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Albumin interaction with caries-like lesions in bovine enamel.

The exposure of bovine enamel to an albumin-containing demineralizing solution results in penetration of protein into the porous enamel. Washing of this albumin-containing enamel results in a complete (low pretreatment albumin concentrations) or partial removal of the albumin (pretreatment concentrations greater than or equal to 200 micrograms/ml-1). Subsequent exposure to increasing salt concentrations of fluoride, phosphate, calcium or chloride shows a partial removal of albumin at fluoride or phosphate concentrations of 75 mM while complete removal occurred at 150-200 mM fluoride or phosphate. Exposure to either calcium or chloride, even at 3 M concentrations, showed a negligible albumin release. It is proposed that protein removed at high fluoride or phosphate concentrations is bound by a strong interaction between protein-carboxyl groups and calcium on the surface of the enamel mineral. The partial removal of albumin released at low fluoride or phosphate concentrations indicates an enamel-albumin interaction by means of Ca-bridging between protein-carboxyl groups and mineral phosphates. Finally, it is suggested that salt-free washing removes albumin that has lost its native form upon binding to the partially dissolved crystallites of the enamel. It is concluded that enamel is mainly protected from demineralization by the inhibitory effects of protein penetrated into the pores, in addition to possible protection by the pellicle on the surface.

Albumins↗

Comparison between evaluation methods for the anti-caries efficacy of monofluorophosphate-containing dentifrices.

A comparison is described of three methods of preclinical assessment of potential anti-caries efficacy for topical fluoride treatments. Methods are compared using dentifrices containing 1,000, 1,500 and 2,500 ppm F as sodium monofluorophosphate (SMFP). These formulations have been shown elsewhere to give a statistically significant dose response of increasing anti-caries efficacy [Stephen et al., 1988]. An in situ enamel insert model, oral fluoride pharmacokinetics and F uptake to demineralised enamel are all shown to correlate with clinical efficacy for the test dentifrices studied.

Adult↗

A flexible and rapid pH cycling procedure for investigations into the remineralisation and demineralisation behaviour of human enamel.

A rapid and flexible model system has been developed to study human enamel behaviour under conditions of oscillating pH similar to those experienced in the mouth. The model uses realistic time intervals and operates at in vivo temperatures (35-37 degrees C). Mineral loss or gain is measured quantitatively on a volume basis. Results indicate that for single 1-day periods with three 20-min exposures to acid, 1% v/v of enamel mineral was lost. These results, together with the histological appearance of the tissue, are in close agreement with previous studies of enamel caries.

Calcium↗

High resolution fluoride profiles of artificial in vitro lesions treated with fluoride dentifrices and mouthrinses during pH cycling conditions.

A pH cycling model which incorporated a severe demineralization component was used to evaluate fluoride uptake and lesion progression for each of a NaF-based dentifrice, NaF-based mouthrinse and a monofluorophosphate (MFP)-based dentifrice. Simultaneous transverse fluoride and calcium profiles across the resulting artificial lesions were obtained using a proton microprobe technique with a resolution of approximately 10 microns. Longitudinal microhardness testing and proton microprobe calcium profiles were used to determine the extent of lesion progression (delta Z) with respect to untreated controls. Under the pH cycling conditions of the present study, the NaF dentifrice and mouthwash were observed to have a considerably higher uptake of fluoride in the lesion than the MFP dentifrice. Although the mineral content profiles of the lesions differed for treatments with each of the fluoride products, the differences were not significantly different in this model.

Calcium↗

Effect of hard cheese exposure, with and without fluoride prerinse, on the rehardening of softened human enamel.

The in situ rehardening effect was compared between Cheddar cheese consumption and saliva secretion with and without a fluoride pretreatment on softened human enamel. Ten volunteers wearing prostheses which held slices of human enamel participated in this study. Average microhardness of enamel was determined on the surface at baseline, after exposing to an acidic beverage, after exposing to saliva and mastication of cheese, with and without a mouth F prerinse (10 ml Meridol containing 0.025% F). The rehardening was increased in the groups consuming cheese compared to the saliva controls. The effect was increased by an F prerinse; the initial hardness of the intact enamel surface, however, was not reached.

Amines↗

Effect of glutardialdehyde on secondary caries in situ.

In this paper the results are presented on the effect glutardialdehyde (GDA) on the in situ demineralization of human enamel and dentine around an artificial gap of 200 microns width. In this model secondary enamel and dentine caries is simulated in situ; the mineral loss was quantified. The results show that a 2-min application of a 2% acidic GDA solution reduces dentine demineralization substantially, but does not influence enamel demineralization. Microradiography showed a reduction of mineral loss values around the gap in dentine by about 30%. The beneficial effect of GDA on dentine is presumably a combined result of collagen fixation, the reduced diffusion of calcium and phosphate ions out of the dentine lesion, and antibacterial action. The results indicate that GDA might play a role in the future reduction or prevention of secondary dentine caries.

Adult↗

Effects of chewing gums sweetened with sorbitol or a sorbitol/xylitol mixture on the remineralisation of human enamel lesions in situ.

Intra-oral remineralisation of experimental caries-like lesions in human enamel, as determined by polarised light microscopy and quantitative microradiography, was promoted to a similar extent (% fall in delta Z, 18.6 and 19.0) by chewing a sorbitol or sorbitol/xylitol (3:1)-sweetened gum for 20 min after each of three meals and two sugary snacks daily. The results suggest that reported differences in the properties of the two sweeteners do not affect their ability to enhance remineralisation due to salivary stimulation.

Adult↗

Residual effects of fluoride on a severe cariogenic challenge in rats.

The influence of temporary dietary restriction with and without fluoridated drinking water on the progression of caries was studied in 60 desalivated Sprague-Dawley rats. Dietary restriction alone had little effect on caries progression when the challenge was interrupted and then resumed, in contrast to the effects of dietary restriction plus fluoride. Animals subjected to gavage plus fluoride in the drinking water for 11 days developed significantly less severe lesions on their lingual surfaces than did any of the other groups. No significant differences were observed in the microbial flora of the animals at the end of the study. The results show that temporary dietary restriction alone has little permanent effect on caries progression and that fluoride administered even for a short time in the absence of cariogenic challenge has a statistically significant, but probably less than optimum, protective effect against a subsequent caries challenge.

Animals↗

Demonstration of a fluoride dose response with an in situ single-section dental caries model.

The in situ dental caries model developed in Glasgow was evaluated by determining whether it could demonstrate a fluoride dose response in a crossover study using 0, 250, and 1,000 ppm F from sodium fluoride dentifrices. In situ appliances, each carrying four enamel sections with multiple artificial carious lesions, were worn by 12 dentate subjects for three 5-week experimental runs, during which they brushed twice daily with a test paste. Mineral changes in the lesions were measured by analyzing microradiographs, using an image analysis system, after 0, 2, 4, and 5 weeks and the rate of change calculated. Two-way analysis of variance showed no significant intersubject effects (for any of the parameters), but demonstrated strong evidence of a linear fluoride dose effect: total mineral loss (delta z) p = 0.0596; lesion body p = 0.0423; surface zone p = 0.0081. However, the exclusion of the data from 1 low-caries (DMFS = 1), high-calculus-forming subject produced even stronger evidence as to the efficacy of this model (delta z p = 0.0226; lesion body p = 0.0164; surface zone p = 0.0081). Hence, these results suggest this model is useful for studying fluoride products according to guidelines of American Dental Association.

Adult↗

The video camera compared with the densitometer as a scanning device for microradiography.

In the recent past image analysis systems, comprising a video (CCD) camera and dedicated software, have replaced densitometer-based systems to analyze mineral content profiles using transversal microradiography (TMR). The main reasons for the introduction of the CCD camera were the ease and speed at which it can be operated. The densitometer, as a scanning device for TMR, has in the recent years been validated and is in this study considered as 'gold standard'. Comparisons of the two scanning devices for measuring the optical density of microradiograms have never been reported in the literature. The focus of this study was on accuracy and reproducibility of the scanning devices with the emphasis put on possible limitations of the CCD camera relative to the densitometer. These include resolution, number of gray levels and homogeneity of illumination of the scan area. The microscope was arranged in such a way that the same area on the microradiogram could be assessed by both scanning devices. Three different types of lesions were analyzed: a subsurface lesion, a surface-softened lesion and a laminated lesion. Paired t tests showed no significant difference between the mineral content profiles produced by the two scanning devices. The integrated mineral loss values were calculated and compared with analysis of variance and showed no significant differences. It is therefore concluded that mineral content profiles and integrated mineral loss obtained by the CCD camera are as accurate and reproducible as those obtained by the densitometer.

Analysis of Variance↗

Monitoring de- and remineralisation of enamel in vitro using an infrared reflectance meter.

The aim of this study was to design and investigate the use of an inexpensive method of monitoring the progress of demineralisation and subsequent remineralisation in artificial carious lesions. A small infrared (IR) reflectance meter was built which illuminated a 4 mm x 4 mm area on the buccal surface of a tooth and measured the reflected IR intensity. Repeated measurements were taken over a period of 25 days, during which the enamel surface was exposed to demineralising and subsequently remineralising solutions. Thirty-six teeth were studied under a variety of de- and remineralising conditions. It was observed that the IR specular reflectance of the tooth surfaces decreased with time during lesion formation and increased with time during remineralisation. It is suggested that the decrease in IR specular reflectance during demineralisation and the increase during remineralisation are a result of continuous changes in the crystals at the enamel surface during these processes.

Dental Caries Activity Tests↗

Laser fluorescence quantification of remineralisation in situ of incipient enamel lesions: influence of fluoride supplements.

The aims of this study were to test the laser fluorescence method for quantification of remineralisation in situ of enamel with incipient lesions and to evaluate the enhancement of remineralisation by fluoride (F) supplements when a F dentifrice was used on a regular basis by healthy young subjects. Enamel samples were cut from extracted premolar teeth with the natural surface kept intact, and subjected to a pH-cycling system to produce subsurface demineralisation in vitro. The enamel blocks were then inserted into composite holders bonded to the buccal surfaces of both upper first molars of 12 panelists. Each panelist participated in 3 separate experiments in a randomised order; each lasted for 5 weeks with washout intervals of 2 weeks between experiments; experiment 1: F dentifrice (0.145% F as NaF) only; experiment 2: F dentrifice + F lozenges (0.25 mg F x 6/day); experiment 3: F dentifrice + F chewing-gum (0.25 mg F x 6/day). Fluorescence radiance was measured before, during, and after in vitro demineralisation, and once a week during the in situ experimental periods. The enamel samples were then sectioned and analysed with transverse microradiography (TMR). Anova and Pearson correlation coefficient were used for the statistical analysis. At the end of the 5-week in situ periods, fluorescence radiance had been regained to a level of 80-100% of the value before in vitro demineralisation, indicating remineralisation of the enamel samples. There were no differences in the fluorescence radiance gain between the 3 different F exposures. However, there was a statistically significant time trend (p < 0.001), and a highly significant linear dependence (p < 0.001) between the final measurements obtained with the laser fluorescence method (LAF) and the data obtained from TMR, r = 0.76. It was concluded that: (1) with the sensitive LAF method it was possible to register the small changes in the enamel week by week during in situ remineralisation: (2) when F dentrifice was used regularly, F supplements such as F lozenges or F chewing-gum did not significantly enhance the in situ remineralisation of incipient enamel lesions in healthy, young adults with normal salivary flow.

Adult↗

The effect of fluoridated milk on human dental enamel in an in vitro demineralization model.

Fifty-seven sound human permanent premolars were demineralized for 14 days and then exposed to six different treatments: group 1, 1 mg/1 fluoride in milk for 7 days; group 2, 1 mg/l fluoride in milk for 14 days; group 3, 10 mg/l fluoride in milk for 7 days; group 4, 10 mg/l fluoride in milk for 14 days; group 5, control non-fluoridated milk for 14 days, and group 6, control tap water for 14 days. Enamel etch samples were taken and analysed for fluoride and for phosphorus. An increase in the enamel surface fluoride content was observed in groups 1-3. A statistically significant elevation (p < 0.01) of fluoride content and a significant decrease (p > 0.001) of acid solubility were found only in group 4.

Acid Etching, Dental↗

Enamel demineralization in situ with various frequencies of carbohydrate consumption with and without fluoride toothpaste.

There is little information in the literature on the relationship among the frequency of carbohydrate consumption, the use of fluoride toothpaste, and enamel demineralization. The aim of this investigation was to compare the extent of demineralization of enamel slabs in situ, with a sugar-based solution, consumed in constant amounts but with various frequencies in subjects both with and without the use of fluoride (F) toothpaste. Eight subjects wore removable mandibular appliances carrying an enamel slab cut from white-spot lesions. The subjects were required to drink 500 mL of a 120-gm/L sugar solution either once, 3, 5, 7, or 10 times/day for 30 sec on each occasion, for a period of 5 days while brushing their teeth twice daily with either a F (1450 ppm NaF) or a F-free toothpaste. Mineral analysis revealed that when the subjects used a F toothpaste, net demineralization was evident only with the seven- and 10-times/day regime (ns). When F-free toothpaste was used, statistically significant demineralization was observed when the frequency exceeded 3 times/day. This study demonstrates the importance of F-containing toothpaste in enamel re-/demineralization by varying the frequency of carbohydrate challenge

Adult↗

The nature of early caries lesions in enamel.

Since 1935, various mechanisms have been suggested for the formation of subsurface lesions and, in particular, the surface layer covering enamel lesions. The relatively intact mineral-rich and porous surface layer is most likely caused by kinetic events. The suggested mineral-rich outer layer in sound enamel, the organic matrix, the pellicle, or a non-uniform ion distribution have all been shown to be non-essential for surface layer formation; they may, however, influence the rate of surface layer formation. Models based on outer surface protection by adsorbed agents, the dissolution-precipitation mechanism, and combinations of these two models, as well as models based on porosity or solubility gradients, are discussed in this paper together with their advantages and disadvantages. Most models have not explained some important recent experimental observations on initial in vivo caries lesion formation: e.g., initial enamel lesions formed in vivo do not have a surface layer initially but develop this mineral-rich layer later on; and the fact that the F- level in the solid sound enamel is not determining the subsurface lesion formation. Furthermore, the observations that in vitro fluoride ions in the liquid at very low levels (approximately equal to 0.02 ppm) determine surface layer formation are difficult to explain. A new kinetic model for subsurface lesion formation is described, in which inhibitors such as F- or proteins play an important role. The model predicts that if lesions depth and demineralization period are denoted by df and t, lesion progress can be described by: dfp = alpha t + c, where alpha and c are constants with 1 less than or equal to p less than or equal to 3, depending on the lesion formation conditions. If lesion progress is entirely diffusion-controlled, p = 3, corresponding to low inhibitor concentrations; if the inhibitor content is so high that the progress is controlled by processes at the crystallite surface, p = 1. A kinetic mechanism for surface layer formation in vivo is proposed, based on the assumption that F- is a main inhibitor in the plaque-covered acidic in vivo situation. The inhibiting fluoride, adsorbed onto the crystallite surfaces at OH- vacancies, originates from the so-called fluoride in the liquid phase (FL) between the enamel crystallites. Under acidic conditions (plaque), we have, due to an influx of fluoride from the saliva or plaque as FL, an aqueous phase in the enamel supersaturated with respect to the mineral for a small distance (x*) only.(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗