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PubMed1988

A method of semi-quantitative microradiographic analysis of root surface lesion remineralization.

The purpose of this study was to present a modified photometer based digital analysis system for image enhanced microradiographic semi-quantitation of reactions of demineralization and remineralization of root surface lesions. The system was used to determine effects of fluoride on abraded root surface dentin in vitro. Lesions of 30-40 micron depth were produced during 18 h exposure of 180 micron thick single sections in solution of 3 mM Ca (Ca/P 1.67) and 30 mM lactic acid at pH 5.1. Mean mineral content of the lesions was 32% relative to adjacent sound dentin. Exposure of 20 h in the same acid with 5 mM Ca (Ca/P 1.67) and 0.12 mM NaF at pH 6.1 restored the mean mineral content to 76% of normal and increased the resistance of the lesions to demineralization. Remineralization and subsequent demineralization characteristics indicated the growth of fluorapatites on residual minerals in the dentin lesions. The microradiographic analysis system proved to be sensitive and critical in these studies.

Densitometry↗
PubMed1992

An intra-oral single-section demineralization/remineralization model.

This paper reviews the use of our intra-oral crown single-section model for the evaluation of in situ demineralization and remineralization. The model uses normal, healthy adults who are in need of a gold crown. A slot is placed in the working crown which can hold 3-4 single sections. A typical experiment would use an enamel lesion, root lesion, and sound root section which are characterized with polarized light microscopy and/or microradiography prior to insertion in the crown. After the experimental regimen, the sections are removed and re-characterized for any changes. The model has been used to evaluate mineral changes from the use of fluoride dentifrices and rinses, chewing gum, and food sequencing. The advantages of the model system are the before-and-after measurements on the same section, a natural plaque formation, interaction with saliva, episodic demineralization and remineralization, no bulky appliances, and the use of reasonable time frames. This model, therefore, reduces the artificiality of the in situ study to a great extent and appears to be a useful predictor of demineralization/remineralization interactions.

Adult↗
PubMed1986

Remineralization by a monofluorophosphate dentifrice in vitro of root dentin softened by artificial caries.

Artificial caries-softened dentin lesions in root surfaces were treated with 50% slurries of a monofluorophosphate (MFP) dentifrice or a placebo dentifrice twice daily for ten days. Between dentifrice treatments, the lesions were kept in a remineralizing solution. Both treatments resulted in statistically significant remineralization, with the MFP dentifrice being significantly better than the placebo. Deposition of new mineral from the MFP dentifrice occurred about equally at or within the surface zone and at the deepest part of the lesion. Mineral deposition from the placebo appeared to be more uniformly distributed within the lesion.

Dental Caries↗
PubMed1994

In situ remineralization of root surface lesions using a fluoride chewing gum or fluoride-releasing device.

The in situ remineralization of early root surface lesions was studied using a fluoride-releasing device (FRD) or a fluoride chewing gum. Root specimens with subsurface lesions were mounted in removable lower appliances in 6 adult subjects. Test groups chewed five sticks/day (0.1 mg F/stick) or one FRD (0.5 mg F/day release rate) was mounted in the midline of the appliance. A fluoride-free dentifrice was used three times/day for each 21-day control and the two test regimens. Separate root lesions were used to measure fluoride uptake or changes in mineral content by quantitative microradiography. Comparable values for percent remineralization for both FRDs and F gum were higher than controls, and the F uptake for FRDs exceeded both the F gum and controls (p = 0.05).

Adult↗
PubMed2002

Effect of demineralization and remineralization on microhardness of irradiated dentin.

The aim of this in vitro study was to evaluate the effects of irradiation and fluoridation on the demineralization and remineralization patterns of root dentin. From the cervical regions of 84 bovine incisors, each of four dentinal blocks were prepared and randomly assigned to four groups: 1) no irradiation; 2) irradiation of specimens up to 60 Gy (2 Gy/d, 5 d/w); 3) no irradiation, but fluoridation of specimens for 5 min/d with Elmex Gelée; and 4) irradiation and daily fluoridation of specimens for 5 min/d. Subsequently, the specimens were demineralized for 2, 4, 6 or 8 days with acidulated hydroxyethylcellulose (n = 21), and Knoop hardness numbers (KHN) were determined before, as well as after the demineralization period. Then seven specimens from each group were fluoridated with one of three fluoride gels (Elmex Gelée [1.25%], STOP [0.4%], Fluoridgel [1.25%]; 2 x 15 min/d, 10 d), and immersed in synthetic saliva at a temperature of 37 degrees C. Finally, KHN for all specimens were determined. Irradiation resulted in a significant decrease in microhardness. There was a reduction in microhardness with increasing demineralization time in all groups. The highest percentage decrease in microhardness could be observed with group 1. Due to the preceding decrease of KHN in the irradiated specimens (group 2), these samples showed less percentage reduction in microhardness during demineralization when compared to group 1 (ANOVA; p < 0.001). The decrease in microhardness was significantly hampered by fluoridation in the non-irradiated, as well as in the irradiated samples (groups 3 and 4; p < 0.001). The remineralization with Fluoridgel resulted in the greatest increase in microhardness. It is concluded that demineralization can be hampered by regular fluoride application in irradiated dentin. However, due to the considerable irradiation effect, this benefit might be negligible.

Amines↗
PubMed2006

In vitro caries formation in primary tooth enamel: role of argon laser irradiation and remineralizing solution treatment.

BACKGROUND: The authors evaluated the effects of argon laser (AL) diation and remineralizing solution (RS) treatment alone and in combination on carieslike lesion formation in primary tooth enamel in an in vitro study. MATERIALS AND METHODS: The authors divided 10 caries free primary tooth enamel surfaces into four segments and assigned them to one of four treatment groups: no treatment control, AL irradiation alone at 13.5 joules per square centimeters (0.270 watts, 5-millimeter beam, 10 seconds), RS treatment alone for two minutes and AL irradiation before RS treatment. The authors created in vitro caries using a modified ten Cate solution. They evaluated longitudinal sections (three per tooth segment, 30 per treatment group) for mean lesion depth. RESULTS: After lesion formation, mean lesion depths (+/- standard deviation) were 179 +/- 16 micrometers for the no treatment controls, 137 +/- 19 microm for AL irradiation alone, 87 +/- 9 microm for RS treatment alone and 68 +/- 12 microm for AL irradiation before RS treatment. All treatment groups had mean lesion depths that were significantly less than those for the matched no-treatment control group (analysis of variance [ANOVA], Duncan multiple range [DMR] test, P < .05). AL irradiation before RS treatment significantly reduced lesion depth compared with AL irradiation alone or RS treatment alone (ANOVA, DMR test, P < .05). CONCLUSIONS: The maximum reduction in lesion depth in primary tooth enamel was achieved when the RS--which contained calcium, phosphate and fluoride in a carbopol base--was combined with AL irradiation. CLINICAL IMPLICATIONS: It would appear that to improve clinical caries resistance to enamel dissolution, AL irradiation before RS treatment could be used.

Acrylic Resins↗
PubMed1997

Effect of a two-solution fluoride mouth rinse on deposition of loosely bound fluoride on sound root tissue and remineralization of root lesions in vitro.

A constant-composition fluoride (F) titration method was used to measure the amount of leachable F deposited on root surfaces in vitro by a 1-min rinse with a 12 mmol/l sodium fluoride (228 micrograms/g F) solution or a two-solution rinse that contained 2 mmol/l sodium fluorosilicate (228 micrograms/g total F ) and 10 mmol/l calcium chloride. The mean +/- standard deviations (n = 3) F uptake from the two rinse treatments were 0.70 +/- 0.24 micrograms/cm2 and 3.25 +/- 0.74 micrograms/cm2, respectively. In a separate experiment, the effects of sodium fluoride and the two-solution rinses on remineralization of root lesions were evaluated in an in vitro pH cycling model. The results showed that the average decrease in mineral loss (delta Z) in the two-solution rinse group (60%) was significantly greater than that obtained in the NaF rinse (41%) or the control (9%) group.

Aluminum Compounds↗
PubMed1992

Human root caries: histopathology of arrested lesions.

The histopathology of arrested root caries lesions was examined in extracted human teeth. The main structural characteristics of arrested lesions were the completely mineralized surface area and the formation of a distinct sclerosis of the dentinal tubules. Intertubular dentin was, with the exception of the dentinal tubules, fully mineralized up to the surface. Dentinal tubules near the surface were either filled with ghosts of microorganisms or with crystals of different shapes. Sclerosis of the dentinal tubules was characterized by the presence of three different patterns of intratubular mineralization that occur in distinct regions of the zone of tubular sclerosis. The patterns were distinguishable by the type of crystals and their association with organic structures such as collagenous fibrils or odontoblast processes. It is suggested that arrested lesions are based on (1) the formation of an inner barrier that interrupts the diffusion of substrata from the pulp to invaded bacteria, (2) the formation of an outer barrier by a compact, highly mineralized surface region which blocks the diffusion of products of bacterial metabolism into dentin, and (3) an area of mineralization which extends from the outer barrier toward the root canal within demineralized dentin. The present study demonstrates the considerable potential of caries lesions in dentin to become arrested, and subsequently partially remineralized. These phenomena seem to depend on the severity of an active lesion and its location on the root surface. This should be taken into account when diagnosing root caries lesions. The potential of root caries lesions to become arrested indicates that the treatment concept of active root caries lesions should be reconsidered.

Adult↗
PubMed2005

Effect of topical fluoride and fluoride varnish on in vitro root surface lesions.

PURPOSE: To evaluate the effect of a fluoride varnish on demineralization and remineralization of root surfaces in vitro. METHODS: 80 caries-free teeth were selected from a large pool of extracted anterior and premolar teeth from elderly patients. Acid resistant nail varnish was painted on all surfaces except for a window (l x 4 mm) on the buccal or lingual root surfaces. Teeth were randomly divided into four treatment groups: CONTROL: washed with deionized/distilled water; Daily gel: treated with Karigel-N (5,000 ppm) for 4 minutes daily; Weekly gel: treated with Karigel-N for 4 minutes weekly; and Weekly varnish: treated with Duraflor (22,600 ppm) weekly (the varnish was removed 24 hours after each application). Teeth were then placed in a cycle of demineralization (6 hours at pH 4.3) and remineralization (17 hours at pH 7.0) for 21 days. Half the specimens of each group were brushed with no dentifrice for 10 seconds twice daily. Specimens were evaluated under polarized light microscopy and contact microradiography. The depth of each lesion and width of the remineralization bands were measured. An ANOVA model was used to assess the effect of different treatments. RESULTS: The control group had the deepest lesions and the daily gel group had the shallowest lesions. The weekly varnish group was found to have significantly shallower lesions than the weekly gel group. The varnish brushing subgroup had significantly deeper lesions than varnish non-brushing subgroup (P = 0.01). Remineralization bands were detectable in most lesions. There was no significant difference in band width between different groups (F = 0.634, P = 0.594). However, a significant difference was found when remineralization bands were calculated as percentage of lesion depth between different groups (F = 4.24, P = 0.001). The varnish non-brushing subgroup had significantly higher percentage than the control group, but daily gel non-brushing had the highest percentage. Brushing was a significant factor in the varnish group. Lesions were significantly shallower in the non-brushing varnish subgroup.

Aged↗
PubMed1998

Physical, chemical, and histologic changes in dentin caries lesions of primary teeth induced by regular use of polyol chewing gums.

A previous clinical trial showed that long-term use of saliva-stimulating polyol (xylitol and sorbitol) chewing gums was associated with arrest of dental caries in young subjects. After a 20-22-month intervention (when the subjects were 8 years old), a total of 23 primary teeth with extensive dentin caries lesions whose surface in clinical examination was found to be totally rehardened (remineralized) could be removed because the teeth were near their physiologic exfoliation time. These teeth were subjected to histologic, microhardness, and electron microscopic tests. The majority of the specimens had been remineralized from the surface by a non-cellular-mediated process within the remaining collapsed, organic extracellular matrix associated with the remaining dentinal surface. Many of the underlying dentinal tubules were filled with a matrix that had been subsequently mineralized. Dental microanalyses showed that the topmost (outer) 20-microm-thick rehardened layer of the lesions exhibited the highest Ca:P ratio, which leveled off at a depth of approximately 150 microm. The rehardened surface layer (normally <0.1 mm in thickness) was significantly (P < 0.001) harder than sound dentin and nearly as hard as sound enamel. Although the main source of the mineral present in the rehardened layer was most likely of salivary origin, some extracellular remineralization was probably mediated by odontoblasts. The results complete the dinical diagnoses of the original trial and suggest that regular use of polyol chewing gums may induce changes in dentin caries lesions, which in histologic and physiochemical studies show typical characteristics of rehardening and mineralization.

Calcium↗
PubMed1990

Automatic pH-cycling caries model applied on root hard tissue.

The development of a caries lesion is a dynamic process that includes frequently alternating periods of de- and remineralization, a process for which no in vitro models currently exists. The aim of this study was to develop a model which could repeatedly generate identical pH versus time curves over extended periods of time. To test the model demineralization studies on cementum/dentin were performed. Cementum/dentin blocks were repeatedly subjected to de- and remineralizing solutions delivered by a computerized pump system connected to a pH-meter and a recorder. pH versus time curves similar to those produced in plaque after carbohydrate intake were generated 18 times during 15 h followed by a remineralizing period of 9 h every day for 16 days. The intra-day and inter-day variation of the pH-cycling model were found to be low. The mineral change of the blocks was followed by 125I absorptiometry and the transmission through the blocks during the experimental period increased in average by 1.4 +/- (SE) 0.18%. Microradiographic analysis of the transversal sections of the blocks confirmed the development of lesions resembling root caries.

Absorptiometry, Photon↗
PubMed1995

Remineralization of root lesions with concentrated calcium and phosphate solutions.

Remineralization of enamel lesions in vitro by use of sequential treatments with an alkaline (pH 9) phosphate (1 mol/L) solution and slightly acidic (pH 6) calcium (1 mol/L) solution was reported to be relatively ineffective. An analysis of the diffusion processes that may occur during the remineralization treatments suggested that the driving force for diffusion of Ca into the lesion can be increased by making the calcium solution more alkaline than the phosphate solution. In the present study this modified treatment procedure was evaluated for remineralizing root lesions in vitro. Results show that (1) in the control group there was a slight increase in mineral density in the surface region of the lesion, (2) in the experimental group there were significant (p < 0.05) increase in mineral content in the outer 40 microns of the lesion, and (3) in contrast to the finding reported previously, thick mineral deposits on the surface of the root were not observed.

Calcium↗
PubMed1992

Effect of fluoride concentrations on overdenture abutments.

This study evaluated the preventive effect of four concentrations of fluoride. Twenty-five extracted caries-free anterior teeth from patients aged 50-70 were prepared as overdenture abutments. The teeth were sectioned mesiodistally into two halves. The teeth were covered with a protective varnish, leaving a window on the root surface and one on the cut dentin of the occlusal. The root halves were randomly divided into 5 groups of 10 specimens and each group received a different 5-minute topical treatment prior to being placed in the demineralizing solution. The treatments were: Group 1: distilled H2O only; Group 2: 100 ppm F-, Group 3: 250 ppm F-, Group 4: 500 ppm F-; and Group 5: 1000 ppm F-. The teeth were cycled for 6 hours in a demineralizing solution and for 17 hours in a fluoride-free remineralizing solution. The cycling was maintained for 10 days. The root halves were sectioned and prepared for histologic examination. The depth of the lesions were measured from standardized photo-micrographs by means of a sonic digitizer. The conclusions were: (1) the lesions on the root surface were too small to be measurable, (2) the lesions on dentin were all of similar depth, and (3) the lesions had bands within them and the width of these bands showed a dose response to the fluoride concentration of the topical application.

Aged↗
PubMed2001

Microhardness of enamel restored with fluoride and non-fluoride releasing dental materials.

Demineralization caused by frequent ion loss can be detected by a decrease in enamel microhardness. The purpose of this study was to determine the microhardness of the enamel adjacent to restorations with fluoride and non-fluoride dental materials after demineralization and remineralization treatments using crowns of 6 recently extracted unerupted third molars which were sectioned into 4 parts. Five penetrations were made in the enamel of the control group and in the enamel adjacent to restorations made with Vitremer, Heliomolar or Z100, to obtain the Knoop microhardness. There was no significant statistical difference between the microhardness of the enamel of the control group and the enamel adjacent to the restorations made with Vitremer and Heliomolar (p < 0.01), nor between the enamel adjacent to the Heliomolar and Z100 restorations. However, there was a statistically significant difference when the Z100 group was compared to the control group and to the Vitremer group. The results point out that some phenomena occurred which interferred with the ionic loss and, consequently, the microhardness of the enamel of the Vitremer and Heliomolar groups, because it was not possible to observe any difference between the microhardness of the enamel of the control group and the groups restored with Vitremer and Heliomolar.

Acrylic Resins↗
PubMedDate not supplied

Prevention of artificial caries: effect of bonding agent, resin composite and topical fluoride application.

This study investigated the effect of fluoride containing resin composites and bonding agents, as well as the topical fluoride (F) application on the inhibition of artificial caries progression by using a pH-cycling model with alternating demineralizing (pH:4.5) and remineralizing (pH:7.0) solutions. Two bonding systems (F-containing bonding system [Reactmer Bond: RB] and non-F containing bonding system [Clearfil SE Bond: SE]), two resin composites, (F-containing [Reactmer Paste: RP] and non-F containing [Clearfil AP-X: AP]) were used. A combination of each bonding agent and a resin composite, RB+RP, RB+AP, SE+RP and SE+AP, was placed in 2 x 3 x 1.5-mm cavities on root dentin of extracted molars (n=96). Specimens were subjected to pH-cycling for 6 or 12 weeks. Half of all specimens were immersed in 0.05% NaF solution for 1 minute once a day as a topical F application. After the pH cycling period, a microradiograph of each specimen was taken, and the outer lesion depth of the artificial caries was measured by means of image analyzing software. The depths of the outer lesions at different periods were analyzed by one-way ANOVA and Sheffe's test at p=0.05. The combination that received F treatment showed reduced lesion depth compared to the same combination without F application. Except for the F application group of 12 weeks, there was no significant difference in lesion depth among each bonding and composite combination (p>0.05). At week 12 with the F application, RB+RP showed the shallowest lesion compared to the other combinations (p<0.05). The results indicated that the F application reduced the progression of artificial caries. Moreover, the combination of fluoride containing bonding agent and restorative material was the most effective for the inhibition of artificial caries progression based on the 12-week experimental period with topical F application.

Cariostatic Agents↗
PubMed1994

Effects of frequency and duration of acid exposure on demineralization/remineralization behaviour of human enamel in vitro.

An in vitro oscillating system, employing human enamel and realistic time intervals and temperature (approximately 35 degrees C) and measuring mineral loss/gain on a volume basis, was used to investigate the effects of both frequency and duration of exposure to low pH (< 5) on the demineralization and remineralization behaviour of human enamel. Sections of human teeth were cycled through one of three different regimens: (1) 3 x 20-min acid challenges; (2) 6 x 10-min acid challenges and (3) 6 x 20 min acid challenges, over single 24-hour periods. The acid challenge periods of 3 x 20, 6 x 10 and 6 x 20 min produced no significant differences in net mineral lost, i.e., the volume of mineral lost per volume of enamel exposed was similar irrespective of frequency or duration of acid exposure (approximately 0.5% vol/vol). Increased frequency of acid exposure did, however, tend to alter the total demineralization/total remineralization amounts, resulting in significantly greater amounts of mineral loss and gain. The data suggest that the remineralization capacity of enamel is considerable and that factors such as inhibition of remineralization may be important in determination of net mineral loss from the tooth.

Acetates↗