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The acid-tolerant microbiota associated with plaque from initial caries and healthy tooth surfaces.

The intent of this study was to compare the inherent acid tolerance of bacteria in samples of dental plaque from tooth sites in subjects with and without initial caries. Plaque was collected from approximal surfaces showing early enamel caries and from healthy tooth surfaces in the same subjects, as well as from enamel surfaces of caries-free individuals. In addition to plating on blood agar, the plaque samples were plated directly on non-selective solid agar medium buffered to pH 7.0, 6.0, 5.5, 5.0, 4.5 and 4.0 to avoid any loss of adaptation to acid during primary isolation of plaque bacteria. The results showed that approximately 50% of the total cultivable plaque microbiota from caries, as well as healthy tooth sites, was able to grow at pH 5.5 and 1% at pH 5.0, pH values regarded as critical for the demineralization of tooth enamel. At pH 5.0, members of the genus Streptococcus were the dominant group, but mutans streptococci accounted for less than half of the streptococcal viable count. The other acid-tolerant streptococcal isolates included Streptococcus anginosus, Streptococcus constellatus, Streptococcus gordinii, Streptococcus intermedius, Streptococcus mitis, Streptococcus oralis, Streptococcus salivarius and SStreptococcus sanguis. Analysis of the results indicated that the mutans streptococci in dental plaque were highly variable with respect to acid tolerance, and that both caries and healthy sites harboured significant numbers of mutans streptococci that were not acid-tolerant.

Acids↗

[Increased resistance to demineralization on enamel cavity walls by application of fluoride solution].

Dental enamel cavity walls of bovine extracted incisors were submitted to different treatments before to be "restored" with amalgam. The Group A non received treatment; the Group B received only a conventional cavity varnish and the Group C received a solution of sodium fluoride (2%) + conventional cavity varnish (2 applications). After 7 days of immersion in gel acid, the ground sections were studied in polarized microscope. The Group C that received sodium fluoride + conventional cavity varnish presented more resistance to demineralization. The Group B that received only cavity varnish presented a reduction in resistance to demineralization, and the Group A that non received treatment presented minor resistance to demineralization. Therefore, is emphasized the importance of application of sodium fluoride in cavity walls before lining with conventional cavity varnish and restoring with amalgam to obtain more resistance to demineralization.

Animals↗

In situ induced demineralization in irradiated and non-irradiated human dentin.

The objective of this study was to evaluate the onset of initial demineralization in irradiated and non-irradiated human dentin. Dentin specimens were prepared from the cervical regions of 48 third molars. Either the lingual or the buccal dentin specimen of each tooth was irradiated fractionally up to 60 Gy (2 Gy/d, 5 d/wk). The remaining dentin sample was not irradiated. Two irradiated and two non-irradiated dentin specimens were inserted into both buccal aspects of each 12 intraoral mandibular appliances. The appliances were worn by 12 persons for 5 wk day and night. One side was brushed daily with a fluoride-free toothpaste. On the other side, plaque was allowed to grow. Individual oral hygiene techniques were performed without any fluorides. During meals, the appliance was stored in 10% sucrose solution. After the in situ period, slabs (150 microm) were ground and studied by means of transversal microradiography and microscopic techniques. Concerning mineral loss and lesion depth, ANOVA revealed significant differences between brushed and non-brushed specimens, whereas no differences between irradiated and non-irradiated dentin lesions were found. It is concluded that (in vitro) irradiated dentine is not more susceptible to caries than non-irradiated, if adequate oral hygiene techniques are implemented.

Adult↗

AFM observation of collapse and expansion of phosphoric acid-demineralized dentin.

The objective of this study is to provide additional data regarding morphological changes that occur to dentin matrices following demineralization with etchants. Our understanding of the mechanism of diffusion of comonomers into the demineralized substrate is very limited. It has been hypothesized that certain water-soluble polyelectrolytes (acidic proteins) and neutral proteins in dentin can influence the collapse of demineralized dentin when it is air dried. Some of these solubilized substances are thought to aggregate by the action of Ca cations, which become dissolved during H(3)PO(4) etching, ultimately resulting in some degree of collapse. In the current study, dentin surfaces were examined by atomic force microscopy (AFM) before and after treatment by 10% H(3)PO(4)containing increasing concentrations of CaHPO(4). Reversal of matrix collapse by aqueous 30% 2-hydroxyethyl methacrylate (HEMA) was evaluated by AMF for 60 min. The results demonstrate two forms of matrix collapse; we speculate that one form is induced by acidic noncollagenous polyelectrolytes and the other by neutral peptides. Our data indicate that further evaluation of the influence of endogenous noncollagenous proteins must be studied to understand the mechanism of the collapse and reexpansion dynamics of demineralized dentin networks.

Animals↗

[Prevention of enamel demineralization adjacent to orthodontic brackets bonded with resin-modified glass ionomer: an in vitro pH cycling study].

OBJECTIVE: To investigate the resin-modified glass ionomer cement for inhibition of enamel demineralization adjacent to orthodontic brackets under a pH cycling experiment. METHODS: The study used 5 pairs of extracted human premolars. The experiment teeth were bonded with resin-modified glass ionomer, the control teeth were bonded with composite resin. All samples were under the pH cycling experiment each day for 60 days. Demineralization lesions of enamel adjacent to orthodontic brackets were evaluated with polarized light microscopy. The depth and area of the lesion, and the distance between the edge of the adhesive on the enamel surface and the border of the lesion were measured. RESULTS: The depth and area of lesions of control were greater than those of experiment group were. Paired t test showed significant differences (p < 0.001). There was always a distance between the lesions border and the glass ionomer cement. In control group, all lesions were developed under the edge of composite resin. CONCLUSION: It was suggested that resin-modified glass ionomer may become an orthodontic bonding agent to minimize enamel demineralization.

Glass Ionomer Cements↗

Comparative reduction of enamel demineralization by calcium and phosphate in vitro.

In theory, calcium and phosphate in the plaque fluid exert a large influence on the demineralization of enamel surface. In order to know the effect of increasing the concentration of either of these factors, the following in vitro experiment was conducted. Three thin sections, about 150 Im thick, were cut out from each of 13 human premolars. All surfaces of the sections, except for the original enamel surface, were coated with nail varnish. These sections were immersed into one of two sets of demineralizing solutions for 1 week at 25 degrees C. Each set, the 'calcium set' and the 'phosphate set', contained three solutions. The composition of these solutions differed mainly in calcium or phosphate concentrations. After 1 week, the degree of demineralization was determined by image analysis of contact microradiograms from each section. The subsurface demineralization in enamel was reduced by 95% by increasing the calcium concentration of the demineralizing solution from 7 to 21 mmol/l. A similar reduction (87%) was observed by increasing the phosphate concentration. However, the amount of phosphate needed was approximately 20 times more than that of calcium. The larger inhibitory effect that calcium has on enamel demineralization was related to the larger effect it has on the degree of saturation of the solution. Even though no statistically significant difference was found between the effect of calcium and phosphate on the demineralization of enamel (when the solutions had the same degree of saturation), the difference in the standard deviation of demineralization suggests the existence of some other factors which have an influence on the demineralization reaction.

Adolescent↗

Demineralization effects of 10 percent carbamide peroxide.

OBJECTIVES: The purpose of this in vitro study was to measure the amount of calcium lost from enamel exposed to a 10% carbamide peroxide solution. METHODS: Nine teeth (3 incisors, 2 premolars, 4 molars) were sectioned to serve as paired test and control specimens. Each tooth half was coated with wax, leaving a uniform 3 mm x 4 mm window of exposed enamel. Test specimens were placed in culture tubes with 1.00 ml of deionized water and 0.02 ml of 10% carbamide peroxide for 6 h; controls were exposed to water alone. Calcium concentrations in the solutions were measured using a Perkin-Elmer 5100 atomic absorption spectrophotometer. RESULTS: Teeth exposed to carbamide peroxide lost an average of 1.06 micrograms/mm2 of calcium. This amount of loss was significantly greater than controls (p < 0.001), according to ANOVA. For comparison, teeth were exposed to a cola beverage for 2.5 min, the time equivalent of drinking a 16 oz. beverage. The amount of calcium lost from these teeth was also about 1 microgram/mm2. CONCLUSIONS: Teeth exposed to 10% carbamide peroxide lost calcium. However, the amount of loss was small, and may not be clinically significant.

Analysis of Variance↗

A study of the effect of fluoride delivered from solution and dentifrices on enamel demineralization.

An in vitro demineralization model has been developed and used to examine the effect of various fluoride treatments on early enamel demineralization. The effect of fluoride treatments on the calcium demineralization rate of enamel was studied by analyzing the amount of calcium which demineralized from teeth into solution when the teeth were exposed to weak acid solutions. Continuous (72 h total) exposure of enamel to very low levels of fluoride, 0.014 ppm, was observed to have a protective effect against demineralization, as was intermittent exposure to higher levels of fluoride delivered from solution and from dentifrices for shorter periods of time (40 min total). This work suggests that the residual salivary fluoride concentrations reported to be reached by water fluoridation (0.016 ppm) or brushing with a fluoride-containing dentifrice (0.014 ppm) give a level of fluoride in saliva which may give some protection to the dental enamel from demineralization.

Adult↗

Development and control of caries lesions on the occlusal surface using a new in vivo caries model.

The aim of this study was to develop a new in vivo caries model for the occlusal surface and to describe the enamel features observed before and after dental plaque control (DPC). Four volunteers (12-15 years old) participated in the experiment, each of which was due to have 2 homologous first premolars extracted for orthodontic reasons. Test surfaces did not present visible signs of demineralization, opacities or fillings. A wire mesh was used to promote dental plaque accumulation on the occlusal surface. After 4 weeks, the wire mesh was removed and DPC was performed. In Groups 1 and 2, DPC was performed by the subjects daily and, in Groups 3 and 4, DPC was performed by the subjects daily and by the professional weekly. One tooth/pair of Groups 1 and 3 was extracted after 2 weeks. One tooth/pair of Groups 2 and 4 was extracted after 4 weeks. All test surfaces showed demineralization after the wire mesh was removed. The observed re-establishment of the enamel brightness was directly related to the increase of the DPC duration. In polarized light microscopy, interindividual differences varying from pseudoisotropic areas to enamel lesions were noted in specimens submitted to 2 weeks of DPC. Specimens submitted to 4 weeks of DPC showed less tissue porosity. It was concluded that the new in vivo caries model was effective since all occlusal surfaces presented clinical and microscopic signs of mineral loss in different stages after 4 weeks of cariogenic challenge. After DPC on the test surfaces, there was a reduction of mineral loss suggesting control of demineralization on these surfaces.

Adolescent↗

Dental enamel: detection of surface changes by ultrasound.

Evidence indicates that the tooth surface differs in structure from the enamel immediately beneath it, and particularly that the enamel rod type structure is minimal in the true natural surface. Furthermore, the rod ends appear to disappear with age after the eruption of the tooth. The thickness of the surface layer may be as much as 25 micrometers. Studies of caries incidence show a peak in the attack curve 2 to 4 years after eruption and a decline thereafter for all teeth. This information indicates that the mechanical structure of the tooth surface should be carefully studied. A highly useful means appears to be ultrasound since the specific acoustic impedance of highly mineralized tissue like enamel is strongly dependent on fraction volume mineralization and since non-destructive test techniques can be based on ultrasonics. An experimental demonstration of ultrasonic detection in vitro of tooth surface demineralization is given.

Collagen↗

Effect of Carisolv solution on sound, demineralized and denatured dentin--an ultrastructural investigation.

The purpose of this in vitro study was to analyze the micromorphological changes caused by Carisolv gel on sound, demineralized, and denatured dentin. Fractured dentinal surfaces, dentinal surfaces demineralized superficially by phosphoric acid etching and dentinal surfaces denatured due to lactic acid and collagenase pretreatment were exposed to freshly mixed Carisolv gel or 0.25% sodium hypochlorite. No additional mechanical action was exerted during the 20-min exposure of specimens to the Carisolv solution. Specimens were evaluated by transmission electron microscopy. Electron microscopic evaluation did not indicate any ultrastructural changes of the fractured or demineralized dentinal surfaces due to the 20-min Carisolv treatment. Denatured dentin was partially removed within a 20 min period of chemical action of the Carisolv solution leaving only a 1- to 2-micron thick layer of residual denatured dentin on the specimen's surface. In contrast, 0.25% sodium hypochlorite treatment completely dissolved the demineralized as well as denatured dentin layer within 20 min. It is concluded that Carisolv gel (1) does not affect sound fractured dentin, (2) does not dissolve demineralized dentin, and (3) has a limited potential to chemically dissolve denatured dentin.

Cariostatic Agents↗

[Observation on the inhibiting effect of fluor protector on the demineralization of bovine enamel after exposure to some beverages].

OBJECTIVE: To investigate the role of Fluor Protector in the demineralization of bovine enamel after exposure to some beverages. METHODS: Twenty-four bovine teeth were divided into experimental and control groups. The enamel specimens of the experimental group were pretreated with Fluor Protector and then exposed to beverages; the enamel specimens of the control group were exposed to beverages directly. All the enamel specimens were exposed to beverages 10 times a day and 5 minutes each time. After 7 days' exposure to the beverages, all the specimens were observed by scanning electron microscope (SEM). RESULTS: Different degrees of solubilization of enamel prisms in the control group were demonstrated by SEM. The solubilization of enamel prisms in the experimental group was much more slight than that in the control group. CONCLUSION: Fluor Protector can inhibit the demineralization of enamel caused by beverages.

Animals↗

Inhibition of demineralization in vitro around fluoride releasing materials.

Replacement of restorations because of secondary caries is a continuing problem in restorative dentistry. This investigation assessed the capacity of fluoride-releasing restorative materials to resist caries in vitro when used in roots. Class 5 cavities were prepared in buccal and lingual surfaces of 30 extracted premolars and restored with one of three polyacid modified resin composites (F-2000, Hytac and Compoglass F), a resin modified glass-ionomer cement (Fuji II LC) a conventional glass ionomer (Ketac-Fil), and a resin composite (Z-100). After 5 weeks in an acid gel for caries-like lesion formation, the teeth were sectioned longitudinally and examined with polarized light. The results showed that restoration of caries with polyacid modified resin composites and resin modified glass ionomer cements may be of great importance in the prevention of secondary caries around the restorations in roots. Clinical Relevance Light cured fluoride-releasing restorations may inhibit caries-like lesions. Inhibition of demineralization in vitro around fluoride releasing materials.

Bicuspid↗

Prevention of enamel demineralization during orthodontic treatment: an in vitro study using pit and fissure sealants.

Enamel demineralization during active orthodontic treatment remains a significant problem. The purpose of this in vitro study was to evaluate the efficacy of applying a light-cured unfilled resin, a conventional pit and fissure sealant, to the labial surface of teeth with previously placed orthodontic appliances to prevent demineralization. Orthodontic brackets were bonded to 40 extracted human teeth with a commercially available orthodontic adhesive. The exposed labial surfaces of 30 teeth (experimental group) were sealed with a clear, light-cured, unfilled resin. The remaining 10 teeth (control group) were left unsealed. Both groups were placed in a demineralization environment, and then all teeth were sectioned and examined under polarized light microscopy for the presence or absence of enamel demineralization. Every member of the control group exhibited demineralization of the entire exposed labial surface, whereas 80% of the sealed teeth exhibited no demineralization. Small, isolated areas of enamel loss were seen in six of the sealed teeth representing "breaks" in the sealant layer. The results of this study indicate that light-cured sealant treatment after orthodontic appliance placement significantly reduces enamel demineralization.

Bisphenol A-Glycidyl Methacrylate↗

[Comparison of demineralization of different organic acid to enamel].

The rates of demineralization of 5 organic acids (mathanoic acid, formic acid, propionic acid, Lactic acid, acetic acid, mixed acid) to the bovine enamel were tested and analysed with the self-made calcium ionselective microelectrodes(Ca(2+)-ISME) basing on a neutral carriers of ETH1001. The results showed; 1. The difference between the rates of demineralization of formic acid and lactic acid, formic acid and propionic acid, formic acid and acetic acid, acetic acid and mixed acid, acetic acid and lactic acid, propionic acid and mixed acid, propionic acid and lactic acid, lactic acid and mixed acid were of great significance (P < 0.01); 2. The rates of demineralization of acetic and mixed acid decreased with time, due to saturation of the solution during demineralization; 3. Ca(2+)-ISME was of the advantages of simplicity, rapidity, sensitivity and accuracy. The results suggest that the cariogenic potential is related to different acid products of different cariogenic bacteria, and the degree of mineral saturation within solution affects the rate of demineralization.

Acetic Acid↗