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Results for “Tooth Remineralization”
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Results after two years of non-operative treatment of occlusal surface in children with high caries prevalence.
The aim of this study was to describe the 2-year results of an individualized treatment program designed to control occlusal caries in erupting first permanent molars. The sample consisted of 145 five-to-six-year-old students divided into a control group (n = 71) and a test group (n = 74). All test children received a biannual basic preventive program and a recall system according to individual disease activity. The basic program consisted of 3 (March) and 2 (August) sessions of oral hygiene orientation and toothbrushing with fluoride gel. The analysis of the baseline and 1-2-year data showed a significant reduction in the number of active lesions in the test group. In the control group, there were initially 70 active lesions and after two years 68 surfaces remained with disease and 24 surfaces had been filled. The children in the test group had 80 surfaces with active lesions initially and after two years only 3 surfaces with disease remained. From the 15 cavitated lesions, only 5 surfaces needed to be filled. This program showed that care of erupting teeth on an individualized basis can control occlusal caries.
Visual evaluation of in vitro cariostatic effect of restorative materials associated with dentifrices.
This study evaluated in vitro the cariostatic effect of 6 restorative materials with and without fluoride release (Fuji II LC, F-2000, Degufil Mineral, Sure Fil and Z-250) associated with a fluoridated and a non-fluoridated dentifrice (Sensodyne Original Formula and Sensodyne Sodium Bicarbonate), on human enamel. Class V-like cavities were prepared on 240 enamel slabs, assigned to 12 groups (6 materials and 2 dentifrices). After cavity restoration, the slabs were submitted to a thermocycling regimen of 1000 thermal cycles and demineralization/remineralization cycles. During pH cycles, slurries of fluoridated and non-fluoridated dentifrices were applied for 5 min. Formation of artificial caries-like lesions was scored independently and blindly by 5 calibrated examiners according to an ordinal scale ranked 0 to 3 by visual examination. The results were analyzed statistically by the Kruskal-Wallis test and pair-wise comparisons (alpha=0.05). There were no significant differences (p>0.05) among the restorative materials associated with the fluoridated dentifrice. When used in association with the non-fluoridated dentifrice, Ketac-Fil showed the highest cariostatic effect followed by Fuji II LC and the other materials. Ketac-Fil was the only material that did not differ statistically when combined with either the fluoridated or the non-fluoridated dentifrice. In conclusion, under the tested experimental conditions, the association of restorative materials and fluoridated dentifrice yielded higher cariostatic effect, except for the conventional glass ionomer cement, whose cariostatic effect was not influenced by the type of dentifrice.
The effect of gamma radiation on enamel hardness and its resistance to demineralization in vitro.
Given the importance of sterilizing human teeth before using them in research, the effects of a 25 kGy dose of gamma radiation on the mechanical properties of enamel and its resistance to demineralization were evaluated. Thirty human teeth were sectioned longitudinally, and while one half of each tooth was irradiated, the other half was kept as a control. Abraded and unabraded enamel slabs were obtained from these halves. The surface microhardness (SMH) of abraded slabs of irradiated and non-irradiated enamel was determined to evaluate the effect of radiation on enamel structure. Further, both abraded and unabraded slabs, either irradiated or non-irradiated, were submitted to a pH-cycling model to evaluate enamel resistance to demineralization, which was quantified by mineral loss (deltaZ) using cross-sectional microhardness. The data for SMH and deltaZ were statistically analyzed by t-test and ANOVA, respectively. The difference in enamel SMH between slabs from irradiated teeth and non-irradiated teeth was not statistically significant (P > 0.05). The abraded enamel slabs showed higher values of deltaZ than unabraded enamel slabs (P < 0.05), but the irradiation effect was not statistically significant (P > 0.05). The results suggest that the medical gamma radiation dose of 25 kGy does not affect either enamel hardness or its resistance to demineralization.
Demineralization effects of 2 bleaching procedures on enamel surfaces with and without post-treatment fluoride application.
In this in vitro study, the demineralization effect of 2 different bleaching procedures on enamel surfaces with and without the post-treatment application of fluoride was determined. Bovine enamel specimens (n= 180) were ground flat, polished and divided into 6 groups. Group A (n=30) specimens were bleached with Opalescence, 10% carbamide peroxide (Ultradent Products, Inc) for 8 hours daily for 2 weeks; Group B (n=30) specimens were treated with Whitestrips, 5.3% hydrogen peroxide (Procter & Gamble) for 1 hour daily for 2 weeks; Group C (n=30): the same as Group A, but after bleaching, a fluoride varnish was applied on the specimens and left for 1 hour (Duraphat, 2.26% F-); Group D (n=30): the same as Group B, followed by the same fluoride application as Group C; Group E (n=30): the specimens were covered with a glycerin gel as a control group; Group F (n=30): specimens were kept in Coca Cola 1 hour daily for 2 weeks. The mineral loss (vol% microm) and lesion depth (microm) were measured by microradiography. Data analysis was accomplished using the Kolmogorov-Smirnov, Kruskal-Wallis and Mann-Whitney U tests (p<0.05) (SPSS 11.0). The median mineral loss was statistically significantly higher in the non-fluoride groups (A: 271.20 vs C: 128.00 and B: 364.90 vs D: 151.10). The highest mineral loss was found in Group F (581.85 vol% microm) and was lowest in Group E (32.80 vol% microm). No statistically significant difference between groups was found for lesion depth.
Xylitol-induced changes of enamel microhardness paralleled by microradiographic observations.
The study, aimed to analyze the feasibility of a prospective field study, was carried out in Polynesian children with rampant untreated caries. Slabs of bovine enamel were inserted for 8-12 days in cavities and subsequently replaced by permanent fillings. Before use, the surface of the slab was polished, and one half predemineralized and tested for microhardness. The follow-up in 30 subjects involved 54 slabs, 30 from negative controls with no added sweets and 24 from subjects receiving 20 g/day of xylitol in candy. The microhardness of the slabs was reassessed, and the difference between measurements calculated and tested for significance. The differences between the groups were highly significant, the predemineralized halves showing pronounced rehardening at exposure to xylitol. Parallel microradiographic observations conformed with the above findings. The results indicate that the use of a noncariogenic sweetener might be of value in high caries risk subjects.
A newly designed automatic pH-cycling system to simulate daily pH fluctuations.
The aim of this study was to develop and evaluate an automatic pH-cycling system, which was intended for performing time-lapse analyses of dental caries. Two single-section specimens prepared from each of the five extracted human incisors were studied under a condition of 3- or 9-cycles/day for seven weeks. Increase of mineral loss (delta delta Z) and increase of Ld (delta Ld) were examined and compared at the end of every week during the study. In the 3-cycles/day condition, delta delta Z and delta Ld significantly increased only at Week 7. In the 9-cycles/day condition, delta deltaZ increased significantly from Week 5. delta Ld increased from Week 2, and then there were no further increases for the subsequent five weeks. Based on the results of this study, progression pattern was found to be significantly different between the two conditions. We therefore concluded that the automatic pH-cycling system which we have developed qualified as a model system that simulated the human oral cavity. As such, it could be beneficially employed to clarify the roles of many factors that cause or prevent caries development in human teeth.
An in vitro evaluation of pH variations in calcium hydroxide liners.
The purpose of this present study was to determine the pH changes of five different commercially available calcium hydroxide liners and variations of pH at different time intervals. The following commercially available materials were investigated: Dycal (LD Caulk); Calcimol (Vocco Products); calcium hydroxide powder (Deepti Products); Calcimol LC (Vocco Products); Lime-Lite (Pulpdent Corporation). Five samples were prepared from each liner. The pH measurements were recorded at time intervals of 1 h, 24 h, 3 days and 7 days after mixing of the liner. The pH variations of each material at the given time intervals were recorded and the means were calculated. Comparison of the mean values at all time intervals with the statistical analysis showed significantly high differences (P < 0.001) between pH values induced by each material at all time intervals. Among the water-insoluble products, Dycal had the strongest alkaline effect after 7 days interval. The materials that chemically hardened produced higher pH values than materials that hardened by a visible light source after 7 days.
The in vitro effect of fluoridated milk in a bacterial biofilm--enamel model.
OBJECTIVES: The purpose of this study was to investigate the effect of milk and fluoridated milk on bacterially induced caries-like lesions. SAMPLE AND METHODS: Extracted impacted human molars were cut in half and covered with a varnish leaving a 4*4 mm window. The samples were coated with biofilm of S. sobrinus and were further divided into three experimental groups of S. sobrinus, S. sobrinus and milk and S. sobrinus and fluoridated milk. As negative controls served teeth incubated in saline. Of twenty tooth halves serial ground sections were cut through the lesions and investigated with polarization light microscopy (PLM) and scanning electron microscopy (SEM) and EDX element analysis. The PLM photographs were used for 3D reconstruction, volumetric assessment and determination of the extension of the lesion zones. Of eight tooth halves the biofilm on the enamel surface was studied with SEM and EDX element analysis. RESULTS: Volumetric assessment showed a statistically significant difference in the volume of the body of the lesion and the translucent zone between the milk group and fluoridated milk group. Quantitative element analysis demonstrated significant differences between sound enamel and the superficial layer in the fluoridated milk group. The biofilm on the enamel surface showed an increased Ca content in the milk group and fluoridated milk group. CONCLUSIONS: Milk as a common nutrient seems to play a complex role in in-vitro biofilm--enamel interactions stimulating bacterial demineralization on one hand, and, as effective fluoride carrier, inhibits caries-like demineralization.
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Decay-inhibiting restorative materials: past and present.
Clear differences exist in the fluoride release characteristics and setting reactions of glass-ionomer cements and compomers. Differences in decay inhibition associated with specific materials are less clear. Furthermore, resin added to glass ionomer cement formulations and acids added to composite resins make it difficult to distinguish composite resins from compomers and glass ionomer cements, all of which have reported fluoride release. Optimal fluoride release from a dental restorative depends on several conditions, including oral flora, saliva, diet, mineral content of the dental tissues, and marginal seal of the restoration. Presently, in vitro and in vivo studies suggest that materials which behave similarly to silicate cements in their setting reactions and hydration characteristics will behave as decay-inhibiting restoratives. Until optimal fluoride release from dental restoratives can be quantified, dental clinicians are encouraged to consider clinical outcomes as the best test for decay inhibition. Nearly a century of clinical findings support the anticariogenicity of silicate cements. This article reviews fluoride release and anticariogenicity of restorative materials using silicate cement as a model with a well-defined mechanism for preventing secondary caries. The behavior of newer materials is compared to silicate cement for predicting decay inhibition.
[Mechanism of action of fluorides in local/topical application].
The marked caries reduction in many countries over the last two decades is thought to be mainly the result of the widespread and frequent use of low concentrations of fluorides mainly via toothpastes. This article gives a review on fluoride sources in the oral cavity and discusses the physiochemical mechanisms by which fluoride interacts with enamel during the caries process and its reversal. From this review it becomes clear that fluoride incorporated into the enamel mineral during tooth development has little effect on the caries process. It is the fluoride incorporated posteruptively and in the aqueous phase during the caries challenge that is of primary importance. The most effective caries preventive fluoride regimen, both from a theoretical perspective and as proved clinically, is the frequent (daily) low concentration application of fluoride from toothpastes and/or mouthrinses. High concentrations, however, used at intervals of months or years and administered by the dentist, work initially not only on both de- and remineralisation, but also by providing fluoride as calcium-fluoride or absorbed in early lesions which is subsequently available over prolonged periods.
[Saliva: natural protection against caries].
Salivary secretions protects the teeth and the oral mucosa. The physiology and biochemistry of saliva are discussed in detail. Following functions of saliva such as mechanical protection of teeth and mucosa; antimicrobial properties of saliva, regulation of pH and the role of saliva in de- and remineralisation of dental enamel are reviewed. Salivary gland dysfunction (etiology and treatment) emphasises the item of caries prevention.
Gingiva, teeth and sea salt.
This article presents a review of the effects of sea salt on gingival tissues. The beneficial effects of sea salt are described.
Dental applications of amorphous calcium phosphates.
Certain commercial materials and equipment are identified in this paper to specify the experimental procedure. In no instance does such identification imply recognition or endorsement by the National Institute of Standards and Technology or the ADA Health Foundation, or that the material or equipment identified is necessarily the best available for the purpose.
Baby boomers make cosmetic dentistry boom.
Baby Boomers want to stay younger longer. As they age, a healthy attractive smile becomes much more important to their appearance. Nothing conveys good health and maintenance like aesthetically pleasing teeth. Because the timing is perfect for cosmetic dentistry, there is no reason for people to not have a great smile. Smile-Vision and the latest cosmetic dentistry techniques and materials helped the case patient first see and then become the person he wanted to be. His teeth look and feel better, resulting in a more confident appearance. (Figures 14 through 16).
Dealing with sensitive teeth.
Dental pain is extremely common in the UK and can severely reduce the quality of life when it is associated with eating, drinking or speech. Patients often present complaining of a short, sharp, stabbing pain from hot or cold air, foods or drinks: while this may be caused by tooth decay, failing fillings or cracks in teeth, a major cause is sensitivity from exposed dentine. Treatment varies from dietary control, desensitising toothpastes to protection with dentine-bonding agents and glass ionomers. In extreme cases elective devitalisation is necessary.
Considering a new paradigm in caries diagnosis. Towards a more conservative approach to treatment.
Advances in the understanding of caries and the introduction of new treatment techniques have led to the development of a new approach, or new paradigm. This paper contrasts the new paradigm with its predecessor, discusses the implications of both for the diagnosis and treatment of caries, and describes impediments to the adoption of the new paradigm.