = 5). RESULTS In color stability results, there was significant difference between time (14 and 28 days); ICL demonstrated significant difference among treated groups in all measures (∆L*, ∆a*, ∆b*, ∆E00, ∆WID) regardless of time; I and E demonstrated similar behavior on those measures and EH differed from I in ∆L*. For ∆S, ICL group showed a significant difference compared to I and EH groups, but did not differ from E. CONCLUSION The nanohydroxyapatite incorporation suggested an effective mineral recovery on initial caries lesion in depth; however, it showed high color variation, such as Icon. In terms of ∆S, I and EH had lower mineral loss, suggesting a reinforcement on initial caries lesion. CLINICAL RELEVANCE Commercial and experimental infiltrants containing nanohydroxyapatite present low color stability and might reinforce mineral in initial caries lesion.
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Affiliation(s)
- Jade Laísa Gordilio Zago
- Division of Operative Dentistry, Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Avenida Limeira 901, Piracicaba, São Paulo, Brazil.
| | - Gabriela Alves de Cerqueira
- Division of Operative Dentistry, Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Avenida Limeira 901, Piracicaba, São Paulo, Brazil
| | - Robson de Sousa Ferreira
- Division of Biochemistry, Department of Biosciences, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Flávio Henrique Baggio Aguiar
- Division of Operative Dentistry, Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Avenida Limeira 901, Piracicaba, São Paulo, Brazil
| | - Cínthia Pereira Machado Tabchoury
- Division of Biochemistry, Department of Biosciences, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Giselle Maria Marchi
- Division of Operative Dentistry, Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Avenida Limeira 901, Piracicaba, São Paulo, Brazil
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Alsafi AM, Taher NM. Microhardness and surface roughness of resin infiltrated bleached enamel surface using atomic force microscopy: An in vitro study. Saudi Dent J 2023; 35:692-698. [PMID: 37817796 PMCID: PMC10562102 DOI: 10.1016/j.sdentj.2023.07.001] [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: 03/26/2023] [Revised: 06/23/2023] [Accepted: 07/02/2023] [Indexed: 10/12/2023] Open
Abstract
to evaluate the microhardness (VHN) and surface roughness (Ra) of human enamel surface treated with resin infiltration followed by in office bleaching and to study the effect of artificial saliva (AS) storage time on the VHN and Ra of resin infiltrated enamel. Materials and methods: Eighty enamel specimens were prepared from extracted human premolar teeth. Specimens were divided into two main groups (I and II) then, they were demineralized to create white spot lesions (WSLs). Group I was divided into A and B sub groups. Group A was treated with in office bleaching material while for group B, resin infiltration (Icon) was applied after 24 h storage in AS followed by bleaching. Group II was divided into (C and D). Group C was treated like group B. Specimens in group D were stored in AS for 14 d after treatment with Icon and before application of bleaching. Atomic force microscopy (AFM) Ra analysis and VHN calculation were done. Independent T Test was used to compare between groups at P < 0.05. Results: Group B demonstrated a significant increase in VHN compared with group A. Storage time in AS showed no significant difference on VHN or Ra between groups. Conclusion: Application of resin infiltration before bleaching significantly increased VHN and slightly improved Ra of WSLs compared with bleaching alone. Application of bleaching material after 24 h or 14 days of the application of resin infiltration did not have a significant effect or surface hardness or roughness of WSLs.
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Affiliation(s)
- Alaa M. Alsafi
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nadia M. Taher
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Chabuk MMG, Al-Shamma AMW. Surface roughness and microhardness of enamel white spot lesions treated with different treatment methods. Heliyon 2023; 9:e18283. [PMID: 37539286 PMCID: PMC10395522 DOI: 10.1016/j.heliyon.2023.e18283] [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: 04/04/2023] [Revised: 06/17/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Objective To analyse the surface roughness and microhardness of artificial enamel white spot lesions before and after WSL formation, after treatment (Opalsutre™ microabrasion, Sylc® bioactive glass, and ICON® resin infiltration), and after pH cycling with the help of the profilometer surface roughness tester and the digital Vickers microhardness tester. Materials and methods Seventy-five extracted molars were used to acquire one hundred specimens. 50 specimens were randomly assigned to five groups (n = 10) for the surface roughness study: 1) Sound group, 2) WSL group, 3) micro abrasion (MA; Opalustre, Ultradent, South Jordan, UT, USA), 4) bioactive glass 45S5 Sylc powder (Sylc; Denfotex Research Ltd, Inverkeithing, UK), and 5) ICON resin infiltration (ICON; DMG, Hamburg, Germany). An additional 25 specimens were used to obtain 50 enamel slabs for the surface microhardness study, which were also assigned to the same groups. All groups underwent a final stage of pH cycling. Surface roughness and surface microhardness measurements were performed at different stages for all groups. Results Regarding surface roughness, ICON significantly reduced the surface roughness compared to Opalustre and Sylc, with no significant difference between Opalustre and Sylc. In terms of surface microhardness, ICON showed the highest improvement, followed by Sylc and then Opalustre. Both surface roughness and microhardness were significantly affected by demineralization, partially improved after treatment, and then regressed significantly after pH cycling. Conclusion ICON resin infiltrant can be considered as a superior treatment option for improving surface roughness and microhardness, while Opalustre demonstrated relatively the poorest performance compared to the other treatment options. It is noteworthy that the pH cycling procedure had an adverse impact irrespective of the treatment option used.
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Affiliation(s)
- Mina MG. Chabuk
- Corresponding author. Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad. Al-Mansour, Baghdad, 10011, Iraq.
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Nicholas LS, Yew Christopher QE, Fei Frank LK. Conservative esthetic management of brown enamel fluorosis using combination therapy: A clinical report. J Conserv Dent 2023; 26:349-354. [PMID: 37398859 PMCID: PMC10309132 DOI: 10.4103/jcd.jcd_632_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/22/2022] [Accepted: 03/25/2022] [Indexed: 12/12/2022] Open
Abstract
Dental fluorosis is caused by ingestion of excessive fluoride during tooth development resulting in hypomineralization of the enamel and can present as white or brown intrinsic lesions. This case report describes a combination of minimally invasive techniques: microabrasion, bleaching, and resin infiltration to address brown enamel fluorosis present on the maxillary anterior teeth of a young patient. Before resin infiltration, air microabrasion was targeted at subsurface lesions located on the maxillary central and lateral incisors, and chairside bleaching was done with 37% hydrogen peroxide (Opalescence). After which, hypoplastic lesions on the buccal surfaces were etched before being treated with two sessions of resin infiltration (ICON and DMG). Following treatment, satisfactory esthetic outcomes were achieved. Accurate diagnosis, depth of lesions, and understanding the effectiveness and limitations of each technique are essential to select the appropriate type of treatment to obtain the best esthetic outcome. In conclusion, the conservative management of varying severity of dental fluorosis may require the appropriate use of combination treatment modalities, such as microabrasion, bleaching and resin infiltration, when clinically indicated, to address the treatment needs and achieve a desired outcome.
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Affiliation(s)
| | - Quek Eng Yew Christopher
- Senior Lecturer, Department of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore
| | - Lee Kong Fei Frank
- Senior Lecturer, Department of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore
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Souza AF, Souza MT, Damasceno JE, Ferreira PVC, Alves de Cerqueira G, Baggio Aguiar FH, Marchi GM. Effects of the Incorporation of Bioactive Particles on Physical Properties, Bioactivity and Penetration of Resin Enamel Infiltrant. Clin Cosmet Investig Dent 2023; 15:31-43. [PMID: 36923270 PMCID: PMC10010126 DOI: 10.2147/ccide.s398514] [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: 11/29/2022] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
Purpose The resinous infiltrant lacks remineralizing activity. This research aimed to develop and evaluate bioactivity, physico-mechanical properties and penetration of resin infiltrants containing Biosilicate or nanohydroxyapatite. Methods Experimental resin infiltrant (ERI; 75/25 wt.% TEGDMA/BisEMA) was divided among the groups Pure Experimental (PE); ERI + Biosilicate 5 or 10% (Bio5; Bio10), ERI + 10% nanohydroxyapatite (Hap10), and Icon (DMG, Germany). Bioactivity was analyzed by SEM, EDS and FT-IR/ATR after soaking in SBF. Degree of conversion (DC), sorption and solubility (SO; SOL), flexural strength, modulus of elasticity (FS; E-modulus), contact angle (CA) and penetration were characterized. Extent of penetration was analyzed by treating white spot lesions (WSL) in human dental enamel samples with the infiltrants and subsequently analyzing specimens by confocal laser scanning microscopy. Data from each test were submitted to ANOVA and Tukey's tests (p < 0.01). Results SEM, EDS and FT-IR showed the formation of precipitates and increase in the rates of Ca and P in the groups with bioactive particles, after storage in SBF. Hap10 showed higher DC and CA values than all the other groups. Groups Bio5 and Bio10 showed CA values similar to those of Icon, higher SO and SOL values, and reduction in other properties. All infiltrants were capable of penetrating into the WSLs. Conclusion The incorporation of Biosilicate (5 or 10%) or nanohydroxyapatite (10%) into ERI induced mineral deposition on the surface and did not compromise infiltration and penetration into WSLs, however, compromising their physico-mechanical properties.
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Affiliation(s)
- Ana Ferreira Souza
- Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brasil
| | - Marina Trevelin Souza
- Laboratory of Vitreous Materials, Department of Materials Engineering, Federal University of São Carlos, São Carlos, São Paulo, Brasil
| | - Janaína Emanuela Damasceno
- Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brasil
| | - Paulo Vitor Campos Ferreira
- Department of Restorative Dentistry, Dental Materials Division, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brasil
| | - Gabriela Alves de Cerqueira
- Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brasil
| | - Flávio Henrique Baggio Aguiar
- Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brasil
| | - Giselle Maria Marchi
- Department of Restorative Dentistry, Piracicaba Dental School, Campinas State University - UNICAMP, Piracicaba, São Paulo, Brasil
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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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Yang S, Sui B, Cui Y, Liu X, Sun J, Wang J. A novel dental infiltration resin based on isosorbide-derived dimethacrylate with high biocompatibility, hydrolysis resistance, and antibacterial effect. Front Bioeng Biotechnol 2022; 10:1049894. [PMID: 36440443 PMCID: PMC9685411 DOI: 10.3389/fbioe.2022.1049894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 09/10/2023] Open
Abstract
Objectives: The available infiltration resin has raised biosafety and treatment stability concerns because of the cytotoxicity of the main component, TEGDMA, and its susceptibility to hydrolysis in the oral environment. This study aimed to develop a TEGDMA-free infiltration resin to overcome these drawbacks. Methods: Using the synthetic bioderived monomer bis(methacrylate) isosorbide (IBM) and the zwitterionic compound 2-methacryloyloxyethyl phosphorylcholine (MPC), a novel infiltrant IBMA was developed and preferentially selected. We investigated the performance of the IBMA resin regarding cytotoxicity, antibiofilm adhesion, and hydrolysis resistance and further verified its ability to restore the demineralized enamel and stability of the infiltrated area under artificial aging conditions. Results: Compared with the commercial TEGDMA-based infiltration resin ICON, IBMA not only demonstrated similar enamel morphologic and esthetic restorative effects in chalky lesions but also exhibited favorable cell viability, durable Streptococcus mutans UA159 biofilm-repellent performance, and higher enamel microhardness (204.0 ± 5.12 HV) of the infiltrated enamel. Specifically, because of the high crosslink density [(47.77 ± 5.76) ×103 mol/mm3] and low water sorption [12.79 ± 2.56 µg/mm3] of the polymer network, the IBMA resin was more resistant to hydrolysis than ICON, which prevents the disruption of the infiltrant's micropore-blocking effect after aging. Enamel lesions treated with IBMA demonstrated good color stability after the tea-staining challenge, which was significantly better than that in the ICON group. Conclusion: Based on these findings, the IBMA resin exhibits favorable cell viability, hydrolysis resistance, and biofilm-repellent properties, which alleviates the defects of traditional TEGDMA systems. Therefore, it is a better alternative for microinvasive treatment involving early caries and enamel whitish discoloration.
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Affiliation(s)
- Su Yang
- Department of Pediatric Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Innovative Research Team of High-Level Local Universities in Shanghai, China
| | - Baiyan Sui
- Department of Dental Materials, Shanghai Biomaterials Research and Testing Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yinan Cui
- Department of Dental Materials, Shanghai Biomaterials Research and Testing Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xin Liu
- Department of Dental Materials, Shanghai Biomaterials Research and Testing Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jiao Sun
- Department of Dental Materials, Shanghai Biomaterials Research and Testing Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Innovative Research Team of High-Level Local Universities in Shanghai, China
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12
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Nedeljkovic I, Doulabi BZ, Abdelaziz M, Feilzer AJ, Exterkate RA, Szafert S, Gulia N, Krejci I, Kleverlaan CJ. Cytotoxicity and anti-biofilm properties of novel hybrid-glass-based caries infiltrant. Dent Mater 2022; 38:2052-2061. [DOI: 10.1016/j.dental.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022]
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13
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Shimada Y, Sato T, Inoue G, Nakagawa H, Tabata T, Zhou Y, Hiraishi N, Gondo T, Takano S, Ushijima K, Iwabuchi H, Tsuji Y, Alireza S, Sumi Y, Tagami J. Evaluation of Incipient Enamel Caries at Smooth Tooth Surfaces Using SS-OCT. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5947. [PMID: 36079329 PMCID: PMC9457457 DOI: 10.3390/ma15175947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: Dental caries, if diagnosed at the initial stage, can be arrested and remineralized by a non-operative therapeutic approach preserving tooth structure. Accurate and reproducible diagnostic procedure is required for the successful management of incipient caries. The aim of this study was to evaluate the diagnostic accuracy of 3D swept-source optical coherence tomography (3D SS-OCT) for enamel caries at smooth tooth surface if the lesion was with remineralization. (2) Methods: Forty-seven tooth surfaces of 24 extracted human teeth visibly with/without enamel caries (ICDAS code 0−3) were selected and used in this study. The tooth surfaces of investigation site were cleaned and visually examined by four dentists. After the visual inspection, SS-OCT scanning was performed onto the enamel surfaces to construct a 3D image. The 2D tomographic images of the investigation site were chosen from the 3D dataset and dynamically displayed in video and evaluated by the examiners. A five-rank scale was used to score the level of enamel caries according to the following; 1: Intact enamel. 2: Noncavitated lesion with remineralization. 3: Superficial noncavitated lesion without remineralization. 4: Deep nonvacitated lesion without remineralization. 5: Enamel lesion with cavitation. Sensitivity and specificity for 3D OCT image and visual inspection were calculated. Diagnostic accuracy of each diagnostic method was calculated using weighted kappa. Statistical significance was defined at p = 0.05. (3) Results: 3D SS-OCT could clearly depict enamel caries at smooth tooth surface as a bright zone, based on the increased backscattering signal. It was noted that 3D SS-OCT showed higher sensitivity for the diagnosis of remineralized lesions and deep enamel lesions without cavitation, as well as cavitated enamel lesions (p < 0.05). No significant difference of specificity was observed between the two diagnostic methods (p > 0.05). Furthermore, 3D SS-OCT showed higher diagnostic accuracy than visual inspection (p < 0.05). (4) Conclusions: Within the limitations of this in vitro study, 3D SS-OCT showed higher diagnostic capacity for smooth surface enamel caries than visual inspection and could also discriminate lesion remineralization of enamel caries.
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Affiliation(s)
- Yasushi Shimada
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Takaaki Sato
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Go Inoue
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Hisaichi Nakagawa
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tomoko Tabata
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yuan Zhou
- Department of Periodontology, Shenzhen Stomatological Hospital, Southern Medical University, 1092 Jianshe Road, Luohu District, Shenzhen 518001, China
| | - Noriko Hiraishi
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tadamu Gondo
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Syunsuke Takano
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Kei Ushijima
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Hirotoshi Iwabuchi
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yukiko Tsuji
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Sadr Alireza
- Biomimetics, Biomaterials, Biophotonics, Biomechanics & Technology (B4T) Laboratory, Department of Restorative Dentistry, University of Washington, Seattle, WA 98195, USA
| | - Yasunori Sumi
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Junji Tagami
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
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14
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Changes in the Color and Brightness of White Spots Associated with Orthodontic Treatment 6 Months after the Application of Infiltrative Resins: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159277. [PMID: 35954634 PMCID: PMC9368113 DOI: 10.3390/ijerph19159277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022]
Abstract
One of the risks that we find after orthodontic treatment is the secondary appearance of white spot lesions (WLS) after the removal of fixed multi-bracket appliances. Today, there are several treatment methods, resin infiltration being the most used in the most serious cases. The objective of this study is to carry out a systematic review and meta-analysis to determine the efficacy and stability in the variables of color and gloss, six months after resin infiltration. A comprehensive search was performed in the following databases: PubMed, Embase, Google Scholar, Scopus, Medline, and Web of Science. Articles published in the last 10 years were selected, including in vivo studies with a six-month follow-up. PRISMA guidelines were followed to carry out this systematic review. All studies where the application of resin was performed on carious lesions were discarded. Once the inclusion and exclusion criteria were applied, a final sample of four articles was obtained, on which the review and meta-analysis were carried out. Once examined, all authors considered that there was an immediate improvement in both variables. However, statistically significant differences were obtained in the color change outcome, but not in the brightness outcome in the subgroup analysis after six months of icon resin infiltration.
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15
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Nedeljkovic I, Abdelaziz M, Feilzer AJ, Szafert S, Gulia N, Dawaa M, Krejci I, Kleverlaan CJ. Novel hybrid-glass-based material for infiltration of early caries lesions. Dent Mater 2022; 38:1015-1023. [DOI: 10.1016/j.dental.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/17/2022] [Accepted: 04/01/2022] [Indexed: 11/26/2022]
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16
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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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17
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Penetration ability and microhardness of infiltrant resin and two pit and fissure sealants in primary teeth with early enamel lesions. Sci Rep 2022; 12:4652. [PMID: 35301422 PMCID: PMC8931074 DOI: 10.1038/s41598-022-08725-9] [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: 11/07/2021] [Accepted: 03/10/2022] [Indexed: 11/08/2022] Open
Abstract
To determine the penetration depth and enamel microhardness (EMH) of an infiltrant resin and two fissure sealants in primary teeth with early enamel lesions. We randomly divided 174 sound teeth into six groups (n = 29): (1) phosphoric acid (PA) + Clinpro, (2) PA + Aegis, (3) Icon, (4) hydrochloric acid (HCl) + Clinpro, (5) HCl + Aegis, and (6) control. Percentage penetration (%PP) was analyzed by confocal laser scanning microscopy (n = 15). EMH was measured (n = 12), and the percentage of EMH recovery (%REMH) was calculated. Twelve samples were examined under a scanning electron microscope (SEM). All data were analyzed with the Kruskal–Wallis and one-way ANOVA tests (p < 0.05). Groups 3 and 4 showed the highest %PP (all, p < 0.05). Icon application led to significantly higher %REMH compared to the others (p < 0.05). Groups 2 and 5 showed the lowest reduction in %REMH after pH-cycling. Application of Icon and Clinpro with HCl pretreatment showed the greatest %PP. pH-cycling led to a decrease in %REMH for all of the materials, although this effect was lower in teeth treated with Aegis.
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18
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Li M, Yang Z, Huang Y, Li Y, Zhou Z. In vitro effect of resin infiltrant on resistance of sound enamel surfaces in permanent teeth to demineralization. PeerJ 2022; 9:e12008. [PMID: 35047244 PMCID: PMC8759355 DOI: 10.7717/peerj.12008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 07/27/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate the effect of resin infiltrant on resistance of sound permanent enamel surfaces to demineralization. METHOD Eighty healthy premolars were sectioned to obtain enamel blocks from the buccal surface. Specimens with baseline surface microhardness values of 320-370 were selected. The experimental group were treated with resin infiltrant, while the control group was not. Specimens from each group were artificially demineralized and the surface microhardness values were measured again. Confocal laser scanning microscopy was used to measure the depth of demineralization and detect the penetration ability of the resin infiltrant. The specimens were subjected to a simulated toothbrushing abrasion test. Scanning electron microscopy was used to observe changes in the surface morphology of specimens after each of these procedures. RESULTS No significant differences between the experimental and control groups were observed in the baseline microhardness values or in the experimental group after resin infiltration compared with the baseline conditions. After artificial demineralization, the microhardness value in the control group was significantly lower than that in the experimental group (266.0 (±34.5) compared with 304.0 (±13.0), P = 0.017). Confocal laser scanning microscopy results showed that the demineralization depth in the control group was significantly deeper than that in the experimental group (97.9 (±22.8) µm vs. 50.4 (±14.3) µm, P < 0.001), and that resin infiltrant completely penetrated the acid-etched demineralized area of the tooth enamel with a mean penetration depth of 31.6 (±9.0) µm. Scanning electron microscopy showed that the surface morphology was more uniform and smoother after simulated toothbrushing. The enamel surface structure was more severely destroyed in the control group after artificial demineralization compared with that of the experimental group. CONCLUSION Resin infiltrant can completely penetrate an acid-etched demineralized enamel area and improve resistance of sound enamel surfaces to demineralization. Our findings provide an experimental basis for preventive application of resin infiltrant to sound enamel surfaces to protect tooth enamel against demineralization.
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Affiliation(s)
- Meng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zhengyan Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yajing Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yueheng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zhi Zhou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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19
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Comparison of bleaching effects when applied to white-spot lesions before or after resin infiltration: An in vitro study. J Am Dent Assoc 2021; 153:39-49. [PMID: 34763817 DOI: 10.1016/j.adaj.2021.07.017] [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: 02/22/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of this study was to compare color alterations (ΔE) of white-spot lesions (WSLs) bleached before versus after resin infiltration (RI). METHODS Using the facial surfaces of bovine maxillary incisors, WSLs were created and the teeth were allocated into 2 groups (n = 45/group): bleach then RI (B-RI group) and RI then bleach (RI-B group). To determine ΔE, Commission Internationale de l'Eclairage L∗ a∗ b∗ (L∗ represents lightness, ranging from black to white [0-100]; a∗ represents green to red chromaticity [-150-+100]; and b∗ represents blue to yellow chromaticity [-100-+150]) measurements were obtained at baseline, after WSL formation, and after RI and bleaching. Representative specimens were evaluated by means of scanning electron microscopy. Statistical analyses included the Mann-Whitney U and Wilcoxon signed rank tests (P ≤ .0016) and repeated measures analysis of variance (P ≤ .05). RESULTS No differences in ΔE were found comparing B-RI with RI-B groups or when the B-RI group was compared with bleached enamel. A statistically significant difference was found when the RI-B group was compared with bleached enamel (ΔE, 0.81; P < .001), but the difference was deemed not clinically significant. Scanning electron microscopy revealed that bleaching after RI increased surface roughness of the resin. CONCLUSIONS There were no clinically significant differences in ΔE of WSLs when bleach was applied before or after RI; however, applying bleaching agent after RI roughened the surface of the resin material. PRACTICAL IMPLICATIONS Results indicate that ΔE were not clinically significantly different between WSLs bleached before versus after RI, although it is best to sequence bleaching before RI therapy, as bleaching after RI roughened the restoration's surface.
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20
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Saitoh M, Shintani S. Molar incisor hypomineralization: A review and prevalence in Japan. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:71-77. [PMID: 34149971 PMCID: PMC8192692 DOI: 10.1016/j.jdsr.2021.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 01/21/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is defined as hypomineralization of systemic origin of one to four first permanent molars, and incisors are also frequently affected. This disorder is a serious concern in pediatric dentistry. Teeth affected by MIH have many dental problems, such as hypersensitivity, poor aesthetics, and rapid progression of dental caries. The prevalence of MIH ranges from 2.8% to 21% among studies with more than 1000 subjects in different countries and age groups. The etiology of MIH is unclear, but genetic and environmental factors have been proposed. This review describes the prevalence, etiology, and clinical management of MIH. A detailed description of MIH prevalence in Japan is also provided.
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Affiliation(s)
- Masato Saitoh
- Division of Pediatric Dentistry, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
- Corresponding author at: Division of Pediatric Dentistry, School of Dentistry, Health Sciences University of Hokkaido, 1757 Kanazawa, Tobetsu, Ishikari, Hokkaido 021-0293, Japan.
| | - Seikou Shintani
- Department of Pediatric Dentistry, Tokyo Dental Collage, Tokyo 101-0061, Japan
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21
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Alagha E, Alagha MI. Comparing Impact of Two Resin Infiltration Systems on Microhardness of Demineralized Human Enamel after Exposure to Acidic Challenge. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This study compared the impact of two resin infiltration systems on microhardness of demineralized enamel before and after an acidic challenge.
MATERIALS AND METHODS: A total of forty human maxillary molar teeth were used in this study. Each tooth has 4 groups (four standardized windows onto each tooth). Group A1: Untreated sound enamel surface (positive control), Group A2: Artificially demineralized enamel surface (negative control), Group A3: Icon resin infiltrating to demineralized enamel, while Group A4: Single bond universal adhesive applied to the demineralized enamel surface. All teeth were immersed in a demineralizing solution. The groups (A3 and A4) were further subdivided into two subgroups according to acidic ethanol challenge Subgroup B1: Specimens tested before an acidic challenge and B2: Specimens tested after an acidic challenge. Vickers microhardness test was done for all groups. One-way analysis of variance (ANOVA) was used to study the difference between tested groups on mean microhardness within each group. Tukey’s post-hoc test was used for pair-wise comparison between the means when ANOVA test was performed, and the significance level was set at p ≤ 0.05.
RESULTS: Icon resin infiltration and single bond universal adhesive showed significantly higher mean microhardness than negative control, but significantly lower mean microhardness than positive control. However, insignificant difference was found between icon and single bond universal adhesive. After the acidic challenge, icon resin infiltration showed significantly higher mean microhardness than negative control. However, single bond universal adhesive showed insignificant difference as compared to the negative control.
CONCLUSION: After an acidic challenge, icon resin infiltration was more successful than single bond universal total-etch adhesive system in microhardness.
RECOMMENDATION: Icon resin infiltration technique is a promising, noninvasive approach that prevents the progress of the carious lesion.
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22
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Diniz M, Campos P, Souza M, Guaré R, Cardoso C, Lussi A, Bresciani E. The Evaluation of Different Treatments of Incipient Caries Lesions: An in Situ Study of Progression Using Fluorescence-based Methods. Oper Dent 2021; 46:87-99. [PMID: 33882139 DOI: 10.2341/19-268-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2020] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE Effective methods to control incipient caries lesions are needed. In this investigation, several methods provide encouraging results. SUMMARY This study aimed to evaluate in situ the inhibition of incipient caries lesion progression using different treatment protocols and to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, DIAGNOdent pen, and VistaProof fluorescence camera [FC]) in monitoring this process. The research was conducted in four phases: (1) at baseline, (2) after a first cariogenic challenge, (3) after treatment modalities, and (4) after a second cariogenic challenge. Sixteen volunteers used intraoral acrylic palatal appliances, each containing six enamel blocks (n=96). The cariogenic challenge was performed using a 20% sucrose solution over a 14-day period. The appliances were removed eight times a day and, upon removal, two drops of the solution were placed onto each enamel block. The enamel blocks were randomly assigned to three treatment groups: fluoride varnish ([FV] Duraphat; n=32), resin infiltrant ([RI] Icon; n=32), and adhesive system ([AS] Scotchbond; n=32). At the end of each phase, the surface microhardness (SMH) was measured, and two trained examiners evaluated the specimens using fluorescence-based methods. In addition, integrated mineral loss (ΔΔZ; vol%.min x μm) and lesion depth (ΔLD; μm) were evaluated using transverse microradiography. A two-way analysis of variance and a Tukey post hoc test were calculated (α=5%). Significant differences in SMH were observed according to the treatment, phases, and interaction of factors (p<0.001). Treatment with FV resulted in significantly higher SMH values in phases 3 and 4 compared to RI and AS, with the last two treatments resulting in similar values (p>0.05). The ΔΔZ value was similar for FV and AS but significantly higher for RI (p=0.016). ΔLD was not significantly different among the groups (p=0.126). Significant differences in the measurement of fluorescence for each fluorescence-based method were observed between each phase of the study (p<0.05). It can be concluded that all treatments were effective in inhibiting the in situ progression of incipient lesions, although to different degrees, with minor mineral loss changes observed for the AS and FV. Besides, all fluorescence-based methods tested, except for that using the FC device, were effective in monitoring caries lesion progression.
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Chen Y, Chen D, Lin H. Infiltration and sealing for managing non-cavitated proximal lesions: a systematic review and meta-analysis. BMC Oral Health 2021; 21:13. [PMID: 33413327 PMCID: PMC7791990 DOI: 10.1186/s12903-020-01364-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels. Methods Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. Results In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15–0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18–0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20–0.45; permanent dentition: OR = 0.20, 95% CI 0.14–0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.17, 95% CI 0.10–0.29; and high risk: OR = 0.14, 95% CI 0.07–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.20, 95% CI 0.10–0.39; and high risk: OR = 0.14, 95% CI 0.05–0.37). Conclusion Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.
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Affiliation(s)
- Yuanyuan Chen
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China
| | - Dongru Chen
- Department of Orthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China
| | - Huancai Lin
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China. .,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China. .,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China.
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Horuztepe SA, Ergin E, Onen A, Gürgan S. Comparison of Resin Infiltration Technique with Conventional Preventive Applications on Occlusal Fissures in Terms of Chemical Analysis and SEM. Acta Stomatol Croat 2020; 54:382-391. [PMID: 33642602 PMCID: PMC7871427 DOI: 10.15644/asc54/4/5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objective To compare the subsurface mineral loss preventing capability of resin infiltration technique with topical fluoride and fissure sealant applications to demineralized occlusal fissures under simulated oral conditions. Materials and Methods Occlusal surfaces of 64 extracted intact human third molars were demineralized. Next, the teeth were classified into four groups according to preventive applications (n = 16): G1, Specimens used as the control group with no preventive treatment; G2, Topical fluoride application (APF Gel/ DEEPAK); G3, Fissure sealant application (ClinproTMSealant/ 3M ESPE); and G4, Resin infiltration technique (Icon/ DMG). Chemical compositions before pH cycling were evaluated for eight specimens from each group. The remaining eight teeth from each group were subjected to pH cycling for 15 days to simulate the oral conditions. Subsequently, the specimens were fractured after immersion in liquid nitrogen and the subsurface fluoride (F), calcium (Ca), phosphorus (P) levels, and Ca/P ratio of each specimen were measured using energy dispersive x-ray spectrometer (EDS). The data were subjected to statistical analysis (p = 0.05). The effects of preventive applications to surface topography of specimens were evaluated using scanning electron microscope (SEM). Results There were no significant differences among the groups in subsurface F, Ca, and P levels and Ca/P ratios before or after pH cycling (p > 0.05). All three preventive applications were effective during pH cycling according to SEM observations. Conclusions The subsurface mineral loss preventing capability of resin infiltration technique applied to occlusal fissures was comparable to topical fluoride and fissure sealant applications. Clinical significance The resin infiltration technique could represent a valid alternative to traditionally used both preventive and restorative treatments for treating initial carious lesions on occlusal fissures, offering the advantages of better resin penetration and retention.
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Affiliation(s)
| | - Esra Ergin
- Hacettepe University, School of Dentistry, Department of Restorative Dentistry, Ankara, Turkey
| | - Alev Onen
- Hacettepe University, School of Dentistry, Department of Restorative Dentistry, Ankara, Turkey
| | - Sevil Gürgan
- Hacettepe University, School of Dentistry, Department of Restorative Dentistry, Ankara, Turkey
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Do bleaching gels affect the stability of the masking and caries-arresting effects of caries infiltration-in vitro. Clin Oral Investig 2020; 25:4011-4021. [PMID: 33319337 PMCID: PMC8137601 DOI: 10.1007/s00784-020-03732-4] [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: 06/09/2020] [Accepted: 12/04/2020] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this study was to evaluate the influence of different bleaching gels on the masking and caries-arresting effects of infiltrated and non-infiltrated stained artificial enamel caries lesions. Materials and methods Bovine enamel specimens (n = 240) with each two sound areas (SI and SC) and each two lesions (DI and DC) were infiltrated (DI and SI), stained (1:1 red wine-coffee mixture,70 days), and randomly distributed in six groups to be bleached with the following materials: 6%HP (HP-6), 16%CP (CP-16), 35%HP (HP-35), 40%HP (HP-40), and no bleaching (NBl,NBl-NBr). Subsequently, specimens were pH-cycled (28 days, 6 × 60 min demineralization/day) and all groups except NBl-NBr were brushed with toothpaste slurry (1.100 ppm, 2×/day, 10 s). Differences in colorimetric values (ΔL, ΔE) and integrated mineral loss (ΔΔZ) between baseline, infiltration, staining, bleaching, and pH cycling were calculated using photographic and transversal microradiographic images. Results At baseline, significant visible color differences between DI and SC were observed (ΔEbaseline = 12.2; p < 0.001; ANCOVA). After infiltration, these differences decreased significantly (ΔEinfiltration = 3.8; p < 0.001). Staining decreased and bleaching increased ΔL values significantly (p ≤ 0.001). No significant difference in ΔΔE was observed between before staining and after bleaching (ΔEbleaching = 4.3; p = 0.308) and between the bleaching agents (p = 1.000; ANCOVA). pH-cycling did not affect colorimetric values (ΔEpH-cycling = 4.0; p = 1.000). For DI, no significant change in ΔZ during in vitro period was observed (p ≥ 0.063; paired t test). Conclusions Under the conditions chosen, the tested materials could satisfactorily bleach infiltrated and non-infiltrated stained enamel. Furthermore, bleaching did not affect the caries-arresting effect of the infiltration. Clinical relevance The present study indicates that bleaching is a viable way to satisfactorily recover the appearance of discolored sound enamel and infiltrated lesions.
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Wang L, Freitas MCCDA, Prakki A, Mosquim V, González AHM, Rios D, Honório HM. Experimental self-etching resin infiltrants on the treatment of simulated carious white spot lesions. J Mech Behav Biomed Mater 2020; 113:104146. [PMID: 33125956 DOI: 10.1016/j.jmbbm.2020.104146] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate the penetration depth (μm) of experimental resin infiltrants containing different percentages of triethylene glycol dimethacrylate (TEGDMA) and phosphoric acid 2-hydroxyethyl methacrylate ester (PAM) in artificial carious white spot lesions (WSL). METHODS WSL were produced in 65 bovine flat enamel specimens by pH cycling protocol, which were treated with either Icon (control) or experimental acidic infiltrants based on different percentages of TEGDMA and PAM monomers (acidic), and their association or not with previous acid-etching with phosphoric acid. Ten readings using Confocal Laser Scanning Microscopy were conducted on each specimen and the penetration depth was calculated from the surface until the deepest point with the fluorescent dye Rhodamine B (0.02 mg/mL). The pH and the viscosity of the experimental infiltrants were also tested. Data were statistically analyzed with two-way ANOVA and Tukey tests (α < 0.05). RESULTS The material factor and the interaction material*acid-etching were statistically significant. The lowest penetration depth was observed for the samples treated with the commercial infiltrant after etching with 15% hydrochloric acid. When specimens were pre-treated with PA, highest penetration was seen for specimens treated with 100% TEGDMA, which differed from all other groups. The lowest penetration was seen for those treated with 50:50 TEGDMA:PAM infiltrants. When specimens were not previously etched, highest penetration was seen for Icon, which differed only from those treated with 25% TEGDMA 75% PAM, where the lowest values were seen. The values of viscosity increased and the pH decreased with the addition of PAM in the infiltrant formulations. CONCLUSION the association between TEGDMA and PAM seems to allow similar infiltration depth reached by Icon infiltrant without acid etching the enamel surface.
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Affiliation(s)
- Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil.
| | - Maria Cristina Carvalho de Almendra Freitas
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil; DeVry FACID, DeVry Education Group, Teresina-PI, Brazil
| | - Anuradha Prakki
- Faculty of Dentistry, University of Toronto, Restorative Department, Toronto-ON, Canada
| | - Victor Mosquim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | | | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
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Klaisiri A, Janchum S, Wongsomtakoon K, Sirimanathon P, Krajangta N. Microleakage of resin infiltration in artificial white-spot lesions. J Oral Sci 2020; 62:427-429. [PMID: 32830164 DOI: 10.2334/josnusd.19-0321] [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: 11/01/2022]
Abstract
This study examined the effectiveness of resin infiltration in inhibiting microleakage from artificial white-spot lesions (AWL) in enamel. Fifty sound extracted premolars were selected and randomly divided into five groups (n = 10 each). Group 1 included sound teeth. In contrast, an AWL was created in all specimens in groups 2 to 5, as follows-Group 2: AWL with no treatment; Group 3: AWL treated with resin infiltration; Group 4: AWL treated with resin infiltration and 5,000 cycles of thermocycling; Group 5: AWL treated with resin infiltration and 10,000 cycles of thermocycling. All specimens were then coated with nail varnish, except for a 4 × 4 mm2 area on the buccal surface (the measurement area), immersed in 2% methylene blue solution, and sectioned buccolingually. Microleakage was evaluated with a stereomicroscope. Data were analyzed by using the Kruskal-Wallis test and Bonferroni post-hoc correction. Application of resin infiltrant reduced microleakage in AWL. No microleakage was seen in Group 3, and differences between Groups 3, 4, and 5 were not significant (P > 0.05). The resin infiltration technique appears to aid in sealing enamel AWL and may help provide long-term protection against microleakage in enamel AWL.
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Affiliation(s)
- Awiruth Klaisiri
- Division of Operative Dentistry, Faculty of Dentistry, Thammasat University
| | | | | | | | - Nantawan Krajangta
- Division of Operative Dentistry, Faculty of Dentistry, Thammasat University
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28
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3D imaging of proximal caries in posterior teeth using optical coherence tomography. Sci Rep 2020; 10:15754. [PMID: 32978464 PMCID: PMC7519687 DOI: 10.1038/s41598-020-72838-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/07/2020] [Indexed: 11/08/2022] Open
Abstract
Optical coherence tomography (OCT) can create cross-sectional images of tooth without X-ray exposure. This study aimed to investigate the diagnostic accuracy of 3D imaging of OCT for proximal caries in posterior teeth. Thirty-six human molar teeth with 51 proximal surfaces visibly 6 intact, 16 slightly demineralized, and 29 distinct carious changes were mounted to take digital radiographs and 3D OCT images. The sensitivity, specificity and area under the receiver operating characteristic curve (AUC) for the diagnosis of enamel caries and dentin caries were calculated to quantify the diagnostic ability of 3D OCT in comparison with digital radiography. Diagnostic accuracy was evaluated by the agreement with histology using weighted Kappa. OCT showed significantly higher sensitivity, AUC and Kappa values than radiography. OCT can be a safer option for the diagnosis of proximal caries in posterior teeth that can be applied to the patients without X-ray exposure.
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El Meligy OAES, Alamoudi NM, Eldin Ibrahim ST, Felemban OM, Al-Tuwirqi AA. Effect of resin infiltration application on early proximal caries lesions in vitro. J Dent Sci 2020; 16:296-303. [PMID: 33384812 PMCID: PMC7770447 DOI: 10.1016/j.jds.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background/purpose Resin infiltration (RI) material ICON is used in treating early proximal caries lesions, as it depends on a micro-invasive infiltration technology. This in vitro study aimed to evaluate the effect of ICON resin infiltration (RI) on early proximal caries by comparing surface roughness and hardness before and after treatment with RI using atomic force microscopy (AFM), automated microhardness testing system (AMHTS), and scanning electron microscopy (SEM) in vitro. Materials and methods Twenty seven premolars extracted for orthodontic reasons were sectioned buccolingually, creating 54 specimens. Each specimen was immersed in demineralizing solution to induce caries. Only teeth with "International Caries Detection and Assessment System" codes 1 and 2 were selected. The specimens were divided randomly into either AFM, AMHTS or SEM groups, which examined demineralized enamel before and after treatment with ICON. Results The mean average surface roughness and root mean square roughness values of demineralized enamel treated with ICON were significantly higher than untreated lesions (P < 0.001). The mean Vickers hardness values for demineralized enamel treated with ICON was significantly higher than untreated lesions (P < 0.001). SEM showed irregular, pitted and rough demineralized enamel surface with destruction of enamel rods and dissolution of enamel crystals. After ICON application, the surface showed complete blockage of enamel rods with RI and irregular, rough uneven topography. Conclusion RI application on proximal incipient caries increased surface roughness and hardness significantly.
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Affiliation(s)
- Omar Abd El Sadek El Meligy
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Najlaa Mohammed Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shimaa Tag Eldin Ibrahim
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama Mahmood Felemban
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amani Ahmed Al-Tuwirqi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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de Oliveira Correia AM, Bühler Borges A, Torres CRG. Color masking prediction of posterior white spot lesions by resin infiltration in vitro. J Dent 2020; 95:103308. [PMID: 32112912 DOI: 10.1016/j.jdent.2020.103308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/22/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To investigate parameters that could predict the color masking effect (ME) of white spot lesions (WSLs) after resin infiltration (RI). METHODS Sixty extracted human teeth with natural WSLs were selected (28 premolars, 29 molars and 3 incisors). At baseline, the laser fluorescence (LF) of surrounding sound enamel (SE) and the WSLs were analyzed with DIAGNOdent. Standardized photographs were obtained under D65 and UV illuminants, from which the CIE L*a*b* color coordinates and natural fluorescence (NF) of the WSLs and SE were obtained. The color difference (ΔE00) and differences of NF and LF between the SE and WSLs were calculated. The lesion dimensions (area, perimeter, width, and height) were determined. After RI, the assessments were repeated. ME was considered as the reduction of ΔE00 values after RI. One-way ANOVA and the Tukey tests were used to analyze the absolute means of the LF and NF values. The t test was used to compare the ΔE00 values and lesion dimensions before and after infiltration. The correlations between all parameters at baseline and ME were analyzed. RESULTS The absolute mean values of LF at the baseline (B) and after infiltration (I) were SE/B-3.98a, WSL/B-13.28c, SE/I-3.36a, WSL/I-7.95b (p = 0.001). The mean values for NF were SE/B-7.93a; WSL/B-6.29b, SE/I-7.93a, WSL/I-7.27a (p = 0.001). The results for ΔE00 were B-11.74a, I-8.66b (p = 0.001). RI significantly reduced lesion dimensions. No correlations were observed between the baseline parameters and the ME. CONCLUSIONS The WSLs presented higher LF and smaller NF than SE, which were respectively reduced and increased after RI. Prediction of the masking effect by the parameters evaluated at baseline was not possible, which could be due to the choice of mainly caries lesions in posterior teeth. Nonetheless, infiltration was found suitable to mask most of the WSL. CLINICAL SIGNIFICANCE The color masking effect of white spot lesions after resin infiltration cannot be predicted by a previous analysis of fluorescence, color, or dimensions of the lesion.
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Affiliation(s)
- Ayla Macyelle de Oliveira Correia
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Alessandra Bühler Borges
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
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Silva VBD, Carvalho RND, Bergstrom TG, Santos TMPD, Lopes RT, Neves ADA. Sealing Carious Fissures with Resin Infiltrant in Association with a Flowable Composite Reduces Immediate Microleakage? PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pan Z, Que K, Liu J, Sun G, Chen Y, Wang L, Liu Y, Wu J, Lou Y, Zhao M. Effects of at-home bleaching and resin infiltration treatments on the aesthetic and psychological status of patients with dental fluorosis: A prospective study. J Dent 2019; 91:103228. [PMID: 31704387 DOI: 10.1016/j.jdent.2019.103228] [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: 09/19/2019] [Revised: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the effect of the combination approach of at-home bleaching (HB) and resin infiltration (RI) techniques on different severity degrees of dental fluorosis (DF) and further analyze the psychological changes caused by HB and RI in patients. METHOD Twenty-two patients (4 males, 18 females, 27.8 ± 1.6 yrs) with 186 fluorotic teeth were included in this study and classified into mild (N = 56), moderate (N = 100) and severe (N = 30) DF groups according to the Dean's index. The treatment effects on patients with DF were assessed by questionnaires including the changes in patients' subjective evaluation of their teeth and psychological status before and after treatments. Standardized digital photographs were taken at each time point of the treatment process, including baseline (T1), after bleaching (T2), immediately after RI treatment (T3) and more than six months after RI treatment (T4). The color alterations (ΔE) between the fluorotic (F2) and the surrounding relatively sound areas (F1) were analyzed. RESULTS Bad tooth appearance caused 13.64% of patients often depressed, frustrated, or disappointed, whereas 72.72% occasionally had these feelings. After treatment, the satisfaction of DF patients regarding tooth appearance increased from 0% (satisfied) to 58.82% (satisfied) and 23.53% (very satisfied). Moreover, these treatments improved all patients' confidence in smiling, laughing and showing their teeth. The percentage of fluorotic teeth with ΔE values more than 3.0 and 3.7 units decreased gradually from T1 stage to T3 stage in mild and moderate DF groups (p < 0.05), whereas the ΔE value in T3 stage was significantly lower than that of T2 stage in severe DF group (p < 0.05). In T4 stage, no significant difference was observed in the ΔE values between T4 and T3 stages (p > 0.05). CONCLUSION This study shows the obvious positive aesthetic effect of HB and RI treatment on different severity degrees of DF and the great improvements in psychological discomforts. CLINICAL SIGNIFICANCE The combination treatment of RI and low concentration HB gel improves the aesthetics of DF and may have a stable effect after 6-months follow-up, suggesting that this approach is a valuable clinical choice for dentists to treat DF.
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Affiliation(s)
- Zhouyan Pan
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Kehua Que
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China.
| | - Jie Liu
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Guangxu Sun
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Yi Chen
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Lisha Wang
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Yangqiu Liu
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Jiaxin Wu
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Yaxin Lou
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Mengming Zhao
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
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Borges AB, Abu Hasna A, Matuda AGN, Lopes SR, Mafetano APVP, Arantes A, Duarte AF, Barcellos DC, Torres CRG, Pucci CR. Adhesive systems effect over bond strength of resin-infiltrated and de/remineralized enamel. F1000Res 2019; 8:1743. [PMID: 31723426 PMCID: PMC6833993 DOI: 10.12688/f1000research.20523.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 12/03/2022] Open
Abstract
Background: The purpose of this study was to evaluate the effect of different bonding agents on bond-strength to demineralized enamel after remineralizing treatments and resin infiltration. Methods: Buccal enamel of 120 bovine incisors was polished and then were divided into five experimental groups: SE (sound enamel); DE (demineralized enamel); AS (demineralized enamel immersed in artificial saliva for eight weeks); NaF (demineralized enamel treated with 0.05% sodium fluoride solution (one minute) for eight weeks); Ic (demineralized enamel infiltrated with a low-viscosity resin (Icon-DGM). These groups were subdivided according to adhesive system used: self-etching adhesive Adper Easy One (3M/ESPE) and etch-and-rinse adhesive Single Bond (3M/ESPE). The composite resin blocks were fabricated using a Teflon matrix. A thermomechanical cycling machine was used to carry out the artificial aging of the specimens and thus were sectioned into sticks. The microtensile tests were performed using a universal testing machine at a cross-head speed of 1 mm/min. Data (in MPa) were subjected to two-way ANOVA and Tukey's tests (5%). Results: Significant differences were found for both factors tested and interactions (p<0.05). Tukey's test results of µTBS (mean ± SD) were: etch-and-rinse SE (28.79±3.93); DE (30.41±7.22); AS (29.03±3.33); NaF (29.81±4.06)a; Ic (29.47±5.5); and self-etching SE (30.37±6.96); DE (14.62±4.47); AS (9.79±2.32); NaF (9.36±2.31); Ic (30.78±8.68). Conclusions: Resin infiltration did not affect the bond strength of demineralized enamel for both adhesive systems tested. For etch-and-rinse adhesive, no differences were observed for the tested groups. For self-etching adhesive, only the resin-infiltrated group showed similar bond strength to sound enamel. Both etch-and-rinse and self-etching adhesive systems can be used in resin-infiltrated enamel, if a composite restoration needs to be further performed. In enamel that has undergone the de/remineralization process, the use of a total-etch adhesive might be preferable for the restorative procedure.
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Affiliation(s)
- Alessandra Buhler Borges
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Amanda Guedes Nogueira Matuda
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Stephanie Ribeiro Lopes
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Ana Paula Valente Pinho Mafetano
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Aline Arantes
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Angélica Ferreira Duarte
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Daphne Camara Barcellos
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Cesar Rogério Pucci
- Department of Restorative Dentistry, Operative Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
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Combined Near-Infrarred Light Transillumination and Direct Digital Radiography Increases Diagnostic In Approximal Caries. Sci Rep 2019; 9:14224. [PMID: 31578410 PMCID: PMC6775139 DOI: 10.1038/s41598-019-50850-5] [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] [Received: 01/13/2019] [Accepted: 09/15/2019] [Indexed: 12/03/2022] Open
Abstract
The objective of this study was to evaluate the clinical ability of Near-Infrared Light-Transillumination (NILT) for approximal dentinal caries detection and to compare with direct digital-radiography (DDR), as well as to determine whether the combination of both techniques improves the diagnostic capacity of the lesions. From 88 patients (over 18 years), 138 posterior teeth (76 molars and 62 premolars), that had approximal caries reached into dentine determined by DDR, were included. Lesion extension and DDR images were scored as follows: D0 = sound surface, D1/D2 = caries restricted to the outer/inner-half of the enamel, and D3/4 = caries restricted to the outer/inner-half of the dentin. Opening of the approximal surface using 0.5 mm-in-diameter diamond-bar was used as gold-standard. The lesion extension was then determined by the following criteria: no dentinal caries (D0/1/2) or dentinal caries (D3/4). Seventy-one lesions were D3 and 67 lesions were D4. Sensitivities of overall/D3/D4 were 98.0/95.7/100.0 (NILT) and 100/100/100 (DDR), respectively. Correlations with gold-standard were 0.92 (NILT) and 0.42 (DDR), respectively. The correlation increased to 0.97 (p = 0.045) on combining NILT and DDR. There was no difference in sensitivity between the methods (p > 0.05); but was differences in the correlation (p < 0.01). It can be concluded that NILT showed sensitivity similar to that of DDR and higher correlation than DDR for approximal dentinal caries detection. Accordingly, it may be used to monitor the progression of caries without exposing the patient to ionizing radiation, this being of particular interest in growing patients and in pregnant women. In this respect, NILT can be an effective diagnostic tool adjunctive to bitewing radiographs in detecting approximal dentinal caries. The combination of NILT and DDR represents an increase in the diagnosis of approximal lesions The proposed diagnostic protocol comprises visual examination, followed by NILT and DDR only if the former technique detects approximal caries.
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Jorge RC, Ammari MM, Soviero VM, Souza IPR. Randomized controlled clinical trial of resin infiltration in primary molars: 2 years follow-up. J Dent 2019; 90:103184. [PMID: 31465818 DOI: 10.1016/j.jdent.2019.103184] [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] [Received: 05/30/2019] [Revised: 08/08/2019] [Accepted: 08/24/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of this split-mouth, randomized, controlled clinical trial was to evaluate the efficacy of resin infiltration in controlling the progression of non-cavitated proximal lesions in primary molars after two-years follow-up. METHODS Fifty healthy children presenting at least two primary molars with proximal lesion detected radiographically (in the inner half of enamel or the outer third of dentin) were included in the study. The proximal lesions were randomly allocated into resin infltration + flossing (test group) or flossing (control group). All patients received oral hygiene instructions for daily brushing with fluoride toothpaste (1100 ppmF) and flossing. The proportion of caries progression was compared using the McNemar test. The main outcome after 2-years, caries progression in the radiography was assessed by pair-wise reading by an independent examiner who was blind regarding the treatment. RESULTS The sample comprised 28 (56%) girls and 22 (44%) boys with a defs of 7,3 (SD = 6,5), mainly of moderate (46%) to high (48%) caries risk. Results after one year were published previously. After 2-years, 29 (58%) patients were assessed. Caries progression was observed in 24.1% (7/29) of the test lesions, compared with 55.2% (16/29) of the control lesions (p = 0.012). The therapeutic effect was 31.1% and the relative risk reduction (RRR) was 56.3%. Eigth lesions from the control group and two lesions from the test group progressed to the inner third of dentin and were restored. CONCLUSIONS In conclusion, resin infiltration was more efficacious in controlling proximal caries lesions in primary molars than non-invasive approach alone. CLINICAL SIGNIFICANCE The results indicate that resin infiltration was an efficacious method in controlling proximal caries lesions in primary molars after 2 years, even in patients with high caries risk, reaffirming the results of 1-year follow-up.
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Affiliation(s)
- R C Jorge
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil; Dental School, Faculty of Arthur Sá Earp Neto, Petrópolis, RJ, Brazil
| | - M M Ammari
- Department of Specific Training, School of Dentistry, Universidade Federal Fluminense - UFF, Nova Friburgo, RJ, Brazil; Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil
| | - V M Soviero
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil; Dental School, Faculty of Arthur Sá Earp Neto, Petrópolis, RJ, Brazil.
| | - I P R Souza
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil
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Ricketts D, Lamont T, Innes NPT, Kidd E, Clarkson JE. WITHDRAWN: Operative caries management in adults and children. Cochrane Database Syst Rev 2019; 7:CD003808. [PMID: 31339555 PMCID: PMC6653982 DOI: 10.1002/14651858.cd003808.pub4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The management of dental caries has traditionally involved removal of all soft demineralised dentine before a filling is placed. However, the benefits of complete caries removal have been questioned because of concerns about the possible adverse effects of removing all soft dentine from the tooth. Three groups of studies have also challenged the doctrine of complete caries removal by sealing caries into teeth using three different techniques. The first technique removes caries in stages over two visits some months apart, allowing the dental pulp time to lay down reparative dentine (the stepwise excavation technique). The second removes part of the dentinal caries and seals the residual caries into the tooth permanently (partial caries removal) and the third technique removes no dentinal caries prior to sealing or restoring (no dentinal caries removal). This is an update of a Cochrane review first published in 2006. OBJECTIVES To assess the effects of stepwise, partial or no dentinal caries removal compared with complete caries removal for the management of dentinal caries in previously unrestored primary and permanent teeth. SEARCH METHODS The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 12 December 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 11), MEDLINE via OVID (1946 to 12 December 2012) and EMBASE via OVID (1980 to 12 December 2012). There were no restrictions regarding language or date of publication. SELECTION CRITERIA Parallel group and split-mouth randomised and quasi-randomised controlled trials comparing stepwise, partial or no dentinal caries removal with complete caries removal, in unrestored primary and permanent teeth were included. DATA COLLECTION AND ANALYSIS Three review authors extracted data independently and in triplicate and assessed risk of bias. Trial authors were contacted where possible for information. We used standard methodological procedures exacted by The Cochrane Collaboration. MAIN RESULTS In this updated review, four new trials were included bringing the total to eight trials with 934 participants and 1372 teeth. There were three comparisons: stepwise caries removal compared to complete one stage caries removal (four trials); partial caries removal compared to complete caries removal (three trials) and no dentinal caries removal compared to complete caries removal (two trials). (One three-arm trial compared complete caries removal to both stepwise and partial caries removal.) Four studies investigated primary teeth, three permanent teeth and one included both. All of the trials were assessed at high risk of bias, although the new trials showed evidence of attempts to minimise bias.Stepwise caries removal resulted in a 56% reduction in incidence of pulp exposure (risk ratio (RR) 0.44, 95% confidence interval (CI) 0.33 to 0.60, P < 0.00001, I2 = 0%) compared to complete caries removal based on moderate quality evidence, with no heterogeneity. In these four studies, the mean incidence of pulp exposure was 34.7% in the complete caries removal group and 15.4% in the stepwise groups. There was also moderate quality evidence of no difference in the outcome of signs and symptoms of pulp disease (RR 0.78, 95% CI 0.39 to 1.58, P = 0.50, I2 = 0%).Partial caries removal reduced incidence of pulp exposure by 77% compared to complete caries removal (RR 0.23, 95% CI 0.08 to 0.69, P = 0.009, I2 = 0%), also based on moderate quality evidence with no evidence of heterogeneity. In these two studies the mean incidence of pulp exposure was 21.9% in the complete caries removal groups and 5% in the partial caries removal groups. There was insufficient evidence to determine whether or not there was a difference in signs and symptoms of pulp disease (RR 0.27, 95% CI 0.05 to 1.60, P = 0.15, I2 = 0%, low quality evidence), or restoration failure (one study showing no difference and another study showing no failures in either group, very low quality evidence).No dentinal caries removal was compared to complete caries removal in two very different studies. There was some moderate evidence of no difference between these techniques for the outcome of signs and symptoms of pulp disease and reduced risk of restoration failure favouring no dentinal caries removal, from one study, and no instances of pulp disease or restoration failure in either group from a second quasi-randomised study. Meta-analysis of these two studies was not performed due to substantial clinical differences between the studies. AUTHORS' CONCLUSIONS Stepwise and partial excavation reduced the incidence of pulp exposure in symptomless, vital, carious primary as well as permanent teeth. Therefore these techniques show clinical advantage over complete caries removal in the management of dentinal caries. There was no evidence of a difference in signs or symptoms of pulpal disease between stepwise excavation, and complete caries removal, and insufficient evidence to determine whether or not there was a difference in signs and symptoms of pulp disease between partial caries removal and complete caries removal. When partial caries removal was carried out there was also insufficient evidence to determine whether or not there is a difference in risk of restoration failure. The no dentinal caries removal studies investigating permanent teeth had a similar result with no difference in restoration failure. The other no dentinal caries removal study, which investigated primary teeth, showed a statistically significant difference in restoration failure favouring the intervention.Due to the short term follow-up in most of the included studies and the high risk of bias, further high quality, long term clinical trials are still required to assess the most effective intervention. However, it should be noted that in studies of this nature, complete elimination of risk of bias may not necessarily be possible. Future research should also investigate patient centred outcomes.
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Affiliation(s)
- David Ricketts
- Dundee Dental School, University of DundeePark PlaceDundeeTaysideUKDD1 4HN
| | - Thomas Lamont
- University of Dundee, Dental School & HospitalPark PlaceDundeeTaysideUKDD1 4HN
| | - Nicola PT Innes
- Dundee Dental School, University of DundeePark PlaceDundeeTaysideUKDD1 4HN
| | - Edwina Kidd
- King's College London Dental InstituteDepartment of Conservative DentistryLondonUKSE1 9RT
| | - Janet E Clarkson
- Dundee Dental School, University of DundeeDivision of Oral Health SciencesPark PlaceDundeeScotlandUKDD1 4HR
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Kannan A, Padmanabhan S. Comparative evaluation of Icon® resin infiltration and Clinpro™ XT varnish on colour and fluorescence changes of white spot lesions: a randomized controlled trial. Prog Orthod 2019; 20:23. [PMID: 31204437 PMCID: PMC6571438 DOI: 10.1186/s40510-019-0276-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 05/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this trial was to comparatively evaluate Icon® resin infiltration and Clinpro™ XT varnish in restoring aesthetics of white spot lesions (WSLs) present post-orthodontic treatment. Materials and methods Two hundred forty WSLs were detected in 193 teeth of 12 patients. The participants were analysed—before intervention (T0), immediately after intervention (T1), 3 months later (T2) and 6 months later (T3), with a 1:1 allocation ratio for the application of Icon® resin infiltration and Clinpro™ XT varnish. Using a computer-generated allocation sequence, block randomization was done. A spectrophotometer was used to assess the colour of WSLs and the adjacent enamel, while a DIAGNOdent® was used to assess the fluorescence loss. Results Immediately after the intervention, Icon® resin infiltration showed statistically significant better improvement than Clinpro™ XT varnish in restoring the colour (p = 0.000); however, at 3 (p = 0.001) and 6 months (p = 0.000), this was reversed. Except at 3 months, the fluorescence loss sequentially reduced more for Icon® resin infiltration (4.48 ± 1.42 at T0 to 1.48 ± 0.81 at T3) and was not statistically significant. Conclusions Clinpro™ XT varnish showed significantly better improvement than Icon® resin infiltration in restoring the colour and lightness of the WSLs at 3 and 6 months. The fluorescence loss significantly recovered with both intervention methods between immediate application and at 6 months. However, Clinpro™ XT varnish-treated WSLs showed a statistically significant difference compared to the adjacent sound enamel at 6 months.
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Affiliation(s)
- Annapurna Kannan
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
| | - Sridevi Padmanabhan
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Gu X, Yang L, Yang D, Gao Y, Duan X, Zhu X, Yuan H, Li J. Esthetic improvements of postorthodontic white-spot lesions treated with resin infiltration and microabrasion: A split-mouth, randomized clinical trial. Angle Orthod 2019; 89:372-377. [PMID: 30719932 DOI: 10.2319/041218-274.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To compare the esthetic improvement between postorthodontic white-spot lesions (WSLs) treated by resin infiltration and microabrasion for 12 months. MATERIALS AND METHODS A total of 20 patients with 128 teeth with postorthodontic WSLs were recruited. A simple randomized, split-mouth, positive controlled design was used to allocate patients to resin infiltration or microabrasion groups. The lesion area ratio (R value) was calculated between the area of a WSL and the labial surface of the corresponding tooth based on standardized clinical photographs. The color change (ΔE) of each tooth was measured with a Crystaleye spectrophotometer (Olympus, Tokyo, Japan). Every measurement was taken before treatment (T0) and at different time points after treatment: 1 week (T1), 6 months (T6), and 12 months (T12). RESULTS A total of 16 patients with 108 trial teeth were available at T12. Each group had 54 trial teeth. In both groups, there was a significant decrease in R value and ΔE between T1 and T0 (P < .0001). In the infiltration group, the R value and ΔE had no significant changes over time from T1 to T12. In the microabrasion group, the R value and ΔE decreased significantly from T1 to T6. The R value of resin infiltration was lower when compared with microabrasion at every recall point (P < .001). The ΔE had no significant differences between the two groups at any timepoint. CONCLUSIONS Resin infiltration and microabrasion improved the esthetic appearance of WSLs and showed sufficient durability for 12 months. Resin infiltration showed a better esthetic improvement effect when compared with microabrasion at 12 months.
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Kim J, Shin TJ, Kong HJ, Hwang JY, Hyun HK. High-Frequency Ultrasound Imaging for Examination of Early Dental Caries. J Dent Res 2018; 98:363-367. [PMID: 30412680 DOI: 10.1177/0022034518811642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The extent of dental tissue destruction during the treatment of white spot lesions (WSLs) increases with the severity of the lesion. If the depth and shape of WSLs can be predicted with a noninvasive diagnostic method before dental caries treatment, more conservative interventions can be planned. Given the superiority of high-frequency ultrasound (HFUS) imaging in observing the internal structures of the body, the present study aimed to verify the possibility of HFUS imaging to examine the depth and shape of WSLs. We prepared tooth samples and developed a biomicroscopic system with a HFUS transducer to obtain images of normal and WSL regions. HFUS images were compared with conventional ultrasound images and micro-computed tomography images. HFUS distinctly differentiated demineralization within WSL and normal regions. WSL depth calculated in the micro-computed tomography image was similar to that in HFUS. This study revealed that HFUS imaging has the potential to detect early dental caries and offer information on the invasion depth of early dental caries quantitatively.
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Affiliation(s)
- J Kim
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - T J Shin
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - H J Kong
- 3 Department of Biomedical Engineering, College of Medicine, Chungnam National University, and Chungnam National University Hospital, Daejeon, Republic of Korea
| | - J Y Hwang
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - H K Hyun
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Arslan S, Lipski L, Dubbs K, Elmali F, Ozer F. Effects of different resin sealing therapies on nanoleakage within artificial non-cavitated enamel lesions. Dent Mater J 2018; 37:981-987. [PMID: 30298854 DOI: 10.4012/dmj.2017-027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate nanoleakage within the different lesion-sealing therapies applied to artificial non-cavitated enamel lesions. Thirty-two human anterior teeth were used. Artificial subsurface enamel lesions were produced on the labial surfaces of teeth. The specimens were then randomly divided into three groups (n=10): Group I- Clinpro Sealant application; Group II- ExciTE F adhesive resin application; and Group III- ICON resin infiltrant application. Each group was further divided into two subgroups: control and thermocycler. Nanoleakage was calculated by the digital image analysis software. In the control and thermocycled groups, there was no statistically significant difference between the Groups I, II, and III (p>0.05). The only significant leakage scores were obtained between the Group III control and thermocycler groups (p=0.027). ICON infiltrant can be used as an alternative to dental adhesives and fissure sealants in the sealing of initial non-cavitated enamel lesions. But the resin may become more affected by the water sorption than other resin materials over time. More studies are needed to evaluate long-term durability of resin infiltrants.
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Affiliation(s)
- Soley Arslan
- Department of Restorative Dentistry, Faculty of Dentistry, Erciyes University
| | - Linda Lipski
- Department of Materials Science and Engineering, Faculty of Engineering, University of Pennsylvania
| | - Keegan Dubbs
- Department of Materials Science and Engineering, Faculty of Engineering, University of Pennsylvania
| | - Ferhan Elmali
- Department of Biostatistics, Faculty of Medicine, Erciyes University
| | - Fusun Ozer
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania
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Minimally Invasive Approach for Improving Anterior Dental Aesthetics: Case Report with 1-Year Follow-Up. Case Rep Dent 2018; 2018:4601795. [PMID: 30271637 PMCID: PMC6146902 DOI: 10.1155/2018/4601795] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/19/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022] Open
Abstract
Dental aesthetics have become highly important in recent years. Treating aesthetic demands with noninvasive or minimally invasive techniques can preserve the natural tissues. A 20-year-old female patient presented to the clinic with aesthetic concerns. After the clinical and radiographic examinations, hypomineralization was identified in the maxillary anterior teeth except the maxillary right canine. An external discoloration was also identified in the maxillary left canine tooth. Moreover, the right canine tooth was identified as a Turner's tooth according to the patient's anamnesis. The resin infiltration technique was applied to the maxillary anterior teeth except the maxillary right canine. The bleaching treatment was applied to the maxillary left canine tooth. Then, a laminate veneer restoration was applied to the upper right canine tooth with Turner's hypoplasia. Following the treatment, a satisfactory aesthetic restoration was achieved. After 1-year examination, no clinical failures were observed.
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Yazkan B, Ermis RB. Effect of resin infiltration and microabrasion on the microhardness, surface roughness and morphology of incipient carious lesions. Acta Odontol Scand 2018; 76:473-481. [PMID: 29447057 DOI: 10.1080/00016357.2018.1437217] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The effects of resin infiltration and microabrasion on incipient carious lesions by surface microhardness, roughness and morphological assessments, and resistance to further acid attack of treated lesions were evaluated. MATERIAL AND METHODS Eighty artificially-induced incipient lesions were randomly divided into five groups (n = 16): resin infiltration with an adhesive resin (Excite F, Ivoclar Vivadent, Schaan, Liechtenstein), resin infiltration with a resin infiltrant (Icon, DMG, Hamburg, Germany), microabrasion without polishing (Opalustre, Ultradent, South Jordan, UT, USA), microabrasion with polishing (Opalustre, Ultradent, Diamond Excel, FGM, Joinville, SC, Brazil), and distilled water (control group). All specimens were exposed to demineralization for another 10 d. Microhardness, roughness and morphological assessments were done at baseline, following initial demineralization, treatment and further demineralization. Data were analysed by the Kruskal-Wallis, Friedman's and Bonferroni tests (p < .05). RESULTS Enamel lesions treated with resin infiltrant and microabrasion demonstrated similar hardness values, with a nonsignificant difference compared with sound enamel. Resin infiltration demonstrated lower roughness values than those of microabrasion, and the values did not reach the values of sound enamel. Further demineralization for 10 d did not affect the hardness but increased the roughness of infiltrated and microabraded enamel surfaces. Polishing did not influence the roughness of microabraded enamel surfaces. After resin infiltration, porosities on enamel were sealed completely. The surface structure was similar to that of the enamel conditioning pattern for microabraded enamel lesions. CONCLUSIONS Within the limitations of this study, the icon infiltration and microabrasion technique appeared to be effective for improving microhardness. Icon appeared to provide reduced roughness, although not equal to sound enamel. Further research is needed to elucidate their clinical relevance.
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Affiliation(s)
- Basak Yazkan
- Department of Restorative Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - R. Banu Ermis
- Department of Restorative Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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Chatzimarkou S, Koletsi D, Kavvadia K. The effect of resin infiltration on proximal caries lesions in primary and permanent teeth. A systematic review and meta-analysis of clinical trials. J Dent 2018; 77:8-17. [DOI: 10.1016/j.jdent.2018.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022] Open
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Liang Y, Deng Z, Dai X, Tian J, Zhao W. Micro-invasive interventions for managing non-cavitated proximal caries of different depths: a systematic review and meta-analysis. Clin Oral Investig 2018; 22:2675-2684. [PMID: 30238416 DOI: 10.1007/s00784-018-2605-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 08/22/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to further evaluate the caries-arresting effectiveness of micro-invasive interventions for non-cavitated proximal caries and analyze their efficacy for caries lesions of different depths. MATERIALS AND METHODS Randomized clinical trials (RCTs) of micro-invasive interventions for non-cavitated proximal caries were included in this study. We searched the Cochrane Library, PubMed, Embase, and Web of Science on May 25, 2017, without restrictions. After duplicate study selection, data extraction, and risk of bias assessment, a meta-analysis of the odds ratios (OR) with 95% confidence intervals (95% CIs) and a publication bias analysis were conducted using Stata 12.0. RESULTS After 2195 citations were screened, 8 citations of seven studies with follow-up periods from 12 to 36 months were included. The subgroup analysis showed that resin infiltration and resin sealant, but not glass ionomer cement (GIC), could reduce the caries progression rate (resin infiltration: OR = 0.15, 95% CI 0.09 to 0.24; resin sealant: OR = 0.33, 95% CI 0.19 to 0.58; GIC: OR = 0.13, 95% CI 0.01 to 2.65). Further analysis of their efficacies for caries lesions of different depths indicated that resin infiltration could arrest progression of enamel caries and caries around the enamel-dentin junction (EDJ) (enamel: OR = 0.05, 95% CI 0.01 to 0.35; EDJ: OR = 0.07, 95% CI 0.01 to 0.70). However, when the outer third of the dentin was involved, resin infiltration yielded significantly different results compared with the control group (OR = 0.42, 95% CI 0.16 to 1.10). Resin sealant seemed to be ineffective regardless of the caries depth (enamel: OR = 0.62, 95% CI 0.13 to 3.00; EDJ: OR = 0.44, 95% CI 0.09 to 2.15; dentin: OR = 0.43, 95% CI 0.07 to 2.63). CONCLUSIONS Resin infiltration is effective in arresting the progression of non-cavitated proximal caries involved in EDJ, while the therapeutic effects of resin sealant for different caries depths still needs to be further confirmed. CLINICAL RELEVANCE Based on existing evidence, dentists should carefully select appropriate micro-invasive interventions according to the different depths of non-cavitated proximal caries.
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Affiliation(s)
- Yuee Liang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zilong Deng
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xingzhu Dai
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Wanghong Zhao
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Peters MC, Hopkins AR, Yu Q. Resin infiltration: An effective adjunct strategy for managing high caries risk-A within-person randomized controlled clinical trial. J Dent 2018; 79:24-30. [PMID: 30227152 DOI: 10.1016/j.jdent.2018.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/07/2018] [Accepted: 09/13/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Micro-invasive resin-infiltration has shown to inhibit lesion progression of proximal non-cavitated carious lesions, suggesting an alternative to early operative treatment. This split-mouth, randomized placebo-controlled clinical trial evaluated the effects of proximal lesion infiltration supplementary to standard-of-care management in high caries risk (HCR)-patients. METHODS Forty-two HCR-subjects with two similar interproximal posterior lesions received professional HCR-regimen including repeated F-varnish applications. Two affected E2/D1-surfaces were randomized and concurrently treated by resin-infiltration or mock-infiltration (control). Individually standardized digital radiographs provided visual determination of lesion-size distribution at baseline and 2-year follow-up. Data were analyzed by logistic regression and McNemar's test. RESULTS Thirty-two lesion pairs (76%) were evaluated after 2 years. Categorical lesion depths were not different between groups (P > .5). Comparative pairwise assessment (image sets BL-2 yr) showed significantly more progression in control (7) versus infiltration (1) lesions (P = .035). Cumulative prevented fraction after two years was 97% for infiltrated lesions versus 74% for control lesions. CONCLUSIONS Two-year follow-up showed resin infiltration to be a highly efficacious (RRR: 86-89%) therapy. Long-term follow-up is needed to strengthen the evidence for efficacy of resin-infiltration as an adjunct to standard-of-care HCR-regimen including F-varnish. CLINICAL SIGNIFICANCE Showing 24% more stabilized lesions, the resin-infiltrated group performed significantly better than their controls, confirming successful early lesion management. Adjunct resin-infiltration provided an effective micro-invasive approach to inhibit short-term lesion progression.
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Affiliation(s)
- Mathilde C Peters
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA & Clinical Professor, School of Dentistry, Louisiana State University Health Science Center, New Orleans, LA, USA.
| | - Aubrey R Hopkins
- Operative and Comprehensive Dentistry, USADC West Point, NY & Comprehensive Dentistry, DC, USA
| | - Qingzhao Yu
- Biostatistics Program, Louisiana State University, New Orleans, LA, USA
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Abbas BA, Marzouk ES, Zaher AR. Treatment of various degrees of white spot lesions using resin infiltration-in vitro study. Prog Orthod 2018; 19:27. [PMID: 30079435 PMCID: PMC6081872 DOI: 10.1186/s40510-018-0223-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 06/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was conducted to evaluate the efficiency of resin infiltration to improve the color of white spot lesions (WSLs) and to estimate the effect of different numbers of etching and resin infiltrant applications on the color change of WSLs with various depths. Ninety-six sound extracted premolars were subjected to acid attack inducing different depths of WSLs. Using a DIAGNOdent, teeth were divided into four main groups according to the depth of the WSLs: shallow enamel, deep enamel, shallow dentine, and deep dentine without cavitation. Then each of the main groups was subdivided into four groups: six teeth each with different protocols of resin infiltration as follows: 1 etching + 1 infiltrant application (EA), 1 etching + 2 infiltrant applications (EAA), 2 etchings + 1 infiltrant application (EEA), 2 etchings + 2 infiltrant applications (EEAA). Spectrophotometric analysis was measured at baseline (T0), after inducing the WSLs (T1), and following resin infiltration application (T2) for each group. RESULTS In shallow enamel, EA produced the least mean color difference (1.62 ± 0.85), with high significant difference (P < 0.001), when compared with the clinically detectable threshold (ΔE = 3.7). While in deep enamel, EAA showed the least mean color change (1.95 ± 0.4), with P < 0.001 when compared with the critical value. Also, in shallow dentine, the least mean change was noticed with EAA (3.0 ± 0.45), with P < 0.001 when compared with the clinical color detection threshold. Furthermore, in deep dentine, EAA had the least mean difference (3.76 ± 0.6) but with no significant difference, when compared with the clinically detectable threshold. CONCLUSIONS As the WSL got deeper, the color of the lesion became more clinically visible. In shallow enamel, the best treatment option was one etching with one resin infiltrant application. For deep enamel and shallow dentine, one etching with two applications of infiltrant gave the best lesion masking. In deep dentine, it is advisable to perform one etching with two infiltration steps, taking in consideration that all deep dentine lesions without cavitation were partially masked, remained clinically detectable, and might require more invasive restorative procedures.
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Affiliation(s)
- Bassant A Abbas
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Azarita, Alexandria, Egypt.
| | - Eiman S Marzouk
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Azarita, Alexandria, Egypt
| | - Abbas R Zaher
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Azarita, Alexandria, Egypt
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Freitas MCCDA, Nunes LV, Comar LP, Rios D, Magalhães AC, Honório HM, Wang L. In vitro effect of a resin infiltrant on different artificial caries-like enamel lesions. Arch Oral Biol 2018; 95:118-124. [PMID: 30099240 DOI: 10.1016/j.archoralbio.2018.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES A resin infiltrant was employed for the treatment of active white spot lesions due to its ability to penetrate into the enamel pores and prevent the progression of the lesion. However, limited information is available about its mechanical effect on different artificial enamel lesions as well as on its resistance to further demineralization. Therefore, this study aimed to evaluate the effects of the Icon® infiltrant on different artificial caries-like enamel lesions and its resistance to new acid challenges. DESIGN Artificial lesions were produced in bovine enamel using three different protocols (demineralization/remineralization cycling, DE-RE; 8% methylcellulose gel, MC; and methyl ethyl diphosphonate solution, MHDP; n = 13). The specimens were treated with Icon® and subjected to a new acid challenge using DE-RE cycling. The surface and cross-sectional hardness were evaluated in sound, demineralized, treated and further demineralized enamel areas. Data were statistically analyzed using ANOVA and Tukey's test (p < 0.05). RESULTS All of the demineralizing protocols produced subsurface artificial caries lesions. The infiltrant was able to partially recover the surface hardness and prevent further surface hardness loss in enamel previously demineralized using the DE-RE and MHDP protocols. In regard to cross-sectional hardness, no positive effect was found. CONCLUSIONS The effect of the infiltrant depends on the type of lesion created in vitro, and its action is limited to the lesion surface.
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Affiliation(s)
- Maria Cristina Carvalho de Almendra Freitas
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil; DeVry FACID, DeVry Education Group, Avenida Rio Poti, 2381, ZIP code: 64999-999, Teresina, PI, Brazil
| | - Larissa Vasconcellos Nunes
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Lívia Picchi Comar
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil.
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In vitro study of white spot lesion: Maxilla and mandibular teeth. Saudi Dent J 2018; 30:142-150. [PMID: 29628737 PMCID: PMC5884248 DOI: 10.1016/j.sdentj.2017.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/05/2017] [Accepted: 12/13/2017] [Indexed: 11/24/2022] Open
Abstract
Aim The aim of the study was to evaluate the effect of resin infiltration on colour changes and surface roughness of artificial white spot lesions (WSLs) on maxillary and mandibular premolar. Materials and methods Sixty (60) extracted sound Maxilla (Mx) and Mandibular (Mn) premolars were randomly divided into 2 groups (test and control). Artificial WSLs were produced on buccal surface of teeth and were immersed in artificial saliva for 8 weeks. Colour components (L∗, a∗, b∗) and surface roughness (Sa∗) were assessed on 40 teeth using colour difference meter RD-100 and Alicona® Infinite Focus profilometer respectively. The measurements were done at baseline (T1), directly after artificial WSLs (T2), after 24 hours immersed in saliva and application of resin (T3) and immersion in artificial saliva for 1 (T4), 2 (T5), 4 (T6), 6 (T7) and 8 (T8) weeks. SEM images analysis were carried out on 20 teeth in four time points. Results The values of L∗ (lightness), b∗ (yellow/blue) and Sa∗ (surface roughness) are gradually reduced to the baseline value. Whereas, the value of a∗ gradually increased with distinct treatment time to achieve the baseline value. The higher value of L∗ and Sa∗, the whiter the lesion suggesting higher degree of enamel demineralization and surface roughness. Lower L∗ values suggest a masking colour effect. Conclusion The material produced favorable esthetics on colour and the surface roughness of teeth at distinct treatment times. It is recommended to be used to improve WSL post orthodontic treatment.
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ESPIGARES J, HAYASHI J, SHIMADA Y, TAGAMI J, SADR A. Enamel margins resealing by low-viscosity resin infiltration. Dent Mater J 2018. [DOI: 10.4012/dmj.2017-153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jorge ESPIGARES
- Cariology and Operative Dentistry Department, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Juri HAYASHI
- Cariology and Operative Dentistry Department, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yasushi SHIMADA
- Department of Operative Dentistry, Graduate School of Medicine and Dentistry, Okayama University
| | - Junji TAGAMI
- Cariology and Operative Dentistry Department, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Alireza SADR
- Biomimetics Biomaterials Biophotonics Biomechanics & Technology (B4T) laboratory, Department of Restorative Dentistry, University of Washington School of Dentistry
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Swamy DF, Barretto ES, Mallikarjun SB, Dessai SSR. In vitro Evaluation of Resin Infiltrant Penetration into White Spot Lesions of Deciduous Molars. J Clin Diagn Res 2017; 11:ZC71-ZC74. [PMID: 29207838 DOI: 10.7860/jcdr/2017/28146.10599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/29/2017] [Indexed: 11/24/2022]
Abstract
Introduction Caries Infiltration is a recent microinvasive restorative technique that permits treatment of non-cavitated demineralized lesions, known as White Spot Lesions (WSL). Aim To evaluate the extent of penetration of a commercially available resin caries-infiltrant into natural WSL occurring in deciduous tooth enamel. Materials and Methods Deciduous molars with natural WSL on any smooth surface were selected and sectioned into halves to yield equal control and experimental groups. Therefore, 25 samples in the control group were untreated whereas 25 samples in the experimental group were treated with caries-infiltrant according to the manufacturer's instructions. Samples were then evaluated under cross-polarized light microscope. Lesion Depth (LD) and Penetration Depth (PD) of the caries-infiltrant were measured quantitatively and descriptive statistics were calculated. Results Mean LD (standard deviation) for all samples (n=50) was 367(±182) μm. Caries-infiltrant demonstrated varying depths of resin penetration into the natural white spot lesions of deciduous molars. Mean PD (standard deviation) was 352 (± 141) μm. Conclusion Resin-infiltrants can deeply and predictably penetrate enamel porosities in natural WSL in deciduous molars and impede lesion progression and prevent cavitation.
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Affiliation(s)
- Dinesh Francis Swamy
- Lecturer, Department of Paedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Elaine Savia Barretto
- Lecturer, Department of Paedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Shanthala B Mallikarjun
- Professor and Head, Department of Paedodontics and Preventive Dentistry, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Sapna Sada Raut Dessai
- Lecturer, Department of Oral Medicine and Radiology, Goa Dental College and Hospital, Bambolim, Goa, India
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