Efficacy of erbium-doped yttrium aluminum garnet laser with casein phosphopeptide amorphous calcium phosphate with and without fluoride for remineralization of white spot lesions around orthodontic brackets

Progress in Biomaterials and Technologies in Dentistry

The field of dental biomedicine continues to evolve with significant advancements that are aimed at improving oral health outcomes [...].

Effects of Two Remineralizing Agents in Combination with Er:YAG and CO2 Laser Irradiation on Microhardness of Demineralized Enamel: A Preliminary In Vitro Study

Objectives: This study assessed the effects of two remineralizing agents namely MI Paste Plus containing casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACFP) and Remin Pro containing hydroxyapatite, fluoride and xylitol (HFX) with/without erbium-doped yttrium aluminium garnet (Er:YAG) and CO2 laser irradiation on demineralized enamel microhardness. Materials and Methods: In this in vitro study, 70 sound human premolars were mesiodistally sectioned, demineralized at a pH of 4.6 for 8 hours, and randomly divided into 7 remineralization groups (n=10): of (I) MI Paste Plus (CPP-ACFP), (II) Remin Pro (HFX), (III) MI Paste Plus+CO2 laser (0.7 W power, 50 Hz), (IV) Remin Pro+CO2 laser, (V) MI Paste Plus+Er:YAG laser (1 W power, 10 Hz), (VI) Remin Pro+Er:YAG laser, and (VII) negative control. The Vickers hardness number of specimens was then measured. The groups were compared by one-way ANOVA and Tukey's test (α=0.05). Results: The mean microhardness was 319.8±49.9, 325.3±44.6, 359.4±35.7, 296.4±33.7, 319.9±58.1, 358.9±28.4, and 240.0±41.6 kg/mm2 in groups 1 to 7, respectively. The difference in microhardness was significant among the groups (P<0.0001). Pairwise comparisons revealed significant differences in microhardness between all groups (P≤0.03) except between groups 1 and 2, 1 and 5, 2 and 5, and 3 and 6 (P>0.05). Conclusion: Both Remin Pro (containing HFX) and MI Paste Plus (containing CPP-ACFP) can cause enamel remineralization. MI Paste Plus+CO2 laser irradiation and Remin Pro+Er:YAG laser irradiation were significantly more effective than the application of each remineralizing agent alone.

Characterization of Novel Cement-Based Carboxymethyl Chitosan/Amorphous Calcium Phosphate

OBJECTIVE

 This study aimed to analyze, evaluate, and characterize novel cement-based carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP).

MATERIALS AND METHODS

 The three cement groups studied were gypsum (Gyp), and CMC/ACP-gypsum cement-based 5% (5% CAG) and 10% (10% CAG). The groups were characterized using Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), setting time, and scanning electron microscopy (SEM) data. The characterization results were analyzed qualitatively, but the data for setting time were analyzed using SPSS (p < 0.05).

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

 FTIR showed phosphate groups indicate the presence of calcium phosphate in the form of amorphous (ACP) in the CMC/ACP, CMC/ACP post-milled powder, and CMC/ACP cement-based (5% CAG and 10% CAG). XRD showed no difference in the diffraction spectra among the Gyp, 5% CAG, and 10% CAG groups. SEM images revealed that the CMC/ACP cement-based groups (5% CAG and 10% CAG) showed CMC/ACP cluster filled with hollow spaces between the gypsum crystals and aggregations surrounding the gypsum crystals. The CMC/ACP showed envelopes and attached to the crystalline structures of the gypsum. Setting times of 5% CAG and 10% CAG showed significant differences compared with Gyp (p < 0.05).

CONCLUSION

 The result of our study showed that CMC/ACP cement-based (5% CAG and 10% CAG) demonstrated amorphous characteristic, which can stabilize calcium ions and phosphate group (ACP). In addition, the modification of gypsum using CMC/ACP as cement-based extended the time of setting.

Shear bond strength of metallic brackets bonded to enamel pretreated with Er,Cr:YSGG LASER and CPP-ACP

Background

Increased risk of enamel demineralization during and after orthodontic treatment raises the demand for better preventive measures including combinations of laser, CPP-ACP, and fluoride. The combination of Er,Cr:YSGG laser with CPP-ACP was proved to have a synergetic effect compared to each of them alone. Shear bond strength (SBS) of orthodontic brackets bonded to the enamel surface after being treated with preventive measures is critical. The aim of this study was to compare the SBS and failure mode of metallic brackets bonded to teeth with no pretreatment and pretreated enamel surface, either with Er,Cr:YSGG laser alone or combined with CPP-ACP.

Methods

Sixty sound extracted human premolar teeth were allocated randomly to 3 groups: In Group 1 (control), teeth were etched and bonded directly; in Group 2, laser pretreatment of the enamel surface was done followed by etching and bonding as in the control group; in Group 3, the enamel surface was lased then CPP-ACP was applied according to the manufacturer instructions, etched and bonded. SBS and Adhesive remnant index (ARI) were evaluated.

Results

No significant differences were found between the 3 groups neither in the SBS nor in the ARI scores.

Conclusions

The use of combined Er,Cr:YSGG laser with CPP-ACP as a preventive measure before bonding orthodontic brackets does not endanger the bracket’s bonding strength.

How Can the Value and Use of Egg Yolk Be Increased?

The major driving force for the egg consumption in the United States over the past few decades was processed egg. However, the consumption of egg through the processed egg reached the plateau in recent years because of the imbalance in the demands between the egg white and yolk products. The consumer demands for egg white products are very high while those for the egg yolk, the co-product of dried egg white, are low because of the negative perceptions on egg yolk. Two key approaches that can be used to increase the value and use of egg yolk are: (1) developing new commodity products by fractionating egg yolk and apply them in various food processing, and (2) separating functional proteins and lipids from yolk and use them as is or further develop functional peptides and functional lipids and use them as pharmaceutical, nutraceutical, and cosmeceutical agents. These approaches can diversify the use of egg yolk, which eventually will help increase the consumption of egg. This review (1) discusses the current use of egg yolk products and the development of new functional commodity products from egg yolk, (2) review the important functional components in egg yolk and overview the current separation methods and their applications, (3) discuss the production of functional peptides and lipids using the separated egg proteins and lipids, and (4) suggest the future directions for the best use of egg yolk components. Development of scale-up production methods, which is vital for the practical applications, is discussed when appropriate.