1
|
Yang Q, Zheng W, Zhao Y, Shi Y, Wang Y, Sun H, Xu X. Advancing dentin remineralization: Exploring amorphous calcium phosphate and its stabilizers in biomimetic approaches. Dent Mater 2024:S0109-5641(24)00154-4. [PMID: 38871525 DOI: 10.1016/j.dental.2024.06.013] [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: 03/29/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE This review elucidates the mechanisms underpinning intrafibrillar mineralization, examines various amorphous calcium phosphate (ACP) stabilizers employed in dentin's intrafibrillar mineralization, and addresses the challenges encountered in clinical applications of ACP-based bioactive materials. METHODS The literature search for this review was conducted using three electronic databases: PubMed, Web of Science, and Google Scholar, with specific keywords. Articles were selected based on inclusion and exclusion criteria, allowing for a detailed examination and summary of current research on dentin remineralization facilitated by ACP under the influence of various types of stabilizers. RESULTS This review underscores the latest advancements in the role of ACP in promoting dentin remineralization, particularly intrafibrillar mineralization, under the regulation of various stabilizers. These stabilizers predominantly comprise non-collagenous proteins, their analogs, and polymers. Despite the diversity of stabilizers, the mechanisms they employ to enhance intrafibrillar remineralization are found to be interrelated, indicating multiple driving forces behind this process. However, challenges remain in effectively designing clinically viable products using stabilized ACP and maximizing intrafibrillar mineralization with limited materials in practical applications. SIGNIFICANCE The role of ACP in remineralization has gained significant attention in dental research, with substantial progress made in the study of dentin biomimetic mineralization. Given ACP's instability without additives, the presence of ACP stabilizers is crucial for achieving in vitro intrafibrillar mineralization. However, there is a lack of comprehensive and exhaustive reviews on ACP bioactive materials under the regulation of stabilizers. A detailed summary of these stabilizers is also instrumental in better understanding the complex process of intrafibrillar mineralization. Compared to traditional remineralization methods, bioactive materials capable of regulating ACP stability and controlling release demonstrate immense potential in enhancing clinical treatment standards.
Collapse
Affiliation(s)
- Qingyi Yang
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China
| | - Wenqian Zheng
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China
| | - Yuping Zhao
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China
| | - Yaru Shi
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China
| | - Yi Wang
- Graduate Program in Applied Physics, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208, USA
| | - Hongchen Sun
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China
| | - Xiaowei Xu
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology, Jilin University, Changchun 130021, PR China.
| |
Collapse
|
2
|
Fernando JR, Shen P, Yuan Y, Adams GG, Reynolds C, Reynolds EC. Remineralisation of enamel and dentine with stabilised stannous fluoride dentifrices in a randomised cross-over in situ trial. J Dent 2024; 143:104895. [PMID: 38387598 DOI: 10.1016/j.jdent.2024.104895] [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: 11/15/2023] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVES To compare the remineralisation efficacy and ion bioavailability of two novel SnF2-containing dentifrices in a blinded, cross-over, randomised in situ clinical study. METHODS Six participants wore removal palatal appliances holding human enamel and dentine blocks with subsurface lesions. Appliances were worn for two treatment periods of 14 consecutive days each, with a one-week washout period in-between. Participants were randomly allocated to rinse with a 1:5 diluted coded slurry of one of two dentifrices containing either 5 % casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) +1100 ppm F as SnF2 [MIPOP], or 1100 ppm F as SnF2 [CT], for 1 min, four times a day. Saliva was collected post-treatment and analysed for tin, calcium, inorganic phosphate and fluoride ions using atomic absorption spectrophotometry and ion chromatography. Enamel and dentine lesions were analysed for percent remineralisation (%R) using transverse microradiography and percent surface microhardness recovery (%SMHR). RESULTS MIPOP released significantly higher F (3.00 ± 0.27 mM), Ca (15.23 ± 3.23 mM) and Sn (1.18 ± 0.13 mM) into saliva whereas CT released 2.89 ± 0.32 mM F and only 0.84 ± 0.11 mM Ca and 0.28 ± 0.10 mM Sn. MIPOP produced significantly higher %R than CT: 25.6 ± 1.5 % compared to 15.2 ± 0.7 % in enamel, and 33.6 ± 3.1 % compared to 20.6 ± 1.1 % in dentine. Additionally, MIPOP produced significantly higher %SMHR (18.2 ± 7.9 %) compared to CT (4.1 ± 0.6 %). CONCLUSIONS Both dentifrices promoted remineralisation, but the MIPOP dentifrice with added CPP-ACP and the ion-stabilising effects of CPP released higher amounts of bioavailable tin and produced significantly higher remineralisation and surface microhardness recovery. CLINICAL SIGNIFICANCE Modern dentifrices contain SnF2 for a range of oral health benefits. Challenges associated with stability of these formulations can affect ion bioavailability, reducing efficacy. Two dentifrices with SnF2 promoted remineralisation in situ, however the dentifrice with the added saliva biomimetic CPP-ACP was superior and therefore may produce greater health benefits.
Collapse
Affiliation(s)
- James R Fernando
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Peiyan Shen
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Yi Yuan
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Geoffrey G Adams
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Coralie Reynolds
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Eric C Reynolds
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria 3010, Australia.
| |
Collapse
|
3
|
Bock NC, von Bremen J, Klaus K, Schulz-Weidner N, Ganss C, Ruf S. White spot lesions after fixed appliance treatment-Can we expect spontaneous long-term (≥15 years) improvement? Eur J Orthod 2024; 46:cjad070. [PMID: 38128566 DOI: 10.1093/ejo/cjad070] [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] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To investigate the extent to which post-orthodontic white spot lesions (WSLs) change in appearance over a period of ≥15 years and whether an association with caries data exists. SUBJECTS AND METHODS Seventy-two patients treated with a Herbst-Multibracket appliance at age 14.0 ± 2.7 years for 20.1 ± 5.1 months who attended a recall 18.3 ± 2.9 years post-treatment. Post-treatment (T1) intraoral photographs were assessed by a panel of five dentists using a modified version of the WSL-Index by Gorelick. For affected incisors, photographs from before treatment (T0) and recall (T3) were evaluated. In addition, the WSL-Change Index by Pancherz and Muehlich was assessed for all adequately visible incisors considering T1, T2 (if available), and T3. Radiographic (T0, T1, and T2-if available) and clinical (T3) MFT data were used. RESULTS 37.5% of the patients exhibited WSLs on ≥ 1 incisor at T1; in total, 81 incisors (14.9%) were affected. At T3, 48% of the WSLs had improved. The modified WSL-Index decreased from 1.2 ± 0.4 to 0.8 ± 0.6 (P < .001), with a score 0 in 28% of the previously affected incisors. When comparing T2 vs. T3, additional improvement after T2 occurred in 11% of the teeth. While no difference existed at T0, the MFT values at T1, T2, and T3 were higher (P ≤ .05) in patients with WSLs at T1 than in those without. LIMITATIONS The homogeneity of the subjects was limited and no patient-reported outcome was assessed. CONCLUSIONS Long-term, post-orthodontic WSLs showed spontaneous full recovery in 28% and improvement in 48% of the teeth. Patients affected with WSLs exhibited higher post-treatment MFT values.
Collapse
Affiliation(s)
| | - Julia von Bremen
- Department of Orthodontics, University of Giessen, Giessen, Germany
| | - Katharina Klaus
- Department of Orthodontics, University of Giessen, Giessen, Germany
| | | | - Carolina Ganss
- Department of Operative Dentistry, Endodontology, and Paediatric Dentistry, University of Marburg, Marburg, Germany
| | - Sabine Ruf
- Department of Orthodontics, University of Giessen, Giessen, Germany
| |
Collapse
|
4
|
Cheng L, Yuan R, Fan H, Si M, Hao Z, Feng Z. The effect of the Er,Cr:YSGG laser combined casein phosphopeptide amorphous calcium phosphate for enamel remineralisation: a systematic review and meta-analysis of in vitro studies. Lasers Med Sci 2023; 38:201. [PMID: 37667086 PMCID: PMC10477104 DOI: 10.1007/s10103-023-03864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
The purpose of this systematic review and meta-analysis of in vitro studies was to evaluate the effect of the 2780 nm Er,Cr:YSGG laser combined with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) for enamel remineralisation. The electronic PubMed, Cochrane Library, Web of Science, and EMBASE databases were searched, with no language or date restrictions, up to January 2023. Two reviewers independently performed research information extraction and quality assessment. Continuous variables were analysed by standard mean difference (SMD) with a 95% confidence interval (CI). The statistical analyses were conducted using Review Manager (Version 5.4; Rev Man) and Cochrane Collaboration (2020). Finally, four trials were included for meta-analysis. According to the comprehensive results, the effect of the Er,Cr:YSGG laser combined with CPP-ACP on enamel remineralisation was significantly better than that of CPP-ACP alone: surface microhardness (SMD = - 1.83, 95% CI: [- 2.98, - 0.69], P = 0.002); lesion depth (SMD = 6.63, 95% CI: [4.98, 8.28], P < 0.001). Under the limitations of this meta-analysis, the results show that the Er,Cr:YSGG laser combined with CPP-ACP has a better effect on enamel remineralisation than CPP-ACP alone. The combination of the Er,Cr:YSGG laser and CPP-ACP may be a feasible method to prevent and treat enamel demineralisation.
Collapse
Affiliation(s)
- Lin Cheng
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Yuan
- School and Hospital of Stomatology, Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University, Taiyuan, China
| | - Hao Fan
- School and Hospital of Stomatology, Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University, Taiyuan, China
| | - Minmin Si
- School and Hospital of Stomatology, Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University, Taiyuan, China
| | - Zhaonan Hao
- School and Hospital of Stomatology, Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University, Taiyuan, China
| | - Zhiyuan Feng
- School and Hospital of Stomatology, Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University, Taiyuan, China.
- Department of Orthodontics, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China.
| |
Collapse
|
5
|
Damar S, Gümrü Çelikel AD, Pınar Erdem A. Comparative evaluation of fluoride-free remineralization agents with and without Er,Cr:YSGG laser on artificial enamel remineralization. Lasers Med Sci 2023; 38:172. [PMID: 37526766 DOI: 10.1007/s10103-023-03837-8] [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: 01/13/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
This study aimed to evaluate the efficacy of fluoride-free remineralizing agents in initial enamel caries, with and without combined Er,Cr:YSGG laser application. The remineralization effect of various agents and their combinations on artificial initial caries was investigated using 10 experimental groups (n = 7): NC, negative control; PC, positive control; TM, calcium-phosphate compounds (CPP-ACP); TD, theobromine-containing toothpaste; RG, ROCS® remineralizing gel; L, Er,Cr:YSGG laser (2780 nm; 0.25 W; repetition rate, 20 Hz; pulse duration, 140 μs; tip diameter, 600 μm; without air/water cooling); L + fluoride toothpaste; L + TM; L + TD; and L + RG. The demineralized bovine enamel specimens were subjected to an 8-day pH cycle by daily application of the remineralizing agents and laser therapy once prior to the pH cycle and paste application. The enamel samples underwent the Vickers surface microhardness test, and one sample per group was analyzed with scanning electron microscopy. The Kruskal Wallis test was used to compare the microhardness recovery percentage (SMHR%) for each group, and multiple comparisons were made with the Dunn test. Groups L (p = 0.003), RG (p = 0.019), L + TM (p < 0.001), L + fluoride toothpaste (p = 0.001),and L + RG (p = 0.036) exhibited significant increase in SMHR%. The tested remineralizing agents exhibited no statistically significant difference in effect when used alone and in combination with Er,Cr:YSGG laser. Combined application of Er,Cr:YSGG laser and ROCS® remineralization gel effectively promoted enamel remineralization, while use of CPP-ACP and fluoride toothpaste alone was ineffective. Theobromine-containing toothpaste exhibited the least SMHR%. Long-term evaluation of these agents is recommended.
Collapse
Affiliation(s)
- Serhat Damar
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | | | - Arzu Pınar Erdem
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| |
Collapse
|
6
|
Alkarad L, Alkhouli M, Dashash M. Remineralization of teeth with casein phosphopeptide-amorphous calcium phosphate: analysis of salivary pH and the rate of salivary flow. BDJ Open 2023; 9:16. [PMID: 37041136 PMCID: PMC10090128 DOI: 10.1038/s41405-023-00141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/07/2023] [Accepted: 03/23/2023] [Indexed: 04/13/2023] Open
Abstract
AIM To investigate the changes of salivary flow rate and salivary pH of Syrian children with mixed dentition following application of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP). METHODS This study is part of a double-blind randomized controlled clinical trial. It included 50 children aged 6-8 who were randomly divided into two treatment groups to receive either CPP-ACP GC Tooth Mousse™ (Group A) or placebo (Group B) with 25 participants per group. After the application of the product in the mouth for 3 min, saliva samples were collected four times (T0, T1, T2, and T3) to measure salivary pH and the rate of salivary flow. RESULTS There was no significant difference between group A and B in the mean value of salivary flow rate (t = 1.08, P = 0.28, 0.57 ± 0.28 versus 0.56 ± 0.38 respectively) and salivary pH (t = 0.61, P = 0.54, 7.28 ± 0.44 versus 7.25 ± 0.36 respectively). However, there was a significant difference between different time points (T0, T1, T2, and T3) in the mean value of salivary flow rate (0.41 ± 0.30, 0.65 ± 0.36, 0.53 ± 0.28, and 0.56 ± 0.34 respectively) and salivary pH (6.99 ± 0.44, 7.46 ± 0.36, 7.36 ± 0.32, and 7.26 ± 0.32 respectively). CONCLUSION The application of the GC Tooth Mouse (CPP-ACP) was similar to placebo in increasing the salivary pH and salivary flow rate. TRIAL REGISTRATION ISRCTN17509082, Registration date 22/11/2022.
Collapse
Affiliation(s)
- Lubna Alkarad
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Muaaz Alkhouli
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Mayssoon Dashash
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
| |
Collapse
|
7
|
de Holanda Ferreira DA, Rolim de Abreu NM, Meira KRS, de Sousa FB. Organic volume and permeability variations in the surface layer of artificial and natural enamel carious lesions. Arch Oral Biol 2023; 148:105645. [PMID: 36804643 DOI: 10.1016/j.archoralbio.2023.105645] [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: 12/10/2022] [Revised: 01/23/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Test the hypothesis the type of enamel caries (natural, artificial induced by gel, and artificial induced by acid solutions) affect the organic volume and the permeability of the surface layer in enamel caries lesions. DESIGN Artificial enamel caries, induced by either acidic solution (organic-poor; Group 1) or acidic gel (organic-rich; Group 2), and natural non-cavitated inactive approximal enamel caries lesions (NEC; Group 3) were obtained, from which longitudinal ground sections were prepared. Measurements of the mineral (Vmin) (by microradiography), and water (α) and organic (β) volumes (by optical birefringence) were obtained at three points in the surface layer (n = 30/group). RESULTS The main outcomes were the ratio between experimental β by predicted β (β Ratio) and the ratio between experimental and predicted permeabilities (αd Ratio). β Ratio in Group 1 was lower than in Groups 2 (Cohen's d: -1.81; 95% CI:-1.45,-2.32; p < 0.001) and 3 (Cohen's d: -0.71; 95% CI:-0.27,-1.18; p = 0.004), and Group 2 surpassed Group 3 (Cohen's d: 0.49; 95% CI:0.07,0.94; p = 0.03). αd Ratio in Group 1 was higher than in Groups 2 (Cohen's d: 1.86; 95% CI:1.49,2.33; p < 0.001) and 3 (Cohen's d: 0.60; 95% CI:0.18,1.14; p = 0.01), and Group 3 surpassed Group 2 (Cohen's d: 0.61; 95% CI:0.23,1.07; p = 0.01). CONCLUSIONS The highest organic volume and the lowest permeability occurred at the surface layer of gel-induced artificial enamel caries lesions, which should be preferred in in vitro studies on de- and remineralization and resin infiltration.
Collapse
Affiliation(s)
- Danilo Augusto de Holanda Ferreira
- Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Cidade Universitária, 58051-900 João Pessoa, Paraiba, Brazil
| | - Nathalie Murielly Rolim de Abreu
- Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Cidade Universitária, 58051-900 João Pessoa, Paraiba, Brazil
| | - Kássia Regina Simões Meira
- Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Cidade Universitária, 58051-900 João Pessoa, Paraiba, Brazil
| | - Frederico Barbosa de Sousa
- Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Cidade Universitária, 58051-900 João Pessoa, Paraiba, Brazil; Department of Morphology, Health Science Center, Federal University of Paraiba, Cidade Universitária, 58051-900 João Pessoa, Paraiba, Brazil.
| |
Collapse
|
8
|
Adel SM, El-Harouni N, Vaid NR. White Spot Lesions: State of the Art Biomaterials and Workflows used in Prevention, Progression and Treatment. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
9
|
Salah R, Afifi RR, Kehela HA, Aly NM, Rashwan M, Hill RG. EFFICACY OF NOVEL BIOACTIVE GLASS IN THE TREATMENT OF ENAMEL WHITE SPOT LESIONS: A RANDOMIZED CONTROLLED TRIAL✰. J Evid Based Dent Pract 2022; 22:101725. [PMID: 36494113 DOI: 10.1016/j.jebdp.2022.101725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES to evaluate the efficacy of 2 types of bioactive glass (45S5) compared to casein-phosphopeptide stabilized-amorphous calcium phosphate (CPP-ACP) in the treatment of orthodontically-induced white spot lesions (WSLs). METHODS Sixty post-orthodontic WSLs (ICDAS II score 2) were randomly allocated to a double blind randomized controlled trial with 3 parallel arms (n = 20). Test group I (Bio-BAG) received BiominF slurry and toothpaste, and test group II (N-BAG) received Novamin slurry and toothpaste. While the positive control group (CPP-ACP) received Recaldent paste. Products were applied daily in-office during week 1, and boosted by self-administered home application for 4 weeks (week 1-4). Standard oral hygiene care was performed by all participants twice daily during months 2-6. All patients were assessed for change in WSL dimensions using computer assisted analysis based on standardized digital intraoral photographs in addition to laser fluorescence DIAGNOdent assessment before treatment (T0) and at 1 week (T1), 1 month (T2), 3 months (T3,) and 6 months (T4) follow up periods. RESULTS Kruskal Wallis test was used (P < .05 for all). At T4, a statistically significant (P < .001) regression of WSL was disclosed in all 3 groups compared to baseline, and a highly significant lesion size percent reduction in Bio-BAG group compared to the control group (P < .001). The mean area of the lesions decreased by 64.8%, 32.2%, and 31.6% for groups I, II and III respectively (P = .001). DIAGNOdent findings largely reflected the clinical scores (Mean scores at baseline/T4 for groups I, II, and III respectively; 16.57/3.62, 16.93/7.90, 21.95/19.27). No adverse effects were reported. CONCLUSIONS The combined in-office and home-application of BiominF paste for 4 weeks resulted in greater esthetic improvements of post-orthodontic WSLs compared to Novamin and CPP-ACP. In addition, BiominF showed a significant reduction in fluorescence intensity which indicates potential lesion remineralization. CLINICAL RELEVANCE Post-orthodontic WSLs can be diminished using bioactive glass remineralization therapy.
Collapse
Affiliation(s)
- Rania Salah
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Rania R Afifi
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Hany A Kehela
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Nourhan M Aly
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maher Rashwan
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt; Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Robert G Hill
- Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
10
|
Effects of Alternative Solvents in Experimental Enamel Infiltrants on Bond Strength and Selected Properties. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4293975. [DOI: 10.1155/2022/4293975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/26/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022]
Abstract
Objective. To evaluate different concentrations of solvents (tetrahydrofuran (THF) and dimethyl sulfoxide (DMSO) and monomers on the degree of conversion, microtensile bond strength, and mechanical properties of experimental resin infiltrants. Materials and Methods. Resin infiltrants were formulated and divided into eleven groups: (1) Icon, (2) 75% TEGDMA (T) +25% UDMA (U), (3) T +25% BIS-EMA (B), (4) T + U +0.5%DMSO, (5) T + U +5% DMSO, (6) T + U +0.5% THF, (7) T + U +5% THF, (8) T + B +0.5% DMSO, (9) T + B +5% DMSO, (10) T + B +0.5% THF, and (11) T + B +5% THF. One hundred and ten bovine mandibular incisors were sectioned, treated, and destined to the degree of conversion, tensile cohesive strength, microtensile bond strength, flexural strength, and elastic modulus. Data were submitted to one-way ANOVA and Tukey’s test (
). Results. The degree of conversion was lowest for T + B +5%THF (41.9%) and highest for T + U +5%THF (62.1%). In flexural strength and E-modulus, the T + B (96.5 MPa and 0.49 GPa) obtained the highest values and the lowest for T + U +5% DMSO (18.5 MPa and 9.7 GPa). Icon showed the highest bond strength (19.3 MPa) and cohesive strength (62.2 MPa), while T + U +5%DMSO (9.7 MPa) and T + B +5% DMSO (9.8 MPa) the lowest values and T + B +0.5% DMSO (12.3 MPa) the lowest cohesive strength. Conclusions. The addition of lower concentrations of DMSO or THF (0.5%) did not impair bond strength or significantly affect monomer conversion, but reduced the mechanical properties of resin infiltration.
Collapse
|
11
|
Evaluation of the Efficacy of CPP-ACP Remineralizing Mousse in MIH White and Yellow Opacities-In Vitro Vickers Microhardness Analysis. Dent J (Basel) 2022; 10:dj10100186. [PMID: 36285996 PMCID: PMC9600031 DOI: 10.3390/dj10100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/09/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Remineralization of tooth enamel can be partially achieved by the application of a casein phosphopeptides and amorphous phosphate (CPP-ACP) complex. However, evidence to support its effectiveness in Molar-incisor-hypomineralization (MIH)-affected teeth is scarce. The study’s aim is to evaluate the efficacy of CPP-ACP mousse in remineralizing MIH-affected enamel using a Vickers microhardness test. Two groups of enamel opacities of hypomineralized permanent teeth, white (group A) and yellow (group B) lesions (n = 14), went through a 28-day treatment protocol with GC Tooth Mousse. Before and after treatment, microhardness was measured in three different areas of each tooth (hypomineralized, transition, and outside the hypomineralized area). Data were analyzed using parametric and non-parametric tests with a significance of p < 0.05. The mean microhardness values increased in the hypomineralized and transition areas in both groups after the treatment protocol (in group A, 105.38 ± 11.70 to 158.26 ± 37.34; 123.04 ± 22.84 to 156.33 ± 35.70; in group B, 108.63 ± 14.66 to 143.06 ± 22.81; 132.55 ± 20.66 to 146.00 ± 12.88) and the differences pre/post-treatment were statistically significant within each group (p < 0.001 for both groups). Between groups, there was a statistically significant difference in the same areas (hypomineralized: p = 0.003; transition: p = 0.008) with a higher improvement in enamel hardness in group A. Topical application of CPP-ACP showed an increase in the physical strength of the hypomineralized and transition areas of MIH-affected enamel, likely due to an increase in mineral content.
Collapse
|
12
|
Ayad AH, AbdelHafez MI, AlGhandour RN, Mustafa DS, Nour KA. Effect of different surface treatments on the microhardness and colour change of artificial enamel lesions. Aust Dent J 2022; 67:230-238. [PMID: 35224731 DOI: 10.1111/adj.12908] [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: 11/18/2021] [Revised: 12/15/2021] [Accepted: 02/20/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND To investigate the effect of three different surface treatments on the microhardness and colour change of artificial enamel lesions. MATERIALS AND METHODS One hundred bovine teeth were randomly assigned into four groups. Artificial enamel lesions were created using demineralizing solution for all groups except the sound enamel group. Different surface treatments were then performed G1: resin-infiltrant; G2: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); G3: artificial saliva; G4: Sound Enamel. Each group was subdivided into three subgroups, where each subgroup was subjected to a different testing method. Subgroup 1: surface microhardness; subgroup 2: cross-sectional microhardness; subgroup 3: colour measurement. Statistical analysis was performed by ANOVA, followed by Tukey's post hoc test. RESULTS Sound enamel group recorded the highest surface and cross-sectional microhardness results. No significant difference was found between the resin-infiltrant group and CPP-ACP regarding surface and cross-sectional microhardness at different lesion depths. Resin-infiltrant group showed the least colour change (∆E) results compared to the other groups. CONCLUSION Resin-infiltrant can effectively enhance surface microhardness and enamel resistance to demineralization, additionally, reduces the staining susceptibility of white spot lesions (WSLs) after treatment. CPP-ACP application for 4 weeks seems to improve surface microhardness; however, has a limited effect in resisting staining of WSLs after treatment. © 2022 Australian Dental Association.
Collapse
Affiliation(s)
- A H Ayad
- Operative Dentistry Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - M I AbdelHafez
- Conservative Dentistry Department, Faculty of Dentistry, Newgiza University (NGU), Giza, Egypt
| | - R N AlGhandour
- Operative Dentistry Department, Faculty of Dentistry, Egyptian Russian University, Cairo, Egypt
| | - D S Mustafa
- Operative Dentistry Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - K A Nour
- Operative Dentistry Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| |
Collapse
|
13
|
Phonghanyudh A, Duangthip D, Mabangkhru S, Jirarattanasopha V. Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158992. [PMID: 35897363 PMCID: PMC9331268 DOI: 10.3390/ijerph19158992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
Background: There is limited information on the effectiveness of 38% silver diamine fluoride (SDF) in managing enamel caries. Objective: This study aimed to compare effectiveness of 38% SDF and 5% Sodium fluoride (NaF) varnish in arresting enamel caries in young children when applied semiannually over 18 months. Methods: A randomized controlled trial was conducted on children aged 1−3 years who had at least one active carious surface. They were allocated into two groups: Group 1 (38% SDF) and Group 2 (5% NaF varnish). Visual-tactile examination was used to assess extent of carious lesions. Enamel caries that did not progress to dentin were classified as having caries arrest. Intention-to-treat analysis was performed. Results: At baseline, 290 children with 1974 tooth surfaces with enamel caries were recruited. Caries arrest rates at the tooth surface level in Group 1 and Group 2 were 59.1% and 58.8%, respectively (p = 0.873), at 18 months. The multilevel logistic regression analysis revealed that tooth position, tooth surface, extent of enamel caries at baseline, caries experience, and brushing with fluoride toothpaste influenced caries arrest (p < 0.05). Conclusion: The semiannual application of 38% SDF and 5% NaF varnish had comparable effectiveness in arresting enamel caries in primary teeth.
Collapse
Affiliation(s)
- Araya Phonghanyudh
- School of Dentistry, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
| | | | | | | |
Collapse
|
14
|
Evaluation of remineralizing potential of hydroxyapatite, phosphopeptide-amorphous calcium phospahate and fluoride dentifrices using SEM/EDX analysis: A randomized controlled in-vitro study. PEDIATRIC DENTAL JOURNAL 2022. [DOI: 10.1016/j.pdj.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
15
|
Singal K, Sharda S, Gupta A, Malik VS, Singh M, Chauhan A, Aggrawal A, Pradhan P, Singh M. Effectiveness of Calcium Phosphate derivative agents on the prevention and remineralization of caries among children- A systematic review & meta-analysis of randomized controlled trials. J Evid Based Dent Pract 2022; 22:101746. [DOI: 10.1016/j.jebdp.2022.101746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/07/2022] [Accepted: 05/01/2022] [Indexed: 12/30/2022]
|
16
|
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.
Collapse
|
17
|
Butera A, Maiorani C, Morandini A, Simonini M, Morittu S, Trombini J, Scribante A. Evaluation of Children Caries Risk Factors: A Narrative Review of Nutritional Aspects, Oral Hygiene Habits, and Bacterial Alterations. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020262. [PMID: 35204983 PMCID: PMC8870668 DOI: 10.3390/children9020262] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 11/18/2022]
Abstract
Dental caries is one of the most common diseases—both in adults and children—that occurs due to the demineralization of enamel and dentine by the organic acids formed from bacteria present in dental plaques through anaerobic metabolism of dietary sugars. The aim of this article is to provide a guideline to assess the risk of caries by looking for the main factors involved. Literature research was performed for studies that analyzed the factors most involved in the development of child caries, such as poor oral hygiene, bad eating habits (or food disorders), and an alteration of the oral bacterial flora—with an increase of Streptococci spp., Lactobacilli spp., Candida albicans, Cryptococcus neoformans, and Candida sake. It is therefore essential to assess the risk of caries in children, based on the assessment of risk factors, in order to be able to establish preventive and/or therapeutic approaches that will reduce or stop the development of dental caries. The use of fluoride products, products made from casein phosphopeptide-amorphous calcium phosphate, substituted zinc biomimetic hydroxyapatite products, or products containing self-assembling oligopeptide SAP-P11-4 are useful. In terms of the clinical approach, a communicative approach should be added to learn about the eating habits and the oral hygiene habits of the child and parents; in addition, the use of a simple method to frame the factors involved, and subsequently establish the risk of carious lesions in the child, allows the reduction of the DMFT (Decayed Missing Filled Teeth) or ICDAS (International Caries Detection and Assessment System) index on large scales.
Collapse
Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.)
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.)
| | | | - Manuela Simonini
- “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (S.M.); (J.T.)
| | - Stefania Morittu
- “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (S.M.); (J.T.)
| | - Julia Trombini
- “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (S.M.); (J.T.)
| | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| |
Collapse
|
18
|
Wahba N, Schwendicke F, Kamel MA, Allam G, Kabil N, Elhennawy K. Preventing and Arresting Primary Tooth Enamel Lesions Using Self- Assembling Peptide P 11-4 In Vitro. J Int Soc Prev Community Dent 2022; 12:58-70. [PMID: 35281691 PMCID: PMC8896585 DOI: 10.4103/jispcd.jispcd_257_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives To evaluate self-assembling peptides (SAP) for caries prevention and arrest in primary tooth enamel in vitro. Materials and Methods Overall, 180 extracted primary teeth were used. In the prevention experiment (n = 20 samples per group), self-assembling peptide for prevention (SAPP), fluoride varnish/mouthwash (FV/FMW), casein-phosphopeptide amorphous-calcium phosphate (CPP-ACP), and nanohydroxyapatite (nHA) were applied. Samples were subjected to a demineralizing pH cycling for 14 days. In the arrest experiment (n = 15/group), 60 samples were pre-demineralized; induced lesions were treated using self-assembling peptide for repair (SAPR), FV, CPP-ACP plus fluoride, and resin infiltration (RI) and submitted to pH cycling. Mineral loss and its differences as well as lesion depth were determined using transversal microradiography. Numerical data were tested for normality using Shapiro-Wilk's test and were compared using Kruskal-Wallis test followed by pairwise comparisons utilizing multiple Mann-Whitney U tests with Bonferroni correction. The significance level was set at P < 0.05 within all tests. Results FV (median: -46.3 [interquartile range: 175.52] vol% × µm) and FMW (-33.35 [124.65] vol% × µm) prevented caries significantly more effectively than all other groups (P < 0.001), which did not show significant preventive effects. RI (median: 4949.70 [1637.20] vol% × µm) and FV (median = 6076.05 [5190.08] vol% × µm) arrested lesions, whereas SAPR and CPP-ACPF did not show such arrest. Conclusions FV and FMW showed the largest caries-preventive effect, whereas RI and FV arrested lesion progression in primary tooth enamel in vitro.
Collapse
Affiliation(s)
- Nour Wahba
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité – Universitätsmedizin Berlin, Germany,Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt,Address for correspondence: Mrs. Nour Wahba, Pediatric Dentistry Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St, El-Qobba Bridge, Al Waili, Cairo Governorate, Egypt. E-mail:
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité – Universitätsmedizin Berlin, Germany
| | - Mohamed A Kamel
- Department of Operative Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Gehan Allam
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt,Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Noha Kabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt,Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité – Universitätsmedizin Berlin, Germany
| |
Collapse
|
19
|
Lamba G, Nagpal DI, Chowdhari P, Hotwani K, Gunwal MK. Oral Healthcare Management of Children after COVID-19 Outbreak. Int J Clin Pediatr Dent 2021; 14:293-297. [PMID: 34413609 PMCID: PMC8343668 DOI: 10.5005/jp-journals-10005-1906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The emergence of the novel 2019 coronavirus disease (COVID-19) pandemic has led to a significant challenge to healthcare professionals. Among all the healthcare providers, dental clinical setup is exposed to the generation of potentially hazardous aerosols which could be a point of cross-contamination. Dentists catering to pediatric patients need to take special precautions, as they have milder symptoms or could be asymptomatic and hence potential vectors for the transfer of infection. One needs to change the perspective to manage the oral health of children as a child's oral health presents specific problems that could be time-bound and hence need to be treated accordingly. These problems can be managed on one hand by preventive methods, and on the other by implementing specific protocols relating to the conditions that represent an emergency, or those situations that fall into the category of elective dental procedures. This article highlights the routes of transmission in a dental practice and focuses on the categorization of treatment for children based on treatment needs. It proposes a restructuring of the treatment protocol and hence shifting to minimal invasive or non-aerosol-generating procedures (AGP). These techniques are also proposed to be used even after the end of the current emergency period to minimize the aerosol splatter. Clinical significance The article highlights the protocol that needs to be followed after treatment categorization during and after COVID-19 pandemic. How to cite this article Lamba G, Nagpal DI, Chowdhari P, et al. Oral Healthcare Management of Children after COVID-19 Outbreak. Int J Clin Pediatr Dent 2021;14(2):293-297.
Collapse
Affiliation(s)
- Gagandeep Lamba
- Department Pediatric and Preventive Dentistry, VSPM's Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Devendra I Nagpal
- Department Pediatric and Preventive Dentistry, VSPM's Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Purva Chowdhari
- Department of Pediatric Dentistry, VSPM's Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Kavita Hotwani
- Department Pediatric and Preventive Dentistry, VSPM's Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Mohit K Gunwal
- Department of Conservative Dentistry and Endodontics, VSPM's Dental College and Research Centre, Nagpur, Maharashtra, India
| |
Collapse
|
20
|
de Oliveira PRA, Schubach da Costa Barreto L, Tostes MA. Effectiveness of CPP-ACP and Fluoride Products in Tooth Remineralization. Int J Dent Hyg 2021; 20:635-642. [PMID: 34392591 DOI: 10.1111/idh.12542] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/15/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the effectiveness of the casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP) in the in situ remineralization of enamel exposed to two different degrees of preformed enamel lesions. METHODS One hundred and sixty 3x3x2 mm human enamel slabs were demineralized and divided into two subgroups according to baseline surface hardness (SH=B1≤150 and B2 >150). During each of four 10-day experimental periods, 10 participants wore intraoral removable acrylic palatal expanders with four human enamel slabs with preformed lesions (B1 and B2): CO1 and CO2 - Control: silica dentifrice without fluoride; MP1 and MP2: MI Paste; MPP1 and MPP2: MI Paste Plus; and FD1 and FD2: Fluoride dentifrice. The Knoop hardness test (50/15s Micromet 2001, Buehler, IL, USA) was performed after demineralization (B1 and B2) and after treatment (T1 and T2). RESULTS SH was higher in all treatment groups when compared with the controls, except for CO2 (Mann Whitney Wilcoxon Test; p <0.05). %SH was similar between MPP2 and FD2 and between MPP2 and MP2; however, FD2 and MPP2 products were more effective in microhardness recovery. In B1, all treatment groups were similar. CONCLUSION MPP and FD are more effective in preventing demineralization in enamel subsurface lesions.
Collapse
|
21
|
Sharda S, Gupta A, Goyal A, Gauba K. Remineralization potential and caries preventive efficacy of CPP-ACP/Xylitol/Ozone/Bioactive glass and topical fluoride combined therapy versus fluoride mono-therapy - a systematic review and meta-analysis. Acta Odontol Scand 2021; 79:402-417. [PMID: 33459095 DOI: 10.1080/00016357.2020.1869827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare the remineralization potential and caries preventive efficacy of CPP-ACP/bioactive glass/xylitol/ozone and topical fluoride (TF) combined therapy versus TF mono-therapy. MATERIAL AND METHODS Embase, PubMed, Scopus, Web of Science and Cochrane databases were searched. 4457 records were screened and 26 trials were included. Data from 16 trials was pooled using Review Manager 5.4. Level of significance was p < .05. The certainty of the evidence was evaluated using GRADE. RESULTS Pooled analysis of two trials for white spot lesions (WSLs) regression (SMD -0.6, 95% CI: [-1.07 to -0.14], p = .01) and three trials for post-intervention DIAGNOdent values (SMD -1.24, 95% CI: [-1.96 to -0.52], p = .0007) significantly favoured CPP-ACP-TF combined therapy over TF mono-therapy. The sub-group analysis for caries increment (SMD -0.14, 95% CI: [-0.21 to -0.07], p < .0001) and the post intervention S mutans count (SMD -0.42, 95% CI: [-0.62 to -0.23], p < .0001) significantly favours 'xylitol-TF' and 'CPP-ACP-TF' combined therapy respectively. The high/unclear risk of bias, imprecision and indirectness of the included trials presented a low certainty of evidence. CONCLUSION CPP-ACP-TF exhibits superiority over TF monotherapy in remineralizing existing lesions and demonstrates better antibacterial effect, whereas it is not more effective for preventing caries incidence. However, Xylitol exerts an added benefit over fluoride alone in preventing caries increment. The low-certainty evidence highlights the need for more good quality trials.
Collapse
Affiliation(s)
- Shweta Sharda
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arpit Gupta
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashima Goyal
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Gauba
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
22
|
Yavuz BS, Kargul B. Comparative evaluation of the spectral-domain optical coherence tomography and microhardness for remineralization of enamel caries lesions. Dent Mater J 2021; 40:1115-1121. [PMID: 33980748 DOI: 10.4012/dmj.2020-279] [Citation(s) in RCA: 3] [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
This study aimed to evaluate the Cirrus high-definition (HD) spectral-domain optical coherence tomography (SD-OCT) for the remineralization of artificial enamel caries and to compare it with the comparison surface microhardness (SMH) analysis. Artificial caries lesions were produced on forty human enamel samples. Then, three different remineralization agents containing casein phosphopeptide amorphous calcium phosphate; casein phosphopeptide amorphous calcium fluoride phosphate; calcium glycerophosphate, magnesium chloride, and xylitol; and remineralization solution (control) were applied with pH cycling for six days. The optical depth of backscattered light and microhardness of enamel were measured using SD-OCT and SMH. All remineralization agents were significantly efficient in reducing optical lesion depth on enamels (p1=0.001, p2=0.002, p3=0.006, p4=0.025), and in increasing the SMH of enamels (p1-3=0.005, p4=0.017). However, the optical lesion depths of the enamel showed no correlation with the SMH in the groups. In conclusion, demineralization and remineralization of artificial lesions can be assessed with both SD-OCT and SMH.
Collapse
Affiliation(s)
- Betul Sen Yavuz
- Department of Pediatric Dentistry, School of Dental Medicine, Bahcesehir University
| | - Betul Kargul
- Department of Pediatric Dentistry, School of Dentistry, Marmara University
| |
Collapse
|
23
|
Niu LN, Jiao K, Fang M, Chen JH. [Application of biomimetic restoration in oral-maxillofacial hard tissue repair]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:129-135. [PMID: 33834666 DOI: 10.7518/hxkq.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Oral-maxillofacial hard tissue is the support of maxillofacial structure and appearance, and lays the foundation for functions of oral and maxillofacial system. Once the defect occurs, it will not only affect the physiological functions such as chewing and pronunciation, but also have a significant impact on the psychological and social life of patients. However, the self-repairing capability of the oral-maxillofacial hard tissue is pretty limited, in which case, substitute materials are required for tissue repair. A huge gap exists between the physical, chemical, structural characteristics of conventional substitute materials and those of human hard tissues, resulting in poor repair effect. Based on this, scholars simulated the process of biomineralization in the development of hard tissues, to improve the structure and function of materials through biomimetic mineralization technology and enhance the repair performance of materials. The current understanding of biomineralization theory and the construction of biomimetic repair technology is still in the stage of rapid development. In recent years, a mass of innovative studies are keeping emerging. In this review, the representative advances in the repair of oral-maxillofacial hard tissues of the past five years are reviewed.
Collapse
Affiliation(s)
- Li-Na Niu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Key Laboratory of Stomatology, School of Stomatology, Air Force Medical University, Xi,an 710032, China
| | - Kai Jiao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Key Laboratory of Stomatology, School of Stomatology, Air Force Medical University, Xi,an 710032, China
| | - Ming Fang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Key Laboratory of Stomatology, School of Stomatology, Air Force Medical University, Xi,an 710032, China
| | - Ji-Hua Chen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Key Laboratory of Stomatology, School of Stomatology, Air Force Medical University, Xi,an 710032, China
| |
Collapse
|
24
|
Sionov RV, Tsavdaridou D, Aqawi M, Zaks B, Steinberg D, Shalish M. Tooth mousse containing casein phosphopeptide-amorphous calcium phosphate prevents biofilm formation of Streptococcus mutans. BMC Oral Health 2021; 21:136. [PMID: 33740976 PMCID: PMC7980609 DOI: 10.1186/s12903-021-01502-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/08/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Streptococcus mutans is a common cariogenic bacterium in the oral cavity involved in plaque formation. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been introduced into tooth mousse to encourage remineralization of dental enamel. The aim of this research was to study the effect of tooth mousse containing CPP-ACP (GC Tooth Mousse®) or CPP-ACP with 0.2% fluoride (CPP-ACPF; GC Tooth Mousse Plus®; GCP) on S. mutans planktonic growth and biofilm formation. METHODS S. mutans was cultivated in the presence of different dilutions of the tooth mousse containing CPP-ACP or CPP-ACPF, and the planktonic growth was determined by ATP viability assay and counting colony-forming units (CFUs). The resulting biofilms were examined by crystal violet staining, MTT metabolic assay, confocal laser scanning microscopy (CLSM), and scanning electron microscope (SEM). RESULTS The CPP-ACP tooth mousse (GC) at a dilution of 5-50 mg/ml (0.5-5%) did not inhibit planktonic growth, and even increased the ATP content and the number of viable bacteria after a 24 h incubation. The same was observed for the CPP-ACPF tooth mousse (GCP), except for the higher concentrations (25 and 50 mg/ml) that led to a drop in the bacterial count. Importantly, both compounds significantly decreased S. mutans biofilm formation at dilutions as low as 1.5-3 mg/ml. 12.5 mg/ml GC and 6.25 mg/ml GCP inhibited biofilm formation by 90% after 4 h. After 24 h, the MBIC90 was 6.25 mg/ml for both. CLSM images confirmed the strong inhibitory effect GC and GCP had on biofilm formation when using 5 mg/ml tooth mousse. SEM images of those bacteria that managed to form biofilm in the presence of 5 mg/ml tooth mousse, showed alterations in the bacterial morphology, where the streptococci appear 25-30% shorter on the average than the control bacteria. CONCLUSION Our data show that the tooth mousse containing CPP-ACP reduces biofilm formation of the cariogenic bacterium S. mutans without killing the bacteria. The use of natural substances which inhibit biofilm development without killing the bacteria, has therapeutic benefits, especially in orthodontic pediatric patients.
Collapse
Affiliation(s)
- Ronit Vogt Sionov
- The Biofilm Research Laboratory, The Faculty of Dental Medicine, The Institute of Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Danae Tsavdaridou
- The Biofilm Research Laboratory, The Faculty of Dental Medicine, The Institute of Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
- International Postgraduate Program, Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
- Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Muna Aqawi
- The Biofilm Research Laboratory, The Faculty of Dental Medicine, The Institute of Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Batya Zaks
- The Biofilm Research Laboratory, The Faculty of Dental Medicine, The Institute of Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Doron Steinberg
- The Biofilm Research Laboratory, The Faculty of Dental Medicine, The Institute of Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Miriam Shalish
- Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| |
Collapse
|
25
|
Sbaraini A, Adams GG, Reynolds EC. Experiences of oral health: before, during and after becoming a regular user of GC Tooth Mousse Plus ®. BMC Oral Health 2021; 21:14. [PMID: 33413323 PMCID: PMC7792129 DOI: 10.1186/s12903-020-01360-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/09/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Clinical trials and laboratory studies from around the world have shown that GC Tooth Mousse Plus® (TMP) is effective in protecting teeth from tooth decay and erosion, buffering dental plaque pH, remineralising white spot lesions and reducing dentine hypersensitivity. However, no other study has assessed the experiences of oral health, before, during and after individuals becoming regular users of TMP. The aim of this study was to identify how participants' oral health status changed after introducing TMP into their oral hygiene routine. METHODS A qualitative study using Charmaz's grounded theory methodology was conducted. Fifteen purposively sampled regular users of TMP were interviewed. Transcripts were analysed after each interview. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation. RESULTS Participants described their experiences of oral health and disease, before, during and after introducing TMP into their daily oral hygiene routine, together with the historical, biological, financial, psychosocial, and habitual dimensions of their experiences. Before becoming a regular user of TMP, participants described themselves as having a damaged mouth with vulnerable teeth, dry mouth, and sensitivity. Various aspects of participants' histories were relevant, such as, family history and history of oral disease. Having a damaged mouth with vulnerable teeth, dry mouth and sensitivity was explained by those elements. Despite some initial barriers, once being prescribed TMP by a dental professional, a three-fold process of change was initiated: starting a new oral hygiene routine, persevering daily, and experiencing reinforcing outcomes. This process led to a fundamental lifestyle change. Participants transitioned from having a damaged mouth with vulnerable teeth to having a comfortable mouth with strong teeth; at the same time participants felt empowered by this newly found status of being able to keep their teeth for life. Barriers and facilitators for incorporating TMP on daily oral hygiene routine were also identified. CONCLUSIONS Participants valued having a comfortable mouth with strong teeth, which did not require repeated restorations. Seeing concrete results in their mouths and experiencing a more comfortable mouth boosted adherence to daily applications of TMP, which was maintained over time.
Collapse
Affiliation(s)
- Alexandra Sbaraini
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Geoffrey G. Adams
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Eric C. Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
| |
Collapse
|
26
|
Darroudi M, Rangrazi A, Ghazvini K, Bagheri H, Boruziniat A. Antimicrobial Activity of Colloidal Selenium Nanoparticles in Chitosan Solution against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
27
|
Shen P, Zalizniak I, Palamara JE, Burrow MF, Walker GD, Yuan Y, Reynolds C, Fernando JR, Reynolds EC. Recharge and increase in hardness of GIC with CPP-ACP/F. Dent Mater 2020; 36:1608-1614. [DOI: 10.1016/j.dental.2020.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/29/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022]
|
28
|
Shen P, Fernando JR, Walker GD, Yuan Y, Reynolds C, Reynolds EC. Addition of CPP-ACP to yogurt inhibits enamel subsurface demineralization. J Dent 2020; 103:103506. [PMID: 33115668 DOI: 10.1016/j.jdent.2020.103506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/28/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the capacity of an approved food additive with anticariogenic properties, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), when added to a processed, sugar-containing yogurt with added lactic-acid bacteria (probiotics), to prevent demineralization of enamel subsurface lesions in vitro. METHODS Enamel subsurface demineralised lesions were created in thirty extracted human third molars. These were then exposed to artificial saliva (AS) with: 1) Danone yogurt alone; 2) Danone yogurt with 0.2 % w/w CPP-ACP; or 3) Danone yogurt with 0.5 % w/w CPP-ACP at 37 °C for two weeks. The yogurt/AS was replaced with fresh preparations each day. At the completion of each treatment the enamel slabs were embedded, sectioned and analyzed using transverse microradiography to measure changes in enamel lesion depths and subsurface mineral content. Yogurt samples were analysed for soluble calcium (Ca) and inorganic phosphate (Pi) levels and pH. RESULTS Yogurt alone demineralized enamel subsurface lesions to produce significantly larger lesions. However, the addition of 0.2 % CPP-ACP to the yogurt resulted in significant reduction in demineralization compared with yogurt alone (p < 0.0001). The addition of 0.5 % CPP-ACP to the yogurt produced a net remineralization effect with a significant increase in lesion mineral content (p < 0.0001). The addition of CPP-ACP resulted in a significant (p < 0.0001) dose-related increase in Ca, Pi and pH. CONCLUSIONS The addition of CPP-ACP to a commercial yogurt exhibited a dose related protective effect with 0.5 % CPP-ACP producing remineralization of existing enamel subsurface lesions under the in vitro experimental conditions. CLINICAL SIGNIfiCANCE: The results of this study suggest that some processed yogurts with added sugar could result in enamel demineralization when frequently consumed by individuals with poor oral hygiene. The addition of CPP-ACP to these yogurts may help prevent demineralization and promote enamel subsurface lesion remineralization, and therefore, make them safer for teeth.
Collapse
Affiliation(s)
- Peiyan Shen
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - James R Fernando
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Glenn D Walker
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yi Yuan
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Coralie Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eric C Reynolds
- Centre for Oral Health Research, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia.
| |
Collapse
|
29
|
Biomimetic Aspects of Oral and Dentofacial Regeneration. Biomimetics (Basel) 2020; 5:biomimetics5040051. [PMID: 33053903 PMCID: PMC7709662 DOI: 10.3390/biomimetics5040051] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 12/12/2022] Open
Abstract
Biomimetic materials for hard and soft tissues have advanced in the fields of tissue engineering and regenerative medicine in dentistry. To examine these recent advances, we searched Medline (OVID) with the key terms “biomimetics”, “biomaterials”, and “biomimicry” combined with MeSH terms for “dentistry” and limited the date of publication between 2010–2020. Over 500 articles were obtained under clinical trials, randomized clinical trials, metanalysis, and systematic reviews developed in the past 10 years in three major areas of dentistry: restorative, orofacial surgery, and periodontics. Clinical studies and systematic reviews along with hand-searched preclinical studies as potential therapies have been included. They support the proof-of-concept that novel treatments are in the pipeline towards ground-breaking clinical therapies for orofacial bone regeneration, tooth regeneration, repair of the oral mucosa, periodontal tissue engineering, and dental implants. Biomimicry enhances the clinical outcomes and calls for an interdisciplinary approach integrating medicine, bioengineering, biotechnology, and computational sciences to advance the current research to clinics. We conclude that dentistry has come a long way apropos of regenerative medicine; still, there are vast avenues to endeavour, seeking inspiration from other facets in biomedical research.
Collapse
|
30
|
Cianetti S, Pagano S, Nardone M, Lombardo G. Model for Taking Care of Patients with Early Childhood Caries during the SARS-Cov-2 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3751. [PMID: 32466392 PMCID: PMC7312964 DOI: 10.3390/ijerph17113751] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/21/2020] [Accepted: 05/24/2020] [Indexed: 12/19/2022]
Abstract
Pending the availability of vaccines to contain the SARS-CoV-2 pandemic, the current solution is "social distancing" with a reduction of dental treatments to those assessed as urgent and emergency cases. These treatments also involve Early Childhood Caries (ECC) due to the fact that this disease affects preschool children (a vulnerable population) and, in addition, shows a propensity to evolve into more serious complications (dental pain, infections). A narrative review was carried out to support a protocol for treating ECC with efficacious and safe (in terms of SARS-CoV-2 transmission) procedures. Protocol involves criteria for patients' selection remotely (telemedicine), and well-detailed criteria/equipment and hygiene procedures to combat against SARS-CoV-2 transmission. Moreover, the protocol proposes innovative caries treatments, named Minimally Invasive Treatments (MITs), well known in pedodontics for their high level of children's acceptance during dental care. MITs allow for caries removal (particularly in primary teeth) without any high-speed rotating instrument cooled with nebulized air-water spray (with high risk of virus environmental diffusion), usually adopted during traditional treatments. For evaluating MITs effectiveness in caries management, only Systematic Review and Randomized Controlled Trials (RCTs) were included in our study, without any risk of bias assessment. The indications proposed in this protocol could support clinicians for the temporary management of ECC until the SARS-CoV-2 pandemic ends.
Collapse
Affiliation(s)
- Stefano Cianetti
- Biomedical Sciences, Unit of Paediatric Dentistry, University of Perugia, 06100 Perugia, Italy; (S.C.); (G.L.)
| | - Stefano Pagano
- Biomedical Sciences, Unit of Paediatric Dentistry, University of Perugia, 06100 Perugia, Italy; (S.C.); (G.L.)
| | - Michele Nardone
- Azienda Socio-Sanitaria Territoriale, Melegnano e della Martesana, 20070 Milano, Regione Lombardia, Italy;
| | - Guido Lombardo
- Biomedical Sciences, Unit of Paediatric Dentistry, University of Perugia, 06100 Perugia, Italy; (S.C.); (G.L.)
| |
Collapse
|
31
|
Gümüş H, Aydınbelge M, Sönmez H. Evaluation of the Efficacy of Different Remineralizing Agents on Artificial Early Enamel Lesions of Primary Teeth: An In Vitro Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820919664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: To analyze the remineralization efficacy of casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) and 8% arginine on artificial early enamel lesions on primary teeth enamel samples. Materials and Methods: In this in vitro study, artificial enamel lesions were created in 120 primary teeth. Teeth were randomly divided into 5 groups: group C: CPP–ACP paste; group CF: CPP–ACPF paste with 900 ppm flour; group A: paste with 8% arginine; group K+: 500 ppm NaF as a positive control; and group K–: deionized water as a negative control. After 4 weeks of the remineralization process, the effect of remineralization on samples of agents used the microhardness, atomic force microscope, and scanning electron microscope analyses. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS version 20.0, SPSS Inc., Chicago, IL, USA). ANOVA and Tukey Post-Hoc multiple comparison test were applied ( p < .05). Results: Increasing percentage values of the microhardness at groups C, CF, and A were significantly better than group K– ( p < .05), whereas there is no statistically significant difference with group K+ ( p > .05). The average surface roughness values of groups C and CF were similar with group K+ in AFM analysis, whereas average surface roughness values of group A were significantly higher than K+ group. Conclusion: The CPP–ACP, CPP–ACPF, and arginine are effective agents for remineralization of early childhood caries lesions.
Collapse
Affiliation(s)
- Hüsniye Gümüş
- Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Mustafa Aydınbelge
- Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Hayriye Sönmez
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| |
Collapse
|