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At least 919 records · Page 51Linked to original sources
PubMed1992

[Caries-- changing patterns].

This article briefly describes the pathogenesis of dental caries. It focuses on the relevant chemical processes and histological changes in dental enamel. Recent studies have shown that the mineral balance at the tooth-oral fluid interface are determinants for the occurrence of caries, and more important than the intrinsic tissue properties. During periods of low pH, following bacterial metabolism of fermentable carbohydrates, enamel is demineralized. However, loss of tissue may be compensated by mineral deposition from saliva during subsequent periods at neutral pH ('remineralization'). The mineral balance is positively affected by the presence of low fluoride levels in the oral fluids. Clinically this becomes manifest in the decreasing rates of caries initiation and progression. Also it may affect the appearance of incipient enamel lesions, which in turn could complicate caries diagnosis. The changing patterns of dental changes thus have implications for procedures in preventive and restorative practise.

Acid-Base Imbalance↗
PubMed1995

Nutritional role of sugars in oral health.

The dental risk of dietary sugars is dependent mainly on the frequency of intake, but the prevalence of caries in a population is strongly modified by other dietary, social, and behavioral factors independent from intake of sugars. Regarding dietary factors, it must be remembered that hidden sugars in fruit as well as polysaccharides are cariogenic. The most important of the other factors is regular tooth brushing, which results in the removal of the bacterial plaque that causes caries and periodontal diseases and makes fluoride (which is contained in every advanced toothpaste) available for maintenance of the hard dental tissues and for remineralization wherever demineralization has occurred. This explains why in most highly developed countries caries prevalence has decreased markedly during the past 20 y although consumption of sugars remained high.

Dental Caries↗
PubMed1999

Does ART have a place in preservative dentistry?

The ART technique consists of hand excavating carious tissue and placing a highly viscous glass ionomer cement as a restoration material and as a sealant. Although the results of several studies are promising, the retention rates of these restorations for primary teeth are not impressive. Materials and methods that yield greater success rates are needed to improve long-term caries management outcomes. In principle, ART should yield outcomes similar to those associated with preservative dentistry, including the potential for minimal surgical intervention, conservation of sound tooth structure, avoidance of pain and need for local anesthetic injections, reduced risk for subsequent endodontics and tooth extraction, and increased survival time of the affected teeth. The ideal direct-filling ART material would be biocompatible and tooth colored; "forgiving" in its handling properties; insensitive to moisture or desiccation; hardenable without special equipment; able to form stable bonds to enamel and dentin; able to seal marginal gaps against bacteria; capable of releasing fluoride or remineralization and antibacterial agents when demineralization is most likely; and resistant to chemical attack. The highly viscous glass ionomer materials currently used for ART meet several of this criteria, though they may be deficient in their ability to seal marginal gaps against bacteria and in their sensitivity to desiccation. Furthermore, although they release fluoride over the lifetime of the restoration, this fluoride release alone may not prevent caries progression in all cases. It is necessary for cases of high caries risk to use chlorhexidine in conjunction with fluoride to achieve caries arrest and remineralization of adjacent areas of the affected teeth. Thus, while the ART technique offers some benefits in restoring function and reducing the rate of caries progression, it is unlikely that current materials will be able to arrest caries progression completely in high-risk persons.

Dental Caries↗
PubMed2006

Microradiographic study on the effects of mucin-based solutions used as saliva substitutes on demineralised bovine enamel in vitro.

Sialic acids and proteins bound to mucins are known to form complexes with calcium, and this mechanism may hamper the remineralization of calcium-containing mucin-based saliva substitutes. Thus, the aim of this investigation was to evaluate the effects of adding various concentrations of calcium phosphate to self-made mucin-containing solutions on demineralised bovine enamel in vitro. Bovine specimens were prepared, embedded in epoxy resin, and polished to 4000 grit. Subsequently, the surfaces of the specimens were partially covered with nail varnish, thus serving as a control of sound enamel, and demineralised (37 degrees C; pH 5.0) for 14 (19 groups; n=10) or 28 days (three groups; n=9). After demineralization, the specimens were exposed to mucin-based solutions (30 g/l) with various saturations with respect to apatites containing 0.1 mM NaF, CaCl(2) (0-20 mM) and KH(2)PO(4) (0-52 mM) at two different pH values (5.5 or 6.5). A fluoride-free solution and the commercially available saliva substitute Saliva Orthana (Orthana, Kastrup, Copenhagen Denmark) served as controls. The differences in mineral loss (DeltaDeltaZ) between the values prior to (DeltaZ(Demin)) and after storage (DeltaZ(Effect)) in the various solutions were evaluated from microradiographs of thin sections (100 microm). The general linear model revealed a significant dependency of DeltaDeltaZ for calcium (P=0.006), but not for phosphate (P=0.081) or pH (P=0.114). DeltaZ(Effect) was only significantly reduced compared with DeltaZ(Demin) in the group with the highest saturation with respect to hydroxyapatite (P<0.05; t-test). In conclusion, mucin-based saliva substitutes with an adequate composition are able to remineralize bovine enamel in vitro.

Animals↗
PubMed1988

The pre- and posteruptive effects of fluoride in the caries decline.

The widespread availability of fluoride from many sources is accepted as a major reason for the caries decline among children in developed countries. There is still controversy, however, about its principal mode of action. This article reviews the evidence on fluoride's preeruptive and posteruptive effects, and suggests reasons for its continuing role in the caries decline. Early fluoridation studies accepted that fluoride acted preruptively through incorporation into developing enamel; but further research could not explain why fluoride levels were not clearly higher in enamel exposed to fluoride, nor why there were no clear correlations between caries experience and enamel fluoride concentration. Instead, considerable evidence suggests that fluoride acts mainly, though not entirely, through posteruptive remineralization of demineralized enamel. Caries experience has declined in nonfluoridated as well as in fluoridated areas, though DMF scores are still consistently lower in fluoridated areas. Posteruptive remineralization effects are seen from fluoridated drinking water as well as with fluoride from other sources. The continuing caries decline, beyond the level suggested by early fluoridation field trials, can be attributed either to more efficient remineralization or to long-term, intraoral ecological change, or to both.

Child↗
PubMed2001

[Increase of resistance of dental abutment tissues to acid demineralization after preparation for fitting with permanent dentures].

The efficiency of various protective treatments of teeth were studied in 50 patients divided into 4 groups: 1) (15 patients) 30 teeth with viable pulp were coated with fluorine varnish; 2) (15 patients) 30 teeth were examined after wearing temporary polypropylene crowns fixed on aqueous dentin; 3) (10 subjects) 30 teeth were examined after removal of permanent dentures and treatment of the enamel with fluorine-containing varnish; and 4) (10 subjects) after removal of permanent dentures the enamel was treated with calcium-containing gel using gingivodental kappa according to the proposed method. The status of dental hard tissues was evaluated using acid biopsy of the enamel (Leontyev and Distel's method in our modification) and analysis of the oral fluid. The efficiency of different methods of dental hard tissue protection from acid medium was evaluated. Positive results were obtained with pathogenetically justified new remineralizing procedure.

Acid Etching, Dental↗