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Shah SA, Sharma M, Ismail PMS, Babaji P, Mohammed A, Malik B, Mandal A. Evaluation of Remineralizing Capacity of Tricalcium Phosphate, Nano-Hydroxyapatite and Ozone Remineralizing Agents on the Artificial Carious Lesion. Indian J Dent Res 2024; 35:84-87. [PMID: 38934756 DOI: 10.4103/ijdr.ijdr_704_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/03/2023] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Dental caries is a dynamic process. By using therapeutic agents, early, noncavitated lesions and caries limited to the enamel can be stopped or even remineralized. For the remineralization of the initial carious lesion, many nonfluoridated remineralizing agents were investigated. OBJECTIVES An observational study to assess the remineralizing efficacy of tricalcium phosphate (TCP), nano-hydroxyapatite (nHAp) and ozone remineralizing agents on the artificial carious lesion. METHODOLOGY In this observational research, the artificial carious lesion was produced on extracted 40 premolar teeth. Later, remineralizing agents (Group A: nHAp, Group B: TCP, Group C: Ozone remineralizing agents, Group D: Control group (Deionized water) were used to remineralize demineralized teeth. Utilizing the Vickers Hardness Number, the level of demineralization and remineralization was assessed. Later these readings were statistically assessed using the Tukey's HSD (honestly significant difference) and ANOVA tests in SPSS version 21.0. The P value was set at 0.05 or less. RESULTS After demineralization, there was a decrease in enamel microhardness values, with 32% in Group A, 26% in Group B, 22% in Group C, and 21% in Group D, respectively. From the baseline to demineralization, there was a statistically significant decrease in microhardness across all groups. After remineralization, Groups A, B, and C experienced an increase in microhardness while Group D experienced no changes. This showed that Group A had the highest remineralization percentage, followed by Group B and Group C. CONCLUSION nHAp and TCP had the greater remineralizing ability, which can be used to manage initial carious lesions.
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Affiliation(s)
- Shahzad Ali Shah
- Department of Restorative Dentistry, College of Dentistry, Ar Rass College of Applied Health Sciences, Qassim University, Saudi Arabia
| | - Mehak Sharma
- Department of Conservative Dentistry and Endodontics, Swami Devi Dyal Hospital and Dental College, Panchakula, Haryana, India
| | - Prabu Mahin Syed Ismail
- Department of Restorative Dentistry, College of Dentistry, Ar Rass College of Applied Health Sciences, Qassim University, Saudi Arabia
| | - Prashant Babaji
- Department of Pediatric Dentistry, Sharavathi Dental College and Hospital, Shimogaa, Karnataka, India
| | - Azhar Mohammed
- Department of Orthodontics and Dentofacial Orthopaedics, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Bhavna Malik
- Department of Dentistry, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India
| | - Ananyo Mandal
- Department of Conservative Dentistry and Endodontics, Kusum Devi Sunderlal Dugar Jain Dental College, Kolkata, West Bengal, India
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Serdar Eymirli P, İleri T, Ergin E, Turgut MD. Evaluation of ER;CR:YSGG Laser and Remineralization Agents on Mineral Density and Ion Levels of Primary and Permanent Enamel. Photobiomodul Photomed Laser Surg 2024; 42:81-89. [PMID: 38252494 DOI: 10.1089/photob.2023.0107] [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] [Indexed: 01/24/2024] Open
Abstract
Objective: The aim of this study is to evaluate the efficacy of two different fluoride varnishes used alone or in combination with laser treatment on permanent and primary tooth enamel. Methods: Ninety-six primary and 96 permanent molar samples were divided into six groups. The levels of calcium, phosphorus, fluoride, and silver ions of each sample were analyzed using energy-dispersive X-ray spectroscopy (EDS). Six different treatments were applied to 12 different groups (n = 15) as control (g1/G1), fluoride varnish (g2/G2), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-fluoride varnish (g3/G3), laser (g4/G4), laser+fluoride varnish (g5/G5), and laser+CPP-ACP-fluoride varnish (g6/G6). After the procedures, ion levels were reanalyzed with EDS. The teeth were subjected to the artificial caries-forming procedure and ion levels were again evaluated by EDS. One sample from each group was prepared separately for the focused ion beam-scanning electron microscope measurement; initial and final images were recorded. The obtained data were statistically analyzed with the SPSS 23.0 program. Results: Compared with the initial measurement, phosphorus percentages increased in most of the groups in the last measurement. Calcium percentages of primary teeth increased in the last measurement, except for the g1 group, but in permanent teeth, there was an increase only in the G6 group. There was a statistically significant difference between g1/G1 and g6/G6 groups in the last measurement of phosphorus and calcium percentages. Conclusions: The combined use of laser with CPP-ACP-fluoride varnish enhanced remineralization in the primary and permanent teeth. However, in permanent teeth, the use of laser alone was not as effective as in primary teeth. Therefore, combined usage with CPP-ACP-fluoride varnish can enhance its efficacy. This in vitro study was approved by the local ethics committee of Hacettepe University (Project No.: GO 20/441).
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Affiliation(s)
- Pınar Serdar Eymirli
- Department of Pediatric Dentistry and School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Tülin İleri
- Department of Pediatric Dentistry and School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Esra Ergin
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Ankara, Turkey
- Hacettepe University Dental Laser Application and Research Center, Ankara, Turkey
| | - Melek Dilek Turgut
- Department of Pediatric Dentistry and School of Dentistry, Hacettepe University, Ankara, Turkey
- Hacettepe University Dental Laser Application and Research Center, Ankara, Turkey
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Ghilotti J, Mayorga P, Sanz JL, Forner L, Llena C. Remineralizing Ability of Resin Modified Glass Ionomers (RMGICs): A Systematic Review. J Funct Biomater 2023; 14:421. [PMID: 37623665 PMCID: PMC10455182 DOI: 10.3390/jfb14080421] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
The selective caries removal approach leads to the need to use materials with the ability to remineralize remaining partially demineralized dentin. Among the materials proposed are resin-modified glass ionomer cements (RMGICs). The aim of this systematic review was to evaluate, based on in vitro experimental studies, whether RMGICs are suitable for remineralizing affected dentin. A systematic literature search was performed in four databases, followed by article selection, data extraction, and quality assessment. Studies assessing the remineralizing potential of RMGICs on dentin were included in our review. Studies which compared such properties between different RMGICs or with other materials were also eligible. The studies report the remineralizing ability of RMGICs, albeit with differences between different commercial products. RMGICs show a similar ability to conventional GICs to remineralize affected dentin, fulfilling the function for which they are designed. Moreover, the incorporation of additives, such as bioactive glass (BAG) or CCP-ACP, improves their remineralizing potential. The results of this review support the use of RMGICs as restorative materials after selective caries removal.
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Affiliation(s)
| | | | - José Luis Sanz
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain
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Mashhour A, Allam G, Wassel M. Comparative evaluation of prevention of demineralization of artificial enamel caries treated with two fluoride varnishes and 38% SDF in primary teeth: an in vitro study. BMC Oral Health 2023; 23:110. [PMID: 36803462 PMCID: PMC9938617 DOI: 10.1186/s12903-023-02799-1] [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: 09/10/2022] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND This study aimed to compare the effect of Clinpro™ White varnish containing 5% sodium fluoride (NaF) and functionalized tricalcium phosphate, MI varnish containing 5% NaF and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 38% Silver diamine fluoride (SDF) in preventing demineralization of treated white spot lesions (WSLs) in enamel of primary teeth. METHODS Forty-eight primary molars with artificial WSLs were allocated into four groups as follows: Group 1: Clinpro white varnish, Group 2: MI varnish, Group 3: SDF, and Group 4: control (no treatment). The three surface treatments were applied for 24 h and then enamel specimens were subjected to pH cycling. Thereafter, the mineral content of specimens was evaluated by Energy Dispersive X-ray Spectrometer and the lesion depth was assessed via Polarized Light Microscope. One-way ANOVA followed by Tukey's post hoc test were used at p ≤ 0.05 to identify significant differences. RESULTS Insignificant difference in mineral content was observed among treatment groups. Treatment groups exhibited significantly higher mineral content compared to control except for Fluoride (F). MI varnish showed the highest mean calcium (Ca) ion content (66.57 ± 0.63), and Ca/P (2.19 ± 0.11), followed by Clinpro white varnish, and SDF. MI varnish also displayed the highest phosphate (P) ion content (31.46 ± 0.56), followed by SDF (30.93 ± 1.02), and Clinpro white varnish (30.53 ± 2.19). Fluoride content was highest in SDF (0.93 ± 1.18), followed by MI (0.89 ± 0.34) and Clinpro (0.66 ± 0.68) varnishes. Significant difference in lesion depth was observed among all groups (p < 0.001). The lowest mean lesion depth (µm) was found in MI varnish (226.23 ± 44.25) which was significantly lower than Clinpro white varnish (285.43 ± 44.70), SDF (293.32 ± 46.82), and control (576.69 ± 42.66). Insignificant difference in lesion depth was found between SDF and Clinpro varnish. CONCLUSIONS In primary teeth, WSLs treated with MI varnish displayed better resistance to demineralization compared to WSLs treated with Clinpro white varnish and SDF.
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Affiliation(s)
- Alshaimaa Mashhour
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566, Egypt.
| | - Gehan Allam
- grid.7269.a0000 0004 0621 1570Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566 Egypt
| | - Mariem Wassel
- grid.7269.a0000 0004 0621 1570Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566 Egypt
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Turkay EY, Kargul B, Aydinoglu AK, Yoruc ABH. Evaluation of different remineralization agents in the treatment of natural caries-affected dentin in permanent teeth. Biomed Mater Eng 2023; 34:133-142. [PMID: 36120758 DOI: 10.3233/bme-221396] [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: 11/15/2022]
Abstract
BACKGROUND In the preventive treatment protocol, providing remineralization of the tissue in demineralized dentin caries is an important step. OBJECTIVE In this in vitro study, the effectiveness of remineralization agents in natural caries-affected dentin (NCAD) were investigated. METHODS Forty caries slices were prepared from permanent molar dentin with International Caries Detection and Assessment System (ICDAS 2) (Code 3). The interventions with 8 days pH cycling were as follows: Deionized water (DW); 5% Sodium Fluoride (5% NaF) Varnish; Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate (CPP-ACFP); Calcium Glyserophosphate (CaGP) + Magnesium (Mg) + Xylitol. DIAGNOdent (Laser Fluorescence, LF), Surface Microhardness (SMH), and X-ray Fluorescence (XRF) Spectroscopy measurements were calculated before and after pH cycling. RESULTS LF values decreased between 5% NaF, CCP-ACFP and CaGP. NCAD treated with 5% NaF, CaGP and CCP-ACFP exhibited statistically higher hardness compared to the control group. After 5% NaF application, SMH values were significantly higher than the others. There was no statistically significant difference between baseline and after pH cycling hardness of the control group. After cycling, XRF showed that Ca and P concentrations were increased in all groups. CONCLUSION The application of agents used in the study could be recommended and promoted as a treatment option of caries dentin for conventional management of caries.
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Affiliation(s)
| | - Betul Kargul
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Aysu Karakas Aydinoglu
- Metallurgical and Materials Engineering Department, Chemistry and Metallurgy Faculty, Yildiz Technical University, Istanbul, Turkey
| | - Afife Binnaz Hazar Yoruc
- Metallurgical and Materials Engineering Department, Chemistry and Metallurgy Faculty, Yildiz Technical University, Istanbul, Turkey
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Elashwah M, Elezz AFA, Safy RK. Correlation between Two Evaluation Methods for the Effect of Two Desensitizing Materials: An In Vitro Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8494] [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 was conducted to assess the efficiency of enamel matrix derivative (EMD) on dentin remineralization at two different application times.
MATERIALS AND METHODS: Thirty-two human dentin specimens of 1 mm thickness were prepared and randomly divided into two groups according to the treatment material (M) used: fluoride varnish with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (M1) and Enamel matrix derivative (EMD) (M2). Following treatment, each group was subdivided into two subgroups (n = 8) based on the storage time in artificial saliva into: (S); subgroup (S1); storage for 15 days and subgroup (S2); storage for 30 days. Dentin permeability was measured for all specimens at baseline and after applying the treatment protocol. All specimens were photomicrographed using ESEM before and after the treatment protocol.
RESULTS: The highest permeability reduction percent mean value was recorded for M1S2 specimens (90% ± 20), with a statistically significant difference with other subgroups, followed by subgroup M2S2 (56% ± 8) and subgroup M1S1 (51% ± 11), respectively. Meanwhile, the subgroup M2S1 had the lowest mean value (36% ± 9). In addition, the dentin permeability test was confirmed by the ESEM results.
CONCLUSION: EMD could be used as a promising remineralizing agent for dentin remineralization.
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Kumar A, Goyal A, Gauba K, Kapur A, Singh SK, Mehta SK. An evaluation of remineralised MIH using CPP-ACP and fluoride varnish: An in-situ and in-vitro study. Eur Arch Paediatr Dent 2022; 23:79-87. [PMID: 34057698 DOI: 10.1007/s40368-021-00630-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 05/05/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Molar incisor hypomineralization (MIH) affected teeth have enamel with altered mineral content like decreased calcium and phosphorus and increased carbon content leading to porous enamel and subsequent post-eruptive breakdown. AIM An in situ study was conducted to evaluate and compare the effects of a Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP)-based cream and fluoride varnish on the remineralization of MIH affected teeth. METHODS Enamel slabs were prepared from MIH affected teeth that had been extracted for various reasons and inserted in appliances of 30 participants who were undergoing interceptive orthodontic therapy. They were randomly divided into two groups using block randomization technique: Group A-daily single application of CPP-ACP cream (n = 15); Group B-professional application of fluoride varnishes every 3 months (n = 15). After 6 months of regular wear of the appliance, the enamel slabs were placed under Field Emission Scanning Microscope (FESEM) and Energy-Dispersive Spectroscopy (EDS) for evaluation of ultra structure and mineral content, respectively. RESULTS A significant increase in calcium and phosphorus content, and a decrease in carbon content was observed within the 6 months period, suggesting remineralization in both the groups. On comparing the Ca:P and Ca:C ratios, a significant increase in the Ca:C ratio was evident in the two groups. No significant difference was seen in the Ca:P ratio in the CPP-ACP group at six months. The inter-group comparison did not reveal any significant difference between the two groups either at baseline or at 6 months post-intervention. CONCLUSION Remineralization can be achieved in MIH affected teeth with the use of remineralizing agents.
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Affiliation(s)
- A Kumar
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Goyal
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K Gauba
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kapur
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S K Singh
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - S K Mehta
- Punjab University, Chandigarh, India
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Yadav R, Bharti D, Tikku A, Verma P, Shakya V, Pandey P. Comparative evaluation of remineralizing effect of fluoride and nonfluoride agents on artificially induced caries using different advanced imaging techniques. J Conserv Dent 2022; 25:26-31. [PMID: 35722071 PMCID: PMC9200184 DOI: 10.4103/jcd.jcd_426_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/12/2021] [Accepted: 12/21/2021] [Indexed: 11/22/2022] Open
Abstract
Aim: The aim of the study is to evaluate and compare the in-vitro remineralization efficacy of remineralizing agents, i.e., fluoride-free toothpaste, fluoride toothpaste, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), CPP-amorphous calcium fluoride phosphate (CPP ACFP), and silver diamine fluoride (SDF) paste on dentine over time. Methodology: Seventy-five extracted human permanent molars were selected. The buccal section of these samples was shaped into a slab. Artificial caries was induced by dipping the samples into the demineralizing solution (pH 4.5) for 21 days. They were then divided into five groups (n = 15). Each experimental group underwent one of the following treatments: Group 1 – Fluoride-free toothpaste (negative control), Group 2 – Fluoride toothpaste (positive control), Group 3 – CPP-ACP, Group 4 – CPP-Amorphous Calcium fluoride Phosphate and Group 5 – SDF. Postremineralizing treatment, Scanning electron microscope, Energy dispersive X-ray and Quantitative light induced fluorescence imaging were carried out to analyze the remineralizing efficacy. The data obtained was then subjected to statistical analysis using ANOVA and Paired t-tests. Results: It was seen that SDF showed highest remineralization efficacy followed by CPP-amorphous calcium fluoride phosphate, CPP-ACP, fluoride toothpaste and fluoride-free toothpaste. The difference in mean value among the groups was statistically significant (P < 0.001). Conclusion: SDF showed the highest remineralizing potential in scanning electron microscopy and energy dispersive X-ray, followed by CPP-ACFP, CPP-ACP, Fluoride toothpaste, and Fluoride-free toothpaste. Quantitative light fluorescence analysis showed more fluorescence changes in the CPP-ACFP followed by CPP-ACP, Fluoride toothpaste, and Fluoride-free toothpaste.
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Manas A, Jena D, Venkateswararao CH, Salama M, Syed Ismail P, Basha S. Comparative evaluation of efficacy of bioactive glass, tricalcium phosphate, and ozone remineralizing agents on artificial carious lesion. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S959-S961. [PMID: 36110679 PMCID: PMC9469230 DOI: 10.4103/jpbs.jpbs_117_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives: Evaluation of efficacy of bioactive glass (BAG), tricalcium phosphate, and ozone remineralizing agents on artificial carious lesion. Materials and Methods: Freshly extracted 48 human premolar teeth were included for this in vitro study. Remineralization of demineralized teeth was done with respective remineralizing agents (Group A – calcium sodium phosphosilicate [BAG], Group B – tricalcium phosphate [Clinpro Tooth Crème], Group C – ozone remineralizing agents, and control group: Group D – deionized water) three times a day for 12 days for 4 min. The degree of demineralization and remineralization was evaluated with Vickers hardness number. Results: There was a decrease in microhardness from baseline to demineralization in all the groups. The difference in microhardness values from demineralization to remineralization in all the three test groups was found to be statistically highly significant. Conclusion: BAG and Tricalcium phosphate had higher remineralizing capacity, which can be used clinically to treat early carious lesions.
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Abdel-Azem HM, Elezz AFA, Safy RK. Effect of Galla Chinensis on Remineralization of Early Dentin Lesion. Eur J Dent 2020; 14:651-656. [PMID: 33003237 PMCID: PMC7541333 DOI: 10.1055/s-0040-1716778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective
This study aimed to investigate the efficacy of the Galla chinensis extract (GCE) on early dentin lesion remineralization.
Materials and Methods
Seventy-two dentin specimens were divided into three groups according to the treatment solution. In group S1, specimens were treated with GCE; in group S2, the specimens were treated with sodium fluoride (NaF); meanwhile, specimens of group S3 were treated with distilled water (DW). Each group was further subdivided into two subgroups according to the treatment time (1 minute and 5 minutes). An
in vitro
pH-cycling model for 12 days was done. Subsequently, surface microhardness (SMH) of the specimens, elemental analysis, and their micromorphological appearance were evaluated.
Statistical Analysis
Data were statistically analyzed. One-way analysis of variance was used to compare numerical (parametric) data between more than two separate groups followed by post hoc Tukey.
Results
There was no significant difference between the mean SMH of dentin between NaF and GCE groups. Regarding the time, the 5-minute treatment with NaF and DW groups recorded higher mean SMH value of dentin than the 1-minute treatment group. Meanwhile, for GCE groups, the 1-minute immersion recorded higher mean SMH value than the 5-minute immersion without any significant difference between them. The microhardness results were confirmed by environmental scanning electron microscope and energy dispersive X-ray analysis results.
Conclusion
GCE could be used as an effective alternative for dentin remineralization.
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Affiliation(s)
| | - Ahmed Fawzy Abo Elezz
- Department of Restorative Dentistry, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | - Rehab Khalil Safy
- Department of Restorative Dentistry, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
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Tulumbaci F, Gungormus M. In vitro remineralization of primary teeth with a mineralization-promoting peptide containing dental varnish. J Appl Oral Sci 2020; 28:e20200259. [PMID: 32901695 PMCID: PMC7480669 DOI: 10.1590/1678-7757-2020-0259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/30/2020] [Accepted: 07/09/2020] [Indexed: 11/28/2022] Open
Abstract
Mineralization-promoting peptides are attractive candidates for new remineralization systems. In previous studies, peptides have been applied as aqueous solutions, which is not a clinically relevant form. OBJECTIVE This study aims to investigate the efficiency of a mineralization-promoting peptide, applied in varnish, on remineralizing artificial caries on primary teeth. METHODOLOGY 55 primary molars were collected. Specimens were immersed in a demineralizing solution for 7 days and then, divided into 7 groups: Baseline: No-remineralization, Placebo: Blank colophony, F: Colophony 5% fluoride, P: Colophony 10% peptide, P+F: Colophony 5% fluoride and 10% peptide, Embrace: Embrace™ varnish, Durashield: Durashield™ varnish. A mixture of 35% w/v colophony varnishes were prepared in ethanol and applied accordingly. Specimens were immersed in a remineralization solution for 4 weeks and it was evaluated using PLM and SEM. Lesion depth reduction was examined by one-way ANOVA. RESULTS There was no significant difference in mean lesion depths between baseline (147.04 ± 10.18 μm) and placebo groups (139.73 ± 14.92 μm), between F (120.95 ± 12.23 μm) and Durashield (113.47 ± 14.36 μm) groups and between P (81.79 ± 23.15 μm) and Embrace (90.26 ± 17.72 μm) groups. Lesion depth for the P+F group (66.95±10.59 μm) was significantly higher compared to all other groups. All groups contained samples with subsurface demineralized regions. Number of subsurface demineralized regions were higher in fluoride-containing groups. CONCLUSIONS We conclude that the mineralization-promoting peptide (MPP3) is effective in this in vitro study and the peptide shows benefits over fluoride as it yields less subsurface demineralized regions.
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Affiliation(s)
- Fatih Tulumbaci
- Ankara Yildirim Beyazit University, School of Dentistry, Department of Pediatric Dentistry, Ankara, Turkey
| | - Mustafa Gungormus
- Ankara Yildirim Beyazit University, School of Dentistry, Department of Basic Sciences, Ankara, Turkey
- Ankara Yildirim Beyazit University, School of Engineering and Natural Sciences, Biomedical Engineering, Ankara, Turkey
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Baafif HA, Alibrahim IF, Alotaibi SH, Alharbi HG, Shubaily MN, Elkwatehy WMA. The Efficacy of Resin Infiltrant and Casein Phosphopeptide-amorphous Calcium Fluoride Phosphate in Treatment of White Spot Lesions (Comparative Study). J Int Soc Prev Community Dent 2020; 10:438-444. [PMID: 33042885 PMCID: PMC7523932 DOI: 10.4103/jispcd.jispcd_483_19] [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: 12/06/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/29/2022] Open
Abstract
Background: White spot lesions (WSLs) are considered as the first sign of the progression of dental caries that can be reversed. Casein phosphopeptide–amorphous calcium fluoride phosphate (CPP-ACFP) varnish can promote remineralization process of the demineralized tooth structure. Also, WSLs can be managed by using caries infiltrant (ICON), which infiltrates etched enamel surface of the WSLs. Objectives: The main aim was to evaluate and compare the efficacy of ICON versus CPP-ACFP varnish to treat WSLs in the same oral environments. Materials and Methods: A total of 30 participants aged 20–40 years with at least two WSLs have participated in this trial. Split-mouth technique has been used in this trial where WSLs on the left side have been treated with ICON, whereas WSLs on the right side have been treated with CPP-ACFP varnish. Clinical evaluation using DIAGNOdent was carried out at baseline, 1 week, 1, 3, 6, and 12 months after application to determine the effectiveness of these materials in treating WSLs. Results: Significant differences were observed between all follow-up DIAGNOdent scores compared to baseline readings of both ICON and CPP-ACFP (P = 0.000 for all comparisons). Statistically significant differences were observed between DIAGNOdent scores of ICON compared to CPP-ACFP at all follow-up intervals (P = 0.006, 0.008, 0.045, 0.036, and 0.000). Conclusion: Both ICON and CPP-ACFP were effective in the treatment of WSLs of smooth surfaces but the efficacy of CPP-ACFP was better than ICON.
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Affiliation(s)
| | | | - Sami H Alotaibi
- Faculty of Dentistry, Umm AlQura University, Mansoura, Egypt
| | - Hatem G Alharbi
- Faculty of Dentistry, Umm AlQura University, Mansoura, Egypt
| | | | - Wahdan M A Elkwatehy
- Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Umm Al-Qura University, KSA and Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Sahin F, Oznurhan F. Antibacterial efficacy and remineralization capacity of glycyrrhizic acid added casein phosphopeptide-amorphous calcium phosphate. Microsc Res Tech 2020; 83:744-754. [PMID: 32191375 DOI: 10.1002/jemt.23465] [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: 01/08/2020] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 12/16/2022]
Abstract
The aim was to evaluate remineralization capacity and antibacterial efficiency of Tooth Mousse and various amounts of glycyrrhizic acid added Tooth Mousse on primary tooth enamel. Three groups were formed; Group 1 (CPP-ACP), Group 2 (CPP-ACP + 5% glycyrrhizic acid), and Group 3 (CPP-ACP + 10% glycyrrhizic acid) in order to evaluate remineralization capacity. Enamel samples were immersed in demineralization solution and then remineralization agents were applied. Surface microhardness and SEM analyses were performed at the beginning, after demineralization and remineralization. For antibacterial tests, four groups were formed; Group 1, Group 2 and Group 3 and Group 4 (control). Biofilms were then exposed to 10% sucrose eight times per day for 7 days. After biofilm growth period, samples were treated with materials to evaluate antibacterial efficiency except control group. After application of materials, samples were incubated 2 more days at 37°C and at the end of this period, absorbance values of biofilms were determined and data were analyzed. An increase in microhardness values was Group 2 > Group 3 > Group 1, respectively, but there were no significant differences. After remineralization, microhardness values showed significant increases when compared to demineralized groups, but there was no significant difference. All groups showed decreased absorbance value of biofilm when compared with control group but they were insignificant. It was observed that both in Group 2 and Group 3, glycyrrhizic acid did not have a negative effect on remineralization and although they have an increase, it was insignificant. Although glycyrrhizic acid added CPP-ACP groups showed increased antibacterial activity, they were not statistically significant.
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Affiliation(s)
- Feride Sahin
- Department of Pediatric Dentistry, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
| | - Fatih Oznurhan
- Department of Pediatric Dentistry, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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14
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Priya CHL, Kumar NK, Naik S, Merwade S, Brigit B, Guruprasad CN, Prabakaran P. Evaluation of the remineralizing potential of Nigella sativa, sodium fluoride and caesin phosphopeptide-amorphous calcium phosphate on enamel: An In vitro study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2020. [DOI: 10.4103/jiaphd.jiaphd_130_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gangwar A, Jha KK, Thakur J, Nath M. In Vitro evaluation of remineralization potential of novamin on artificially induced carious lesions in primary teeth using scanning electron microscope and vickers hardness. Indian J Dent Res 2019; 30:590-594. [PMID: 31745058 DOI: 10.4103/ijdr.ijdr_326_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aims The objective of this in vitro study was to find out the efficacy of Novamin in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using Vickers Hardness Testing Machine and Scanning electron microscope (SEM). Settings and Design A total of 40 primary teeth were selected and divided into two groups: Control group and SHY NM (Novamin). All the samples were subjected to ph cycle protocol and assessed using Vickers Hardness Testing Machine and Scanning electron microscope. Each demineralized sample was randomly divided into two groups: Gp I -Control group, Gp II - Novamin (SHY NM). After 10-day period of ph cycle, the obtained data was analyzed statistically. Statistical Analysis Used Pre and post groups were compared by paired t test. The significance of mean difference between the groups was done by Tukey's post hoc test after ascertaining normality by Shapiro-Wilk (W) test and homogeneity of variance by Levene's test. A two-tailed P value less than 0.05 (P < 0.05) was considered statistically significant. All analyses were performed on SPSS software (Windows version 17.0). Results Statistical analysis showed that bioactive glass (novamin) remineralizes artificially induced carious lesion in primary teeth. Conclusions SHY NM (Novamin) exhibited superior remineralization potential.
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Affiliation(s)
- Anshul Gangwar
- Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Kaushal Kishor Jha
- Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Jyoti Thakur
- Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Madhuri Nath
- Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Salman NR, ElTekeya M, Bakry N, Omar SS, El Tantawi M. Comparison of remineralization by fluoride varnishes with and without casein phosphopeptide amorphous calcium phosphate in primary teeth. Acta Odontol Scand 2019; 77:9-14. [PMID: 30045657 DOI: 10.1080/00016357.2018.1490967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To compare MI (5% NaF with 2% CPP-ACP) and Prevident (5% NaF) varnishes in remineralizing caries-like lesions in primary teeth regarding calcium and phosphate enamel content and lesion depth. MATERIAL AND METHODS Caries-like lesions were created in 48 primary teeth which were divided into 2 halves; one left untreated (control) and the other half treated with MI or Prevident varnishes. Calcium and phosphate content was assessed using energy dispersive X-ray spectrometer and reduction in lesion depth was assessed using polarized light microscopy. Demineralization and remineralization values in each group were compared using paired t test and percentage change between groups was compared using t test and Mann Whitney U test. RESULTS A greater percentage increase of calcium was observed in MI than Prevident specimens (median = 8.97 and 2.67, p < .0001), with greater calcium phosphate ratio percentage increase (median = 28.96 and 7.40) and phosphate percentage reduction (median = 15.5 and 4.51). The mean (SD) percentages reduction in lesion depth in the MI varnish was significantly greater than in Prevident varnish (44.41 (7.12) and 22.73 (9.35), p < .0001). CONCLUSIONS MI varnish had better remineralization effect in primary teeth than Prevident varnish in terms of higher mineral content and shallower lesion depth.
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Affiliation(s)
- Nehal Raid Salman
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Pharos University, Alexandria, Egypt
| | - Magda ElTekeya
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Niveen Bakry
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Samia Soliman Omar
- Department of Oral Biology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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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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Pinto de Souza SCT, Araújo KCD, Barbosa JR, Cancio V, Rocha AA, Tostes MA. Effect of dentifrice containing fTCP, CPP-ACP and fluoride in the prevention of enamel demineralization. Acta Odontol Scand 2018; 76:188-194. [PMID: 29157063 DOI: 10.1080/00016357.2017.1401658] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the effect of different fluoride- and calcium- and/or phosphate-containing products on their ability to prevent enamel demineralization under pH cycling conditions. MATERIAL AND METHODS Enamel bovine specimens were assigned to the following groups: G1-MPP (MI Paste Plus, 0.2% NaF, Recaldent™, GC Corporation Tokyo, Japan); G2-FD (Crest™ Cavity Protection, 0.243% NaF, Procter & Gamble, USA); G3-CLP (Clinpro™ 5000, 1.1% NaF, 3M ESPE, USA); and G4-CO (Control without fluoride, Silica-based dentifrice; Daudt Ltda, Brazil). The specimens were soaked in demineralizing solution for 6 h and remineralizing solution for 18 h alternatively for 10 days. The toothpaste was prepared with deionized water in a 1:3 ratio (w/v) for three minutes daily. The solutions were renewed every 48 h. After cycling, enamel changes were analysed by percentage change of SMH (%SMH) and energy-dispersive X-ray spectroscopy (EDS). The %SMH value observed for G3-CLP (2.9 ± 39.2) was higher than that found in G4-CO (-13.0 ± 20.7), G1-MPP (-8.9 ± 20.9) and G2-FD (-3.9 ± 27.1). The %SMH was similar for all treatment groups (one-way ANOVA and Tukey's HSD; p < .05). The pH, Ca2+ and Ptotal in the remineralization solutions were not different among all groups (Kruskal-Wallis; p < .05). At 24 h, the Ca2+ concentration in the demineralization solution was significantly lower in G1-MPP. Ca2+ concentration increased in all groups after 48 h, except for G3-CLP. The EDX quantitative analysis showed that the atomic % of elements is lower level at G4-CO. CONCLUSIONS The Clinpro™ 5000 demonstrated having the most protective effect against demineralization; however, the % SMH was similar for all groups.
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Affiliation(s)
| | | | | | - Viviane Cancio
- School of Chemistry, Fluminense Federal University, Niterói, RJ, Brazil
- Pediatric Dentistry Department, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
| | - Anderson Araújo Rocha
- Analytical Chemistry Department, Institute of Chemistry, Fluminense Federal University, Niterói, RJ, Brazil
| | - Mônica Almeida Tostes
- Pediatric Dentistry Department, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
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Watanabe K, Sasabe T, Nakamura A, Eda K, Tanase K, Ikeda H, Ohata N, Minohara Y, Maki K, Watanabe S. Advantage of Introducing Quantitative Light-Induced Fluorescence in School Dental Checkups. Health (London) 2018. [DOI: 10.4236/health.2018.108083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Khamverdi Z, Kordestani M, Soltanian AR. Effect of Proanthocyanidin, Fluoride and Casein Phosphopeptide Amorphous Calcium Phosphate Remineralizing Agents on Microhardness of Demineralized Dentin. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2017; 14:76-83. [PMID: 29104598 PMCID: PMC5662512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of dentin remineralization using proanthocyanidin (PA), fluoride varnish and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) paste and their various combinations on microhardness of demineralized root dentin. MATERIALS AND METHODS One-hundred and twenty freshly extracted sound human premolars were selected and randomly divided into eight groups for dentin treatment as follows. C: Deionized water (control); PA: 6.5% PA solution; F: fluoride varnish (5% NaF, 22600 ppm fluoride); CP: CCP-ACP; PAF: 6.5% PA + fluoride varnish; PACP: 6.5% PA + CCP-ACP; FCP: fluoride varnish + CCP-ACP and PAFCP: 6.5% PA + fluoride varnish + CCP-ACP. All specimens were subjected to Vickers microhardness test (500 g, 10 seconds, 3 points). Data were analyzed using one-way ANOVA and Tukey's post hoc test. The significance level was set at 0.05. RESULTS The mean and standard deviation (SD) values of Vickers hardness number (VHN) in groups C, PA, F, CP, PAF, PACP, FCP and PAFCP were 37.39±4.97, 38.68±4.62, 48.28±2.68, 41.91±3.32, 48.59±2.55, 53.34±2.57, 48.413±4.00 and 55.20±1.82, respectively. Pairwise comparisons of the groups revealed that there was no significant difference between groups C and PA, PA and CP, F and PAF, F and FCP, PAF and FCP, and PACP and FPACP (P>0.05); but significant differences were observed between other groups (P<0.05). CONCLUSIONS The results of this study showed that the tested dentin treatments increased the microhardness of demineralized root dentin except for PA application.
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Affiliation(s)
- Zahra Khamverdi
- Professor, Dental Research Center, Department of Restorative Dentistry, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Matin Kordestani
- Post Graduate Student, Department of Restorative Dentistry, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran,Corresponding author: M. Kordestani, Department of Restorative Dentistry, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran,
| | - Ali Reza Soltanian
- Professor, Department of Biostatiatics, School of Public Health and Modeling of Noncomunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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