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Yang SY, Han AR, Kim D, Kim KM, Kwon JS. Hydrated Calcium Silicate in Resin Composites for Prevention of Secondary Caries. Int Dent J 2024:S0020-6539(24)00145-X. [PMID: 38849287 DOI: 10.1016/j.identj.2024.05.010] [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: 03/27/2024] [Revised: 05/12/2024] [Accepted: 05/16/2024] [Indexed: 06/09/2024] Open
Abstract
INTRODUCTION AND AIMS The gaps at the margins of restorative composite resin can increase as the carious process occurs underneath the materials, causing further demineralization along the tooth cavity wall. The aim of this study was to evaluate the effects of restorative resin composite containing hydrated calcium silicate (hCS) filler on enamel protection against demineralization by simulating microleakage between the test material and teeth in a cariogenic environment. METHODS The experimental resin composites were composed of 70 wt.% filler, which was mixed with a glass filler and hCS in a weight ratio of 70.0% glass (hCS 0), 17.5% hCS + 52.5% glass (hCS 17.5), 35.0% hCS + 35.0% glass (hCS 35.0), and 52.5% hCS + 17.5% glass (hCS 52.5). A light-cured experimental resin composite disk was positioned over a polished bovine enamel disk, separated by a 30-µm gap, and immersed in artificial saliva with pH 4.0 for 15, 30, and 60 days. After the immersion period, the enamel disk was separated from the resin composite disk and evaluated using a microhardness tester, atomic force microscopy, and polarized light microscopy. The opposing sides of the enamel and resin composite disks were observed using scanning electron microscopy/energy dispersive X-ray spectrometry. RESULTS The enamel surface showed a significant increase in microhardness, decreased roughness, and remineralization layer as the proportion of hCS increased (P < .05). In the scanning electron microscopy image, the enamel surface with hCS 35.0 and 52.5 after all experimental immersion periods, showed a pattern similar to that of a sound tooth. CONCLUSIONS The results demonstrated that increasing the hCS filler level of restorative resin composites significantly decreased enamel demineralization. CLINICAL RELEVANCE Hydrated calcium silicate laced restorative resin composites may be a promising dental biomaterial for protecting teeth against demineralization and preventing secondary caries around restorations.
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Affiliation(s)
- Song-Yi Yang
- Department of Dental Hygiene, Konyang University, Daejeon, Republic of Korea
| | - A Ruem Han
- Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Dohyun Kim
- Department of Conservative Dentistry, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kwang-Mahn Kim
- Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jae-Sung Kwon
- Department and Research Institute of Dental Biomaterials and Bioengineering, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Altamura S, Augello FR, Ortu E, Pietropaoli D, Cinque B, Giannoni M, Lombardi F. Efficacy of the Probiotic L. brevis in Counteracting the Demineralizing Process of the Tooth Enamel Surface: Results from an In Vitro Study. Biomolecules 2024; 14:605. [PMID: 38786012 PMCID: PMC11118116 DOI: 10.3390/biom14050605] [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: 04/30/2024] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Enamel plays an essential role in protecting the underlying layers of the human tooth; therefore, preserving it is vital. This experimental study aimed to evaluate the potential ability of L. brevis to counteract the action of a demineralizing agent on dental enamel morphology and mineral composition in vitro. METHODS The sample consisted of 12 healthy human posterior teeth. The coronal portion of each tooth was subdivided into two equal parts longitudinally. The specimens were randomly divided into four groups: artificial saliva, L. brevis suspension, demineralizing agent (DA), and DA plus L. brevis. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) were used to evaluate the surface micromorphology and the mineral content, respectively. The statistical analysis was conducted using a one-way ANOVA, followed by Tukey's post hoc test. RESULTS SEM analysis did not highlight significant changes in the enamel microstructure of L. brevis-treated specimens compared to the control. DA-induced damage to the enamel structure was drastically reduced when the specimens were contextually exposed to the probiotic. The treatment with DA substantially reduced the weight % of crucial enamel minerals, i.e., Ca and P. Notably, the probiotic was able to reverse the demineralization process, bringing Ca and P weight % back to basal levels, including the Ca/P ratio. CONCLUSIONS The findings indicate that L. brevis is able to efficiently protect the dental enamel surface from the damage caused by DA and increase the enamel resistance to demineralization. Overall, L. brevis confirms its efficacy in preventing or counteracting the action of carious lesions through a novel mechanism that protects the tooth surface under a chemical challenge that mimics the caries process.
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Affiliation(s)
- Serena Altamura
- Department of Life, Health & Environmental Sciences, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy; (S.A.); (F.R.A.); (E.O.); (D.P.); (F.L.)
- Ph.D. School in Medicine and Public Health, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy
- Center of Oral Diseases, Prevention and Translational Research—Dental Clinic, 67100 L’Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), 67100 L’Aquila, Italy
| | - Francesca Rosaria Augello
- Department of Life, Health & Environmental Sciences, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy; (S.A.); (F.R.A.); (E.O.); (D.P.); (F.L.)
| | - Eleonora Ortu
- Department of Life, Health & Environmental Sciences, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy; (S.A.); (F.R.A.); (E.O.); (D.P.); (F.L.)
- Center of Oral Diseases, Prevention and Translational Research—Dental Clinic, 67100 L’Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), 67100 L’Aquila, Italy
| | - Davide Pietropaoli
- Department of Life, Health & Environmental Sciences, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy; (S.A.); (F.R.A.); (E.O.); (D.P.); (F.L.)
- Center of Oral Diseases, Prevention and Translational Research—Dental Clinic, 67100 L’Aquila, Italy
- Oral Diseases and Systemic Interactions Study Group (ODISSY Group), 67100 L’Aquila, Italy
| | - Benedetta Cinque
- Department of Life, Health & Environmental Sciences, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy; (S.A.); (F.R.A.); (E.O.); (D.P.); (F.L.)
| | - Mario Giannoni
- Department of Life, Health & Environmental Sciences, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy; (S.A.); (F.R.A.); (E.O.); (D.P.); (F.L.)
- Center of Oral Diseases, Prevention and Translational Research—Dental Clinic, 67100 L’Aquila, Italy
| | - Francesca Lombardi
- Department of Life, Health & Environmental Sciences, University of L’Aquila, Building Rita Levi Montalcini, Coppito, 67100 L’Aquila, Italy; (S.A.); (F.R.A.); (E.O.); (D.P.); (F.L.)
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Vitiello F, Orilisi G, Notarstefano V, Furlani M, Riberti N, Bellezze T, Carrouel F, Putignano A, Orsini G. A Modern Multidisciplinary Method to Characterize Natural White Spot Lesions with 2D and 3D Assessments: A Preliminary Study. J Pers Med 2024; 14:542. [PMID: 38793124 PMCID: PMC11122579 DOI: 10.3390/jpm14050542] [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: 03/27/2024] [Revised: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
In this preliminary study, a multidisciplinary method based on high-resolution analytical techniques (such as microcomputed tomography, Raman Microspectroscopy, scanning electron microscopy, and Vickers microhardness test) was exploited to evaluate the alterations that occur in human teeth at the initial stage of the carious lesion. To this purpose, six extracted molars displaying a natural white spot lesion (WSL) were investigated. Specific morphological, structural, and chemical parameters, such as the mineral density, indentation hardness, molecular and elemental composition, and surface micromorphology were obtained on the WSL, and the results were statistically compared (t-test, p < 0.05) to those of the sound enamel on the same tooth. In the WSL, with respect to the sound area, a decrease in the mineral density and crystallinity was detected together with differences in the molecular composition and surface microstructure, such as the occurrence of micropores and irregularities. Moreover, the elemental analysis highlighted in WSL showed a statistically significant decrease in Ca and P percentages. In conclusion, this multidisciplinary approach allows us to fully characterize the area of interest, providing a deeper knowledge of these enamel lesions, which could have important clinical implications.
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Affiliation(s)
- Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, 69008 Lyon, France;
| | - Giulia Orilisi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, Polytechnic University of Marche (DISVA), Via Brecce Bianche, 60131 Ancona, Italy;
| | - Michele Furlani
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
| | - Nicole Riberti
- Department of Neurosciences Imaging and Clinical Sciences (DNISC), University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Tiziano Bellezze
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU), Università Politecnica delle Marche, 60131 Ancona, Italy;
| | - Florence Carrouel
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, 69008 Lyon, France;
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
- National Institute of Health and Science of Aging (INRCA), 60124 Ancona, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy; (F.V.); (G.O.); (M.F.); (A.P.)
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Dobrota CT, Florea AD, Racz CP, Tomoaia G, Soritau O, Avram A, Benea HRC, Rosoiu CL, Mocanu A, Riga S, Kun AZ, Tomoaia-Cotisel M. Dynamics of Dental Enamel Surface Remineralization under the Action of Toothpastes with Substituted Hydroxyapatite and Birch Extract. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2038. [PMID: 38730845 PMCID: PMC11084803 DOI: 10.3390/ma17092038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
To address tooth enamel demineralization resulting from factors such as acid erosion, abrasion, and chronic illness treatments, it is important to develop effective daily dental care products promoting enamel preservation and surface remineralization. This study focused on formulating four toothpastes, each containing calcined synthetic hydroxyapatite (HAP) in distinct compositions, each at 4%, along with 1.3% birch extract. Substitution elements were introduced within the HAP structure to enhance enamel remineralization. The efficacy of each toothpaste formulation was evaluated for repairing enamel and for establishing the dynamic of the remineralization. This was performed by using an in vitro assessment of artificially demineralized enamel slices. The structural HAP features explored by XRD and enamel surface quality by AFM revealed notable restorative properties of these toothpastes. Topographic images and the self-assembly of HAP nanoparticles into thin films on enamel surfaces showcased the formulations' effectiveness. Surface roughness was evaluated through statistical analysis using one-way ANOVA followed by post-test Bonferroni's multiple comparison test with a p value < 0.05 significance setting. Remarkably, enamel nanostructure normalization was observed within a short 10-day period of toothpaste treatment. Optimal remineralization for all toothpastes was reached after about 30 days of treatment. These toothpastes containing birch extract also have a dual function of mineralizing enamel while simultaneously promoting enamel health and restoration.
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Affiliation(s)
- Cristina Teodora Dobrota
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
- Department of Molecular Biology and Biotechnology, Faculty of Biology and Geology, Babeş-Bolyai University, 44 Republicii St., 400015 Cluj-Napoca, Romania;
| | - Alexandra-Diana Florea
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
| | - Csaba-Pal Racz
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
| | - Gheorghe Tomoaia
- Department of Orthopedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, 47 General Traian Mosoiu St., 400132 Cluj-Napoca, Romania; (G.T.)
- Academy of Romanian Scientists, 3 Ilfov St., 050044 Bucharest, Romania
| | - Olga Soritau
- Oncology Institute of Cluj-Napoca, 34-36 Republicii St., 400015 Cluj-Napoca, Romania;
| | - Alexandra Avram
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
| | - Horea-Rares-Ciprian Benea
- Department of Orthopedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, 47 General Traian Mosoiu St., 400132 Cluj-Napoca, Romania; (G.T.)
| | - Cristina Lavinia Rosoiu
- Department of Molecular Biology and Biotechnology, Faculty of Biology and Geology, Babeş-Bolyai University, 44 Republicii St., 400015 Cluj-Napoca, Romania;
| | - Aurora Mocanu
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
| | - Sorin Riga
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
- Academy of Romanian Scientists, 3 Ilfov St., 050044 Bucharest, Romania
| | - Attila-Zsolt Kun
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
| | - Maria Tomoaia-Cotisel
- Research Center of Excellence in Physical Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos St., 400028 Cluj-Napoca, Romania; (C.T.D.); (A.-D.F.); (C.-P.R.); (A.A.); (A.M.); (S.R.); (A.-Z.K.)
- Academy of Romanian Scientists, 3 Ilfov St., 050044 Bucharest, Romania
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Balakrishnan N, Subramanian AK, Eswaramoorthy R, Angappan M. Remineralization potential of varying concentrations of two plant-based extracts of Cocos nucifera on white spot lesions using SEM and EDAX analysis: An in vitro study. J Int Soc Prev Community Dent 2024; 14:129-135. [PMID: 38827356 PMCID: PMC11141893 DOI: 10.4103/jispcd.jispcd_146_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 06/04/2024] Open
Abstract
Aim To evaluate the remineralization potential of varying concentrations of two plant-based extracts of Cocos nucifera on white spot lesions using SEM and EDAX in vitro testing methods. Materials and Methods The pulp was freshly obtained from coconut and divided into two. Then, coconut milk was obtained by blending, while the next portion was freeze-dried and lyophilized. Third molar teeth were processed into tooth slabs (N = 40) and split equally into five groups by block randomization. After demineralization, one tooth slab was taken from each, and SEM analysis was done. Remineralization was then performed among the various groups that included Group 1, which acted as a control and consisted of the remineralization solution. Groups 2 and 3 comprised 1:1 and 2:1 concentrations of the coconut milk, whereas Groups 4 and 5 consisted of 1:1 and 2:1 concentrations of the lyophilized extract. SEM and EDAX testing were done post-remineralization. Ca and phosphate values were tabulated, and statistical significance was determined for the obtained values using ANOVA. Results Among the control and treatment groups, surface remineralization was better observed in 1:1 coconut milk and 2:1 coconut milk than in the 2:1 lyophilized coconut, control, and 1:1 lyophilized coconut. Between the control and treatment groups, Ca and phosphate percentages (P < 0.001) showed statistical differences. The lowest value of 2.3% was noted in the 2:1 lyophilized coconut group. Conclusion Coconut extracts exhibit remineralization potential on the artificial carious lesion. Coconut milk exhibited significant improvement in the surface properties than lyophilized coconut.
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Affiliation(s)
- Nivethigaa Balakrishnan
- Department of Orthodontics, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Aravind Kumar Subramanian
- Department of Orthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Rajalakshmanan Eswaramoorthy
- Department of Biomaterials, Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai 600077, Tamil Nadu, India
| | - Mahalakshmi Angappan
- Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai 600077, Tamil Nadu, India
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Kharbot B, Bulgun N, Cölfen H, Paris S. Effect of calcium-coacervate infiltration of artificial enamel caries lesions in de- and remineralizing conditions. J Dent 2024; 142:104838. [PMID: 38211686 DOI: 10.1016/j.jdent.2024.104838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES Calcium-coacervate emulsions (CC) might be considered as mineral precursors to foster remineralization of carious dental hard tissues. This study analyzed the instant effect of repeated infiltration of artificial caries lesions with a CC emulsion as well as the effects of subsequent exposure of CC-infiltrated lesions to demineralizing and remineralizing environments. METHODS Bovine enamel specimens were partly covered with varnish to leave three exposed windows. Artificial enamel caries lesions were created (pH 4.95, 17d). Baseline controls (BL) were obtained by preparing a thin section of each specimen. Specimens were allocated to five groups. In three groups lesions were etched with 37 % phosphoric acid gel, infiltrated with dipotassium hydrogen phosphate and subsequently with a calcium coacervate emulsion, prepared by mixing CaCl2 ⋅ 2H2O with polyacrylic acid sodium salt (PAA-Na). Subsequently, the infiltration effect was either analyzed immediately (Inf.) or after exposition to either de- (Inf.+DS) or remineralizing solution (Inf.+RS) for 10 or 20 days, respectively. In two control groups specimens were exposed to either DS or RS, respectively without prior CC infiltration. Integrated mineral loss [ΔZ(vol%×µm)] was analyzed using transverse microradiography (TMR). RESULTS Infiltration of enamel caries lesions with coacervate solution resulted in only subtle immediate mineral gain even if repeated. When exposed to demineralizing conditions, infiltrated lesions showed significantly less mineral loss compared to untreated controls (p < 0.05; Kruskal Wallis) and exhibited characteristic mineral depositions within the lesion body. CONCLUSIONS While immediate mineral gain by infiltration was only modest, the CC-emulsion might be able to prevent demineralization in acidic conditions. CLINICAL SIGNIFICANCE Calcium coacervates might act protective against further demineralization when infiltrated into enamel caries lesions.
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Affiliation(s)
- Basel Kharbot
- Department of Operative, Preventive and Pediatric Dentistry, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - Neziha Bulgun
- Department of Operative, Preventive and Pediatric Dentistry, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Helmut Cölfen
- Physical Chemistry, Department of Chemistry, University of Konstanz, Konstanz, Germany
| | - Sebastian Paris
- Department of Operative, Preventive and Pediatric Dentistry, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
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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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Orilisi G, Vitiello F, Notarstefano V, Furlani M, Riberti N, Monterubbianesi R, Bellezze T, Campus G, Carrouel F, Orsini G, Putignano A. Multidisciplinary evaluation of the remineralization potential of three fluoride-based toothpastes on natural white spot lesions. Clin Oral Investig 2023; 27:7451-7462. [PMID: 37857734 PMCID: PMC10713761 DOI: 10.1007/s00784-023-05334-2] [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: 07/31/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES This in vitro study aimed assessing the remineralization potential of three commercial fluoride-based toothpastes in permanent teeth with natural white spot lesions (WSLs). A multidisciplinary approach based on Raman microspectroscopy (RMS), Scanning electron microscopy (SEM), Energy-dispersive x-ray spectroscopy (EDS), and Vickers microhardness (VMH) was exploited. METHODS N = 12 human molars with natural WSLs in the proximal-vestibular zone were selected and divided into 4 groups (n = 3) according to the different treatments: HAF (hydroxyapatite with fluoride ions); SMF (sodium monofluorophosphate with arginine); SF (sodium fluoride with enzymes), and CTRL (untreated group). All toothpastes tested contained 1450 ppm of fluoride. Teeth samples were submitted to the following protocol: a 7-day pH cycling treatment, with two daily exposures (2 min each time) to the commercial toothpastes described above. The surface micromorphology (SEM), the chemical/elemental composition (RMS and EDS), and the Vickers microhardness (VMH) were evaluated. Statistical analysis was performed. RESULTS A remarkable remineralization of WSLs in SEM images was observed in all treated groups compared to CTRL. In particular, HAF and SF displayed higher values of VMH, phosphates amount (I960), crystallinity (FWHM960), and lower ones of C/P (I1070/I960) with respect to CTRL. Intermediate values were found in SMF, higher than CTRL but lower with respect to HAF and SF. As regards the Ca/P ratio, statistically significant differences (p < 0.05) were found between SF and the other groups. CONCLUSIONS All the tested dentifrices have shown to remineralize the WSLs. SF and HAF have comparable capability in hardness recovery and crystallinity; however, SF shows the best remineralizing potential according to both micromorphological and chemical analyses. Clinical relevance The daily use of toothpastes containing hydroxyapatite partially replaced with fluoride, sodium monofluorophosphate with arginine and sodium fluoride toothpaste associated with enzymes represents a preventive, therapeutic, effective, and non-invasive tool for remineralize WSLs.
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Affiliation(s)
- Giulia Orilisi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica Delle Marche, 60126, Ancona, Italy
| | - Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica Delle Marche, 60126, Ancona, Italy
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, 69008, Lyon, France
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, Università Politecnica Delle Marche (DISVA), 60131, Ancona, Italy
| | - Michele Furlani
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica Delle Marche, 60126, Ancona, Italy
| | - Nicole Riberti
- Department of Neurosciences Imaging and Clinical Sciences (DNISC), University of Chieti-Pescara, 66100, Chieti, Italy
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica Delle Marche, 60126, Ancona, Italy
| | - Tiziano Bellezze
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU), Università Politecnica Delle Marche, 60131, Ancona, Italy
| | - Guglielmo Campus
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, 07100, Sassari, Italy
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, CH-3010, Bern, Switzerland
| | - Florence Carrouel
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, 69008, Lyon, France
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica Delle Marche, 60126, Ancona, Italy.
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica Delle Marche, 60126, Ancona, Italy
- National Institute of Health and Science of Aging (INRCA), 60124, Ancona, Italy
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9
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Leal IDC, Rabelo CS, de Melo MAS, Silva PGDB, Costa FWG, Passos VF. Polyphenols for Preventing Dental Erosion in Pre-clinical Studies with in situ Designs and Simulated Acid Attack. PLANTA MEDICA 2023; 89:1034-1044. [PMID: 37230482 DOI: 10.1055/a-2100-3542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Dental erosion is a chemical process characterized by acid dissolution of dental hard tissue, and its etiology is multifactorial. Dietary polyphenols can be a strategy for dental erosion management, collaborating to preserve dental tissues through resistance to biodegradation. This study describes a comprehensive review to interpret the effects of polyphenols on dental erosion of pre-clinical models with in situ designs and simulated acid attacks on enamel and dentin samples. We aim to evaluate evidence about Polyphenols' effects in the type of dental substrate, parameters of erosive cycling chosen in the in situ models, and the possible mechanisms involved. An evidence-based literature review was conducted using appropriate search strategies developed for main electronic databases (PubMed, Scopus, Web of Science, LILACS, EMBASE, LIVIVO, CINAHL, and DOSS) and gray literature (Google Scholar). The Joanna Briggs Institute checklist was used to evaluate the quality of the evidence. From a total of 1900 articles, 8 were selected for evidence synthesis, including 224 specimens treated with polyphenols and 224 control samples. Considering the studies included in this review, we could observe that polyphenols tend to promote a reduction in erosive and abrasive wear compared to control groups. However, as the few studies included have a high risk of bias with different methodologies and the estimated effect size is low, this conclusion should not be extrapolated to clinical reality.
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Affiliation(s)
- Isabelly de Carvalho Leal
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Cibele Sales Rabelo
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Mary Anne Sampaio de Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, United States
| | | | - Fábio Wildson Gurgel Costa
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Vanara Florêncio Passos
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
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Pushpalatha C, Gayathri V, Sowmya S, Augustine D, Alamoudi A, Zidane B, Hassan Mohammad Albar N, Bhandi S. Nanohydroxyapatite in dentistry: A comprehensive review. Saudi Dent J 2023; 35:741-752. [PMID: 37817794 PMCID: PMC10562112 DOI: 10.1016/j.sdentj.2023.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/13/2023] [Accepted: 05/19/2023] [Indexed: 10/12/2023] Open
Abstract
Enamel, being the hardest and the highest mineralized tissue of the human body, contains nearly 96% inorganic components and 4% organic compounds and water. Dentin contains 65% inorganic components and 35% organic and water content. The translucency and white appearance of enamel are attributed to Hydroxyapatite (HA), which constitutes the major part of the inorganic component of dental hard tissue. With the advent of nanotechnology, the application of Nanohydroxyapatite (nHA) has piqued interest in dentistry due to its excellent mechanical, physical, and chemical properties. Compared to HA, nHA is found to have superior properties such as increased solubility, high surface energy and better biocompatibility. This is due to the morphological and structural similarity of nanosized hydroxyapatite particles to tooth hydroxyapatite crystals. These nanoparticles have been incorporated into various dental formulations for different applications to ensure comprehensive oral healthcare. To prevent dental caries, several nHA based dentifrices, mouth rinsing solutions and remineralizing pastes have been developed. nHA-based materials, such as nanocomposites, nano impression materials, and nanoceramics, have proven to be very effective in restoring tooth deformities (decay, fracture, and tooth loss). The nHA coating on the surface of the dental implant helps it bind to the bone by forming a biomimetic coating. A recent innovative strategy involves using nHA to reduce dentinal hypersensitivity and to reconstruct periodontal bone defects. The purpose of the present review is to discuss the different applications of nHA in dentistry, especially in preventive and restorative dentistry, dental implantology, bleaching and dentine hypersensitivity management.
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Affiliation(s)
- C. Pushpalatha
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - V.S. Gayathri
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - S.V. Sowmya
- Department of Oral Pathology & Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Dominic Augustine
- Department of Oral Pathology & Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Ahmed Alamoudi
- Oral Biology Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bassam Zidane
- Restorative Dentistry Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Shilpa Bhandi
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
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11
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Khalifa OM, Badawi MF, Soliman TA. Bonding durability and remineralizing efficiency of orthodontic adhesive containing titanium tetrafluoride: an invitro study. BMC Oral Health 2023; 23:340. [PMID: 37254210 DOI: 10.1186/s12903-023-03063-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/19/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Titanium tetrafluoride has been shown to protect tooth enamel from demineralization. This study investigated the effect of incorporating different concentrations of TiF4 (1, 2 and 3 Wt.%) into an orthodontic primer on the shear bond strength of orthodontic brackets and the enamel microhardness after cariogenic challenges. METHODS Three different TiF4 concentrations (1, 2 and 3 Wt.%) were prepared and added to the etch and rinse orthodontic primer. Ninety freshly extracted premolars were randomly divided into five groups according to the experimental primers and ageing conditions: TF0, TF0C, TF1C, TF2C, and TF3C. The TF0C group had no TiF4 in the primer, while TF1C, TF2C, and TF3C had 1, 2 and 3 Wt.% TiF4 in the primer, respectively. In the TF0 group, specimens were immersed in deionized water for 24 h as a control group, while all other groups were immersed in a demineralizing solution for 28 days. Each of the five groups was divided into two subgroups: The first group was subjected to shear bond strength and adhesive remnant index testing (N = 50 teeth, 10/group), while the second group was subjected to enamel surface microhardness testing (N = 25 teeth, 50 tooth halves, 10 tooth halves/group). Fifteen teeth (N = 15 teeth, n = 3/group) representing the five groups were subjected to SEM and microelemental analysis (EDX). SBS, ARI, microhardness, and Ca/P ratio were measured, and the data were analyzed using ANOVA and Tukey's tests. RESULTS The TF2C group had the highest SBS value (9.93 ± 1.23), while the TF0C (5.24 ± 0.65) and TF3C (5.13 ± 0.55) had the lowest SBS values. The enamel microhardness in the TF0C group was significantly reduced (p < .001). Enamel microhardness values were significantly (p < .001) higher in groups TF1C, TF2C, and TF3C than in TF0C. The highest Ca/P ratio was significantly recorded for the TF2C group (2.65 ± 0.02). CONCLUSIONS Incorporation of 1 and 2 Wt.% TiF4 into the orthodontic primers showed adequate bond strength and better remineralization effect. However, 1 Wt.% TiF4 showed lower ARI values than 2 Wt.% TiF4.
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Affiliation(s)
- Omnia Mahmoud Khalifa
- Dental Biomaterials Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Manal Farouk Badawi
- Dental Biomaterials Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Tarek Ahmed Soliman
- Dental Biomaterials Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
- Prosthetic Dentistry Department, Faculty of Dentistry, New Mansoura University, Mansoura, Egypt.
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12
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Tosco V, Vitiello F, Monterubbianesi R, Gatto ML, Orilisi G, Mengucci P, Putignano A, Orsini G. Assessment of the Remineralizing Potential of Biomimetic Materials on Early Artificial Caries Lesions after 28 Days: An In Vitro Study. Bioengineering (Basel) 2023; 10:bioengineering10040462. [PMID: 37106649 PMCID: PMC10135753 DOI: 10.3390/bioengineering10040462] [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: 01/17/2023] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to evaluate the loss of mineral content in the enamel surface in early artificial lesions and to assess the remineralizing potential of different agents by means of SEM coupled with energy-dispersive X-ray analysis (EDX). The analysis was performed on the enamel of 36 molars divided into six equal groups, in which the experimental ones (3-6) were treated using remineralizing agents for a 28-day pH cycling protocol as follows: Group 1, sound enamel; Group 2, artificially demineralized enamel; Group 3, CPP-ACP treatment; Group 4, Zn-hydroxyapatite treatment; Group 5, NaF 5% treatment; and Group 6, F-ACP treatment. Surface morphologies and alterations in Ca/P ratio were evaluated using SEM-EDX and data underwent statistical analysis (p < 0.05). Compared with the sound enamel of Group 1, the SEM images of Group 2 clearly showed loss of integrity, minerals, and interprismatic substances. Groups 3-6 showed a structural reorganization of enamel prisms, interestingly comprising almost the entire enamel surface. Group 2 revealed highly significant differences of Ca/P ratios compared with other groups, while Groups 3-6 showed no differences with Group 1. In conclusion, all tested materials demonstrated a biomimetic ability in remineralizing lesions after 28 days of treatment.
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Affiliation(s)
- Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Maria Laura Gatto
- Department of Industrial Engineering and Mathematical Sciences (DIISM), Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Giulia Orilisi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Paolo Mengucci
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU) & UdR INSTM, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
- National Institute of Health and Science of Aging (INRCA), 60124 Ancona, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, 60126 Ancona, Italy
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13
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Quinzi V, Orilisi G, Vitiello F, Notarstefano V, Marzo G, Orsini G. A spectroscopic study on orthodontic aligners: First evidence of secondary microplastic detachment after seven days of artificial saliva exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 866:161356. [PMID: 36603638 DOI: 10.1016/j.scitotenv.2022.161356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/20/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Clear orthodontic aligners have recently seen increasing popularity. The thermoplastic materials present several advantages, even if it is known that all plastic products can be subjected to environmental and mechanical degradation, leading to the release of microplastics (MPs). Their ingestion could cause oxidative stress and inflammatory lesions. This study aims to evaluate the potential detachment of MPs by clear aligners due to mechanical friction simulated with a 7-day protocol in artificial saliva. The study was performed on orthodontic clear aligners from different manufacturers: Alleo (AL); FlexiLigner (FL); F22 Aligner (F22); Invisalign® (INV); Lineo (LIN); Arc Angel (ARC), and Ortobel Aligner (OR). For each group, two aligners were immersed in artificial saliva for 7 days and stirred for 5 h/day, simulating the physiological teeth mechanical friction. After 7 days, the artificial saliva was filtered; then, filters were analyzed by Raman Microspectroscopy (RMS) and Scanning Electron Microscopy (SEM), respectively to chemically identify the polymeric matrix and to measure the number and size of the detected MPs. RMS spectra revealed that AL, FL, LIN, ARC, and OR aligners were composed by polyethylene terephthalate, while F22 and INV ones by polyurethane. SEM analysis showed that the highest number of MPs was found in ARC and the lowest in INV (p < 0.05). As regards MPs' size, no statistically significant difference was found among groups, with most MPs ranging from 5 to 20 μm. Noteworthy, a highly significant correlation (p < 0.0001) was highlighted between the distribution of MPs size and the different typologies of aligners. This in vitro study highlighted for the first time the detachment of MPs from clear aligners due to mechanical friction. This evidence may represent a great concern in the clinical practice since it could impact human general health.
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Affiliation(s)
- Vincenzo Quinzi
- Università degli Studi dell'Aquila, Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, Piazza Salvatore Tommasi, 67100 L'Aquila, Italy
| | - Giulia Orilisi
- Università Politecnica delle Marche, Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Via Tronto 10, 60126 Ancona, Italy
| | - Flavia Vitiello
- Università Politecnica delle Marche, Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Via Tronto 10, 60126 Ancona, Italy
| | - Valentina Notarstefano
- Università Politecnica delle Marche, Dipartimento di Scienze della Vita e dell'Ambiente, Via Brecce Bianche, 60131 Ancona, Italy
| | - Giuseppe Marzo
- Università degli Studi dell'Aquila, Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, Piazza Salvatore Tommasi, 67100 L'Aquila, Italy
| | - Giovanna Orsini
- Università Politecnica delle Marche, Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Via Tronto 10, 60126 Ancona, Italy.
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