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Enamel fluoride levels after orthodontic band cementation with glass ionomer cement.

The aim of this investigation was to examine the fluoride uptake by enamel after application of glass ionomer cement for orthodontic band cementation compared with zinc phosphate cement. The study was conducted on 21 children whose mean age was 14 years. All the children were reared in the Middle Anatolian cities where the water fluoride concentration was below the level of 0.50 ppm. The subjects were randomly divided into three groups. The first experimental group, had seven subjects whose teeth were topically fluoridated with 2 per cent NaF solution, before orthodontic band cementation with zinc phosphate cement. The second experimental group also had seven subjects whose orthodontic bands were cemented with glass ionomer cement. The third group, consisted of seven control subjects and no dental procedures were performed in this group. All the participants were followed for 3 months and at the end of this period maxillary first premolars, which were in the ninth developmental stage according to Nolla (1960), were extracted for orthodontic purposes. The enamel fluoride concentrations were determined on the left maxillary first premolars at three successive etch depths by means of a fluor ion electrode, whereas the calcium concentrations were determined with an atomic absorption spectrophotometer. The results of this investigation showed that in both cementation groups enamel fluoride concentrations at three successive etch depths were highly increased compared with the control group. However, the difference between the cementation groups was not statistically significant.

Adolescent↗

Influence of fluoride on the prevention of erosive lesions--a review.

This review describes various forms of fluoride applications for reducing dental erosive lesions induced by acidic substances. Fluoride admixtures to acidic solutions in a concentration excluding toxicologically side-effects seem unable to arrest erosive lesions. By contrast, topical fluoride applications of toothpastes, oral rinses, gels or varnishes appear to be an effective agent for reducing demineralization by erosion. In particular, high-concentrated fluoride applications are able to increase abrasion resistance and decrease the development of erosions in enamel and dentin.

Fluorides↗

A clinical comparison of glass ionomer (polyalkenoate) and silver amalgam restorations in the treatment of Class 5 caries in xerostomic head and neck cancer patients.

Fifty-four pairs of restorations (one glass ionomer and the other amalgam) were placed in the mouths of 36 xerostomic head and neck cancer patients. Patients were either fluoride users or fluoride nonusers. In patients who used a daily application of a mildly acidic (pH 5.8) sodium fluoride gel, glass-ionomer cements failed and amalgam restorations did not (P < 0.0001). In patients who neglected to use their topical fluoride as directed, glass-ionomer cement restorations did not fail, but amalgam restorations did (P < 0.001). The mean time to restoration loss for both restorative materials was 8.5 months. In severely xerostomic patients these findings were exaggerated.

Cermet Cements↗

Prevention of fissure caries in rats by dietary F supplement with and without topical application of F and Sr + F.

In our previous studies, combined dietary and topical fluoride have shown to be more effective than each alone. Moreover, supplementation of chlorhexidine-fluoride solution with Sr was beneficial for caries prevention in rats. In the present study, the caries-preventive effect of fluoride added to the diet plus F and/or Sr applications was studied in two experiments with rats. One group received dietary fluoride supplement only. In other groups, either a Sr solution, a fluoride varnish, or a Sr solution plus fluoride varnish were applied to newly erupted molars. In addition, one group received both topical applications of Sr + F and dietary fluoride. Caries development was followed longitudinally during periods of 15, 30 or 54 days. The greatest and most significant reduction of caries resulted from the combination of fluoride varnish plus dietary fluoride supplement. Treatment with Sr solution at the beginning of the experiment had no effect on caries either alone or combined with fluoride varnish. It was found that caries increased rapidly and then levelled off after the 30-days feeding period in all groups. In the treatment groups, however, caries was arrested at a considerably lower level than in the control group.

Administration, Topical↗

Frequency of reported dental visits and professional fluoride applications in a cohort of children followed from birth to age 3 years.

PURPOSE: The purpose of this study is to report the prevalence of having a dental visit and/or a topical fluoride treatment at the dental visit from birth to age 36 months from an observational, longitudinal study of a cohort of children followed since birth. METHODS: Multiple questionnaires were sent to the families of children enrolled in a study of fluoride ingestion to ask parents if their child had had a dental (or dental hygiene) appointment and/or a fluoride treatment during the time interval since the previous mailed survey. Data were analyzed to determine the percentages of children who had at least one dental visit or at least one fluoride treatment by one, two or three years of age. RESULTS: Three hundred and forty parents completed all eleven questionnaires during the 36-month study period. Of these, 2% reported having taken their child for a dental visit by one year of age, 11% by two years of age and 31% by three years of age. Of those with a visit by three years of age, 19% received at least one fluoride treatment. CONCLUSIONS: Despite recommendations for early dental visits, only 31% of the children in this cohort had been seen by a dentist by the time they reached their third birthday and 19% of these had received a professional fluoride treatment.

Child, Preschool↗

Ionic transport through bis-glycidyl methacrylate films.

Specific ion meter studies have shown that ionic transport through bis-GMA fissure sealant films is selective and that dissolved fluoride ions disappear from the solution around tooth sections at a more rapid rate than do calcium and chloride ions. This would indicate that topical fluoridation of pits and fissures can still be effected after placement of a fissure sealant. A causative mechanism for this phenomenon has been postulated. Calcium exchange studies indicate that calcium is removed from the enamel and that the microsolubility of fissure sealed teeth in CaCl2 solution is increased by the preparative and sealing procedure used for the enamel.

Acrylates↗

Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach.

Despite great improvements in the oral health of populations across the world, problems still persist particularly among poor and disadvantaged groups in both developed and developing countries. According to the World Oral Health Report 2003, dental caries remains a major public health problem in most industrialized countries, affecting 60-90% of schoolchildren and the vast majority of adults. Although it appears that dental caries is less common and less severe in developing countries of Africa, it is anticipated that the incidence of caries will increase in several countries of that continent, due to changing living conditions and dietary habits, and inadequate exposure to fluorides. Research on the oral health effects of fluoride started around 100 years ago; the focus has been on the link between water and fluorides and dental caries and fluorosis, topical fluoride applications, fluoride toothpastes, and salt and milk fluoridation. Most recently, efforts have been made to summarize the extensive database through systematic reviews. Such reviews concluded that water fluoridation and use of fluoride toothpastes and mouthrinses significantly reduce the prevalence of dental caries. WHO recommends for public health that every effort must be made to develop affordable fluoridated toothpastes for use in developing countries. Water fluoridation, where technically feasible and culturally acceptable, has substantial advantages in public health; alternatively, fluoridation of salt and milk fluoridation schemes may be considered for prevention of dental caries.

Child↗

Study on hypomineralized areas in hamster molars.

Hypomineralized area (HMA) scores were determined for hamster molars during tooth maturation and fluoride treatment. It was found that the molars were maturing until the animals were 45 days old, but from 45 to 74 days of age the HMA scores remained constant. Fluoride treatment decreased the HMA score. The group with the lowest HMA score was fed a cariogenic diet, inoculated with Streptococcus mutans and received topical fluoride treatment.

Animals↗

[Uptake of fluoride into enamel and its effect on acid resistance by application of fluoride-releasing sealant--Part 1. Comparison with acid phosphate fluoride].

The newly developed fluoride-releasing sealant (F + sealant) used in this experiment is expected to have the combined cariostatic effects of a sealant and fluoride. The purpose of this study was to investigate F + sealant's effects on the enamel in regard to the uptake of fluoride and resistance to acid. F + sealant's effect was compared to that of acid phosphate fluoride (APF) which has effect as topical fluoride applicant. Bovine teeth applied with F + sealant or APF were immersed for 4 weeks in a pH 7.0 phosphate buffer at 37 degrees C. After 4 weeks of immersion, each tooth was biopsied with pH 1.0 sodium acetate-hydrochloric acid buffer. The fluoride and calcium in the biopsy samples were analyzed by means of fluoride ion electrode and atomic absorption spectroscopy, respectively. The following results were obtained: (1) The fluoride in the enamel was significantly increased by the incorporation of fluoride from the F + sealant. Almost all fluoride in the surface enamel was found to be fluorapatite by the method of alkaline extraction. (2) The amount of fluoride increased by APF application was about 50% of that of F + sealant application. (3) The calcium released from the enamel treated with F + sealant or APF decreased by 13% and 9%, respectively, compared to that without treatment.

Acidulated Phosphate Fluoride↗

Fluoride-releasing restorative materials and secondary caries.

Secondary caries is responsible for 60 percent of all replacement restorations in the typical dental practice. Risk factors for secondary caries are similar to those for primary caries development. Unfortunately, it is not possible to accurately predict which patients are at risk for restoration failure. During the past several decades, fluoride-releasing dental materials have become a part of the dentist's armamentarium. Considerable fluoride is released during the setting reaction and for periods up to eight years following restoration placement. This released fluoride is readily taken up by the cavosurface tooth structure, as well as the enamel and root surfaces adjacent to the restoration. Resistance against caries along the cavosurface and the adjacent smooth surface has been shown in both in vitro and in vivo studies. Fluoride-releasing dental materials provide for improved resistance against primary and secondary caries in coronal and root surfaces. Plaque and salivary fluoride levels are elevated to a level that facilitates remineralization. In addition, the fluoride released to dental plaque adversely affects the growth of lactobacilli and mutans streptococci by interference with bacterial enzyme systems. Fluoride recharging of these dental materials is readily achieved with fluoridated toothpastes, fluoride mouthrinses, and other sources of topical fluoride. This allows fluoride-releasing dental materials to act as intraoral fluoride reservoirs. The improvement in the properties of dental materials with the ability to release fluoride has improved dramatically in the past decade, and it is anticipated that in the near future the vast majority of restorative procedures will employ fluoride-releasing dental materials as bonding agents, cavity liners, luting agents, adhesives for orthodontic brackets, and definitive restoratives.

Adolescent↗

Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents.

BACKGROUND: The majority of the detected increment in dental caries is confined to pit and fissure surfaces of first molars. Application of pit and fissure sealants and topical fluorides are widely used procedures in the prevention of decay, and their effectiveness in caries prevention has been proved by systematic reviews. OBJECTIVES: The objective of this study was to compare the effectiveness of pit and fissure sealants with fluoride varnishes in the prevention of dental decay on occlusal surfaces. SEARCH STRATEGY: Electronic searching was performed on the following databases: the Cochrane Oral Health Group's Trials Register (last update November 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 4), MEDLINE (from 1966 to December 2005), EMBASE (from 1974 to November 2004), SIGLE (from 1976 to December 2004), SCISEARCH, CAplus, INSPEC, JICST-EPLUS, NTIS, PASCAL (last update December 2004), DARE, NHS EED and HTA (last update November 2005). Reference lists from articles that fulfilled the inclusion criteria in this review and from review articles based on the search of MEDLINE were searched for additional relevant articles. Conference abstracts published as books or journals and handsearched by the Cochrane Oral Health Group were also included. SELECTION CRITERIA: The inclusion criteria for study selection were: random or quasi-random allocation study design; sealants versus fluoride varnish or sealants and fluoride varnish combination versus fluoride varnish alone; included studies included caries documentation on occlusal surfaces of permanent molars and the subjects were under 20 years of age. Both parallel and split-mouth study designs were accepted. The primary outcome of interest was the increment in the numbers of carious occlusal surfaces of premolars and molars. A study was excluded if sealants and fluoride varnish were not compared with each other. DATA COLLECTION AND ANALYSIS: Two review authors carried out the baseline searches, selecting the papers on the basis of the title, keywords and abstract and making decisions about the eligibility and data extractions. The same review authors assessed the methodological quality of all included studies: for example, the allocation concealment, blinding, and completeness of follow up. Authors of the studies were contacted for additional information. Risk ratios (RR) as effect estimates were calculated for the differences in whether surfaces were carious or not in the treatment groups, along with the appropriate standard errors and 95% confidence intervals (CI). No data could be combined or meta-analyses undertaken due to the clinical and methodological diversity between study designs. MAIN RESULTS: Four studies were eligible for inclusion in the review. Three of the four studies compared the effectiveness of sealants with fluoride varnish application, and one study compared the effectiveness of sealants and fluoride varnish combination with fluoride varnish alone. Results of two studies revealed the effectiveness of pit and fissure sealants to be statistically significantly higher than an application of fluoride varnish every 6 months in preventing occlusal decays of first molars at 23 months (RR 0.74, 95% CI 0.58 to 0.95) and at 9 years follow up (RR 0.48, 95% CI 0.29 to 0.79). One of these studies was classed as at low risk of bias, one of moderate to high risk. One small study at moderate to high risk of bias failed to find a statistically significant difference between sealants and fluoride varnishes. One study of low risk of bias found a statistically significant difference in favour of the sealants and fluoride varnish combination compared with merely fluoride varnish at 24 months follow up with RR 0.36 (95% CI 0.21 to 0.61). The age of children in the included studies was 5 to 9 years. Allocation concealment was classified adequate in two of these four studies. AUTHORS' CONCLUSIONS: There was some evidence of the superiority of pit and fissure sealants over fluoride varnish application in the prevention of occlusal decays. However, it remained unclear to what extent there is difference between the effectiveness of pit and fissure sealants and fluoride varnishes. Therefore, more high quality research is needed. No recommendations for the clinical practice could be given and the benefit of pit and fissure sealants and fluoride varnishes should be considered locally and individually.

Adolescent↗

Primary tooth enamel surface topography with in vitro argon laser irradiation alone and combined fluoride and argon laser treatment: scanning electon microscopic study.

PURPOSE: The purpose of this descriptive scanning electron microscopic study was to characterize surface alterations in primary tooth enamel after in vitro argon laser irradiation alone and combined with topical fluoride treatment either before or after argon laser irradiation. METHODS: Twenty extracted or exfoliated primary teeth underwent soft tissue debridement and a fluoride-free prophylaxis. Buccal and lingual surfaces were determined to be caries-free by macroscopic examination (stereo-zoom binocular microscope, x16). Treatment groups were: (1) no-treatment control; (2) argon laser irradiation (ALI; 11.5 J/cm2); (3) 1.23% acidulated phosphate fluoride (APF before ALI); and (4) ALI before APF. Both buccal and lingual surfaces were evaluated following standard scanning electron microscopic preparation techniques. RESULTS: With controls, enamel surfaces were relatively smooth with occasional enamel prism ends present on their surfaces. There were no areas with cavitations or surface defects. With ALI, the lased surfaces were roughened mildly to moderately irregular without cavitation of the enamel or exposure of enamel prism ends. The surfaces possessed adherent granules to globules, with most being <3 microm in greatest dimension. Only occasional fine cracks and porosities in the surface coatings were noted and these were typically less than 1 microm in width or diameter. With APF before ALI, the surfaces possessed an irregular contour, with numerous granules to globules varying in size from 1 to 3 microm in greatest dimension. With ALI before APF, a homogenous confluent surface was present that masked typical enamel surface markings. The previously noted adherent granules and globules with argon laser treatment alone or APF before ALI were not seen. The argon laser effects on the enamel surfaces were masked by the uniformity of these surface coatings. CONCLUSIONS: Argon laser irradiation and combined APF and argon laser treatment of primary tooth enamel created surfaces that may provide a protective barrier against a cariogenic attack. The surface coatings associated with combined APF and argon laser treatment may contain fluoride-rich calcium and phosphate mineral phases that could act as reservoirs for fluoride, calcium, and phosphate and provide a certain degree of protection from a caries lesion challenge.

Acidulated Phosphate Fluoride↗

Orthodontic positioner used for home fluoride treatments.

It has been well documented that the more time the enamel surface is exposed to fluoride, the higher will be the caries protection. An extremely good method of greatly increasing caries resistance is by daily or weekly home fluoride treatments. This procedure is usually limited to special cases of rampant caries, patients with hemophilia, and handicapped patients in whom caries control is vital. It is not used more widely because of the added costs of impressions, tray fabrication, and professional. If the patient already has a vehicle for applying fluoride, such as a positioner or mouth guard, it is a simple matter to prescribe or dispense fluoride gel to be used when these appliances are being worn. This is expecially true for orthodontic postioners. When bands are removed, a slight space usually exists interproximally. This space greatly facilitates fluoride contact with the proximal surfaces. Fluoride will tend to recalcify decalcified areas of enamel in addition to providing added caries protection for the patient. If positioners are not used after band removal, home fluoride trays or rinses can also be effective. Since many orthodontic patients wear a positioner when bands are removed, the orthodontist can provide his patients with the benefits of topical fluoride by prescribing fluoride gel and explaining how to use it along with his positioner.

Dental Caries↗

Effect of fluoride prophylactic agents on the mechanical properties of nickel-titanium-based orthodontic wires.

BACKGROUND: Titanium-based alloys have high corrosion resistance because they form a thin, stable oxide layer. Nevertheless, fluoride prophylactic agents can cause corrosion and associated discoloration of titanium-based orthodontic wires. The purpose of this investigation was to study the effects of fluoride prophylactic agents on the mechanical properties of nickel-titanium (Ni-Ti) and copper-nickel-titanium (Cu-Ni-Ti) orthodontic archwires. METHODS: Preformed rectangular Ni-Ti and Cu-Ni-Ti wires were immersed in either an acidulated fluoride agent, a neutral fluoride agent, or distilled water (control) for 1.5 hours at 37 degrees C. After immersion, the loading and unloading elastic modulus and yield strength of the wires were measured with a 3-point bend test in a water bath at 37 degrees C, in accordance with the criteria in the current American National Standard/American Dental Association Specification No. 32 for Orthodontic Wires (2000). Scanning electron microscopy was also used to characterize the effects of the fluoride treatment on the wire topography. RESULTS: Unloading mechanical properties of Ni-Ti orthodontic wires were significantly decreased after exposure to both fluoride agents (1-way analysis of variance [ANOVA] and Dunnett's post hoc, alpha =.05); however, Cu-Ni-Ti wire mechanical properties were not significantly affected by either fluoride agent (1-way ANOVA, alpha =.05). Corrosive changes in surface topography were observed for both wires, with Cu-Ni-Ti appearing to be more severely affected. CONCLUSIONS: The results suggest that using topical fluoride agents with Ni-Ti wire could decrease the functional unloading mechanical properties of the wire and contribute to prolonged orthodontic treatment.

Acidulated Phosphate Fluoride↗

Effect of a field program based on systematic plaque control on caries and gingivitis in schoolchildren after 3 years.

The effect of a field program, based on systematic plaque control, on caries and gingivitis was tested during a 3-year period on 1,100 schoolchildren. Once every 3rd week the children were given oral hygiene instructions, professional toothcleaning and fluorides topically delivered by specially trained dental nurses. The children of a control group of approximately the same number of pupils, participated in a preventive program consisting of mouthrinsings once every 2nd week with a 0.2% sodium fluoride solution. The children of the third and fourth grades were, at the start of the experiment, selected as reference groups and then continuously examined once every year. At the end of the trial the mean reduction of surfaces haboring plaque and units with gingival inflammation was 59% and 73%, respectively. The reduction in caries increment was 51%.

Adolescent↗

Oral fluoride retention with thixotropic and APF gels and foam-lined and unlined trays.

Ten child volunteers each received four topical fluoride applications using different techniques. The amounts of fluoride applied, recovered from the mouth, and retained in the mouth were calculated for each treatment. The value of patient expectoration following topical F treatment was also evaluated. The tray system with an absorptive liner significantly reduced the amount of gross oral-retained fluoride (p less than 0.01). Expectoration following topical treatment with either an APF or thixotropic gel was a significant adjunct in reducing the net oral-retained F dose (p less than 0.01). When expectoration is done following a topical F treatment, a thixotropic gel may be an added advantage in reducing oral F retention and ingestion. We recommend that suction devices be used during a topical F treatment, but most importantly that the patient be requested to expectorate thoroughly following topical treatment.

Acidulated Phosphate Fluoride↗

Effect of fluoride varnish and solution on enamel erosion in vitro.

The effect of fluoride varnish and solution on initial enamel erosion was studied. Enamel specimens prepared from human third molars were treated for 24 h with Duraphat varnish (2.26% F) or for 48 h with NaF solution (1.2% F), washed, and immersed in cola beverage (pH 2.6) for up to 15 min. The surface microhardness was measured using a Vickers diamond in a Leitz indentation apparatus at base-line, after fluoride treatment, and after 1, 5, and 15 min exposure to acidic drink. The specimens were then prepared and studied using a JEOL JSM-35 scanning electron microscope. The results showed that both fluoride treatment caused an increase in enamel hardness values and subsequent inhibition of softening which was statistically highly significant. Scanning electron micrographs revealed the difficulty of removing Duraphat varnish from the enamel surface, and remnants of varnish were seen irrespective of vigorous sonication in acetone. However, in areas devoid of varnish, erosion was observed as mainly irregular lesions similar to those seen in the NaF solution treated and control specimens. The present study showed that treatment of enamel with topical fluoride prior to acidic challenge can inhibit initial erosion.

Adult↗