Effect of chicken egg shell powder solution on early enamel carious lesions: an invitro preliminary study

Enamel remineralisation prospect of Moringa Oleifera hydrogel, eggshell hydrogel versus sodium fluoride varnish on artificially demineralised primary teeth: in vitro study

PURPOSE

The purpose of the present in vitro study is to investigate and compare the remineralising potential of Moringa Oleifera extract, eggshell, and sodium fluoride varnish on microhardness of artificially demineralised enamel of primary teeth with biomimetic minimally invasive approach following the world paradigm shift towards natural products in paediatric dentistry.

MATERIAL AND METHODS

Sample size included 44 primary molars. The mineral content and surface microhardness of all specimens were initially assessed using energy dispersive x-ray examination (EDX) and Vickers microhardness. The specimens were artificially demineralised for 96 h at a temperature of 37°C and then reassessed directly after demineralisation. The demineralised enamel specimens were randomly divided into four groups according to the remineralisation regimen utilised. Group 1: Artificial saliva (control); Group 2: Sodium fluoride varnish; Group 3: Eggshell hydrogel; and Group 4: Moringa Oleifera hydrogel. The specimens were stored for 8 days and then subsequently evaluated using EDX and microhardness assessment by Vickers microhardness test and scanning electron microscope (SEM).  Results: Regarding the microhardness test, there was a significant difference between the Moringa Oleifera group and Eggshell group compared to fluoride varnish (p < 0.05). Regarding EDX analysis, there was a statistically significant difference (p < 0.05) between Moringa Oleifera group and Eggshell group compared to fluoride varnish as the highest values were for Moringa Oleifera and Eggshell. On the other hand, there was no statistically significant difference (p > 0.05) between Moringa Oleifera and Eggshell in both the measurements.

CONCLUSION

Moringa Oleifera and Eggshell might be considered as a biomimetic natural material capable of guiding enamel tissue remineralisation in early carious lesion of primary teeth.

CLINICAL RELEVANCE

This research demonstrated the capability for early enamel caries to be remineralised using novel materials with a naturally counterpart implicated in biomineralisation as proved to be more effective than traditionally used fluoride varnish in primary teeth.

Nano eggshell-based slurry as a direct pulp-capping material: In vitro characterization and histopathological assessment in an experimental animal model

AIM

Pulp vitality is essential for tooth integrity. Following pulp exposure, choosing a suitable pulp-capping material is crucial to maintain pulp vitality. However, the reparative dentine bridge created by calcium hydroxide (Ca(OH)2 ) is generally porous and incomplete. The aim of the current study is to assess the in vitro and in vivo bioactivities of nano eggshell-based slurry (NES), using NES as a direct pulp-capping material, compared with Ca(OH)2 in rabbit animal model.

METHODOLOGY

Nano eggshell powder (NE) was characterized for particle morphology, chemical composition and ion release. In vitro bioactivity was tested by immersion in simulated body fluid (SBF) for 7 days. For histopathological evaluation, 36 adult New Zealand rabbits (72 pulp exposures) were divided into nine groups (n = 8) according to the pulp-capping material (NES, Ca(OH)2 and no capping as negative control group) and the animals were sacrificed after 7, 14 or 28 days. The pulps of the two lower central incisors were exposed and then directly capped by Ca(OH)2 or NES or left untreated. The cavities were then sealed with glass ionomer cement. Teeth were collected for histopathological evaluation using an optical microscope. Pulp haemorrhage, inflammation, fibrosis and calcific bridge formation were assessed. Results were statistically analysed using anova and Tukey's tests.

RESULTS

Nano eggshell particles were spherical with a 20 nm diameter and were composed mainly of calcite. Statistical analysis showed that there was a significant increase in the release of all investigated ions between days 1 and 28, except for copper. NES group showed a significantly higher release of all elements as compared to Ca(OH)2 . Environmental scanning electron microscope micrographs of NES incubated for 7 days in SBF showed the formation of HAp with a Ca/P ratio (1.686). For histopathological evaluation, the difference between groups was statistically significant. At day 28, 75% of the pulps of the Ca(OH)2 group showed mild calcific bridge in comparison with 100% moderate calcific bridge in the NES group. The NES group showed significantly less inflammation at days 7 and 28, and higher fibrosis at day 7 compared with Ca(OH)2 .

CONCLUSIONS

Nano eggshell-based slurry represents a promising novel direct pulp-capping material with favourable pulp tissue response.

In vitro determination of the remineralizing potential and cytotoxicity of non-fluoride dental varnish containing bioactive glass, eggshell, and eggshell membrane

PURPOSE

This study compares in vitro remineralization potential and cytotoxicity of fluoride-free varnish combinations containing bioactive glass, eggshell, and membrane powder and fluoride varnish formulations on artificial caries lesions.

METHODS

Artificial caries lesions were formed in two windows on third molars. One of the windows was coated with one of the following varnish formulations: FV (fluoride varnish), F-BAGV (fluoride and bioactive glass containing varnish), BAGV (bioactive glass containing varnish), EPV (eggshell powder containing varnish), EMP-EPV (eggshell membrane protein and eggshell powder containing varnish), STMP-EMP-EPV (sodium trimetaphosphate-treated eggshell membrane protein and eggshell powder containing varnish). The samples were remineralized, then investigated under scanning electron microscopy, and elemental analyses were performed by X-ray dispersive analysis (EDX). In addition, the traditional colorimetric tetrazolium-based reduction assay (XTT) and the modern impedance-based real-time cell analysis system (RTCA) were used to investigate their cytotoxicity.

RESULTS

The varnish applied area's Ca/P ratio was lower than stoichiometric hydroxyapatite except for EPV (1.66) and STMP-EMP-EPV (1.67) groups. Undiluted extracts of all varnishes, 1:2 dilutions of FV and F-BAGV groups were cytotoxic in XTT assay. In RTCA, the normalised cell index of the EMP-EPV and STMP-EMP-EPV groups was higher than the control group.

CONCLUSION

Bioactive glass, eggshell, eggshell membrane proteins and STMP-treated eggshell and eggshell membrane protein containing varnish have similar remineralizing effect to fluoride-containing varnish on demineralized enamel. Integrating biological or bioactive components instead of fluoride into the dental varnishes might reduce cytotoxicity.

Evaluation of the Antibacterial Activity and the Remineralizing Potentiality of Two Natural Extracts and Their Mixture (In Vitro Study)

AIM: This study aimed to assess the antibacterial activity against the cariogenic Streptococcus mutans (ATCC 25175) and the commensal Actinomyces viscous (1300 EMCCN) oral bacteria and to determine the remineralizing effect of the previously demineralized bovine enamel lesion of ginger extract, eggshell extract as well as their mixture. METHODS: The two different extracts; eggshell extract and ginger extract were prepared as well as their mixture in an equal volume. Their antibacterial activity against S. mutans and A. viscous was assessed by well diffusion test and clear zones diameters measurement (mm). Chlorhexidine and Dimethyl sulfoxide solution were utilized as positive and negative control, respectively. Thirty-six anterior bovine teeth were subjected to artificial caries pH cycling regimen including alternate demineralization and remineralization for 5 days. Then they were randomly divided into three groups (G) (n = 12): G1: Ginger, G2: Eggshell, and G3: Mixture. Specimens of each group were separately immersed in 50 ml of the tested extract for 12 h seven successive days. Vickers Microhardness and Energy Dispersive X-ray (EDX) Analysis were assessed at baseline, after demineralization and remineralization. RESULTS: Both extracts had antibacterial effect against the profile growth of S. mutants. However, the mixture showed the highest statistically significant mean inhibition zone diameters (mm), followed by ginger and eggshell extracts with no statistically significant difference between them. Regarding the remineralizing efficacy; G1:(Ginger) group showed the highest statistically significant mean microhardness followed by G3:(Mixture) group, then eggshell treated specimens; which showed the least statistically significant mean microhardness values. Regarding EDIX analysis results, a statistically significant increase in F (wt%) after remineralization in both eggshell and ginger treated specimens. CONCLUSION: Ginger as well as mixture extracts not only have antibacterial effect against cariogenic bacteria but also have a strong remineralizing ability of demineralized enamel.

An Eggshell-Based Toothpaste as a Cost-Effective Treatment of Dentin Hypersensitivity

Objectives This study aimed to test the efficacy of two experimentally produced eggshell-based toothpastes on dentinal tubules occlusion.

Materials and Methods Two experimental eggshell toothpastes, based on natural ingredients, with or without titanium dioxide nanoparticles (TNPs) were produced and coded “TNPs eggshell toothpaste [TNPsESTP]” or “eggshell toothpaste [ESTP],” respectively. Mid-coronal dentin discs, from 28 human extracted molar teeth, etched with 37% phosphoric acid for 60 seconds to simulate the hypersensitive dentin, were randomly divided into four groups—G1: no treatment (negative control), G2: ESTP treated, G3: TNPsESTP treated, and G4: Biorepair treated (positive control). All treated discs were brushed for 2 weeks and 1 month using a toothbrush simulator at 40 mm/s. Dentinal tubules occlusion was studied using a cross-polarization optical coherence tomography (CP-OCT) and scanning electron microscopy (SEM).

Statistical Analysis Unpaired t -test was conducted using GraphPad software (San Diego, California, United States). Continuous variables were expressed as means ± standard deviation and p < 0.05 was considered statistically significant.

Results From CP-OCT, a marked increase in surface reflectivity of dentin was observed after brushing with tested toothpastes. ESTP and NPsESTP showed higher or comparable grayscale values than Biorepair indicating increase in surface density of dentin. From SEM, at 2 weeks, ESTP showed comparable number of completely occluded dentinal tubules to Biorepair. TNPsESTP showed significantly lower numbers of CODT than Biorepair. At 1 month, the number of CODT was difficult to count for all treated groups. Both ESTP and TNPsESTP showed significantly higher numbers of partially occluded dentinal tubules than Biorepair.

Conclusion ESTP or TNPsESTP could offer a cost-effective substitute for the treatment of dentin hypersensitivity.

Formulation and Development of an Experimental Polishing Paste with Antimicrobial Activity Based on Coturnix coturnix (Codorniz) Eggshell

Aim

To formulate and develop a new experimental polishing paste based on Coturnix coturnix eggshell and to evaluate its abrasive, remineralizing, and antibacterial activities.

Materials and Methods

The research was experimental, longitudinal, comparative, and prospective. To measure the antibacterial efficacy, analysis units consisted of wells were made. The microorganisms S. aureus, E. coli, E. faecalis, C. albicans, and S. mutans were inoculated with experimental paste (Coturnix coturnix quail eggshell base) and control paste (Universal Polishing and Diamond Excel) consisting of n = 12 for each group.

Results

It was found that, among the strains inoculated, the quail paste presented with the highest antimicrobial effectiveness to C. albicans and S. mutans with an average of 8.70 ± 0.14 and 11.65 ± 0.15 mm, respectively. On the other hand, the Universal Polishing paste only had an average of 7.00 ± 0.11 and 8.71 ± 0.11 mm for C. albicans and S. mutans, respectively. Significant differences were observed only in these two strains p < 0.001.

Conclusions

The quail paste demonstrated antimicrobial efficacy against C. albicans and S. mutans compared to control paste, Diamond Excel, and Universal Polishing according to the time and type of microorganism.

Recent Advances in Dental Hard Tissue Remineralization: A Review of Literature

The dental caries is not simply a continuous and unidirectional process of the demineralization of the mineral phase, but a cyclic event with periods of demineralizations and remineralisation. The remineralization process is a natural repair mechanism to restore the minerals again, in ionic forms, to the hydroxyapatite (HAP) crystal lattice. It occurs under near-neutral physiological pH conditions whereby calcium and phosphate mineral ions are redeposited within the caries lesion from saliva and plaque fluid resulting in the formation of newer HAP crystals, which are larger and more resistant to acid dissolution. Numerous types of remineralizing agents and remineralizing techniques have been researched and many of them are being used clinically, with significantly predictable positive results. The recent researches on remineralization are based on biomimetic remineralization materials, having the capability to create apatite crystals within the completely demineralized collagen fibers.

HOW TO CITE THIS ARTICLE

Arifa MK, Ephraim R, et al. Recent Advances in Dental Hard Tissue Remineralization: A Review of Literature. Int J Clin Pediatr Dent 2019;12(2):139-144.