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In vitro cytotoxicity of a remineralizing resin-based calcium phosphate cement.

UNLABELLED: Recently, a resin-based calcium phosphate cement (RCPC) has been reported as a remineralizing pulp-capping or lining cement. RCPC consists mainly of tetracalcium and dicalcium phosphates, ethoxylated bisphenol A dimethacrylate and pyromellitic glycerol dimethacrylate monomers and photo- and chemical initiators. OBJECTIVES: Here, the cytotoxic effects of RCPC were evaluated. The hypothesis was that RCPC induced only minor cytotoxic response in immortalized murine odontoblast and pulp cells, comparable to that produced by similar dimethacrylates due to unpolymerized dimethacrylate monomer present after curing. METHODS: Cytotoxicity was determined following the changes in cell succinate dehydrogenase activity after 24 h exposure to the cement components and after a 24 h recovery period. A fourfold range of concentrations was tested of the monomers, the eluate of cured RCPC leached in Dulbecco's modified Eagle's medium, and crushed cured cement in dimethyl sulfoxide. RESULTS: The monomers themselves had cytotoxicities similar to those reported for other dimethacrylates, although they are significantly less toxic than Bis-GMA. Differential cell sensitivity was demonstrated, with the pulp cells having greater sensitivity to the unpolymerized monomer than the odontoblast-like cells. The leached components have cytotoxicity similar to that of the free monomers. The crushed material demonstrated no apparent cytotoxicity at the dilutions tested. SIGNIFICANCE: These data demonstrate that RCPC has an in vitro cytotoxicity that is comparable to other materials containing dimethacrylate monomers and suggest that the material may be suitable for use in dental restorations. The data also indicate that the pulp cells appear more sensitive to dimethacrylates than the odontoblasts.

Animals↗

The effects of 1% pyrophosphate and 0.02% sodium fluoride on artificial caries lesions in vivo.

We evaluated the potential of a pyrophosphate-fluoride solution to affect the remineralizing-demineralizing equilibrium, i.e., caries-inhibiting/-promoting effects on enamel in vivo. Fifteen subjects carried dentin blocks and enamel thin sections with artificial caries lesions in removable partial dentures for periods of two weeks, during which time they rinsed twice daily in a double-blind, randomized cross-over design with solutions containing (a) 90 ppm F, (b) 90 ppm F and 1% pyrophosphate, or (c) no active agents (placebo). A severe cariogenic challenge provided to the lesions by plaque under a stainless steel mesh cover resulted in the placebo-treated lesions losing 70.2% +/- 72.1% mineral. The pyrophosphate rinse with fluoride held the mineral loss to only 28.1 +/- 52.8%, while the fluoride rinse without pyrophosphate held the loss to 24.2 +/- 50.1%. The differences between the fluoride and placebo results were significant (p less than 0.01), but the difference between the two fluoride groups was not. A large amount of fluoride was deposited in the dentin lesions. In the surface layer, the concentration was increased from 1000 ppm F to more than 2300 ppm F by both fluoride treatments. The concentration of fluoride in both groups of fluoride-treated lesions further increased to more than 3500 ppm F in the approximate center of the lesion before declining in deeper layers toward the level found in the placebo-treated group. The findings from both mineral change and fluoride uptake phases of this study show that in the presence of 90 ppm F, 1% pyrophosphate did not promote demineralization of artificial caries lesions.

Adult↗

Comparison of the effects of two topical fluoride regimens on demineralized enamel in vivo.

The purpose of this investigation was to study the intra-oral remineralization of acid-softened enamel by a NaF dentifrice compared with that from a combination of topical F agents. Bovine enamel slabs were demineralized with 0.1 mol/L lactic acid at pH 4.0 for 14 hr and then mounted in a removable mandibular appliance. Control slabs were worn for 96 hr by seven adult males who brushed daily with a F-free dentifrice. Test slabs were brushed with a NaF dentifrice 4 x/day or with the same dentifrice 4 x/day and a 0.02% APF mouthrinse and a 0.4% SnF2 gel which were applied once/day for three days. The natural dentition was also brushed with the NaF dentifrice during both test periods. Microhardness testing was performed on sound enamel, and after acid-softening, intra-oral exposure (IOE), and acid resistance testing (ART) in 0.01 mol/L lactic acid at pH 4.0 for 24 hr. Control and test slabs were etched with 0.5 mol/L HC1O4 for from 15 to 60 sec. The F content was measured with a F electrode and PO4 by spectrophotometry. Contact microradiography and image analyses were performed on control and test slabs so that changes in mineral content resulting from treatment could be assessed. Both test groups were significantly harder after both IOE and ART than were controls, but no differences appeared between the effects of the two test groups. The F content of control slabs was significantly less than that of both test groups, and the combination-treated slabs showed greater F than did the dentifrice-treated slabs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Surface microhardness changes, enamel fluoride uptake, and fluoride availability from commercial toothpastes.

OBJECTIVE: The aim of the present study was to evaluate the ability of a new fluoride-containing dentifrice to protect surface-softened enamel against further erosive challenges in an in vitro cycling model, and to relate any effects to enamel fluoride uptake (EFU) and free fluoride. METHODOLOGY: Human enamel specimens were subjected to a daily cycling regimen comprising: three two-minute treatments; five two-minute challenges using 1% citric acid pH 3.8; and remineralization in a mixture of human saliva and mucin-containing artificial saliva. Surface microhardness (SMH) was measured at baseline, 10, and 20 days, and the fluoride content of biopsied specimens determined at 20 days. EFU studies were based on method #40 described in the United States Food and Drug Administration (FDA) testing procedures. Free-fluoride availability was determined from slurries of one part toothpaste plus three parts deionized water. RESULTS: SMH showed that a 1150 ppm NaF test dentifrice protected enamel specimens greater than Crest Cavity Protection (1100 ppm NaF) and a fluoride-free placebo at both 10 days and 20 days (p < 0.05). The fluoride content of specimens treated with this prototype was higher than either Crest or the placebo. SMH for a 1450 ppm NaF test dentifrice was greater than for Elmex Sensitive (1450 ppm amine F) and placebo at 10 days, while both products were greater than the placebo at 20 days. The fluoride content of specimens treated with this test dentifrice was higher than Elmex Sensitive, which was higher than placebo. The fluoride uptake seen in the cycling model correlated for the NaF dentifrices with a standard EFU procedure. Different EFU results for a series of commercial dentifrices demonstrated that EFU is not necessarily a function of free-fluoride availability. CONCLUSION: This study demonstrated that fluoride dentifrices can increase the protection of enamel against an erosive challenge in vitro, and that the increased protection correlated with fluoride uptake. The fluoride uptake seen in the cycling model correlated with a standard FDA EFU procedure for the NaF dentifrices. The present studies demonstrate the importance of formulation effects on driving performance in in vitro models.

Cariostatic Agents↗

Reversal of incipient and radiographic caries through the use of sodium and stannous fluoride dentifrices in a clinical trial.

Experimental evidence has clearly demonstrated that the early stages of lesion formation (enamel demineralization) are reversible following exposure to saliva and/or fluoride. Clinical evidence for remineralization has also been reported extensively in the literature. However, the literature is lacking with respect to data from well-controlled clinical studies regarding the quantitative contribution of remineralization to arrestment and reversal of caries. Retrospective analysis of an existing clinical trial database provided an opportunity to examine the incidence of clinical lesion reversals in a placebo-controlled, double-blinded caries clinical study. The clinical study examined three treatment groups: 1) 0.243% sodium fluoride/silica dentifrice, 2) 0.4% stannous fluoride/calcium pyrophosphate (positive control) dentifrice and 3) non-fluoridated placebo/calcium pyrophosphate (negative control) dentifrice. Clinical measures in this study included both radiographic and visual-tactile assessments of caries. Examination of all subjects revealed a statistically greater frequency for caries reversals in the sodium fluoride group as compared to the placebo group at Year 3, for both total and radiographic caries. In contrast, while caries reversals in the stannous fluoride group occurred with greater frequency than in the placebo group at Year 3, for both total and radiographic caries, the differences were not statistically significant. When only subjects who were "at risk" for potential reversals (i.e., those with a minimum of one carious lesion at baseline) were examined, a statistically greater frequency in caries reversals was observed in both the sodium fluoride (total, incipient, and radiographic caries) and stannous fluoride (total and radiographic caries) groups as compared to the placebo group at Year 3. Collectively, these data confirm the ability of both 0.243% sodium fluoride/silica and 0.4% stannous fluoride/calcium pyrophosphate dentifrices to clinically reverse caries. The results suggest that sodium fluoride may deliver a greater frequency of caries reversals than stannous fluoride, although these treatments were not found to be significantly different.

Adolescent↗

Effects of a glass-ionomer cement on the remineralization of occlusal caries--an in situ study.

This work evaluated the remineralization of demineralized enamel of pits and fissures of human third molars sealed with a glass ionomer cement (Fuji IX, GC Corporation--Japan) or with a Bis-GMA sealant (Delton--Dentsply). Ten volunteers participated in this in situ study that consisted of two thirty-day periods using intra-oral devices, with a weeks interval in between. Four experimental treatment procedures and one control were randomly assigned to the volunteers specimens: Group I, no treatment, control; Group II, artificial caries process; Group III, same treatment as Group II, but sealed with Delton (Dentsply); Group IV, same treatment as Group II, but sealed with Fuji IX (GC Corporation--Japan); Group V, same treatment as Group II and no sealing. Groups I and II were not submitted to the oral environment and served as controls. After a period of 30 days in the oral environment, the specimens were removed from the devices, embedded in acrylic resin, ground flat and polished. Then, Knoop hardness tests were performed, with a 25 g static load applied for 15 seconds. The measurements were made from the base of the fissure up to an opening of 600 microm, pre-established between the inclines of the cusps. Three indentations were then made, located at 25, 75, and 125 microm in depth from the outer enamel margin and 100 microm apart from each other (Micromet 2003). The Brieger F and Bonferronis tests were applied to the measurements. It was concluded that sealing with the glass ionomer cement Fuji IX was capable of making the enamel of pits and fissures more resistant by increasing the value of Knoop hardness.

Bisphenol A-Glycidyl Methacrylate↗

Dental knowledge and attitudes among Arab schoolteachers in northern Israel.

A representative random sample of 597 Arab school-teachers in northern Israel, was surveyed regarding sources and levels of knowledge and attitudes about dental caries prevention. Data were measured according to a self-administered questionnaire from a 91.4 per cent response rate. When ranking the effectiveness of different caries preventive measures teachers on average listed optimal water fluoridation as a lower priority compared to toothbrushing, dental visits, fluoride mouthrinses and eating fewer sweet products. Placing of fissure sealants was ranked as the second least effective caries preventive measure, with 39.6 per cent not knowing the effectiveness. Only 68.5 per cent of the school-teachers were aware of the anti-bacterial role of fluoride, and only a small minority knew of fluoride's potential in healing incipient caries. Teachers seemed less motivated to being involved in dental health school programmes which involved dedicating school time and their active involvement, such as fissure sealant programmes at school, supervision of brushing and flossing, and school mouthrinsing programmes. They revealed positive attitudes towards: informing parents about the importance of oral hygiene and teaching children about preventive dentistry. Teachers' main reported source of knowledge was the dental office. It is the responsibility of the dental profession to ensure that updated knowledge is correctly conveyed to schoolteachers, who are an important and potentially influential sector of dental health consumers and health education agents.

Adult↗

Onset, development and arrest of dental caries in Brazilian pre-school children.

The aim of this study was to describe the onset, development and arrest of dental caries in Brazilian 1- to 5-year-old children with limited access to dental care. The sample represented 40% of all children in these age groups attending public nursery school in the Federal District of Brazil. A total of 1465 children who benefited from fluoridated water soon after birth were examined for caries. For all teeth and tooth surfaces, the examination recorded whether they were sound, showing active or arrested lesions (non-cavitated or cavitated), filled or indicated for extraction. The onset of dental caries was identified at an early age; 89% of children were free of caries at the age of 1 year, decreasing to 28% at the age of 5 years. Non-cavitated lesions (active and arrested) accounted for 71% (<2 years), 58% (3 years), 47% (4 years) and 40% (5 years) of the total number of surfaces showing caries experience. The corresponding values for cavities were 28%, 38%, 47% and 47%, respectively. Maxillary incisors and molars disclosed the highest caries experience in all ages. For children older than 1 year, both mean deft and defs scores not including non-cavitated lesions were significantly different from those for which non-cavitated lesions were taken into account (t-test, P < 0.0001). At the age of 5 years, defs scores were 5.5 and 8.8, respectively. This study documented that the onset and development of dental disease started at an early age in the population studied, leading to a considerable need for dental care.

Age Factors↗

Some notes on the diffusion of acidic and alkaline agents into natural human caries lesions in vitro.

The aim was to obtain information on the penetration of ions, in particular H+ and OH-, into a wide variety of natural caries lesions in human teeth. Thirty-seven permanent teeth were slit in half and soaked in a 1% neutral (blue) litmus solution for at least a week. The cut face of the tooth was painted with a transparent, colourless nail varnish before the tooth was immersed in either of 0.1 M hydrochloric acid or 0.1 M phosphoric acid. In a reverse experiment the samples were soaked in acid (red) litmus solution and then immersed in 0.1 M sodium hydroxide after varnishing the cut face. All solutions were saturated with enamel apatite to avoid the possibility that the solutions might etch their way into the enamel. The colour change was recorded photographically. Several days of external acid/alkali exposure were required to change the litmus colour in the body of most of the lesions, suggesting that diffusion of acidic and alkaline species through the natural surface into the body was slow. The presence of a well-mineralized surface layer covering the lesion postponed the colour change. In contrast, the colour change of two root surface lesions was rapid, occurring within an hour. Thus, because the lesion body is relatively isolated and because lesion fluid is in intimate contact with the enamel apatite, we conclude that lesion fluid is close to saturation with respect to this mineral. Further, a pH change of lesion fluid in vivo paralleling that in plaque after a sucrose intake is unlikely.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Caries↗

Effects of phosphoprotein on collagen fibril formation in vitro.

Transmission electron microscopy showed that when either dentinal phosphoprotein or calcium-treated phosphoprotein or phosvitin were introduced during type I collagen fibrillogenesis the fibrils formed were significantly wider and the cross-banding was more distinct than in the absence of phosphoprotein. The collagen fibril width also increased with increasing concentrations of these molecules. When either bovine serum albumin (BSA) or dephosphorylated dentine phosphoprotein were used, no differences in the fibril characteristics were seen when compared to the controls that contained no phosphoprotein or BSA. When these dialysed matrices were placed into mineralizing solutions, no mineral was observed in any of the samples.

Animals↗

Experiments on the initiation of calcium fluoride formation with reference to the solubility of dental enamel and brushite.

As calcium fluoride formation following topical application of fluoride may be responsible for at least some of the caries-reducing effect of fluoride, the concentration of fluoride necessary to induce its formation were examined. The aim was to determine the degree of supersaturation with respect to calcium fluoride necessary for inducing its spontaneous precipitation, with close reference to its possible formation and retention on dental hard tissue when topical fluoride solutions are used clinically. Powdered enamel or brushite were suspended for 4 h in aqueous solutions buffered at pH 7.2 and 5.0. After the equilibration, ion concentrations were determined and degrees of saturation with respect to apatite and brushite were calculated. In aqueous solutions at pH 7.2 and 5.0 with similar concentrations as those found in the equilibrated suspensions the fluoride concentration was adjusted to from 5 to 500 parts/10(6). After 2 h of gentle agitation the supernatant was analysed, the precipitate (if any) isolated and examined by X-ray diffraction. Initiation of spontaneous calcium fluoride formation required a calcium fluoride ion-activity product of 10(-7.6) or more, 300 parts/10(6) fluoride were necessary to initiate calcium fluoride formation in neutral solution saturated with enamel, and the increased solubility of enamel apatite at low pH allowed calcium fluoride formation from solutions with as low as 100 parts/10(6) fluoride. When phosphate was present in the solution a competing apatite formation could mask the calcium fluoride formation. In neutral solutions saturated with respect to brushite, spontaneous fluorapatite formation was initiated by 100 pats/10(6) fluoride. With 200 parts/10(6) fluoride a further competing formation of calcium fluoride occurred.

Calcium Fluoride↗

Fluoride retention of incipient enamel lesions after treatment with a calcium fluoride varnish in vivo.

The aim was to determine the fluoride retention in plaque-covered and clean incipient enamel lesions after topical application of a CaF2/NaF varnish (Bifluorid 12). In 50 specimens of bovine enamel an incipient lesion was produced with acidic hydroxyethylcellulose (pH 4.8; 72 h). 40 specimens were fluoride varnished; the 10 remaining specimens were used for measuring baseline fluoride content. Each six of the fluoridated specimens were recessed in the buccal aspects of an intraoral appliance worn for 5 days. During the experimental period one side of the appliance was kept clean, and plaque growth was allowed on the other. KOH-soluble and structurally bound fluoride were determined immediately, 1 day, 3 days and 5 days after fluoridation, and compared with the baseline fluoride content of the enamel. Immediately after fluoridation, a considerable amount of KOH-soluble fluoride was bound, but after 5 days 80% had been lost. Simultaneously a significant increase of non-KOH-soluble or structurally bound fluoride was detected in both plaque-covered and clean enamel. It is evident that this CaF2/NaF varnish deposits more KOH-soluble fluoride on the surface of demineralized enamel than other varnishes, but after 5 days fluoride retention is similar to that from other varnishes.

Analysis of Variance↗

Influence of buffering effects of dentifrices and fluoride gels on abrasion on eroded dentine.

OBJECTIVE: Evaluation of abrasion resistance of eroded and non-eroded dentine brushed with experimental dentifrices and gels of varying buffering capacities. DESIGN: One hundred and twenty human dentine specimens were distributed among six groups (A-F) according to the different buffering capacities of experimental toothpastes and gels. The dentifrices (pH: 4.5) and gels (pH: 4.5) differed in fluoride content, RDA-value and buffer capacity (given as mg KOH needed for neutralisation): (A) 0.125%F, RDA: 77, 6mg KOH; (B) 0.125%F, RDA: 125, 24mg KOH; (C) 0.125%F, RDA: 129, 12mg KOH; (D) 0%F, RDA: 81, 1.55mg KOH; (E) 1.25%F, RDA: 21, 8.5mg KOH; (F) 0.125%F, RDA: 7, 3.11mg KOH. Ten specimens were cycled through three alternating demineralisations (1% citric acid, 5min) and remineralisations (artificial saliva, 1min) including brushing abrasion in an automatic brushing machine (2 x 2000 strokes). Ten samples of each group were not eroded, but only brushed. RESULTS: After three cycles, loss of dentine was determined by profilometry (mean +/- S.D. [microm]). Eroded samples: (A) 37.12+/-4.95; (B) 48.67+/-4.77; (C) 39.88+/-3.76; (D) 32.92+/-2.67; (E) 3.65+/-1.35; (F) 6.47+/-1.31. Uneroded samples: (A) 30.78+/-6.47; (B) 37.84+/-7.75; (C) 30.07+/-3.05; (D) 26.93+/-2.30; (E) 1.76+/-0.94; (F) 0.51+/-0.18. Analysis of variance revealed significantly higher abrasion values for the eroded compared to the non-eroded samples (P<or=0.05). Dentifrices with same pH-value, fluoride content and similar RDA-values but a higher buffering capacity exhibited significantly more abrasion than toothpastes with lower buffering capacity. Highly-concentrated fluoride gel with higher buffering capacity lead to less abrasion values compared to the gel with low fluoride concentration and low buffering capacity. CONCLUSION: Toothbrushing abrasion behaviour of eroded dentine may be influenced by the fluoride content, RDA-value and buffering capacity of the applied dentifrice or gel.

Buffers↗

Quantitative analysis of the impact of the organic matrix on the fluoride effect on erosion progression in human dentine using longitudinal microradiography.

After an initial demineralisation, an intensive fluoridation is capable of inhibiting the erosive mineral loss in dentine completely, which might be related to the presence of the exposed organic dentine matrix. Aim of the present study was, therefore, to evaluate whether fluoride is also effective when the organic material is removed. The study was a cyclic de- and remineralisation model over 5 days in vitro. Samples from human coronal dentine were demineralised with citric acid (pH 2.3; 6 x 10 min per day) and intermittently stored in a remineralisation solution. Groups (n = 25 each) were defined as follows: Group 1: erosion only, no fluoridation; Group 2: erosion, alternately fluoridation with toothpaste (NaF; 0.15% F-; 3 x 5 min per day), mouthrinse (Olaflur/SnF2; 0.025 F-; 3 x 5 min per day) and gel (Olaflur/NaF; 1.25% F-; at Days 1 and 3 instead of one toothpaste application); Group 3: erosion and fluoridation as Group 2, organic material was continuously removed with collagenase (from Clostridium Histolyticum type VII, 100 U/ml) added to the remineralisation solution. Mineral content was monitored daily using longitudinal microradiogaphy. After fluoridation in the presence of collagenase, a linear increase in mineral loss (73.3 +/- 17.6 microm at Day 5) was observed, which significantly (P < or = 0.001) exceeded that of the control group (45.9 +/- 14.3 microm at Day 5). After fluoridation in the absence of collagenase, mineral loss ceased after the 2nd day (12.2 +/- 10.2 microm at Day 5) and was significantly lower compared to Groups 1 and 3 (P < or = 0.001). The results indicate that the dentine matrix is essential for the effectiveness of fluoride in dental erosion.

Cariostatic Agents↗

Defining, classifying, and placing incipient caries lesions in perspective.

A caries lesion begins with the introduction of a disease state, likely due to bacterial strains, in the oral cavity. If accompanied or followed by alterations to salivary flow, frequent periods of reduced salivary pH, or frequent intake of refined carbohydrates, the demineralization of tooth structure is likely to begin. The subsequent lesions first will be visible as white spot lesions, which if ignored, eventually will cavitate. Modern dentistry is capable of testing for the presence of caries lesions before cavitation, and it is suggested that routine testing should be mandatory for all patients who are at risk. If the disease is to be identified and treated before cavitation, it is desirable to adopt a new classification for the recognition and recording of caries lesions.

Dental Caries↗

Review on fluoride-releasing restorative materials--fluoride release and uptake characteristics, antibacterial activity and influence on caries formation.

OBJECTIVES: The purpose of this article was to review the fluoride release and recharge capabilities, and antibacterial properties, of fluoride-releasing dental restoratives, and discuss the current status concerning the prevention or inhibition of caries development and progression. METHODS: Information from original scientific full papers or reviews listed in PubMed (search term: fluoride release AND (restorative OR glass-ionomer OR compomer OR polyacid-modified composite resin OR composite OR amalgam)), published from 1980 to 2004, was included in the review. Papers dealing with endodontic or orthodontic topics were not taken into consideration. Clinical studies concerning secondary caries development were only included when performed in split-mouth design with an observation period of at least three years. RESULTS: Fluoride-containing dental materials show clear differences in the fluoride release and uptake characteristics. Short- and long-term fluoride releases from restoratives are related to their matrices, setting mechanisms and fluoride content and depend on several environmental conditions. Fluoride-releasing materials may act as a fluoride reservoir and may increase the fluoride level in saliva, plaque and dental hard tissues. However, clinical studies exhibited conflicting data as to whether or not these materials significantly prevent or inhibit secondary caries and affect the growth of caries-associated bacteria compared to non-fluoridated restoratives. SIGNIFICANCE: Fluoride release and uptake characteristics depend on the matrices, fillers and fluoride content as well as on the setting mechanisms and environmental conditions of the restoratives. Fluoride-releasing materials, predominantly glass-ionomers and compomers, did show cariostatic properties and may affect bacterial metabolism under simulated cariogenic conditions in vitro. However, it is not proven by prospective clinical studies whether the incidence of secondary caries can be significantly reduced by the fluoride release of restorative materials.

Cariostatic Agents↗

Adhesive systems and secondary caries formation: Assessment of dentin bond strength, caries lesions depth and fluoride release.

OBJECTIVES: The present study evaluated the microtensile bond strength and caries formation on adhesive/dentin interfaces before and after dynamic chemical formation of secondary caries. METHODS: Restorations were prepared on the dentin surface of 80 bovine incisors using four adhesive systems: two fluoride-free (Single Bond and Clearfil SE Bond) and two fluoride containing (Optibond Solo Plus and Clearfil Protect Bond). The restored teeth were then sectioned into multiple slabs that were further trimmed at the bonded interface to a cross-sectional area of 1 mm2. Half of the slabs were subjected to secondary caries formation using a pH cycling model (treated groups); while the other half was used as the control group (no pH cycling). The specimens designated for bond strength evaluation were subjected to microtensile bond strength test (muTBS). Caries lesions formation was assesses by polarized light microscopy at different depths from the adhesive-dentin bonded interface. The fluoride ion concentration was evaluated using the de/remineralization solutions (De/Re). RESULTS: No differences in muTBS were observed among the adhesive systems in both the control and treated conditions. Secondary caries significantly reduced the values of muTBS for all adhesives (p<0.05). Optibond Solo Plus presented the lowest caries formation at 5 microm depth. Fluoride concentrations present in the De/Re were less than 0.03 ppm, regardless of the adhesive system tested. SIGNIFICANCE: Bond strength values significantly decreased after in vitro secondary caries formation. Fluoride present in adhesive systems is not capable of inhibiting secondary caries or maintaining bond strength values following caries formation.

Analysis of Variance↗

Caries and fluoride processes.

OBJECTIVES: The purpose of the work was to establish the level and source of salivary fluoride, whether it could interact with tooth mineral and whether it was able to effect calcium re-acquisition and remineralisation. METHODS: Fluoride in saliva and in solution was measured by electrode, calcium by complexometric titration and phosphate colourimetrically-to measure salivary fluoride, its uptake by mineral and the effects of such low levels on calcium and phosphate levels in solution in contact with suspensions of mineral hydroxyapatite. RESULTS: Fluoride levels in saliva were low but could interact with hydroxyapatite. Such levels caused apatite crystallite growth and preferential acquisition of calcium by calcium-deficient apatite. CONCLUSIONS: Salivary fluoride contents rose with increasing water fluoride levels. It was acquired by hydroxyapatite mineral. Topical fluoride was stored on oral tissues. Even these low fluoride contents could cause mineral crystallite growth with preferential calcium uptake. On a mineral area basis these effects were caused by quite low fluoride uptakes. These findings do not support reliance upon large fluoride uptakes by tooth enamel as evidence for commensurate caries reductions.

Calcium↗