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PubMed1990

Remineralization of human dentine in vitro.

In this paper the in vitro remineralization of human dentine with 0, 0.5, 2 and 10 ppm F in the remineralization solution is presented and analyzed by microradiography. Furthermore, the remineralization data of human and bovine dentine are quantitatively compared. The main results of this paper are: (1) the efficacy of human (and bovine) remineralization is about proportional to the square root of the F level in the remineralizing solution, and (2) the amount of mineral effectively deposited in the dentine is most likely controlled by the diffusion of fluoride into the tissue. This study shows furthermore that although numerical differences exist in the remineralization of human and bovine dentine, the general remineralization behaviour is quite similar. The presence of F- in the parts per million range is essential for the remineralization efficacy in vitro and also for the 'overremineralization' of the outer dentine surface.

Adolescent↗
PubMed1992

The effects of sucralose, xylitol, and sorbitol on remineralization of caries lesions in rats.

The purpose of this study was to determine whether ingestion of sucralose, xylitol, sorbitol, or distilled water alone could enhance remineralization of early caries lesions in rats. Rats were infected by Streptococcus sobrinus, fed diet 2000 (Ziegler Brothers, Gardners, PA) ad libitum for two weeks, and, in addition, were offered drinking water sweetened by sucrose (10% w/v). A group of rats terminated at this time displayed significant levels of sulcal and smooth-surface caries. The remaining animals, for the ensuing three weeks, either continued on the same cariogenic challenge or received their essential nutrition by gavage and drank water, sweetened by one of the agents listed above, ad libitum. At the end of the additional three-week period, animals receiving sucralose, xylitol, sorbitol, or distilled water had fewer lesions than did the animals terminated after the two-week cariogenic challenge. The results show that removal of the cariogenic challenge allowed remineralization to occur and that no sweetening agent was superior to another in this respect.

Animals↗
PubMed1993

A single-section model for enamel de- and remineralization studies. 1. The effects of different Ca/P ratios in remineralization solutions.

A prerequisite for the accurate measurement of differences between pre- and post-experimental mineral profiles in single sections by quantitative microradiography is a high degree of reproducibility of the analytical procedures. We have determined the reproducibility of both the production and analyses of microradiographs. Lesions were made in seven single bovine enamel sections and radiographed three times. Each microradiograph was then analyzed on three different occasions by use of an image analysis system. This resulted in only small standard deviations in the lesion parameters. The method was used to determine the sites of mineral deposition in lesions in single sections during remineralization in three different solutions, one of which contained 1.5 mmol/L Ca and 0.9 mmol/L PO4 (standard solution); the other two solutions were low in either Ca or PO4, but all three had the same degree of supersaturation. The mineral profiles and lesion parameters were determined after lesion formation and after remineralization for 4 days, 1, 2, and 3 weeks. The decrease in IML (integrated mineral loss) in the lesions remineralized in the standard solution was greatest during the first week. Lesion profiles revealed that, under non-standard conditions, mineral deposition was retarded in the deeper part of the lesion, in contrast to the even distribution of mineral deposition from the standard solution. Differences in IML changes and lesion profiles between these bovine enamel experimental groups diminished when remineralization continued for 2 and 3 weeks. Possibly, the reactivity of mineral surfaces in newly made lesions affected the diffusion of remineralizing ions from low concentration solutions to the lesion front.

Animals↗
PubMed1996

The effect of a fluoridated toothpaste on dentinal lesions in plaque-filled grooves: an intra-oral crossover study.

Recently, we introduced an intra-oral dentin demineralization model to evaluate the efficacy of a fluoridated toothpaste at plaque-retention sites with limited access to salivary components and fluoride. Usage of the fluoridated toothpaste reduced mineral loss from grooves in sound dentin by 15% compared with a non-fluoridated toothpaste (Lagerweij et al., 1997). In the current study, preformed dentinal lesions were subjected to similar toothpaste treatments. To improve the power of the model in discriminating between toothpaste groups, we changed the design from monadic to crossover to reduce the influence of variation between the participants. Two sets of specimens were placed in the partial prostheses of 29 participants who used a toothpaste containing either 1000 ppm fluoride or no fluoride during two consecutive six-week periods. Changes in mineral content were analyzed by transverse microradiography. The average mineral loss after the non-fluoride period was 1785 vol% x micron (SD 2399), and 1335 vol% x micron (SD 2039) after the fluoride period, a 25% inhibition in demineralization. Analysis of variance showed that the demineralization was significantly influenced not only by the type of treatment (p < 0.001 level), but also by the participant (p < 0.001), the width of the groove (p < 0.001), and the depth into the groove where changes in mineral content were measured (p < 0.017). Twenty-one percent of all the lesions showed remineralization. No significant difference in the extent or the occurrence of remineralization was found between the treatments.

Adult↗
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↗
PubMed2006

Remineralization of enamel caries can decrease optical reflectivity.

The remineralization of enamel caries can lead to distinct optical changes within a lesion. We hypothesized that the restoration of mineral volume would result in a measurable decrease in the depth-resolved reflectivity of polarized light from the lesion. To test this hypothesis, we measured optical changes in artificial caries undergoing remineralization as a function of depth, using Polarization-sensitive Optical Coherence Tomography (PS-OCT). Lesions were imaged non-destructively before and after exposure to a remineralization regimen. After imaging, microradiographs of histological thin sections indicated that the significant reflectivity reduction measured by PS-OCT accurately represented the increase in mineral content within a larger repaired surface zone. Mineral volume changes arising from remineralization can be measured on the basis of the optical reflectivity of the lesion.

Calcium Phosphates↗
PubMedDate not supplied

[Comparison of 2 techniques for enamel remineralization].

Six patients enrolled at the Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, aging 16 to 20 years, were selected. All patients presented with white spots in both sides of the superior arch, which totalized 41 spots. The left side of the arch was submitted to remineralization by means of the conventional technique with Reminer, a commercially available product. In the right side, a modified technique was employed, with the utilization of fluoridated dentifrices every night, during 8 weeks. It was observed that successful remineralization occurred in 62% of the spots when the conventional technique was employed, whereas, when fluoridated dentifrices were utilized, there was partial remineralization in 10% of the spots. The utilization of Reminer was more effective than the utilization of fluoridated dentifrices.

Adolescent↗
PubMedDate not supplied

Influence of calcium phosphates added to mucin-based saliva substitutes on bovine dentin.

OBJECTIVES: Remineralization of dentin by mucin-containing saliva substitutes might be inhibited by sialic acids bound to mucin, which are known to complex calcium. Thus, the aim of this investigation was to evaluate the effects of various mucin-containing solutions, differing in calcium phosphate concentrations, to be used as saliva substitutes on demineralized bovine dentin in vitro. METHOD AND MATERIALS: Bovine specimens (153) were embedded in epoxy resin, polished (4,000 grit), and partly covered with nail varnish (control of sound dentin). After demineralization for 14 days (pH 5.5), the specimens (n = 9) were exposed to 14 mucin-based solutions (30 g/L) at 2 different pH values (5.5 or 6.5) and differing in saturation with respect to apatites. Two fluoride-free solutions and the commercially available saliva substitute Saliva Orthana(Orthana, Kastrup) served as controls. Differences in mineral loss (deltadeltaZ) and lesion depth (deltaLD) between the values prior to and after storage in the various solutions were evaluated from microradiographs of thin sections (100 microm). RESULTS: The general linear model revealed an almost significant dependency on calcium for deltadeltaZ (P = .050) and a significant dependency on calcium for deltaLD (P = .037). pH influenced deltadeltaZ significantly (P < .001), whereas deltaLD was not influenced significantly (P = .169). Neither deltadeltaZ (P = .475) nor deltaLD (P = .703) were influenced significantly by phosphate. CONCLUSION: Even with low concentrations of calcium and phosphates, mucin-based saliva substitutes are capable of inhibiting demineralization of bovine dentin, whereas with solutions supersaturated with respect to apatites, a remineralizing effect could be observed.

Analysis of Variance↗
PubMedDate not supplied

[Possibilities for remineralization in the incipient decay of the enamel].

Admitting the fact that dental decay is the result of an imbalance between the process of demineralization and that of remineralization, one of the main problems of odontology remains the increase of mineralization in the dental enamel in the post-eruptive maturation stage, and the remineralization of the incipient dental decay lesions. The author reviews the main aspects related to remineralization of the incipient decay which occurs in the dental enamel, as well as the possibilities of stimulation of remineralization with the aid of various agents, or by the use of certain obturation materials, of which certain types of glass ionomeric cements are very promising.

Dental Caries↗
PubMed1995

Effect of low levels of fluoride on calcium uptake by demineralized human enamel.

The effect of fluoride (ca. 0.1 parts/10(6)) on calcium uptake by enamel was examined under alternating remineralizing and demineralizing conditions. The remineralizing solutions contained either 0, 0.058, 0.104, or 0.138 parts/10(6) fluoride (ex NaF), while the demineralizing solutions contained no added fluoride. During the demineralization periods, calcium loss was similar for all groups. However, during the remineralizing periods, all levels of added fluoride were found to promote calcium uptake. Calcium levels taken up by the artificial lesions were sound to increase with increasing fluoride concentration in solution, and were independent of surface area of exposed enamel. In the absence of fluoride, even under conditions that are considered to be remineralizing, further demineralization took place.

Calcium↗
PubMed1996

Dental caries under glass ionomer restorations.

The Atraumatic Restorative Treatment (ART) technique has two potential limitations. Because only hand instruments are used, dental caries can be left during cavity preparation. Beyond this limitation, the glass ionomer filling material currently used has some unfavorable mechanical properties with respect to its strength, wear resistance, and shrinkage during setting. The purpose of this paper is to provide an overview of changes that can be expected in carious dentin when a glass ionomer restoration is placed. Restriction of the substrate supply and the release of different components from the glass ionomer have an inhibiting effect on cariogenic microorganisms. Whether this influence is sufficient to completely arrest the caries process is doubtful. The influence of glass ionomers on the remineralization of carious dentin needs further research.

Bacteria↗
PubMed1992

The effect of lesion characteristic on remineralization and model sensitivity.

A major criterion for assessing the value of any experimental model in scientific research is the degree of correspondence between its results and data from the real-life process it is designed to model. Intra-oral models aimed at predicting the anti-caries efficacy of toothpastes or other topical treatments should therefore be calibrated against treatments proven to be effective in a caries clinical trial. For this to be achieved, it is necessary that a model with high sensitivity be designed, while at the same time retaining relevance to the process to be modeled. This means that the effects of the various experimental conditions and parameters of the model on its performance must be understood. The purpose of this paper was to assess the influence of two specific factors on the performance of an in situ enamel remineralization model, which is based on human enamel slabs attached to partial dentures. The two factors are initial lesion severity and origin of enamel sample. The results indicated that initial lesion size affected whether net remineralization or net demineralization occurred during in situ treatment. Samples with an initial range of from 1500 to 2500 (delta Z) tended more toward demineralization than did samples with delta Z greater than 3500. This means that treatment groups must be well-balanced with respect to initial lesion size. Differences in initial demineralization severity between different tooth locations must also be considered so that systematic treatment bias can be avoided. The solution used in the model discussed here is based on a balanced experimental design, which allows this effect to be taken into account in the data analysis.

Adult↗
PubMed1999

Treatment of orthodontic white spot lesions with a remineralizing dentifrice applied by toothbrushing or mouth trays.

This pilot study investigated the effect of a remineralizing fluoride dentifrice (Enamelon) on newly formed incipient carious lesions using two methods of application. Teenage orthodontic patients with obvious white spot lesions on their teeth were selected to begin treatment within 30 days after debanding. At baseline, the surface enamel of the test teeth was cleaned by air etching with 50 microns alumina at 150 psi. Lesion size (mm2) was measured using a calibrated periodontal probe and surface appearance was quantified as shiny (0), dull (1), or chalky (2). Twice daily for 3 months, one group with a total of 27 lesions brushed with the remineralizing dentifrice, while a second group with 41 total lesions brushed and used a mouth tray to apply the paste directly to the lesions for 5 min. In order to promote treatment compliance, test group assignment was based on subject and parental preference. After 1, 2, and 3 months, lesion size was reduced by 5% (ns), 10% (p < 0.05) and 22% (p < 0.01), respectively, for the brushing group, and 16% (p < 0.05), 37% (p < 0.01) and 30% (p < 0.01) for the combined brushing and tray group, respectively. The dull appearance of the lesions treated by brushing improved slightly over 3 months. However, the lesions receiving combined brushing and tray applications became significantly (p < 0.01) less dull by 28%, 44% and 61% after 1, 2, and 3 months, respectively, indicating the formation of a shiny, intact surface layer. In conclusion, brushing with a remineralizing dentifrice significantly reduced the size of new orthodontic white spots within 2 months, while brushing combined with topical tray applications reduced lesion size within 1 month with concomitant formation of a shiny enamel surface layer. Thus, the combined brushing and mouth tray treatment significantly accelerated the remineralization process.

Adolescent↗
PubMedDate not supplied

Remineralizing potential, antiplaque and antigingivitis effects of xylitol and sorbitol sweetened chewing gum.

The objective of this study was to investigate the effects of xylitol and sorbitol sweetened chewing gums on plaque accumulation, gingival inflammation and remineralizing potential of plaque following six weeks of use. Twenty-eight consenting individuals were randomly assigned to each of three phases (six weeks in duration) consisting of chewing xylitol gum, chewing sorbitol gum and a non-chewing phase. Subjects chewed one stick after every meal and at two other times for a total of five sticks per day. At the completion of each treatment phase, plaque and gingival indexes were performed and plaque was later collected. Calcium concentration in plaque was determined by atomic absorption spectophotometry. Reductions in plaque indexes were significant for both xylitol gum (p < 0.001) and sorbitol gum (p < 0.05) when compared to the no chewing period. The gingival indexes reflected a decrement in gingival inflammation with both xylitol and sorbitol, though only sorbitol values were statistically significant (p < 0.05). Chewing xylitol and sorbitol gums reduced plaque accumulation and gingival inflammation. In addition, both gums enhanced the remineralization potential of plaque. Xylitol gum showed a superior effect with respect to remineralization potential and plaque reduction. Sorbitol gum had a superior effect on gingival health but not significantly so.

Calcium↗
PubMed1991

Effect of the mineralizing agent on the permanent teeth.

In a two-year pragmatic clinical trial, the effect of the mineralizing agent was evaluated on permanent teeth of the first eruption group among Finnish children (7-years old at the beginning of the study) with a low prevalence of DFS. In the test group (n = 123, biweekly mouthrinsing with a 2% solution of mineralizing agent and 0.2% NaF solution) the percentage reduction in increment of both EFDS and DFS was high, whereas in the control group (n = 123, biweekly mouthrinsing with placebo and 0.2% NaF solutions) the incidence for symptoms of caries disease did not differ from that normally found in this age cohort. Positive clinical effect of tested solution was age-related and was associated with remineralization of old and inhibition of occurrence of new EFD lesions.

Cariostatic Agents↗
PubMed1995

Intra-oral comparison and evaluation of the ability of fluoride dentifrices to promote the remineralization of caries-like lesions in dentin and enamel.

The effect of three types of fluoride dentifrices and one non-fluoride dentifrice were evaluated and compared intra-orally for their ability to promote the remineralization of caries-like lesions in thin sections of human dentin and enamel. The three fluoride dentifrices were silica based. One dentifrice contained 0.76% sodium monofluorophosphate (MFP), another contained 0.247% sodium fluoride (NaF), and the third contained 0.247% NaF plus 1.3% pyrophosphate and 1.5% polyvinylmethyl ether/maleic acid (PVM/MA) copolymer (denoted NaF/PPi). The fourth dentifrice (placebo) was also silica based, but contained no fluoride, and served as a negative control. Two week treatment resulted in the following percent mineral changes for the enamel specimens: +21 +/- 16 for MFP, +10 +/- 30 for NaF, +16 +/- 15 for NaF/PPi, and -30 +/- 30 for the placebo. The respective percent mineral change values for the dentin specimens were +28 +/- 20 for MFP, +22 +/- 19 for NaF, +28 +/- 18 for NaF/PPi, and -34 +O/- 61 for the placebo. A statistical analysis revealed that the three fluoride dentifrices were significantly better (p<0.05) than the placebo at promoting remineralization for both types of specimens. No significant differences were found among the three fluoride dentifrices. The following can be concluded from this study: 1) silica based dentifrices containing MFP and NaF are effective at remineralizing caries-like lesions in both enamel and dentin; 2) there was no statistical difference between NaF and MFP in their ability to promote remineralization; and 3) pyrophosphate does not interfere with the remineralizing effects of NaF.

Analysis of Variance↗
PubMed2006

Chemical exchange between glass-ionomer restorations and residual carious dentine in permanent molars: an in vivo study.

OBJECTIVE: To evaluate the remineralization of carious dentine following the restoration of an extensive lesion in a permanent molar with a high strength glass-ionomer cement (GIC). MATERIALS AND METHODS: Thirteen first permanent molars, which were scheduled for extraction because of the presence of extensive caries lesions, were selected for this study. They were first restored, according to the ART technique, using encapsulated Fuji IX(GP), which contains a strontium glass rather than the traditional calcium glass. The cavities were prepared with a clean enamel margin and minimal removal of the carious dentine around the walls. After a period of 1-3 months they were harvested and subsequently sectioned and examined using an electron probe microanalysis (EPMA) and scanning electron microscopy (SEM). RESULTS: EPMA demonstrated that both fluorine and strontium ions had penetrated deep into the underlying demineralized dentine. The only possible source of these ions was the GIC restoration. CONCLUSION: The pattern of penetration of the fluorine and strontium ions into the dentine was consistent with a remineralization process.

Adolescent↗