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Biomedical subjects

J R Mellberg

Publications and source records attributed to J R Mellberg.

At least 19 recordsLinked to original sources
PubMed1997

The mechanism of fluoride protection.

Since the 1940s, researchers have understood the positive effect of fluoride on anticaries activity. Several studies, beginning with the Cheektowaga study, showed that an increased number of concentrated fluoride applications also have a beneficial effect on anticaries activity. In fact, the continuous presence of high-fluoride concentrations has a more significant protective effect than enamel fluoride. A high-potency dentifrice is the ideal form with which to produce protective effects. This article describes how high-fluoride concentrations affect dental caries.

Acidulated Phosphate Fluoride↗
PubMed1992

A study of the ability of an in situ remineralization model to differentiate between the effects of two fluoride dentifrices that produced significantly different clinical caries results.

The purpose of this study was to determine whether an in situ remineralization model was able to show a difference in the effects of two dentifrices of different fluoride concentrations and significantly different clinical efficacies. Three dentifrices were tested in a double-blind, cross-over study design. The products contained 0 ppm F, 250 ppm F, or 1000 ppm F from sodium fluoride and were formulated with a silica base according to the formulations used in a human caries trial (Koch et al., 1990). Nineteen subjects each carried three or four thin sections of enamel in their partial dentures. The thin sections, containing artificial caries lesions, were covered with a steel mesh to provide space for plaque formation and then brushed in situ three times daily with the dentifrices. Following the two-week treatment periods, the specimens were removed from the dentures and analyzed for changes in mineral content. The findings showed that the placebo dentifrice (0 ppm F) resulted in 56.8 +/- 74.3% demineralization, the 250-ppm-F dentifrice produced 12.9 +/- 41.3% demineralization, thereby showing partial caries protection, and the 1000-ppm-F dentifrice produced 17.3 +/- 32.1% remineralization. Linear regression analysis showed that the percent remineralization was significantly related to the fluoride concentration in the dentifrice (p less than 0.001). The 250-ppm-F dentifrice was also significantly less effective than the 100-ppm-F dentifrice (p = 0.04, one-tailed Fisher Protected LSD test). These findings are in accord with the human caries trial and support the use of the present in situ remineralization model for prediction of the anticaries efficacy of fluoride dentifrice products.

Adult↗
PubMed1992

Effect of calcium in model plaque on the anticaries activity of fluoride in vitro.

The uptake of calcium by a polysaccharide (agarose) gel used as a model for plaque from a two-step treatment (consisting of a calcium rinse followed by a fluoride treatment) and the effect of the deposited calcium in model plaque on caries lesion formation in enamel were determined. Calcium uptake was measured by treatment of the model plaques with [45Ca]-CaCl2 solutions with or without NaF. A two-step treatment consisting of calcium followed by fluoride produced a 100% increase in calcium content of model plaque, presumably due to the formation of CaF2, compared with a treatment with artificial saliva followed by calcium alone. The effects of these increased plaque minerals on caries lesion formation were studied by subjecting model-plaque-covered enamel blocks to a cyclic demineralization-remineralization treatment. Artificial-plaque-covered enamel blocks were treated daily with 180 ppm calcium for ten min, then 100 ppm fluoride for ten min, followed by demineralization for 16 h, and finally, remineralization for seven h and 40 min. After five days, the blocks were sectioned, and lesion formation was determined by microradiography-microdensitometry. Artificial plaque treated with a calcium rinse followed by a fluoride rinse reduced lesion size by 90%, compared with a 68% reduction by a fluoride rinse alone. When the experiment was repeated with a simulated pre-brush calcium rinse (180 ppm calcium) followed by a fluoride dentifrice suspension (110 ppm fluoride), lesion size was reduced by 46%, compared with a 32% reduction by the fluoride dentifrice suspension alone.

Absorptiometry, Photon↗
PubMed1992

Findings from an in situ thin-section sandwich model for evaluating cariogenic and anti-cariogenic activity.

This report summarizes the findings from eight individual remineralization studies that used the thin-section sandwich model. This model uses thin sections of human enamel (or dentin) containing caries-like lesions sandwiched between sheets of thin plastic which are then implanted into the buccal surfaces of molars in removable partial mandibular dentures. Toothbrushing with a sodium fluoride-positive control dentifrice for two-week periods always produced positive remineralization of the lesions, and similar use of a placebo always produced mean mineral loss. In most studies, the difference was significant at p less than 0.01. However, variation among specimens placed within an individual mouth were often large and even included cases where one lesion gained mineral while a closely adjacent lesion lost mineral. Similarly, mean mineral changes produced by an individual subject were not consistent from study to study and ranged from net demineralization in one study to net remineralization in another study. Nevertheless, mean mineral changes from all eight studies showed that all subjects produced more remineralization than demineralization when using a sodium fluoride-positive control dentifrice. Data are presented showing remineralization of thin-section lesions from a number of other fluoride and non-fluoride dentifrices and mouthrinses and showing that a product with reduced anti-caries activity (as measured by several tests) also resulted in reduced remineralization by the thin-section model.

Cariogenic Agents↗
PubMed1992

Hard-tissue substrates for evaluation of cariogenic and anti-cariogenic activity in situ.

Hard-tissue substrates include primarily human and bovine enamel and human dentin. They have been used for in situ studies in a natural or sound condition, as well as flattened or containing an in vitro-formed caries-like lesion. Human enamel and dentin are generally the substrates of choice for studies of coronal and root-surface caries, respectively, but bovine enamel appears to offer a suitable alternative for many studies of enamel caries. Substrates with caries-like lesions will respond more rapidly to changes in the intra-oral mineral equilibrium and will allow both demineralization and remineralization to be determined. Findings from some studies suggest that caries-like lesions may respond somewhat differently, depending upon the degree of mineralization of the surface layer. Because in vitro findings with dentin show it to be significantly more soluble in acid than enamel, results from a study that used dentin may not be directly applicable to enamel. Both enamel and dentin substrates can be used in thin-section models. Hard-tissue substrates can also differ, depending upon their intra-oral location. Locations that result in the accumulation of plaque will behave differently from those that are plaque-free. So that plaque would accumulate, substrates have been placed approximally, beneath a fabric or steel mesh, in a protected trough, beneath a metal band or within a depression on the buccal surface. For studies requiring a determination of both demineralization and remineralization, human enamel or dentin containing a surface-softened caries-like lesion and covered with a uniform natural plaque are the substrates of choice.

Animals↗
PubMed1991

Evaluation of the effects of a pyrophosphate-fluoride anticalculus dentifrice on remineralization and fluoride uptake in situ.

Enamel slabs and thin sections with artificially formed caries lesions were placed in the removable dentures of 15 subjects who brushed them three times daily for 2 weeks with a 1.3% pyrophosphate/1,100 ppm F/1.5% Gantrez dentifrice, a 1,100-ppm F dentifrice without pyrophosphate or Gantrez, or a placebo dentifrice in a double-blind, crossover study. Analysis of the thin sections by quantitative microradiography showed that the pyrophosphate/F dentifrice remineralized the lesions 15.9% (p less than 0.05) and the fluoride dentifrice 11.2%, whereas the placebo produced 4.4% demineralization. Fluoride uptake by the enamel slabs was similar for both fluoride dentifrices and significantly greater from the placebo dentifrice (p less than 0.05). The findings suggest that the anticaries mechanisms of fluoride include not only the prevention of demineralization, but also the promotion of remineralization.

Adult↗
PubMed1991

Effect of a steel mesh and human dental plaque on fluoride uptake in vitro.

Blocks of bovine enamel, covered with a steel mesh or a steel mesh plus plaque or with neither, were treated in vitro with a 20% slurry of a fluoride dentifrice for 1 h. An initial experiment showed that fluoride in blocks without mesh or plaque increased significantly, whereas fluoride in blocks covered with a steel mesh harboring intraorally accumulated plaque did not. A follow-up experiment showed that enamel blocks covered with the mesh but without plaque acquired a small amount of fluoride, but significantly less than the blocks without mesh. These experiments indicate that covering enamel specimens with mesh, as is done during in situ experiments, may significantly influence the transport of fluoride to the enamel and, therefore, the amount of fluoride acquired by the specimens and perhaps the degree of de- or remineralization. They also suggest that the fluoride distribution to some areas of the natural dentition may be inadequate.

Animals↗
PubMed1991

Remineralization and demineralization in situ from a triclosan/co-polymer/fluoride dentifrice.

An in situ study was conducted to evaluate the effect of a dentifrice containing 1100 ppm F (NaF) and triclosan, an anti-plaque agent, on remineralization of artificially-formed caries lesions in thin sections of human enamel. The thin sections were placed in mandibular partial dentures of 15 subjects and covered with a steel mesh to provide an area for plaque accumulation. The subjects brushed their teeth and dentures three times daily for two-week periods in a cross-over design, after which the specimens were removed and analyzed by quantitative microradiography for changes in mineral content. Results showed that lesions treated with the triclosan-fluoride product were remineralized 18.0 +/- 23.4% compared with 19.0 +/- 32.3% from a 1100-ppm F (NaF) positive control. Use of a placebo dentifrice resulted in 71.9% demineralization. The findings showed that triclosan neither enhanced nor interfered with the promotion of remineralization by fluoride.

Adult↗
PubMed1991

Fluoride dentifrices: current status and prospects.

Toothpastes have developed from the poorly effective formulations using incompatible abrasive systems to the highly effective products now being given credit for the decline in dental caries in most developed countries. The earliest toothpastes used sodium fluoride but this was soon replaced by stannous fluoride, sodium monofluorophosphate and amine fluoride. Monofluorophosphate has the advantage that it is compatible with a wide variety of abrasive systems. Although most toothpastes world-wide currently contain monofluorophosphate, sodium fluoride formulations are growing in availability because of the development of compatible abrasives. Clinical caries trials have indicated that, with proper formulation, there is little or no difference in effectiveness among toothpastes prepared with different fluoride agents, but that increasing the fluoride concentration will enhance the anti-caries effect. The addition of other active agents to fluoride toothpaste has been a relatively recent occurrence, and it is important to be assured that they do not interfere with the anti-caries activity of fluoride. Pyrophosphate, a calculus control agent, is one additive that was considered to be a potential problem; however, human and animal tests have shown that both caries and calculus inhibiting effects can be obtained from a single formulation. With the use of modern methodology to evaluate toothpaste formulations before clinical trials, many new products containing anti-calculus and other agents will probably become available in the coming years.

Dentifrices↗
PubMed1990

Effect of a strontium complex on fluoride uptake by artificial caries lesions and sound enamel in vitro.

The effect of a strontium-polyacrylate complex on fluoride uptake by bovine enamel was determined. A salivary pellicle was formed on sound enamel and enamel with artificially formed caries lesions. Ten specimens of each were treated with solutions containing (A) 225 ppm F, (B) 225 ppm F plus Sr complex, (C) 200 ppm F, 0.1 M phosphate, pH 4.5 or (D) placebo for 1 h and then washed 24 h to remove labile fluoride. Analysis of ten thin layers of enamel showed that, on both enamel types, solution (C) deposited the largest amount of fluoride. The strontium complex decreased fluoride deposition, particularly in the outermost layer.

Acidulated Phosphate Fluoride↗
PubMed1990

The effect of plaque thickness on progression of artificial caries lesion formation in situ.

Eighty thin enamel sections with artificially-formed caries lesions were implanted in the buccal surfaces of molars (in the removable partial dentures of ten subjects) and covered with a steel mesh for plaque accumulation to occur. The mesh was placed in contact with the enamel surface in half the lesions and 0.5 mm above the lesions in the other half, thus facilitating formation of thin and thick plaque samples. Following two-week use of a non-fluoride dentifrice, the lesions were analyzed for mineral change by quantitative microradiography. Significant mineral was lost from lesions in both groups, but the loss was twice as large in the thick-plaque group. These findings are important to in vivo remineralization models, since they show that plaque thickness should be controlled for minimization of variation.

Dental Caries↗
PubMed1990

Evaluation of topical fluoride preparations.

For practical reasons, evaluation of topical fluoride products must depend upon clinical and laboratory assessments. While not always a good predictor of clinical efficacy by itself, fluoride uptake is the most commonly used laboratory test. A consideration of the relationship between possible anticaries mechanisms of fluoride, different product types, and the meaning of various kinds of fluoride uptake data suggests that both the amount of fluoride taken up by early lesions and the amount of ambient fluoride present at a cariogenic site may play key roles in determining the efficacy of a product. While formulations applied annually or semi-annually probably depend on fluoride deposition, those used daily might not. There are no clear data supporting the superiority of one fluoride compound over another, even for infrequently used products, although there are significant differences among them in fluoride uptake by enamel. This suggests that fluoride uptake in vivo at a cariogenic site might actually be different from that suggested by in vitro data, or that larger differences are required for a clinical effect to be observable. Clinical data support the conclusion that a large increase in the fluoride concentration of a product will somewhat increase its anticaries effectiveness, although the increase will not be linearly related to concentration. There also are no obvious differences in clinical effectiveness caused by the addition of gelling agents to topical solutions. Fluoride varnishes are clinically effective but have not been shown to be superior to topical solutions or gels.(ABSTRACT TRUNCATED AT 250 WORDS)

Dentifrices↗
PubMed1990

Effect of two sodium fluoride dentifrices on fluoride uptake and remineralization in situ.

Two dentifrices containing 1100 ppm F from sodium fluoride in silica bases were compared to a placebo dentifrice in an in situ remineralization and fluoride uptake study. Fifteen subjects brushed artificially-formed caries lesions in 60 thin enamel sections and 30 enamel blocks with each dentifrice in a double-blind, randomized, cross-over study design. Analysis of the thin sections by quantitative microradiography before and after exposure to toothbrushing showed that the fluoride dentifrices produced 18.3% and 7.1% remineralization whereas use of the placebo resulted in 10.3% demineralization. The differences between all three dentifrices were statistically significant. Fluoride concentrations at the surface of the lesion increased from approximately 700 ppm F in untreated specimens to approximately 1800 ppm F in specimens treated with either of the two fluoride dentifrices. These data suggest that formulation differences may affect the anticaries activity of a dentifrice without being reflected by fluoride deposition.

Humans↗
PubMed1989

Fluoride uptake from a composite restorative by enamel.

The purpose of the study was to determine the in vitro uptake of fluoride by enamel adjacent to a fluoride-releasing composite restorative material containing 11.2 mg/g of fluoride. Blocks of human enamel were placed close to cured discs of the composite in synthetic saliva for periods of up to 24 hours. The fluoride content of successive acid-etch biopsy layers of the enamel blocks was determined by specific ion-electrode analysis, and atomic absorption analysis for calcium was used to determine the layer thickness. After 24 hours, a fluoride content of 5400 ppm was found for the outermost 10-micron layer of enamel. Based on the in vitro demonstration of appreciable fluoride uptake by adjacent enamel, the fluoride-releasing composite gives promise of having anticariogenic properties in vivo.

Absorption↗