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PubMedDate not supplied

Rates of mineral loss in human enamel during in vitro demineralization perpendicular and parallel to the natural surface.

Human enamel is a structurally anisotropic material. The aim of this study was to investigate whether this structural anisotropy is reflected in the demineralization behaviour of enamel. Kinetics of demineralization of in vitro caries lesions with the direction of acid attack perpendicular to the natural surface of dental enamel from human premolar teeth were compared with kinetics when demineralized parallel to this surface. Pairs of enamel samples from the same tooth were demineralized under identical conditions. Loss of mineral with time was very nearly linear for both directions (consistent with the rate-controlling step being reaction at the advancing front rather than transport processes), but the perpendicular rate was, on average, about 14% higher than the parallel rate. The rate of demineralization parallel to the surface increased from the natural surface to the enamel-dentine junction by 10-25%, depending on sample. The origin of fine structure and slight departures from linearity in the loss of mineral with time plots are discussed. Mineral masses per unit area were determined from absorption of a 15-microm diameter X-ray beam using photon (AgKalpha) counting methods.

Anisotropy↗
PubMed1997

Effects of collagenase on root demineralization.

The role of proteolytic enzymes in the root caries process remains unclear. The aim of this study was to investigate collagenase activity during tooth root demineralization and remineralization in an in vitro demineralization/remineralization pH-cycling model, Human tooth roots were subjected to pH cycling (alternating demineralization and remineralization) in one of two different time cycles for five days. Collagenase at 90, 180, or 360 micrograms per root was placed into either the demineralizing solution or the remineralizing solution in the pH-cycling system. The effects of additional exposure to collagenase before or after pH cycling were also studied. After the exposure, thin sections of the roots were examined histologically by polarized light microscopy. Changes of calcium and phosphate in the solutions were analyzed chemically. Surface erosion occurred only in the groups where collagenase was contained in the remineralizing solution and in which the root samples were exposed to severe demineralization. However, no differences among the control and experimental groups were found in calcium and phosphate changes in the pH-cycling solutions. These findings suggest that collagenase works during the remineralizing phase and predominantly attacks the organic matrix of the root after demineralization. Additional exposure to collagenase before or after pH cycling did not increase surface erosion except for exposure to collagenase in the absence of phosphate following pH cycling.

Calcium↗
PubMed1992

An in situ model for simultaneous assessment of inhibition of demineralization and enhancement of remineralization.

In situ models to assess the ability of oral care products or food components to enhance remineralization and/or inhibit demineralization of tooth enamel or roots must be very carefully designed to minimize the confounding effects of the many variables involved. Controlling these variables as closely as possible is essential if meaningful answers are to be obtained from the models. We have developed an in situ model which combines the experience of several groups. Detailed screening of subjects is essential. Selection criteria should include good general health, good dental health, mandibular partial denture, at least eight natural teeth, no active caries lesions, known fluoride history, normal salivary function, and no medications that affect salivary function. Each subject carries a sound enamel slab and an enamel slab with a pre-formed caries-like lesion (demineralized in vitro) in his/her denture on each side of the mouth for test periods of two or four weeks. The demineralization challenge is controlled by extra-oral immersion of the appliances in sucrose daily. Daily product exposure or daily food component exposure is used as desired. Compliance indicators and a diet diary are included. Whole saliva flow rate (unstimulated), plaque acidogenicity, and salivary fluoride are monitored during the test periods. At the end of the test period, the test slabs are assessed for mineral change, after being sectioned, by means of cross-sectional microhardness or microradiography. The mineral loss or gain (delta M, microns x vol%), compared with adjacent control sections retained in the lab, is calculated as change in delta Z (microns x vol%), namely, delta M = delta ZTEST - delta ZCONTROL.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Remineralization of carious dentin. I: in vitro microradiographic study in human teeth capped with calcium hydroxide.

The objective of this in vitro study was to evaluate a possible remineralization of human carious dentin by calcium hydroxide. Thirty-nine freshly extracted human permanent and deciduous carious teeth were split into two halves. One half was used as control and the other as experimental. In the latter, a cavity was prepared and the remaining bottom layer of demineralized dentin capped with chemically pure calcium hydroxide. The experimental samples were stored at 37 masculine C. Time intervals were 2, 4, 6, 8, 10 and 12 weeks. All tooth halves were sawed and ground to plano-parallel sections with a thickness varying from 75 to 117 microm. Qualitative microradiographs showed a qualitative increase in radiopacity of the calcium hydroxide treated samples. Quantitative microradiography showed a statistically significant increase in total mineral content in the experimental samples compared to the control samples. These results indicate an in vitro remineralization of carious dentin by calcium hydroxide.

Calcium Hydroxide↗
PubMed2006

Influence of rotating-oscillating, sonic and ultrasonic action of power toothbrushes on abrasion of sound and eroded dentine.

OBJECTIVE: This in vitro study aimed to evaluate the susceptibility of sound and eroded dentine to brushing abrasion performed by different rotating-oscillating, sonic and ultrasonic toothbrushes. METHODS: Toothbrushing abrasion (20 cycles, each 30 s) was applied to bovine dentine samples (each subgroup n = 10) exhibiting both a demineralized (each cycle: 1% citric acid, pH: 2.3, 60 s; 30 min remineralization in artificial saliva) and a sound surface area. Toothbrushing was performed in an automatic brushing machine with the rotating-oscillating, sonic and ultrasonic toothbrushes either (a) activated, supplemented by 20 strokes/min of the brushing machine, (b) inactivated, supplemented by 20 strokes/min of the brushing machine or (c) inactivated, supplemented by 80 strokes/min of the brushing machine. A manual toothbrush was applied with 20, 80 or 100 linear strokes/min. Specimens of the control group were not brushed after erosion. After each cycle, the samples were stored in artificial saliva for 4 h. After 20 cycles, loss of sound and softened dentine was determined by profilometry. Mann-Whitney-Wilcoxon test and Bonferroni corrections were applied to the data (p < 0.05). RESULTS: For all groups, demineralized dentin areas exhibited significantly higher abrasion values than the respective sound dentine surfaces. However, mean dentine loss of both softened and sound dentine was higher after use of the rotating-oscillating, sonic and ultrasonic brushes with the activated regime [(a) eroded dentine: 9.94-16.45 microm; sound dentine: 3.31-5.47 microm] than after brushing with the inactivated regimes [(b) eroded dentine: 5.10-5.62 microm; sound dentine: 1.16-1.81 microm; (c) eroded dentin: 7.64-8.89 microm; sound dentine: 1.38-1.69 microm]. CONCLUSION: The results indicate that rotating-oscillating, sonic or ultrasonic action of the power toothbrushes leads to an increased loss of demineralized and sound dentine.

Animals↗
PubMed2004

Biological factors in dental caries enamel structure and the caries process in the dynamic process of demineralization and remineralization (part 2).

Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The physicochemical properties of the mineral comprising the tooth surface and subsurface modulate the development, arrestment and remineralization of dental caries. Post-eruption maturation of enamel surfaces and exposed root surfaces is important in order for more susceptible mineral phases to be modified by incorporation of soluble fluoride from the plaque into dental hydroxyapatite. The chemical reactions that occur during acidic conditions when tooth mineral dissolves (critical pH) are determined by the supersaturation of calcium and phosphate within plaque and saliva, as well as if fluoride is present.

Apatites↗
PubMedDate not supplied

Relationship between electrical resistance measurements and microradiographic variables during remineralization of softened enamel lesions.

The purpose of this study was to investigate the relationship between electrical resistance (ECM) measurements and microradiographic variables during remineralization of softened enamel lesions. Sound bovine enamel blocks were demineralized and, subsequently, were remineralized for 3, 4, 5, 7 or 14 days. All the specimens were assessed by ECM and transversal microradiography. The mean ECM values in each group increased after remineralization. The ECM values after remineralization (ECM1), mineral loss (DeltaZ) and maximum mineral content in the surface layer (V(max)) were significantly correlated with the remineralization time. The ECM1 values were also significantly correlated with DeltaZ and V(max). It is suggested that ECM could be used as a device to monitor mineral accumulation as a result of preventive treatment in vitro. However, it may take a much longer time to follow up the remineralization changes compared with demineralization.

Animals↗
PubMed2002

Quantitative light-induced fluorescence: a potential tool for general dental assessment.

Current dental diagnostic methods can detect caries but cannot quantify the mineral status of a lesion. Quantitative light-induced fluorescence (QLF) measures the percentage of fluorescence change of demineralized enamel with respect to surrounding sound enamel, and relates it directly to the amount of mineral lost during demineralization. Development of caries-like lesions and subsequent remineralization of the lesions were monitored by QLF. The results showed that the percentage of fluorescence change (Delta Q) increased linearly with the demineralization time and decreased with increased remineralization time. Stained teeth were whitened with a bleaching agent and the change in stain intensity (Delta E) was quantified using QLF. The results showed that Delta E decreased linearly as the tooth regained its natural color. Factors that might affect the use of QLF to detect and quantify caries were also examined. It was concluded that QLF could be used to detect and longitudinally monitor the progression or remineralization of incipient caries, however lesion detection may be limited by the presence of saliva or plaque and enhanced by staining. The change in shade of discolored teeth by whitening agents could be quantitatively measured by QLF.

Dental Caries↗
PubMed2005

Differentiation of developmental and post-orthodontic white lesions using image analysis.

The aim of this study was to investigate differences in shape and size characteristics between developmental opacities and post-orthodontic white enamel lesions using computerized image analysis. Material, in the form of 35 mm slides, was obtained from the archive of photographic patient records in the orthodontic clinic at the Charles Clifford Dental Hospital. Images of 30 teeth with developmental white lesions and 30 teeth with post-orthodontic white lesions were selected using strict inclusion and exclusion criteria. The slides were converted to a digital format, coded, placed in a random order and analysed blindly using a computerized image analysis system by one clinician. After a 2 week interval, the images were recorded, placed in a new random order and the measurements repeated. The outcome measures were: area and luminance proportionality, and the shape of the perimeter line (expressed as the mathematical factor, roundness). Reproducibility was assessed by a paired samples t-test for systematic error and the intra-class correlation coefficient (ICC) for random error. Differences between groups were tested using the Mann-Whitney U-test for non-parametric data. Reproducibility was substantial for all measurements except for developmental white lesion roundness, which was moderate. There was a statistically significant difference between developmental white opacities and post-orthodontic white lesions for measurements of luminance intensity, proportionality (P = 0.002) and roundness (P = 0.001). Developmental white opacities had a higher luminance (i.e. were whiter) and the boundaries were more circular in shape than the post-orthodontic lesions. Roundness is a useful measure when distinguishing developmental and post-orthodontic demineralization.

Dental Enamel↗
PubMed1991

Demineralization of human dentine compared with enamel in a pH-cycling apparatus with a constant composition during de- and remineralization periods.

A comparison was made between the demineralization of enamel and dentine with and without abraded surfaces. This was done in a pH-cycling experiment for different demineralization/remineralization ratios--in the range from 1:1 to 1:4--and for different fluoride additions (up to 2 ppm) in solution. A new automatic pH-cycling system, in which the de- and remineralization solutions have a constant composition during the de- and remineralization cycles, was used to create mineral loss in human dentine and enamel. Changes in mineral content were monitored by means of longitudinal microradiography. A linear correlation was found between the amount of mineral lost and the total demineralization time for both dentine and enamel. The demineralization rates were comparable for abraded enamel and dentine and for polished enamel and dentine, and this rate was roughly doubled by the removal of the outer surface for both tissues. This showed that the presence of the outer surface is equally important to dentine and enamel. Under the pH-cycling conditions used, a logarithmic relation was found between the addition of fluoride and the decrease in demineralization for both enamel and dentine. The inhibitory effect of fluoride on demineralization was most pronounced on abraded enamel, followed by pumice-polished enamel, abraded dentine and pumice-polished dentine. About 2 ppm fluoride was needed under the conditions used to stop enamel demineralization completely; in the case of dentine, however, this amount of added fluoride did not inhibit demineralization.

Analysis of Variance↗
PubMed1999

Caries inhibiting and remineralizing effect of xylitol in vitro.

This study aimed to determine the effect of xylitol on the development and remineralization of caries in vitro, and to compare this effect with that of fluoride alone and in combination. Two experiments were devised. In experiment 1, bovine incisors were each sectioned into 4 portions which were randomly assigned to 4 demineralizing agents: A) acidic buffer (x), B) x + 0.5 ppm fluoride, C) x + 20% xylitol, and D) x + 20% xylitol + 0.5 ppm fluoride. Caries-like lesions were produced in specimens. In experiment 2, carious lesions were produced in teeth. Five lesion-bearing slabs were cut from each tooth. While one was reserved as control (UN), others were randomly assigned to 4 remineralizing agents: 1) artificial saliva (y), 2) y + 0.05 ppm fluoride, (3) y + 20% xylitol, and 4) y + 20% xylitol + 0.05 ppm fluoride. Mineral loss (delta Z) and lesion depth (ld) were quantified after 4-week remineralization. In experiment 1, numerical values of delta Z and ld observed can be ranked as A > C > B > D. These differences were significant only in B and D when compared with A for delta Z, but not between any group for ld. In experiment 2, the numerical values of delta Z and ld for control UN (unremineralized) and remineralized groups (1-4) ranked as UN > 3 > 4 > 1 > 2. Compared with UN, this difference was significant in all groups with ld, but not in any group with delta Z. We concluded that tolerable levels of xylitol alone may not show a significant caries inhibiting and remineralizing effect, but may act as a caries inhibitor additively with fluoride.

Animals↗
PubMed2002

Organic material and the optical properties of the dark zone in caries lesions of enamel.

Sections of uncavitated natural caries lesions of human enamel were extracted with various solvents and examined by polarizing microscopy. After lipid extraction, the dark zone enlarged by 19-162% and its birefringence increased, while after protein extraction it shrank by 37-92% and became less birefringent. It is concluded that occlusion of submicroscopic pores by organic material largely accounts for the optical properties of the dark zone. The results are not consistent with occlusion of pores by reprecipitation of mineral. On the basis of previous work, organic material in this location could influence demineralization and remineralization.

Calcium↗
PubMed1991

The effect of citric acid treatment on periodontal healing after replantation of permanent teeth.

The aim of this study was to evaluate the effect of surface demineralization on the healing of 120 replanted teeth in fifteen 8- to 16-month-old dogs. Replanted teeth were divided into two groups (A and B). In group A, teeth were replanted following planing of the entire root surface. In group B, teeth were replanted following planing and surface demineralization with citric acid. Replanted teeth were splinted for 7 days, and observation periods were 3, 14 and 56 days. A total of 95 teeth and their surrounding tissues were examined histologically under a light microscope. Histological examination of specimens 3 days after replantation revealed that initial reunion between the root and the alveolar periodontal ligament fibres was via a fibrin-like network in both groups. Fourteen days after replantation histological observations showed superior healing in group B with regard to epithelial condition, periodontal ligament fibre reattachment to the root surface, resorption and functional arrangement of the periodontal ligament fibres. By 56 days after replantation, healing was superior in group A; group B was characterized by severe inflammatory and replacement resorption. These results indicated that surface demineralization had an initial positive effect, but later led to impaired healing.

Animals↗
PubMed1993

Fluoride and mineral content in hyper-remineralized coronal bovine dentine in vitro after an acid challenge.

In this paper the acid resistance of hyper-remineralized dentine was quantified by means of fluoride and mineral measurements. Hyper-remineralization was achieved by demineralization of dentine in an acidic gel system (pH 5) for 3 weeks, followed by remineralization in a solution containing 1.5 mM Ca, 0.9 mM phosphate and 10 ppm F at pH 7 and 37 degrees C for 8 days. The samples were subsequently again demineralized in the gel system mentioned for 1, 2 and 3 weeks. Analysis for fluoride was done by means of the microdrill biopsy technique and to obtain information on the fluoride distribution by secondary ion mass spectrometry (SIMS); mineral was assessed by microradiography. The results showed that in hyper-remineralized dentine the original fluoride content was approximately 30,000 ppm F. This value was still in the same order after the acid challenge of 3 weeks at pH 5. These values were substantially higher than the baseline values in sound or in demineralized dentine being about 900 ppm F. The main microradiographic result was that there was no significant mineral change in the hyper-remineralized dentine due to the acid challenges. There was, however, a tendency for mineral redistribution deeper into the dentine lesion leading to lamination phenomena. The SIMS experiments on some of the samples showed a fluoride distribution in agreement with the microdrill fluoride data. Furthermore a fluoride redistribution took place in deeper parts of the lesion due to the acid challenges. The combined fluoride concentration and microradiographical data indicate that fluoride-enriched and highly mineralized hyper-remineralized dentine is more acid resistant than sound or demineralized dentine.

Animals↗
PubMed2003

Influence of fluoride on the prevention of erosive lesions--a review.

This review describes various forms of fluoride applications for reducing dental erosive lesions induced by acidic substances. Fluoride admixtures to acidic solutions in a concentration excluding toxicologically side-effects seem unable to arrest erosive lesions. By contrast, topical fluoride applications of toothpastes, oral rinses, gels or varnishes appear to be an effective agent for reducing demineralization by erosion. In particular, high-concentrated fluoride applications are able to increase abrasion resistance and decrease the development of erosions in enamel and dentin.

Fluorides↗