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PubMed1996

[Micro-abrasion of the enamel: an alternative to the removal of demineralization and superficial decalcification].

Tooth discoloration's may cause serious damage to the aesthetic appearance of the patients. These discoloration's can be treated in several ways but up to lately tooth structure had to be removed in an irreversible manner in order to provide sufficient bulk for the new restorative material. Nowadays thanks to the work of T. Croll and others a method has been established in a scientific way whereby tooth discoloration's confined to the outermost layer of enamel can be removed, through the application of an compound called PREMA which will simultaneous erode and abrade the enamel surface. If carefully selected the discoloration can be removed with only a limited loss of tooth structure. The authors describe the historical background of the method. Furthermore patient's selection, specific instruments and materials are described in detail. The clinical procedure is explained step by step, followed by a complete report of the effects of the procedure on the different tooth structures. Finally the long term results are discussed and the possibility to enhance the result by combining this method with home bleaching.

Complex Mixtures↗
PubMed2003

Microscopic investigation of artificially demineralized surface enamel exposed to controlled intra-oral periods.

BACKGROUND: Arrest and regression of enamel caries is generally followed by clinical surface changes in enamel. The aim of this study was to evaluate microscopic surface changes in demineralized enamel submitted to toothbrushing with a fluoridated dentifrice or to a fluoridated gel in situ. METHODS: Enamel blocks demineralized by an acidic gel, were built in plates of five volunteers during three periods of 14 days each: exposure to the oral cavity (C+); brushing with a fluoridated dentifrice three times a days (B); application of a 2 per cent sodium fluoride gel and exposure to the oral cavity (F). Eight blocks were kept in 100 per cent humidity under refrigeration as negative controls (C-). RESULTS: Stereomicroscopic examination revealed that 15, 47.4 and 30 per cent of samples from C+, B and F presented enamel cavitation after the experimental period. The demineralized enamel area in these groups decreased considerably compared to C-, both in cavitated and non-cavitated samples, although it was statistically significant only in cavitated samples from B (p=0.003; t test). Scanning electron microscopy revealed that C+ and F retained irregularities caused by the acid challenge, while B presented a more leveled profile of the enamel surface. CONCLUSIONS: Exposure of demineralized enamel to intra-oral periods reduced the demineralized enamel area. Tooth brushing enhanced this reduction, because of surface abrasion.

Adult↗
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↗
PubMed1985

Oral effects of sugars and sweeteners.

Increasingly, sweeteners are being used in the diets of caries-prone individuals to reduce sugar intake. Such substitution deprives the bacteria in the dental plaque of the sugars many of them use to produce the acids that cause demineralization of tooth tissue and development of the caries lesion. Sweeteners are particularly effective replacements for dietary sugars because they also stimulate the flow of saliva which can, through several mechanisms, prevent demineralization and even bring about remineralization of already demineralized enamel, dentine or cementum. More saliva means that more of its nitrogen-containing substances will reach the dental plaque where they can be degraded by plaque bacteria and thus produce base and the alkaline conditions that are conducive to a shift from tooth demineralization to tooth remineralization. At the same time, the additional saliva brings to the plaque more calcium and phosphate ions, the necessary ingredients for the remineralization process. At alkaline pH, saliva also provides a source of easily solubilized calcium phosphate that, in association with salivary carbohydrate protein, becomes part of the dental plaque. Because it is dissolved by acid more easily than is the calcium phosphate of the tooth, plaque calcium phosphate acts as a substitute for the tooth tissues when periods of acid attack occur following sugar ingestion. It is proposed that diagnostic tests be developed that can conveniently determine the acid-base and demineralization-remineralization potentials of different dental plaques and that these tests be used to determine the extent to which sugars in the diets of caries-active individuals be replaced with sweeteners.

Bacteria↗
PubMedDate not supplied

Effect of tooth-bound fluoride on enamel demineralization/ remineralization in vitro.

The effect of tooth-bound fluoride (F) on enamel caries formation was investigated under the condition that loosely bound F was essentially absent. Eighteen thin enamel sections, prepared from the lingual or buccal surfaces of extracted human molars, were embedded in acrylic resin with the enamel surfaces exposed. The sections were placed in a pH 7 remineralizing solution (RS; 1.2 mmol/l Ca, 0.72 mmol/l P, 30 mmol/l KCl, 50 mmol/l HEPES) for 5 days, and were randomly divided into 3 groups: (1) control group that received no treatment, (2) acidulated phosphate fluoride (APF) group that received 5 cycles of a 4 min treatment with APF gel followed by immersion in the RS for 2 days (RS changed daily) and (3) dicalcium phosphate dihydrate (DCPD) - APF group that received 5 cycles of a 4-min pH 2.1 DCPD-forming solution followed by 4 min APF gel and then placed in the RS for 2 days. After the treatment cycles, the sections were washed in a constant composition F titration system to remove loosely bound F. An in vitro model, which consisted of cycles of de- (6 h) and remineralization (18 h) each day for 5 days, was used to produce caries-like lesions in the specimens. The DeltaZ (mineral loss) values, measured by quantitative microradiography, of the lesions formed in the three groups were (mean +/- standard deviation; n = 6) 91.2+/-12.3 microm for the control group, 41.3+/-10.1 microm for the APF group and 21.2+/-4.8 microm for the DCPD-APF group. The same system produced lesions in untreated shark enamel with a mean DeltaZ of 4.4+/-0.3 microm (n = 12). One-way fixed-effects ANOVA indicated that mineral loss was significantly different among the different groups (p<0.05). The results showed that enamel resistance to lesion formation increased with increasing tooth-bound F content. Shark enamel was much more resistant to demineralization than human enamel.

Acidulated Phosphate Fluoride↗
PubMedDate not supplied

Demineralization inhibition of direct tooth-colored restorative materials.

This study compared the demineralization inhibition properties of fluoride releasing tooth-colored restorative materials. Materials evaluated included a giomer (Reactmer, Shofu [RM]), a conventional glass ionomer (Fuji II, GC [FJ]), a resin modified glass ionomer (Fuji II LC, GC [FL]) and a compomer (Dyract AP, Dentsply [DY]). A non-fluoride releasing composite (Spectrum TPH, Dentsply [SP]) was used for comparison. Class V preparations on buccal and palatal/lingual were made at the CEJ of 75 freshly extracted molars. The teeth were randomly divided into five groups of 15 and restored with the various materials. The occlusal half of each restoration was in enamel, while the gingival half was in dentin. The restored teeth were stored in distilled water at 37 degrees C for two weeks and subjected to artificial caries challenge (18 hours demineralization [pH 5.0] followed by six hours of remineralization [pH 7.0]) for three days. Sections of 130 +/- 20 microm were examined with a polarized light microscope, and outer lesion depth [OLD] and wall area [WA] lesion/inhibition measurements were made using image analysis software. All data were subjected to statistical analyses at 0.05 significance level. For the various materials, OLD ranged from 54.55 to 65.86 microm and 124.68 to 145.97 microm in enamel and dentin, respectively. WA ranged from -2356.13 to 1398.20 microm2 and -3011.73 to 5095.80 microm2 (positive values indicate wall inhibition, negative values indicate wall lesion) in enamel and dentin, respectively. Results of ANOVA/Scheffe's post-hoc test (p<0.05) were as follows: Enamel OLD--no significant difference between materials; Dentin OLD--SP > FJ, FL & RM; Enamel WA inhibition--FJ, FL & RM > DY & SP and Dentin WA inhibition--FJ > FL > RM > DY > SP. The demineralization inhibition effect of giomers, conventional and resin-modified glass ionomer cements appear to be more evident at the margins of restorations.

Cariostatic Agents↗
PubMed1983

Solution activity product (KFAP) and simultaneous demineralization-remineralization in bovine tooth enamel and hydroxyapatite pellets.

The effects of changing the ion activity product of the remineralization solution at pH 4.5 (pKFAP 108-118) on the remineralization behavior of demineralized bovine tooth enamel and hydroxyapatite pellets have been studied. Solutions containing calcium-4.5, phosphate, and fluoride in acetate buffers were used. The 45Ca/F molar ratios indicated the formation of fluoridated hydroxyapatite in the enamel or the pellet when the pKFAP values for remineralizing solutions were less than 112. When the pKFAP values were greater than 112, the 45Ca/F ratios were found to be much less than 5. Also, when the pKFAP values were large (greater than 112), the remineralization patterns based on the fluoride distribution in the tooth (or pellet) were found to be different than when the pKFAP values were small (less than 112). The hypothesis that a pKFAP value of 112 is the demarcation between remineralization only and simultaneous dissolution-remineralization has been proposed based on these results.

Animals↗
PubMed1989

[Effects of tooth surface treatment with the acid solutions containing metal chloride on the bond strength of a self-curing resin].

We evaluated the use of aqueous solutions containing an acid and metal chloride as a tooth surface pretreating agent. Nineteen solutions containing 10% acetic (AA), citric (CA), lactic (LA) or phosphoric acid (PA) and/or 0.11 M aluminum (Al), cupric (Cu) or ferric chloride (Fe) were prepared. The tensile bond strengths of the TBB-O initiated MENTA resin to tooth surfaces treated with the respective aqueous solutions were measured. The amount of dissolved Ca by each of the solutions was determined. The demineralization of tooth surface was mainly dependent on the pH of the aqueous solutions. There was no specific relationship between the bond strength and amount of dissolved Ca. This suggests that a high bond strength can be obtained without serious demineralization. Pretreatment with the CA-Cu, CA-Fe or LA-Cu solution markedly enhanced the bond strengths to both enamel and dentin, although these solutions demineralized tooth surface less than the solutions containing 10% PA.

Acid Etching, Dental↗
PubMed1994

Enamel and dentin demineralization inhibition of fluoride-releasing materials.

Fluoride-releasing dental restorative materials may provide an additional benefit in preventive dentistry. Although not currently available in the United States, a fluoride-releasing amalgam has demonstrated recurrent caries inhibition at enamel and dentin restoration margins. Likewise, both chemical-cured and light-cured glass ionomer cements have demonstrated caries inhibition at enamel and dentin restoration margins. Fluoride-releasing resin composites have also consistently demonstrated recurrent caries inhibition at enamel margins, yet there are conflicting results whether caries inhibition occurs at dentin margins. Preliminary studies indicate that glass ionomer cement and fluoride-releasing resin composite have synergistic effects with fluoride rinses and fluoridated dentifrices, in the remineralization of incipient enamel caries. The materials may act as a fluoride delivery system. Upon exposure to additional external fluoride, the material surface undergoes an increase in fluoride. This fluoride is subsequently released and has demonstrated demineralization inhibition and even remineralization at adjacent tooth structure. Clinical research to evaluate these fluoride-releasing restorative materials may provide further information for clinical recommendations.

Composite Resins↗
PubMed1998

Brushing abrasion of eroded dentin after application of sodium fluoride solutions.

The aim of the present in vitro study was to evaluate the influence of sodium fluoride solutions on brushing abrasion of eroded dentin. Dentin specimens were prepared from 60 bovine incisors. The specimens were embedded in acrylic resin, ground flat, polished and subsequently covered with tape exposing an area of 1.8 mm x 10.0 mm in the center of the exposed dentin. The samples were alternatingly stored in a demineralizing solution (5 min) and a remineralizing solution (1 min) for 5 times. The erosive soft drink Sprite light(R) served as a demineralizing solution and artificial saliva was used as a remineralizing solution. Prior to storage in artificial saliva 15 specimens were each treated for 1 min with 250 and 2,000 ppm fluoride solution, respectively. Fifteen specimens were treated with distilled water instead of the fluoride solution (= eroded controls). The remaining samples were neither eroded with the soft drink nor fluoridated (= uneroded controls). After each immersion in artificial saliva the specimens were submitted to abrasion in a toothbrushing machine. After 5 demineralization-remineralization brushing cycles the total amount of tooth wear due to erosion and subsequent abrasion was profilometrically evaluated. Statistical analysis revealed the significantly lowest wear in the uneroded controls and the highest amount of abrasion in the eroded controls. Application of the fluoride solutions increased the wear resistance of the eroded dentin specimens, showing significantly better protection by the high-concentration compared to the low-concentration solution. The susceptibility to abrasion of the eroded dentin specimens treated with the high-concentration fluoride solution did not differ significantly from the uneroded dentin samples. It is concluded that application of 2,000 ppm sodium fluoride solutions immediately before toothbrushing significantly reduces abrasion of eroded dentin in vitro.

Animals↗
PubMed1996

Effects of a high-bicarbonate dentifrice on intraoral demineralization.

Dentifrices available on the market today contain sodium bicarbonate in a wide range of concentrations. Anticaries efficacy has been demonstrated for these dentifrices in a variety of tests. New insights were gained in the present study in which the effect of a high-bicarbonate dentifrice on the sucrose-induced demineralization of tooth enamel in situ was examined. With the intraoral Delta Ip system it is possible to follow the minute changes in tooth enamel that essentially model the daily episodes of demineralization accompanying the ingestion of various foods. The results revealed a pronounced effect on the pH of the test plaque and a considerable reduction in mineral loss from the enamel. The effect persisted from more than 1 hour and, during that time, appeared to predominate over the effect of fluoride. These findings suggest that bicarbonate may provide additional protection against the loss of tooth enamel. Such effects may be significant for the design of new high-bicarbonate products.

Animals↗
PubMed1997

Effects of a high-bicarbonate dentifrice on intraoral demineralization.

Dentifrices available on the market today contain sodium bicarbonate in a wide range of concentrations. Anticaries efficacy has been demonstrated for these dentifrices in a variety of tests. New insights were gained in the present study in which the effect of a high-bicarbonate dentifrice on the sucrose-induced demineralization of tooth enamel in situ was examined. With the intraoral Delta Ip system it is possible to follow the minute changes in tooth enamel that essentially model the daily episodes of demineralization accompanying the ingestion of various foods. The results revealed a pronounced effect on the pH of the test plaque and a considerable reduction in mineral loss from the enamel. The effect persisted for more than 1 hour and, during that time, appeared to predominate over the effect of fluoride. These findings suggest that bicarbonate may provide additional protection against the loss of tooth enamel. Such effects may be significant for the design of new high-bicarbonate products.

Animals↗
PubMed1992

Demineralization and remineralization evaluation techniques--added considerations.

Methods used for the analysis of tooth de- and remineralization include techniques with various degrees of sophistication and quantitative capabilities, ranging from direct measures of mineral gain/loss (e.g., microradiography) to indirect measures (e.g., iodide permeability) of changes in tooth mineral properties. In all instances, the capabilities of methods for accurate determination of changes in tooth mineral properties are affected by procedures used in the preparation of specimens for analysis, the magnitude of change taking place in the test (vs. the detection limits of the techniques), and protocols for specimen analysis. In specific instances, such as in the case of dentin, unique specimen-handling and analysis procedures must be used to prevent artifacts. The choice of techniques for the assessment of de- and remineralization depends strongly upon study protocols and laboratory capabilities; however, 'quantitative' measures of mineral gain and loss are possible only if direct chemical or radiographic techniques are used. Either radiographic, cross-sectioned microhardness or polarized light can be used for the determination of lesion depth. Porosity, light-scattering, and surface microhardness are indirect techniques which complement direct measures of mineral gain and loss. Whatever methods are used in the analysis of de- and remineralization, researchers must take care to differentiate accurately among the quantitative capabilities of techniques used in analysis.

Dental Enamel↗
PubMed2000

In vitro approach to evaluate potential harmful effects of beer on teeth.

OBJECTIVE: The purpose of the present work was to examine some properties of different brands of beer manufactured in Brazil that may be important to oral health. METHODS: Samples from seven different beer brands were analyzed for pH, titratable acidity, calcium and phosphate concentrations. Demineralization experiments were carried out by incubating samples with crown tooth particles (40-80 mesh) at 37 degrees C under agitation (100 strokes/min). RESULTS: The pH was lower than 4.0 for three of the seven samples and higher than 4.0 for the others. The amount of titratable acidity, expressed as the volume of 0.1N NaOH solution consumed to raise the initial pH to 7.0, and the concentrations of calcium and phosphate varied. Calcium concentration ranged from 0.21 to 1.59 micromol/ml, while phosphate concentration varied from 0.048 to 0.094 micromol/ml. Calcium released to the incubation medium was proportional to the time of incubation up to 5min. Maltose, a disaccharide, was detected in all samples studied. CONCLUSION: Differences in the properties examined indicated that some brands of beer studied may have potential dental effects.

Beer↗