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Results for “Tooth Remineralization”

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PubMed1986

Effects of two fluoride gels on fluoride uptake and phosphorus loss during artificial caries formation.

Blocks of human enamel were cycled through a demineralization--F-treatment-remineralization procedure and then analyzed for fluoride and the presence of caries-like lesions. Treatments with a sodium fluoride gel (5000 ppm F) increased the enamel fluoride concentration to 6500 ppm F, whereas a stannous fluoride gel (1000 ppm F) increased enamel fluoride to about 1200 ppm F. Although a control treatment (water) allowed caries-like lesions to form, as observed by microradiography, no lesions were found in either of the fluoride-treated groups. When the experiment was repeated with radioactive teeth, mineral loss, as determined by release of 32P, was again greatest in the water-treated control group, but some loss was observed in the fluoride treatment groups. The least loss was found in the sodium fluoride group. It was concluded that the fluoride treatments not only increased enamel resistance but also enhanced remineralization so that calcium phosphate was replaced during the subsequent remineralization phase. Because of the probability that stannous ions were deposited during the stannous fluoride treatments, some of the apparent calcium phosphate re-deposition in this group was probably stannous compounds.

Absorptiometry, Photon↗

PubMed1992

Demineralization and remineralization evaluation techniques.

This paper compares the experimental techniques utilized to assess the de- or remineralization of enamel or dentin in intra-oral studies. In in situ studies, it is important for one to know how much mineral has been lost or gained, and where the loss or gain occurred. The main emphasis in this paper is on techniques suitable for direct or indirect mineral quantification. The measuring techniques considered are microradiography, iodine absorptiometry, various microhardness tests, polarized light, light-scattering, iodide permeability, and wet chemical analysis. The various techniques are compared concerning suitability for the determination of mineral content in vol% (or wt%), mineral changes in vol% micron (or kg.m-2), and mineral distributions. Furthermore, sample preparation, the importance of protein penetration, nominal mineral loss range, the estimated mineral loss threshold, and the applicability to dentin are compared and considered. It is concluded that, although more than ten techniques are available for the measurement of changes after de- or remineralization in situ, transverse microradiography is the most practical technique for the direct and quantitative measurement of mineral content, mineral changes, and mineral distributions. Cross-sectional microhardness testing and light-scattering are also practical indirect techniques for quantitative mineral loss (or gain) determination in intra-oral studies.

Dental Enamel↗

PubMed1990

[Chemical crystal aspects of remineralization of dental enamel].

Incipient dental caries at the stage of demineralization is reversible, and remineralization can be achieved by the help of locally applied fluorides. In crystalchemical experiments, however by treating natural apatites with lanthanides Ce, La, Pr, Nd, Sm, Eu, Tb...Y, Sc, a more resistant complex could be developed. In this study extracted human molar teeth were kept for 60 days in Cerium (III)-nitrate solution, in order to investigate the incorporation of Ce3+ into human sound and carious enamel by light-microscopic-, and electronmicroprobe methods. Ce3+ was incorporated in sound enamel as well as into the incipient carious lesions, showing the histological characteristics of a remineralizing lesion. The mean values of the microprobe analysis data showed an increase in Ce3+ changing place with the Ca2+, the developing cerium-apatite being more hard an resistant from a mineralo-physical point of view.

Cerium↗

PubMed1997

Root caries in the older patient: significance, prevention, and treatment.

Root caries is an emerging challenge to the dental professions because of the growing number of increasingly aging adults who have retained many or all of their teeth. Risk factors for developing root caries point to both intraoral and environmental factors, making the management of root caries complex and multidisciplinary. Prevention based on a composite of risk factors is the most desirable approach for management. Patients who have developed caries of the roots can be treated with remineralization strategies, recontouring techniques, intracoronal restorations of a variety of established and recently introduced materials, or extracoronal restoration. Dental professionals need to keep abreast of new approaches that are emerging for the management of root caries.

Adult↗

PubMedDate not supplied

Fluoride dose response in pH-cycling models using bovine enamel.

The aim of this study was to establish methodologies for verification of the fluoride solution dose-response relationship using bovine enamel and pH-cycling models. Six models of the cariogenic challenge were performed, varying the time of demineralization and pH, time of remineralization, composition of de- and remineralization solutions, frequency and time of application of treatment solutions and pH-cycling duration. For the evaluation of the fluoride effect on caries dynamics, two proposed models provided for improvement in standardization of methods leading to a higher level of precision, demonstrating a dose response between treatments with regard to surface microhardness and DeltaZ. For the evaluation of the fluoride effect on enamel remineralization, the addition of fluoride to the de- and remineralization solutions and the reduction of frequency and time of application of fluoride solutions led to a more suitable pH-cycling model.

Analysis of Variance↗

PubMed1988

An in vivo study of microhardness and fluoride uptake in partially demineralized human enamel covered by plaque.

In this investigation, microhardness changes in partially demineralized human enamel were studied after in vivo use of fluoridated toothpaste systems. Flattened enamel specimens were demineralized in vitro and subsequently positioned in approximal positions in the prostheses of 27 participants for three weeks; the samples were plaque-covered in vivo. After brushing for one week with a non-fluoridated paste to achieve an in vivo equilibrium, participants brushed with an assigned product for a two-week period. This test was a six-way cross-over design which used randomization of subjects. Five fluoridated and one non-fluoridated paste were tested. Knoop hardness measurements were carried out on sound and on in vitro demineralized enamel, and after in vivo exposure of the enamel to the dentifrice treatments. The results showed that during the two weeks of in vivo exposure to the fluoride products, net rehardening of the demineralized enamel did not occur, and no correlation was observed between fluoride uptake into the demineralized enamel and changes in microhardness. That we failed to observe rehardening may be due to the fact that the duration of this study was too short for any net remineralization to have occurred, especially because the samples were constantly covered with plaque. Other possibilities, such as the type and/or severity of the lesions used in this study, may account for the lack of rehardening.

Analysis of Variance↗

PubMed1990

Posteruptive age dependency of cariogenic changes in enamel of permanent teeth of children.

During a cariogenic attack at the enamel surface a white spot can be formed (initiation) or disappear (regression) or remain the same (stabilisation). In the present clinical study it was shown that at least regression and stabilisation depend significantly on the posteruptive age and may be associated therefore with changes in porosity or mineral composition in the young enamel surface after eruption. In contrast, the progression of a white spot towards a cavity, which took place in this study almost exclusively in the fissures, does not change with posteruptive age. An explanation for this may be that in such white spots remineralization is less effective due to retention of acids in the fissures. On the other hand, rapid development of a cavity from sound enamel within half a year decreased with posteruptive age.

Adolescent↗

PubMed2000

Remineralization effects of a two-solution fluoride mouthrinse: an in situ study.

Results from previous studies show that a two-solution fluoride (F) rinse is significantly more effective than a NaF rinse of the same F content of 250 microg/g (ppm) in remineralizing enamel and root lesions in an in vitro cyclic de- and remineralization model. In the present study, the two-solution rinse and two NaF rinses with F contents of 250 ppm and 1000 ppm were evaluated in an intra-oral remineralization model. Caries-like lesions were formed in the enamel of extracted human molars with the use of a pH 4 demineralizing solution. Thin sections of the enamel (approximately 120 microm) containing lesions were prepared, and the mineral contents of the lesions were assessed by quantitative microradiography. With the cut surfaces protected by nail varnish, 3 enamel specimens were mounted with wax in the lingual areas of a removable mandibular appliance. The study used a randomized, crossover design with seven subjects. In each of the 3 legs of the study, subjects wore the appliances continuously except when eating, drinking, and brushing their teeth. Twice daily (after breakfast and before bedtime), the subjects received a one-minute rinse with 20 mL of (1) 250-ppm-F NaF rinse, (2) 1000-ppm-F NaF rinse, or (3) 228-ppm-F two-solution F rinse. At the end of the 14-day experimental period, the sections were retrieved, and the mineral contents of the lesions were again assessed quantitatively. The results show that both the 1000-ppm-F NaF and 228-ppm-F two-solution rinses produced a greater (p < 0.05) remineralization than did the 250-ppm-F NaF rinse. The remineralization produced by the two-solution rinse was not statistically different (p > 0.05) from that produced by the NaF rinse with 4x the F content (1000 ppm F).

Analysis of Variance↗

PubMed1989

[Demineralization and remineralization of enamel in the light of the most recent literature reports].

In the light of a review of the most recent literature reports the present views on demineralization and remineralization of enamel in vivo and in vitro are presented. Modes and conditions of the development of artificial enamel damage of the character of incipient caries are discussed. The possibility in stressed of cure of initial enamel damage after application of calcification-inducing solutions and human saliva.

Dental Caries↗

PubMed1997

Salivary parameters of relevance for assessing caries activity in individuals and populations.

A review of the non-microbial salivary parameters with respect to their possible association with caries activity is presented. The parameters are limited to those which already are or at least in the near future will obviously be simple enough, also for clinical purposes. Salivary flow rate is undoubtedly the most important single parameter since the cariostatic activity or efficacy of practically all other salivary parameters depends on the flow rate. Flow rate as such has no linear association with dental caries but there seems to exist an individual "threshold" limit which is decisive for enhanced caries activity. This threshold limit varies among different individuals and therefore the so-called normal values for unstimulated or stimulated flow rate are more reliable on a population level than among individuals for screening purposes. In any individual a regular and longitudinal follow-up of the flow rate is of higher clinical value than only a single cross-sectional measurement. Salivary buffer effect has only a weak negative association with caries activity and again, this effect is of greater clinical significance on a population level. Since the decisive processes in caries attack occur within or under the dental plaque, the buffering effect of saliva is limited and obviously more important to screen for erosion-than caries-prone individuals. Although important for dental health, none of the salivary antimicrobial agents as such has shown any strong association with caries activity. The only ones with some evidence of a regulatory role are secretory IgA antibodies, hypothiocyanite ions, and agglutinins. However, the data are controversial and it seems that instead of measuring individual parameters, the assessment of saliva's functional properties (such as the ability to aggregate bacteria, prevent their adhesion to hydroxyapatite or sugar metabolism etc.) is more important for clinical purposes. Of the parameters involved in de- and remineralization process, only salivary fluoride content has some association with caries susceptibility but its diagnostic or predictive value is questionable.

Agglutinins↗

PubMed1997

Release of cariostatic agents from a new buffering fluoride- and xylitol-containing lozenge to human whole saliva in vivo.

A new buffering lozenge (sucking tablet) was developed for patients susceptible to dental caries and erosion, in particular for those with reduced salivary secretion. As active ingredients this lozenge comprises of a combination of xylitol, fluoride, calcium, phosphate, zinc and buffering compounds. To test the lozenge's activity in vivo, the release of ingredients was monitored in 19 healthy subjects for 22 min after sucking the lozenge was completed. In subjects with a normal salivary secretion rate the lozenge caused only a slight stimulation of saliva flow, but a significant elevation both in salivary pH and buffer effect was observed. Furthermore, fluoride, calcium and phosphate were effectively released into whole saliva with peak values 2-4 min after use. The same salivary parameters were also quantitated after 1 month's regular use (3 lozenges/day) but no consistent long-term changes were found. Salivary mutans streptococci and total anaerobic microflora did not change significantly during the long-term use. The results show that the buffering fluoride- and xylitol-containing lozenge, which also releases calcium and phosphate, is active in vivo but its serviceability as a remineralizing agent, in particular for elderly patients with reduced salivary flow rate, has to be analysed separately.

Administration, Oral↗

PubMed1998

Mechanical properties of bioactive amorphous calcium phosphate/methacrylate composites.

OBJECTIVES: The aim of this study was to determine whether amorphous calcium phosphate (ACP)-containing composites, which have the ability to release mineralizing levels of Ca and PO4 ions, have appropriate mechanical properties for use as base and lining materials. METHODS: Composites of pyrophosphate-stabilized ACP particulates (mass fraction of 40%) and photo-activated methacrylate resins (mass fraction of 60%) were tested for biaxial flexure strength (BFS), diametral tensile strength (DTS), and compressive strength (CS). Hydroxyapatite (HAP; mass fraction of 40%), and micro-sized glass (mass fraction of 50%) composites as well as a commercial visible light curable base/liner were also tested. The significance between mean values was determined by Student-Newman-Keuls multiple comparisons (p < 0.05). RESULTS: BFS of dry and wet (24 h at 37 degrees C in water) ACP composites (60.3 and 62.0 MPa, respectively) were significantly lower than those of the comparison materials (79.2-109.3 MPa). CS values were likewise lower (62.9 MPa dry and 67.6 MPa wet vs 80.6-196.8 MPa) except for the wet base/liner (58.5 MPa). DTS of the dry ACP composite (21.8 MPa) was comparable with that of the HAP (22.8 MPa) and glass (25.5 MPa) composites, but lower than that of the base/liner (36.2 MPa). DTS decreased significantly when the ACP composite was wet (17.8 MPa). SIGNIFICANCE: These results suggest that the remineralizing ACP polymeric composites, although mechanically weaker in some respects than other polymeric composites, have properties suitable for use as base and lining materials.

Analysis of Variance↗

PubMedDate not supplied

Atraumatic restorative treatment: clinical, ultrastructural and chemical analysis.

With the purpose of checking, in vivo, the effect of atraumatic restorative treatment (ART) on the remaining demineralized dentin, 12 primary molars with deep occlusal lesions from children with ages ranging from 3 to 7 were evaluated. After lesion excavation, and before glass ionomer cement placement, dentin samples were collected from the pulpal wall of the cavity. After 3 months, the restorations were removed and new samples were collected. Six microareas of each sample were analyzed by X-ray energy dispersion spectrometer. Samples obtained before treatment were infected and intertubular dentin had a loosely organized collagen matrix, with well-defined collagen fibers. Following treatment, in addition to a drastic reduction of the amount of bacteria, the intertubular dentin was denser, with more compact and closely packed collagen fibers. An increased calcium concentration was observed in dentin collected after treatment (p < 0.001), suggesting tissue remineralization, but fluoride was not detected. We conclude that ART allows a one-session approach, with the purpose of creating more favorable conditions for the healing process.

Calcium↗

PubMed1992

[Dentin remineralization induced by glass ionomers].

Using an intra-oral model the effects of restorations on adjacently placed demineralized dentine were studied. After 12 weeks in situ, glass ionomer induced hypermineralization of dentine, in particular at the surface in contact with the filling. Next to amalgam restorations the dentine was found to be further demineralized.

Dental Restoration, Permanent↗

PubMed2000

Effect of acid-etching on remineralization of enamel white spot lesions.

This in vitro study aimed at investigating whether full remineralization would occur in white spot lesions when the surface porosity was increased by acid-etching. The effect of fluoride was also investigated. Enamel blocks with in vitro produced white spot lesions were used. Group A was exposed to a remineralizing solution only. In group B, the lesions were etched with 35% phosphoric acid for 30 s, then treated as in group A. Group C was treated as group A + daily treatment with a fluoride toothpaste slurry (1,000 ppm) for 5 min. Group D was treated as group B + the daily fluoride treatment of group C. The remineralization was measured weekly with Quantitative Light-induced Fluorescence during the experimental period. After 10 weeks of remineralization, mineral profiles were assessed with transverse microradiography. The enamel fluorescence was partly regained. There were significant differences in the lesion depth, mineral content at the surface layer, and integrated mineral loss between the groups. Addition of fluoride accelerated the remineralization only in the beginning; in later stages the process leveled out and even reached a plateau in all the groups. It was concluded that full remineralization was not achieved by etching, by the addition of fluoride, nor by the combination of both treatments in this in vitro study.

Acid Etching, Dental↗

PubMed1995

The distribution of fluoride in carious human enamel.

The proton probe has been used to map F concentration changes in the enamel of 15 teeth showing clinical evidence of caries. Thin sections through the lesions were microradiographed and measurements made of the surface zone (radiodense) and body (radiolucent) areas. Each section was then scanned with a focused beam of 2.5 MeV protons, 2000 spot analyses being performed over areas up to 2 x 3 mm. F was determined by detecting gamma rays from a nuclear reaction and the data used to construct 3-D surface plots. The maximum F concentration in the lesion surface zone was extremely variable, ranging from 1750 to 21,700 ppm, and rarely occurred over the deepest part of the lesion. F levels were elevated in the lesion body but usually to a small extent only. A large increase in F throughout the lesion body was found in 3 lesions only, and was associated with a surface zone that was thin or of low x-ray density. Relatively small F increases in the lesion body were associated with either a thick, x-ray dense surface layer having a greatly increased F level (> 10,000 ppm) or, conversely, with a surface layer having a relatively small F increase. Since F uptake can be regarded as a "marker" of past remineralization events, this study shows that remineralization can and does occur in the body of natural enamel caries lesions, especially when the surface layer is thin or lost. Fluoride availability that encourages the formation of an extremely dense surface layer may result in under-achievement of this natural repair process in the lesion body.

Dental Caries↗

PubMed1999

Double blind clinical trial of a remineralizing dentifrice in the prevention of caries in a radiation therapy population.

OBJECTIVES: The purpose of this study is to determine the efficacy and safety of a specially formulated remineralizing toothpaste in controlling caries in a group of high risk, head and neck radiation patients. DESIGN: The study compares the performance of the remineralizing toothpaste with a leading conventional fluoride dentifrice using double-blind randomization. TEST PRODUCTS: The products compared both contain equivalent quantities of fluoride (1150 ppm). The remineralizing toothpaste also delivers soluble calcium and phosphate ions, the essential components of teeth. SUBJECTS: On completion, 50 subjects who received > 50 Gy of radiation to the head and neck. MEASUREMENTS: Examinations include coronal and root caries using the Pitts Diagnostic Criteria, salivary flow rate, plaque and gingival indices and microbiological counts over one year. RESULTS: At this point subjects are enrolled in the study at various phases. However, the current average for the net increment per month per subject is -0.12 (+/- 1.30) for coronal caries and 0.06 (+/- 0.73) for root caries in subjects using the remineralizing toothpaste and 0.53 (+/- 1.62) for coronal caries and 0.45 (+/- 0.98) for root caries in subjects using the conventional fluoride dentifrice. Non-parametric analysis of rank scores for net root surface increments/month was statistically significant (p = 0.02), suggesting lower net root surface increment/month for the remineralizing toothpaste relative to the conventional toothpaste. No significant differences were noted on coronal surfaces. CONCLUSIONS: The results to date indicate that the remineralizing toothpaste is significantly superior to the conventional fluoride dentifrice in preventing root caries in high risk patients.

Adult↗

PubMed1993

Rehardening of surface softened and surface etched enamel in vitro and by intraoral exposure.

The rehardening of surface-softened and surface-etched enamel was investigated in vitro and by intraoral exposure. Surface-softened enamel was obtained by treatment with 0.1 M acetic acid buffer solution (pH = 5.5) for 3 h. Surface-etched enamel was obtained by the acid etch procedure used in clinical situations (37% phosphoric acid gel, 30 s). The enamel lesions were treated in vitro, with calcifying solutions for 8 h or were carried for 48 h in an intraoral appliance. Changes at the enamel surfaces were investigated by surface microhardness measurements. Following the treatment with calcifying solutions a significantly greater indentation length was observed in surface-etched than in surface-softened enamel. No significant difference in indentation length between both types of enamel lesions was observed following intraoral exposure. It was concluded that the initial rate of rehardening between both types of enamel lesions is comparable. At his stage remineralization occurs in microspaces created in the slightly destroyed enamel structures. The influence of the etch pits on the indentation length becomes dominating when remineralization continues. An obliteration of etch pits was observed in enamel samples treated with the calcifying solution with the highest degree of saturation. It was suggested that freshly prepared highly supersaturated calcifying solutions can be used to enhance mineral appositions in accidental etch pits.

Acetates↗