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PubMedDate not supplied

Comparison of QLF and DIAGNOdent for quantification of smooth surface caries.

The aim was to compare the detection and quantification of smooth surface caries by KaVo DIAGNOdent and quantitative laser/light-induced fluorescence (QLF) using a laser and a lamp as two different light sources. On 40 premolar teeth extracted from adolescents, 71 non-cavitated approximal surfaces were assessed. For QLF, both mean and maximum fluorescence losses were registered. To provide a gold standard for verification, the teeth were then sectioned and lesion depth, stratified on a five-point scale, was determined by histopathology and microradiography. The correlation between the gold standard and the two methods was assessed by Spearman's rank correlation coefficient. The sensitivity and specificity of the methods for detection of smooth surface caries at D(3) level were also assessed. For lesion depth, correlation with the gold standard was similar for QLF and DIAGNOdent: about 0.85. With respect to dentinal caries detection, sensitivity for DIAGNOdent was 0.75 and specificity 0.96, with a cut-off point of 9. The corresponding values for QLF were 0.94 and 1, with a cut-off value of 20% of fluorescence loss. Spearman's rank correlation coefficients for enamel mineral loss and QLF and DIAGNOdent, respectively, were 0.76 and 0.67. It was concluded that for quantification of smooth surface caries, the methods are of equal merit, but for scientific purposes, QLF offers the advantage of closer correlation with changes in mineral content.

Adolescent↗
PubMedDate not supplied

In vivo repeatability and reproducibility of the quantitative light-induced fluorescence method.

In vivo repeatability and reproducibility of the quantitative light-induced fluorescence (QLF) method were tested with respect to three variables: lesion area, and average and maximum changes in lesion fluorescence. To test the image-capturing stages, three analysts each captured images of 15 incipient smooth surface lesions in vivo, and the images were analysed by one of the analysts. To test the analytical stage of the method, three analysts analysed the images of 15 in vivo incipient smooth surface lesions. For the image-capturing stage, inter-examiner reliability showed an intra-class correlation coefficient (r) between 0.95 and 0.98. For the analytical stage, intra-examiner reliability for all three analysts showed a value of r between 0.93 and 0.99. Inter-examiner reliability showed a value of r between 0.95 and 0.99. It was concluded that the in vivo repeatability and reproducibility of the QLF method are excellent.

Analysis of Variance↗
PubMedDate not supplied

Fluoride and urea chewing gums in an intra-oral experimental caries model.

The aim of the present investigation was to evaluate the effect of sugar-free chewing gums containing fluoride (F) and urea in an intra-oral experimental caries model. Placebo chewing gums (without any active ingredient) and no gum served as controls. Fifteen subjects participated in a cross-over, single-blind study. Demineralised enamel and dentine blocks were embedded in circular plastic discs and bonded to the buccal surfaces of the lower canines and first premolars. The discs were removed and analysed using transversal microradiography after each of the six 4-week periods during which the subjects used either test or placebo products or no product. The results revealed that frequent use of sugar-free chewing gum is sufficient to inhibit further demineralisation of previously demineralised enamel and dentine specimens in the oral cavity. Comparing F, urea and placebo gums, the data showed that there was little or no difference between the products, except for an inhibitory effect on the chewing side of the dentition after using F chewing gums.

Adult↗
PubMedDate not supplied

The effect of dentine on fluorescence measurements of enamel lesions in vitro.

This study aimed to determine the contribution of the underlying dentine and the enamel-dentine junction to measurements of mineral loss from enamel recorded using quantitative light fluorescence (QLF). Sixteen square blocks (5 x 5 mm) were cut from the labial surfaces of extracted bovine incisor teeth. A dental drill was used to remove dentine and the enamel-dentine junction from half of each specimen. All specimens were embedded in epoxy resin and ground to produce a smooth, flat enamel surface. Half of the enamel surface of the block, perpendicular to where the dentine had been removed, was demineralised for 72 h prior to undertaking QLF measurements from the enamel surface to compare fluorescence loss from different areas of the block. QLF readings taken from lesions with no underlying dentine or enamel-dentine junction were very similar to readings from lesions with underlying dentine. A comparison of the two data sets demonstrated a linear relationship with a gradient of 0.95 and a y intercept of -1.24 (r(2) = 0.936). From these data, the underlying dentine and enamel-dentine junction did not influence mineral loss in enamel measured using QLF.

Animals↗
PubMedDate not supplied

Longitudinal study of the three-dimensional development of subsurface enamel lesions during in vitro demineralisation.

A longitudinal study was made of the 3D development of subsurface enamel lesions in whole human molars. X-ray microtomography (XMT) was used to measure the 3D distribution of linear attenuation coefficients in the tissue at 8-15 stages during cumulative times of 36-107 days demineralisation through approximately 1-mm-wide windows. Although lesion morphology was consistent with preferential anisotropic dissolution parallel to enamel prisms at the advancing front, detail (at a scale of approximately 100 microm) varied in relation to exposed surface sites separated by <1 mm. The distribution of mineral in the most superficial region varied across the exposed face of each lesion. Within lesions, localised foci of low mineral concentration (at a scale of approximately 200 microm) retained their general form through successive stages of demineralisation before coalescing. The most advanced regions within a lesion seemed to correspond with surface regions with lowest mineral concentration. These findings indicate that local variations in fractional pore volume of partially demineralised enamel influence the subsequent spatial development of lesions.

Dental Enamel↗
PubMedDate not supplied

Toothbrush abrasion of surface softened enamel studied with tapping mode AFM and AFM nanoindentation.

The aim of the present in vitro study was to investigate the toothbrush abrasion of surface softened enamel using tapping mode atomic force microscopy (TM-AFM) and AFM nanoindentation. TM-AFM investigations showed that the typical prismatic pattern as observed after demineralisation was retained after toothbrushing. The exposure to artificial saliva resulted in the deposition of a 'sausage-shape' material with random orientation. Brushing of these samples did not lead to a complete removal of this deposited material. Enamel mineral loss increased with increasing demineralisation time and increased further, although only to a small extent, due to subsequent toothbrushing. Exposure to artificial saliva did not alter the amount of enamel mineral lost due to the brushing treatment. AFM nanoindentation investigations showed that the three different demineralisation treatments caused three statistically different reductions in both surface hardness and reduced elastic modulus values, with the shortest exposure time having the least effect on the nanomechanical properties of the enamel samples. Toothbrushing did result only in a small increase in hardness and reduced elastic modulus. The present study has shown that toothbrushing of surface softened enamel leads to minor changes in the surface morphology and nanomechanical properties. The amount of enamel lost due to toothbrushing was independent of the demineralisation time and was lower compared to the mineral loss caused by the demineralisation treatments. Furthermore, the exposure to artificial saliva offers minimal protective effect to the softened enamel surface against toothbrushing.

Chelating Agents↗
PubMedDate not supplied

The effect of video repositioning on the reliability of light-induced fluorescence imaging: an in vivo study.

The ability to monitor longitudinally the development, arrest or resolution of early demineralised lesions is one strength of quantitative light-induced fluorescence (QLF). When taking sequential images of an individual's teeth for monitoring it has been suggested that the subsequent images should be taken from the same position the baseline image. To assist in this process, video repositioning software is available that enables automatic capture of images once the system identifies that they are similar enough to the baseline comparator. The purpose of this study was to determine if the use of such software-assisted capture improves the reliability of subsequent QLF analysis. 20 subjects had 34 surfaces (buccal and occlusal) imaged by 2 examiners at baseline, and again 1 week later using both manual and software-assisted (VidRep) systems. Analysis of the three key reportable values for QLF (DeltaF, lesion area, DeltaQ) suggested that there is no significant improvement in reliability using VidRep although VidRep demonstrates additional advantages above and beyond image geometry, relating to the speed of subsequent image analysis.

Child↗
PubMed2006

In vitro evaluation of acidified toothpastes with low fluoride content.

Fluoride toothpastes are a risk factor for the development of dental fluorosis. Products with low fluoride content offer a higher security, but their effectiveness must be proven. The aim of this in vitro study was to compare two acidified toothpastes with low fluoride concentration (412 and 550 microg F/g) with neutral toothpastes. Bovine enamel blocks were selected by surface microhardness (SMH) and randomized to twelve groups of 13, according to the fluoride concentration in toothpaste (placebo, 275, 412, 550 or 1,100 microg F/g) and pH (7.0 or 5.5). Two commercially available toothpastes were also studied: a 1,100-microg F/g, pH 7.0 paste (positive control) and a children's paste (500 microg F/g, pH 7.0). The blocks were subjected to pH cycling for 7 days. The toothpaste treatment was done twice daily. Surface and cross-sectional microhardnesses were assessed to calculate the percentage change of SMH (%SMH) and the mineral loss (DeltaZ). The amount of fluoride, calcium and phosphorus in the solutions after the pH cycling was also analyzed. Compared to neutral toothpastes, the acidified toothpastes reduced the %SMH in all F concentrations. Higher F and lower Ca and P concentrations were found in solutions for the acidified toothpastes. Regarding DeltaZ, only the positive control, 1,100-microg F/g (acidified and neutral) groups were not statistically different. The acidified toothpastes showed a dose-response relationship with all variables. For the low-fluoride toothpastes evaluated, only the 550-microg F/g acidified paste had the same anticariogenic action as the 1,100-microg F/g neutral paste.

Animals↗
PubMed2007

A comparison of terahertz pulsed imaging with transmission microradiography for depth measurement of enamel demineralisation in vitro.

Terahertz pulsed imaging (TPI) is a relatively new, non-ionising and non-destructive imaging technique for studying hard tissues which does not require tooth section preparation, unlike transmission microradiography (TMR). If TPI can measure the depths of caries/demineralisation lesions accurately the same tooth samples could be reused and remeasured during in vitro and in situ studies on de- and/or re-mineralisation. The aim of this study was to compare TPI and TMR for measuring the depths of a range of artificially induced bovine enamel demineralised lesions in vitro. Bovine slabs with artificial caries, induced to different levels of demineralisation by two different but standard demineralisation techniques ('acid gel' and 'carbopol') were measured by TPI and TMR and the readings compared. The set of TPI/TMR measurements obtained on the gel-demineralised slabs showed an extremely high coefficient of determination (r(2) = 0.995). Detailed analysis of the results and theoretical considerations (involving the relationship between refractive index profiling and mineral loss profile) are used to explain the findings and show that for acid gel lesions TPI is measuring demineralisation in the range of 47% of that of TMR depth plus an intercept of 16 microm, with further calculations allowing the TMR depths to be determined to within 5% using TPI.

Acids↗
PubMed1991

Validity of diagnostic and treatment decisions of fissure caries.

The purpose of this in vitro study was to test the accuracy and the reproducibility of diagnostic and treatment decisions of fissure caries with and without explorer. 34 dentists were asked to diagnose 61 teeth and decide upon possible treatment. The teeth were then histologically prepared and diagnosed. The agreement between histological and clinical diagnoses was assessed. The results showed no difference in diagnostic accuracy between explorer and visual technique only. Sensitivity (62%) and specificity (84%) showed that the dentists were more likely not to treat decayed teeth than to restore sound teeth. The percentage 'correctly diagnosed teeth' was approximately 42%. As there was an inherent possibility of a correct diagnosis by chance, this value had to be corrected to 23% (kappa statistics). The percentage of 'clinically' correct treatment decisions, however, was 73%. The reproducibility test gave kappa values of 0.47 for diagnostic and 0.44 for treatment decisions. It was concluded that the use of an explorer does not improve the validity of the diagnosis of fissure caries when compared to that of a visual inspection alone.

Adolescent↗
PubMed1992

Combined effects of laser irradiation and chemical inhibitors on the dissolution of dental enamel.

It has previously been shown that the susceptibility of human teeth to acid dissolution can be reduced by the presence of various chemical agents in the dissolution medium or by pretreatment of the teeth with laser irradiation. Now synergism between these two approaches to improving acid resistance has been demonstrated. Extracted human teeth were irradiated with a continuous-wave carbon dioxide laser at a wavelength of 10.6 microns. Energy doses of either 65 or 130 J/cm2 given over periods of 2 or 4 s, respectively, were applied and the teeth subjected to a severe acid challenge (0.1 M acetate buffer, pH 4.5, no calcium or phosphate common ion present) for 24 h. Mineral loss was assessed by measurement of mineral density profiles with quantitative microradiography. Experiments were carried out in the presence or absence of three chemical inhibitors with distinctly different mechanisms of action: ethane-1-hydroxy-1, 1-diphosphonic acid, fluoride, and dodecylamine HCl. Laser irradiation alone was found to lead to increased resistance of the teeth to acid challenge, with the higher energy dose being more effective than the lower dose. Each of the chemical inhibitors was effective on both lased and unlased teeth, with the percent reduction of dissolution greater when the inhibitors were applied to teeth lased with an energy dose of 130 J/cm2 which were already more resistant to acid challenge than were unlased teeth or teeth lased with a dose of 65 J/cm2.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1992

Secondary caries in situ around fluoride-releasing light-curing composites: a quantitative model investigation on four materials with a fluoride content between 0 and 26 vol%.

In the literature, secondary caries around composite restorations is reported often. Fluoridated composites are therefore interesting materials because they might reduce or inhibit secondary caries. In this article an in situ model investigation is presented in which the effect of F-releasing composites on enamel demineralisation around an artificial gap of 200 microns width was quantified after 1 month. The fluoride content of the composites varied between 0 and 26 vol%. The beneficial effect of the fluoride released was larger in the gap than at the outer enamel surface. In the gap, all fluoridated composites reduced the enamel demineralisation statistically significantly with respect to the non-fluoridated control. Microradiography showed a reduction of lesion depth values of 27-45%, and a reduction of mineral loss values of 25-56%. At the outer enamel surface next to the artificial gap, a beneficial fluoridation effect was measurable only near the most fluoridated composite. The results indicate that fluoridated composites may play a role in the future prevention of secondary caries.

Acrylic Resins↗
PubMed1993

Relationships between birefringence and mineral content in artificial caries lesions of enamel.

The microradiographic mineral content and birefringence in water and Thoulet's solution were measured at selected points in sections of caries-like lesions. Birefringence was not related to mineral content in sound superficial enamel immersed in Thoulet's solution or in the lesion body immersed in water. For the surface layer of the lesion, birefringence in water could be used to obtain qualitative information about mineral content. For the lesion body, birefringence in Thoulet's solution was linearly related to mineral content and can be used to estimate the latter with a standard error of about 7 vol%. The intrinsic birefringence for the lesion body was estimated as -34.5 (+/- 2.3) x 10(-4); This value may also be valid for other parts of the lesion. From consideration of ionic sizes, it is argued that Thoulet's solution cannot necessarily penetrate all enamel pores accessible to water. It appeared that there is a progressive fall in the content of pores inaccessible to Thoulet's solution in the surface layer of the lesion as demineralisation increases.

Birefringence↗
PubMed1993

Long-term fluoride release of visible light-activated composites in vitro: a correlation with in situ demineralisation data.

Fluoridated composites are able to reduce or inhibit secondary caries around fillings. The aims of this study were firstly to investigate the amount of F released in vitro from composites with a F content between 0 and 26 vol% as a function of time over a 1-year period. A second aim was to correlate the in vitro data on F release with enamel demineralisation data in situ after a 1-month period. The results show that all fluoridated composites release sizable amounts of F in solution, the total amounts of F released from three composites were proportional to log t over at least 1 year. In one case proportionality of the total amount of F released with t was observed. Possible mechanisms of F release are considered. The results presented also show a linear relation between the log of in vitro F release data and the effects on enamel demineralisation in situ next to the composite. Extrapolation of the data reveals that a F release of about 200-300 micrograms/cm2 over a 1-month period from a fluoridated composite would completely inhibit secondary caries under plaque conditions.

Acrylic Resins↗
PubMed1993

In situ anticariogenic potential of glass ionomer cement.

The purpose of this study was to compare the amount of fluoride in plaque formed on glass ionomer cement or composite and to evaluate the effects of fluoride released on growth of cariogenic microflora, fluoride uptake, and secondary caries formation under in situ conditions of a high cariogenic challenge. Ten adult volunteers took part in this crossover study performed in two phases of 28 days. Eighty enamel blocks were randomly restored with glass ionomer cement (Chelon-Fil-Espe) or composite (Silux). During each phase of the study, an acrylic resin appliance, containing four enamel blocks restored with the same material, was constructed for each of the volunteers. During the experimental period, all subjects used fluoride-free dentifrice, refrained from brushing the restored enamel blocks, and immersed the appliances into 20% sucrose solution eight times a day. Fluoride levels, mutans streptococci, and lactobacilli were assessed in dental plaque. Fluoride uptake and microhardness profiles were determined in enamel around the restorations. Statistical analyses indicated a significantly higher level of fluoride (p < 0.05) and a lower level of mutans streptococci plaque formed on glass ionomer cement. Analysis of variance in a split-plot model indicated that in the enamel around the glass ionomer restoration the fluoride uptake was significantly greater (p < 0.025) and the mineral loss significantly lower (p < 0.01). The results show that glass ionomer cement presents a broad anticariogenic effect and may be of value in preventing secondary caries, even under conditions of a high caries risk.

Adult↗