Carbohydrate-electrolyte drinks exhibit risks for human enamel surface loss

Evaluation of developmentally hypomineralised enamel after surface pretreatment with Papacarie Duo gel and different etching modes: an in vitro SEM and AFM study

PURPOSE

This study aimed at investigating the surface morphology and nanotopography of normal enamel (NE) and developmentally hypomineralised enamel (HE) when subjected to various pretreatment protocols under scanning electron microscopy (SEM) and atomic force microscopy (AFM).

METHODS

Sixteen NE, 16 creamy/white (CW) HE and 16 yellow/brown (YB) HE specimens sectioned from extracted hypomineralised first permanent molars (FPMs) were included in this study. They were randomly distributed into 12 experimental groups (n = 4). Each group involved the following: (1) deproteinisation with Papacarie Duo^® gel or no deproteinisation, and (2) the use of Scotchbond™ Universal Adhesive (Scotchbond) in self-etch (SE) mode or 37% phosphoric acid etchant. Subsequently, the surface morphology and nanotopography of pretreated enamel specimens were evaluated under SEM and AFM, respectively.

RESULTS

SEM observation showed that deproteinisation with Papacarie Duo^® gel before phosphoric acid etching led to favourable etching patterns. This was consistent across all groups irrespective of the type of enamel specimen and the severity of hypomineralisation. In contrast, AFM results identified three factors that influenced surface parameters: (1) type of enamel specimen, (2) severity of hypomineralisation and (3) etching mode. YB HE recorded higher surface roughness values than CW HE and NE when subjected to the same pretreatment protocol. Deproteinisation and the application of Scotchbond in SE mode led to minimal topographic changes; however, acid etching was associated with an increase in surface roughness.

CONCLUSION

Deproteinisation with Papacarie Duo^® gel followed by acid etching contributed to improved etching patterns on HE.

Nitrate-rich beetroot juice offsets salivary acidity following carbohydrate ingestion before and after endurance exercise in healthy male runners

There have been recent calls for strategies to improve oral health in athletes. High carbohydrate diets, exercise induced dehydration and transient perturbations to immune function combine to increase oral disease risk in this group. We tested whether a single dose of nitrate (NO₃^-) would offset the reduction in salivary pH following carbohydrate ingestion before and after an exercise bout designed to cause mild dehydration. Eleven trained male runners (V˙O2max 53 ± 9 ml∙kg^-1∙min^-1, age 30 ± 7 years) completed a randomised placebo-controlled study comprising four experimental trials. Participants ingested the following fluids one hour before each trial: (a) 140 ml of water (negative-control), (b) 140 ml of water (positive-control), (c) 140 ml of NO₃^- rich beetroot juice (~12.4 mmol NO₃^-) (NO₃^- trial) or (d) 140 ml NO₃^- depleted beetroot juice (placebo-trial). During the negative-control trial, participants ingested 795 ml of water in three equal aliquots: before, during, and after 90 min of submaximal running. In the other trials they received 795 ml of carbohydrate supplements in the same fashion. Venous blood was collected before and after the exercise bout and saliva was sampled before and repeatedly over the 20 min following carbohydrate or water ingestion. As expected, nitrite (NO₂^-) and NO₃^- were higher in plasma and saliva during the NO₃^- trial than all other trials (all P<0.001). Compared to the negative-control, salivary-pH was significantly reduced following the ingestion of carbohydrate in the positive-control and placebo trials (both P <0.05). Salivary-pH was similar between the negative-control and NO₃^- trials before and after exercise despite ingestion of carbohydrate in the NO₃^- trial (both P≥0.221). Ingesting NO₃^- attenuates the expected reduction in salivary-pH following carbohydrate supplements and exercise-induced dehydration. NO₃^- should be considered by athletes as a novel nutritional strategy to reduce the risk of developing acidity related oral health conditions.

Assessment of surface roughness changes on orthodontic acrylic resins by all-in-one spray disinfectant solutions

Background. The disinfection of orthodontic acrylic resins might change the physical and mechanical properties of these materials. We aimed to investigate the impact of four different commercially available disinfectants on the surface roughness of acrylic resins used for orthodontic appliances.

Methods. Four disinfectant solutions (BirexSE, Opti-Cide3, COEfect MinuteSpray, and CaviCide Spray) were used to disinfect orthodontic acrylic resins using the spraying method. The resins were subjected to repeated disinfection protocols. Distilled water, also applied via spraying method, was used as a control. Surface roughness was scrutinized to examine the extent of surface topography changes by stylus profilometry. Data normality was evaluated via the Shapiro–Wilk test, followed by the Wilcoxon Signed-Rank test for non-parametric data or paired Student’s t-test for parametric data to compare intra-group differences in roughness before and after the use of the disinfectant solutions.

Results. Some of the disinfectants (BirexSE and CaviCide) resulted in significant changes in surface roughness values before and after the disinfection compared to the controls (P<0.05). The groups that were in contact with distilled water, Opti-Cide, and Coeffect did not exhibit significant differences in surface roughness before and after the intervention (P>0.05). However, from a clinical perspective, the resulting variations in surface roughness (<%0.15) induced by these solutions might not reflect clinically significant differences.

Conclusion. The use of disinfectant solutions is unlikely to harm the surface of orthodontic acrylic resins. Oral care providers need to be attentive to the interpretation and implementation of clinically significant changes in their evidence-based approach regarding potential material damages by disinfection sprays.