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Results for “Tooth Remineralization”

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PubMed1999

Caries inhibiting and remineralizing effect of xylitol in vitro.

This study aimed to determine the effect of xylitol on the development and remineralization of caries in vitro, and to compare this effect with that of fluoride alone and in combination. Two experiments were devised. In experiment 1, bovine incisors were each sectioned into 4 portions which were randomly assigned to 4 demineralizing agents: A) acidic buffer (x), B) x + 0.5 ppm fluoride, C) x + 20% xylitol, and D) x + 20% xylitol + 0.5 ppm fluoride. Caries-like lesions were produced in specimens. In experiment 2, carious lesions were produced in teeth. Five lesion-bearing slabs were cut from each tooth. While one was reserved as control (UN), others were randomly assigned to 4 remineralizing agents: 1) artificial saliva (y), 2) y + 0.05 ppm fluoride, (3) y + 20% xylitol, and 4) y + 20% xylitol + 0.05 ppm fluoride. Mineral loss (delta Z) and lesion depth (ld) were quantified after 4-week remineralization. In experiment 1, numerical values of delta Z and ld observed can be ranked as A > C > B > D. These differences were significant only in B and D when compared with A for delta Z, but not between any group for ld. In experiment 2, the numerical values of delta Z and ld for control UN (unremineralized) and remineralized groups (1-4) ranked as UN > 3 > 4 > 1 > 2. Compared with UN, this difference was significant in all groups with ld, but not in any group with delta Z. We concluded that tolerable levels of xylitol alone may not show a significant caries inhibiting and remineralizing effect, but may act as a caries inhibitor additively with fluoride.

Animals↗

PubMed1991

Tooth enamel softening with a cola type drink and rehardening with hard cheese or stimulated saliva in situ.

The in-situ remineralization effect of hard cheese was compared with that of saliva on tooth enamel in man. The intra-oral test of softening enamel surfaces by a cola type drink followed by rehardening by chewing hard cheese and/or parafilm was assessed by microhardness and SEM measurements. Cheese consumption significantly increased the enamel hardness, whereas stimulated saliva did not have this effect. The remineralizing effects are presumably due to uptake of calcium and phosphate salts by the surface enamel. Morphologically, the enamel surfaces did not return to their original state.

Carbonated Beverages↗

PubMedDate not supplied

Role of the acid-etch technique in remineralization of caries-like lesions of enamel: a polarized light and scanning electron microscopic study.

The aim of this in vitro study was to determine the effect of acid-etching on remineralization of caries-like lesions with calcifying fluids (CF). Caries-like lesions were created in two windows of sound enamel on both buccal and lingual surfaces of human molars. A central longitudinal section was taken from each tooth to serve as control lesions (CL). Each tooth was then sectioned into quarters and each quarter assigned to one of four groups: 1) 1mM Ca CF Remineralized (RC1); 2) 1mM Ca CF Remineralized Etch (RE1); 3) 3mM Ca CF Remineralized (RC3); 4) 3mM Ca CF Remineralized Etch (RE3). Lesions in the etch groups were exposed to 30 percent H3PO4 for 30s prior to CF. Etch and non-etch groups were treated with 1mM or 3mM Ca CFs (prepared from HAP [Ca/P ratio = 1.63], pH 7.0, 0.05mM F-) for ten 60-second periods, interspersed with deionized water rinses. Mean lesion depths were determined using a digitized tablet. Following 1mM Ca CF, mean lesion depths were: 179 microns for CL, 157 microns for RC1 and 118 microns for RE1. Following 3mM Ca CF, mean lesion depths were: 188 microns for CL, 171 microns for RC3 and 143 microns for RE3. SEM topographic features of the remineralized etched lesions consisted of adherent surface coatings with finely globular patterns in the 1mM Ca CF group and densely adherent surface coatings which masked the effects of etching in the 3mM Ca CF group.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Etching, Dental↗

PubMed2004

Penetration of a bonding agent into De- and remineralized enamel in vitro.

PURPOSE: To evaluate bonding penetration into different enamel substrates. MATERIALS AND METHODS: Ten extracted human molars were mesiodistally sectioned. Buccal and lingual enamel surfaces were divided into four equal areas using sticky wax. The central two areas of each tooth (n = 20) were demineralized for 12 weeks using an acidic gel (pH 4.8). The lateral areas served as controls. After demineralization, ten specimens were remineralized in a saliva substitute for three weeks. An amine fluoride solution (Elmex Fluid) was applied on one half of each specimen before acid etching. After etching for 120 s, an enamel-bonding agent (Heliobond) containing 0.1% rhodamine was applied onto test and control areas, and was light cured for 60 s. Subsequently, the specimens were sectioned and tag length was determined using a confocal laser scanning microscope (CLSM). Results were statistically compared with ANOVA followed by Scheffe's and Bonferroni/Dunn post hoc tests. RESULTS: With a mean penetration depth of 68 +/- 22 microm, tags in demineralized enamel were significantly longer than in other groups (p < or = 0.01). Penetration decreased significantly in remineralized areas or when fluoride was used (p < or = 0.01), but was still significantly deeper than in control sites (p < or = 0.01). CONCLUSION: Penetration of an unfilled resin into enamel was considerably influenced by the degree of dental hard tissue mineralization. Penetration was increased in demineralized enamel; however, remineralized enamel also allowed good penetration of the bonding agent.

Acid Etching, Dental↗

PubMed2005

Physicochemical characterization of casein phosphopeptide-amorphous calcium phosphate nanocomplexes.

Milk caseins stabilize calcium and phosphate ions and make them available to the neonate. Tryptic digestion of the caseins yields phosphopeptides from their polar N-terminal regions that contain clusters of phosphorylated seryl residues. These phosphoseryl clusters have been hypothesized to be responsible for the interaction between the caseins and calcium phosphate that lead to the formation of casein micelles. The casein phosphopeptides stabilize calcium and phosphate ions through the formation of complexes. The calcium phosphate in these complexes is biologically available for intestinal absorption and remineralization of subsurface lesions in tooth enamel. We have studied the structure of the complexes formed by the casein phosphopeptides with calcium phosphate using a range of physicochemical techniques including x-ray powder diffraction, scanning electron microscopy, transmission electron microscopy, and equilibrium binding analyses. The amorphous nature of the calcium phosphate phase was confirmed by two independent methods: x-ray powder diffraction and selected area diffraction. In solution, the ion activity product of a basic amorphous calcium phosphate phase was the only ion product that was a function of bound phosphate independent of pH, consistent with basic amorphous calcium phosphate being the phase stabilized by the casein phosphopeptides. Detailed investigations of calcium and calcium phosphate binding using a library of synthetic homologues and analogues of the casein phosphopeptides have revealed that although the fully phosphorylated seryl-cluster motif is pivotal for the interaction with calcium and phosphate, other factors are also important. In particular, calcium binding and calcium phosphate stabilization by the peptides was influenced by peptide net charge, length, and sequence.

Animals↗

PubMed1988

Abrasion biopsy in studies of mineral density of experimental enamel lesions.

The profile of mineral density of experimental enamel lesions was determined by means of sampling with a new abrasion biopsy technique. Three types of lesions were produced on bovine enamel slabs: (1) pre-softened in lactic acid buffer for 16 hr; (2) pre-softened and exposed to a test for acid resistance for seven days; and (3) pre-softened, exposed to the seven-day Intra-oral Cariogenicity Test with extra-oral immersions in 1000 ppm F solutions for one min twice daily (ICT/F), plus the seven-day test for acid resistance. Lesions were assessed with measurements of surface microhardness, microradiography of thin sections, and abrasion biopsy. For abrasion biopsy of the experimental lesions, 15 parallel layers of approximately 10 microns each were abraded simultaneously with reference slabs of sound enamel on strips of lapping film. The depth of abrasion for each sample was calculated from the phosphorus content of the reference sample. Exposure to the ICT/F formed an acid-resistant zone within the lesion which diminished the microhardness change, although it did not have an appreciable effect on the total lesion depth as assessed with microradiography; abrasion biopsy indicated the formation of a mineral-dense zone within the lesion. This recently-developed technique of abrasion biopsy of experimental lesions offers the opportunity to link the composition of the lesion to controlled experimental conditions which will improve our understanding of demineralizing and remineralizing reactions on a standard tooth substrate.

Animals↗

PubMed1980

Enamel remineralization as a factor in the pathogenesis of dental caries.

This paper described an investigation of local resistance acquired in response to cariogenic attacks and remineralization periods from environmental fluids. Surfaces from extracted human teeth with yellow and brown areas indicative of consolidated carious lesions were exposed to acid buffers. Subsurface lesions were developed on areas of sound enamel adjacent to, but not in areas of, consolidated lesions. The development of higher tooth resistance to acid through demineralization and remineralization was demonstrated experimentally on bovine enamel presoftened in acid, treated with fluoride, exposed to the oral environment, and finally exposed to acid buffers for development of subsurface lesions. These results are interpreted as an extension of theory of tissue adaptation to an injurious challenge, in that the tooth surface is primed by the challenge for possible remineralization and the development of higher resistance. This, cariogenic challenges can result in either local adaptation of the enamel to the challenge through lesion consolidation or to open cavitation. As in any biological adaptation, the determining factors for the final outcome are: (a) the frequency and duration of the challenge, (b) the frequency and duration of remineralizing conditions, and (c) the composition of the remineralizing fluid. The implications of the theory in the pathogenesis of caries are discussed in the light of clinical and laboratory investigations.

Animals↗

PubMed1999

[Factors that modify de- and remineralization in dental enamel from the aspect of caries susceptibility].

The course of caries depends on an equilibrium between de- and remineralization of enamel. Epidemiologic studies performed during recent years in Poland have demonstrated a high incidence and severity of caries in children and teenagers. Therefore, the actual program of caries prevention covering the whole population of children and teenagers has not performed to the expectations, possibly because the program protocol does not discriminate between children susceptible and resistant to caries. The aims of this work included: 1. Analysis of tooth groups and surfaces as to their susceptibility to caries; 2. Evaluation of the influence of de- and remineralization modifying factors such as: a) dental plaque and sugars, b) caries-causing bacteria, c) enamel resistance to acids, d) biochemical properties of saliva--on the susceptibility to caries; 3. Evaluation of the uptake of fluorides from chewing gum by enamel in relationship to caries susceptibility. An initial clinical examination of permanent teeth was performed in 292 children aged 12 years. Subsequently, two groups were formed: one with 45 children free from caries and another with 77 children at high risk of caries. Control examinations of permanent teeth in both groups were carried out after one and three years from the initial examination. The clinical examination included a check-up of secondary dentition, counting of erupted teeth, sealed teeth, evaluation of oral hygiene status, gingivae, abnormalities in mineralization and measurement of the rate of microdemineralization. The biochemical analysis of saliva was done to measure the content of fluorides, calcium, phosphorus and magnesium, as well as pH. Microsamples of enamel were collected using acid biopsy and the content of calcium and fluorine in the superficial and underlying layer was assayed. The thickness of both layers obtained by biopsy was also measured. Commercial test kits--Dentocult SM and Dentocult LB, served to determine the amount of caries-causing bacteria in saliva. Additionally, the children and their mothers responded to a questionnaire on the diet, previous diseases, therapies with antibiotics and health habits. The results were analysed using Statgraphics software. Differences between means were checked using Student t-test in its classical form or as modified by B. L. Welch. Linear correlation indices were calculated and Spearman rank correlation test was performed. On the basis of the results obtained the following conclusions were drawn: 1. 12-year old children at high risk of caries need intense dental care due to: a) extensive involvement of masticatory surfaces of molar teeth and contact surfaces of premolar teeth, b) treatment inappropriate to actual needs in this group of children. 2. Effective programs to improve the knowledge and health of children at high risk to caries should be introduced due to the following facts: a) oral hygiene was unsatisfactory in the examined children, b) children consumed large quantities of sweets. 3. Disturbances in the mineralization of enamel and the use of antibiotics in childhood were without influence on the susceptibility of teeth to caries. 4. The content of fluorides, calcium and phosphorus in the saliva of children susceptible to caries could have been below the level necessary to maintain an equilibrium between de- and remineralization of enamel. 5. Susceptibility of teeth to caries could be due to differences in the chemical composition and structure of enamel, as it appears from the content of fluorides and calcium, depth of enamel biopsy and uptake of fluorides from chewing gum. 6. Chewing of fluoride-containing gums is a supportive measure in caries prevention, particularly recommended in children at high risk of caries. 7. Caries prevention should be individualized and matched to caries risk.

Academic Dissertations as Topic↗

PubMed2005

Treatment decisions and conservation of tooth structure.

New technology is becoming available to help establish an early diagnosis of incipient and hidden pit and fissure caries, and microdentistry techniques are being developed to follow the principles of minimal intervention. Following the accurate diagnosis of suspected lesions, early intervention can be in the form of chemotherapeutics to promote remineralization or conservative intervention to minimize tooth structure loss. Patient risk factors should have a role in developing and individualized treatment program. The life cycle of a restored molar is used in this article to illustrate the long-term value of early diagnosis, preventive therapy, and conservative intervention to preserve tooth structure and to extend the retention of healthy teeth.

Decision Making↗

PubMed1994

Composition and cariogenic potential of dental plaque fluid.

Our understanding of the chemical events that take place at the tooth-plaque interface has improved greatly through studies of the chemical composition and properties of dental plaque fluid. In the absence of fermentable carbohydrate, plaque fluid has been found to be supersaturated with respect to tooth mineral and other calcium phosphate phases, thus exhibiting the potential to support calculus formation and the remineralization of incipient carious lesions. Following the exposure to fermentable carbohydrate, the degree of saturation of plaque fluid decreases rapidly, primarily due to lactic acid production and the lowering of plaque fluid pH. The extent of these chemical changes has been shown to be associated with differences in caries history. Such studies have been facilitated by the recent development of microanalytical techniques. Unfortunately, little is known about the relationship between the observed chemical changes in plaque fluid and the microbial composition of plaque. Limited information is also available on the association of immune factors in plaque fluid with dental disease.

Calcium Phosphates↗

PubMed2002

Anticaries and hard tissue abrasion effects of a "dual-action" whitening, sodium hexametaphosphate tartar control dentifrice.

A series of "profile" laboratory studies was conducted to confirm the anticaries potential and hard tissue safety of a novel sodium hexametaphosphate dentifrice technology which provides dual-action tooth whitening (i.e., stain prevention as well as stain removal), while simultaneously providing improved anticalculus action. Under remineralization pH cycling conditions, the dual-action whitening dentifrice produced lesion fluoridation comparable to a conventional NaF dentifrice. Under lesion progression pH cycling conditions, the dual-action whitening dentifrice produced enamel protection against caries initiation and progression comparable to a conventional NaF dentifrice, as well as comparable to a conventional tartar control dentifrice, also containing NaF. These results are consistent with clinical data supporting the anticaries effectiveness of NaF dentifrices combined with anionic tartar control inhibitors, such as pyrophosphate. Abrasion assessments were made using Radioactive Dentin and Enamel Abrasivity (RDA and REA) methods. These laboratory studies demonstrated that the new, dual-action whitening dentifrice produces dentin and enamel abrasivity similar to conventional silica-based dentifrice formulations. These in vitro studies verify the anticaries potential and demonstrate the hard tissue safety of the dual-action, sodium hexametaphosphate dentifrice.

Cariostatic Agents↗

PubMedDate not supplied

Binding characteristics of Streptococcus mutans for calcium and casein phosphopeptide.

Casein phosphopeptides (CPP) stabilize amorphous calcium phosphate (ACP) and may be used to localize ACP in dental plaque, maintaining a state of supersaturation with respect to tooth enamel, reducing demineralization and enhancing remineralization [Reynolds, J Dent Res 1997;76:1587-1595]. The aim of this paper is to investigate these effects by measuring the affinity and capacity of Streptococcus mutans for CPP-ACP. Using the equilibrium dialysis system described by Rose and Hogg [Biochim Biophys Acta 1995;1245:94-98], assessment of calcium binding by a plaque streptococcus at a fixed CPP-ACP concentration gives a series of CPP-ACP-influenced dissociation constants for calcium. These data can then be used to derive a true dissociation constant for CPP-ACP itself. The results demonstrate that CPP-ACP binds with about twice the affinity of the bacterial cells for calcium up to a value of 0. 16 g/g wet weight cells. Application of CPP-ACP to plaque may cause a transient rise in plaque fluid free calcium which may assist remineralization. Subsequently, CPP-ACP will form a source of readily available calcium to inhibit demineralization. Hence, CPP-ACP binds well to plaque, providing a large calcium reservoir, which is likely to restrict mineral loss during a cariogenic episode and provide a potential source of calcium for subsequent remineralization. Overall, once in place, CPP-ACP will restrict the caries process.

Binding, Competitive↗

PubMed1994

Saliva stimulation and caries prevention.

The protective role of saliva is demonstrated by the rampant caries seen in human subjects with marked salivary hypofunction, and in desalivated animals. In normal cases, however, the relationship between saliva flow and coronal or root caries experience is doubtful, and to examine the concept that stimulation of saliva might have protective effects against caries, one must look beyond a simple correlation between caries and flow rate. Protective properties of saliva which increase on stimulation include salivary clearance, buffering power, and degree of saturation with respect to tooth mineral. These benefits are maximized when saliva is stimulated after the consumption of fermentable carbohydrates, by reducing the fall in plaque pH leading to demineralization and by increasing the potential for remineralization. Plaque acid production is neutralized, and experimental lesions in enamel are remineralized, when gum is chewed to stimulate saliva after a carbohydrate intake. The pH-raising effects are more easily explained by the buffering action of the stimulated saliva than by clearance of carbohydrates. The remineralization action depends upon the presence of fluoride. These findings suggest that the protective actions of saliva can be mobilized by appropriate salivary stimulation, and that in addition to established procedures such as tooth cleaning and fluoride regimens, eating patterns which lead to saliva stimulation to increase the potential for saliva protection might be included in recommendations for caries prevention. Confirmation of this concept in clinical tests is required.

Dental Caries↗

PubMed2002

Quantitative light-induced fluorescence: a potential tool for general dental assessment.

Current dental diagnostic methods can detect caries but cannot quantify the mineral status of a lesion. Quantitative light-induced fluorescence (QLF) measures the percentage of fluorescence change of demineralized enamel with respect to surrounding sound enamel, and relates it directly to the amount of mineral lost during demineralization. Development of caries-like lesions and subsequent remineralization of the lesions were monitored by QLF. The results showed that the percentage of fluorescence change (Delta Q) increased linearly with the demineralization time and decreased with increased remineralization time. Stained teeth were whitened with a bleaching agent and the change in stain intensity (Delta E) was quantified using QLF. The results showed that Delta E decreased linearly as the tooth regained its natural color. Factors that might affect the use of QLF to detect and quantify caries were also examined. It was concluded that QLF could be used to detect and longitudinally monitor the progression or remineralization of incipient caries, however lesion detection may be limited by the presence of saliva or plaque and enhanced by staining. The change in shade of discolored teeth by whitening agents could be quantitatively measured by QLF.

Dental Caries↗

PubMed2004

Biological factors in dental caries: role of remineralization and fluoride in the dynamic process of demineralization and remineralization (part 3).

Dental caries is a complex disease process that afflicts a large proportion of the world, regardless of gender, age and ethnicity, although it does tend to affect more with a low socioeconomic status to a greater extent. Remineralization may be enhanced by providing low levels of calcium and phosphate, in conjunction with minimal amounts of fluoride. It is truly remarkable the difference that a very small amount of fluoride (<1 ppm) has upon demineralization and remineralization. This is because fluoride acts as a catalyst and influences reaction rates with dissolution and transformation of various calcium phosphate mineral phases within tooth structure and resident within plaque adjacent to tooth surfaces. The incorporation of minimal amounts of fluoride into HAP yields FHAP that resists demineralization to similar level as FAP. New and emerging methods have been and are in the process of being developed. These hold great promise for preventing and reversing caries, especially in the one-fifth of the population that accounts for two-thirds of the caries experience. Still, the mainstay in caries prevention and remineralization is frequent exposure to low levels of fluoride. This may be accomplished with fluoridated toothpastes, supplemented with fluoride mouthrinses, CPP-ACP containing chewing gum and application of fluoride varnishes. The role of systemic fluorides appears to be limited and primarily has a topical effect.

Apatites↗

PubMed1991

Effect of pore topology on the remineralization rate of surface-softened enamel and synthetic hydroxyapatite: an experimental comparison and mathematical model.

Experiments with surface-softened synthetic hydroxyapatite show similar remineralization rates as surface-softened human enamel. The mineral gain with respect to time relates to parameters governing the precipitation of mineral in the specimens. A mathematical model regarding the mineral precipitation on the pore surface is fitted to the experimental values. We obtained comparable precipitation rates for apatite and tooth enamel. The geometry of the pores, however, proved to be different: a mostly tube-like pore structure must be attributed to demineralized enamel, while the synthetic hydroxyapatite specimens remineralize like a ramified, crack-like microstructure of pores.

Chi-Square Distribution↗

PubMed2003

The use of fluorescein-enhanced quantitative light-induced fluorescence to monitor de- and re-mineralization of in vitro root caries.

The use of fluorescein-enhanced quantitative light-induced fluorescence (QLF) in the detection of in vitro root caries demineralization and reminerlization was investigated. Fourteen previously extracted human premolar roots were selected and determined to be caries-free. Cementum was removed and nail varnish applied leaving an exposed window. Positive and negative controls were selected. During a demineralizing regimen, roots were removed at regular intervals (12, 48, 72 and 120 h) and immersed in sodium fluorescein (0.2 mg L(-1)). Following gentle rinsing, each root was examined using QLF before being returned to the demineralizing solution. Following 120 h, each tooth was sectioned through the lesion and one-half retained for transverse micro radiography (TMR) analysis. The remaining half were subjected to a remineralizing regimen undergoing the same fluorescein and QLF examinations at 7, 28 and 36 days. Results showed that QLF effectively monitored demineralization/remineralization of root dentine as represented by fluorescein penetration. TMR analysis showed good correlations with QLF (DeltaZ/DeltaQ) after demineralization (r = 0.89) and remineralization (r = 0.84). The technique could represent an in vivo method for root caries detection and classification.

Bicuspid↗

PubMed2001

Dental enamel formation and its impact on clinical dentistry.

The nature of tooth enamel is of inherent interest to dental professionals. The current-day clinical practice of dentistry involves the prevention of enamel demineralization, the promotion of enamel remineralization, the restoration of cavitated enamel where demineralization has become irreversible, the vital bleaching of dental enamel that has become discolored, and the diagnosis and treatment of developmental enamel malformations, which can be caused by environmental or genetic factors. On a daily basis, dental health providers make diagnostic and treatment decisions that are influenced by their understanding of tooth formation. A systemic condition during tooth development, such as high fever, can produce a pattern of enamel defects in the dentition. Knowing the timing of tooth development permits estimates about the timing of the disturbance. The process of enamel maturation continues following tooth eruption, so that erupted teeth can become less susceptible to decay over time. Mutations in the genes encoding enamel proteins lead to amelogenesis imperfecta, a collection of inherited diseases having enamel malformations as the predominant phenotype. Defects in the amelogenin gene cause X-linked amelogenesis imperfecta, and genes encoding other enamel proteins are candidates for autosomal forms. Here we review our current understanding of dental enamel formation, and relate this information to clinical circumstances where this understanding may be particularly relevant.

Amelogenesis↗