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PubMed1978

Histologic identification of mast cells in human dental pulp.

Previous investigators who attempted to identify mast cells in the dental pulp have used demineralizing or tooth-splitting procedures to obtain their tissue samples. However, Eda and Langeland15 found that the fluorescence of mast cells is destroyed by acid demineralizing agents. On the other hand, tooth splitting may damage the pulp by crushing it with forceps, or cutting and heating it with burs, stones, or discs. In the present study, we used the extirpated pulps from teeth in which endodontic access openings were made by means of high-speed rotary instruments with water spray. Metachromatic staining methods failed to demonstrate mast cells in any of the non-inflamed pulp specimens. Two of the inflamed pulp specimens revealed numerous mast cells which appeared intact and well preserved with no evidence of degranulation. As to the distribution of the mast cells, there was no correlation with the number and types of other inflammatory cells observed. Although several cells present in the specimens examined were suggestive of mast cells, only those cells that revealed definitive metachromasia were included in this study.

Cytoplasmic Granules↗

PubMed2005

Prevention of enamel demineralization: an in-vitro study using light-cured filled sealant.

INTRODUCTION: Enamel demineralization is an undesirable side effect of orthodontic treatment with fixed appliances. The purpose of this in-vitro study was to evaluate the efficacy of applying a light-cured filled sealant onto the buccal tooth surfaces to prevent demineralization. METHODS: Fifty extracted human third molars were allocated to 1 of 5 groups: (1) enamel surface untreated (control); (2) surface etched; (3) fluoride varnish applied; (4) enamel etched and coated with a light-cured, unfilled sealant (control sealant); and (5) enamel etched and coated with a light-cured, filled sealant (Pro Seal, Reliance Orthodontic Products, Itasca, Ill). The enamel surface of each specimen was brushed for 15,000 strokes with nonfluoride toothpaste slurry with a piston-action brushing machine under a standardized load. All samples were then cycled for 14 days through a daily procedure of demineralization for 6 hours and remineralization for 17 hours. Then the teeth were sectioned and evaluated quantitatively by cross-sectional microhardness testing. RESULTS: Demineralization in the Pro Seal group was significantly less (P < .05) than in the other groups. Teeth treated with fluoride varnish exhibited 30% less demineralization than the control teeth, the enamel-etched teeth, and the teeth treated with a light-cured, unfilled sealant (P < .05). CONCLUSIONS: Pro Seal can be considered for use as a preventive method to reduce enamel demineralization adjacent to orthodontic attachments, particularly in patients who exhibit poor compliance with oral hygiene and home fluoride use.

Analysis of Variance↗

PubMed2000

Development of multi-species consortia biofilms of oral bacteria as an enamel and root caries model system.

The aim was to establish defined-species consortium plaque biofilms to investigate enamel and root caries in an artificial mouth. Strains of the putative enamel and root caries pathogens, Streptococcus mutans, Strep. sobrinus, Actinomyces naeslundii and Lactobacillus rhamnosus, were screened in batch culture for potential cariogenic properties: a low terminal pH, ability to aggregate, and catabolic diversity. The strains selected were grown as monoculture biofilms and as consortium plaque biofilms in a multiplaque artificial mouth. The biofilms were supplied with a constant flow of a simulated oral fluid and were given periodic sucrose (and in some instances glucose) to simulate meals. All the bacteria except L. rhamnosus formed large, monospecies biofilms with resting pH in the range 5.3-5.8. The consortia biofilms were larger and had a resting pH of 4.9-5.3. The consortia biofilms supplied with 8-hourly carbohydrate comprised mainly 'mutans' streptococci (58, SD 5.5%) and L. rhamnosus (42, SD 5.7%). A. naeslundii characteristically was absent or present in a low percentage (up to 4% colony-forming units). All biofilms demineralized polished bovine enamel and dentine blocks, as assessed by microradiography and enamel-surface microhardness measurement. The consortia also demineralized intact enamel and tooth roots; they were more cariogenic to enamel than any of the monoculture biofilms, as measured by enamel-surface softening, but variation in lesion depth was proportional to biofilm wet weight irrespective of acidogen composition (r = 0.93, p < 0.05). Enamel lesions had a well-mineralized intact surface and a zone of subsurface demineralization, typical of early natural lesions. Dentine and root lesions showed extensive demineralization but lacked a pronounced surface mineralized zone. Substitution of glucose for sucrose had no effect on the cariogenicity of the consortium to bovine enamel or human roots and had no major effect on the plaque composition. Continuously supplied fluoride (19 parts/10(6)) resulted in a substantially reduced enamel surface softening and subsurface demineralization of intact roots. It was concluded that consortia biofilms of selected caries pathogens generate realistic caries lesions in all tooth hard tissues under controlled growth conditions in the artificial mouth. This in vitro caries experimental model may prove useful for the study of interrelations between the plaque biofilm, tooth tissues and the oral environment, and for the development of procedures to modify the course of caries development.

Actinomyces↗

PubMed1995

Autofluorescence of bulk sound and in vitro demineralized human root dentin.

The aim of this paper is to report on the demineralization-induced changes in dentin autofluorescence. Confocal laser scanning microscopy (CLSM) images and fluorescence excitation and emission spectra in vitro demineralized root surfaces and sound controls on the same tooth roots were compared. When observed in CLSM images, demineralized dentin, excited at 488 nm, gave an increased emission at 529 nm compared to sound dentin. The difference in fluorescence decreased deeper into the root, as the sound dentin underneath the lesion was reached. In contrast, when using fluorescence spectrophotometry, excitation around 460 and 488 nm yielded a lower emission around 520 nm for demineralized dentin than for sound dentin, but in a more pronounced peak. From excitation spectra for emission around 520 nm, it could be seen that in demineralized dentin the contribution of excitation between 480 and 520 nm was more important than in sound dentin. The recorded fluorescence in CLSM images was not affected by demineralization-caused changes in scattering and absorption properties, due to the small measurement volume. Thus, the increased fluorescence for demineralized dentin implies an increased quantum yield. In fluorescence spectrophotometry, where the measurement volume is large, changes in scattering and absorption do have an influence on the fluorescence signal. Then, increased absorption by non-fluorescing chromophores and increased re-absorption around the emission wavelength may compensate for the increase in quantum yield and absorption around the excitation wavelength by fluorophores.

Absorption↗

PubMed1976

Accelerated reattachment with cementogenesis to dentin, demineralized in situ. II. Defect repair.

Three surgical experiments, with histologic evaluation, were performed to study induced gingival reattachment to tooth root dentin demineralized in situ during flap surgery in adult mongrel dogs. Experiments demonstrated aspects of: (1) Weekly histochemical and morphological sequences of repair; (2) Repair of chronically inflamed bony defects simulating periodontal pockets; and (3) Six and 12 month repair of reattached surgical defects. Flap reattachment with cementogenesis was induced by in situ root demineralization using citric acid at pH 1.0 applied for 2 minutes. Results demonstrate: (1) The production of anchoring cementum pins extending into dentin tubules widened by demineralization; (2) Reattachment with cementogenesis of inflamed gingiva to roots exposed to chronically-infected surgical defects for 3 months; (3) Success in repairing chronic interproximal one-walled and labial one surface defects by reattachment; (4) Relative failure to repair bifurcation and horizontal bone defects by flap reattachment; and (5) Complete alveolar bone repair over most labial defects by 1 year, with maintenance of a periodontal ligament between induced bone and cementum. These findings, together with previous reports of induced reattachment to demineralized roots, provide further evidence for mechanisms and consistency and suggest that this regenerative phenomenon may be useful in repairing osseous defects in periodontal therapy.

Alveolar Process↗

PubMed2003

[Effects of dentine phosphoprotein on remineralization of demineralized dentine].

OBJECTIVE: To investigate the relationship between dentine phosphoprotein (DPP) and remineralization of demineralized dentine. METHODS: (1) Soluble DPP was extracted with 1 mol/L NaCl from demineralized dentine and was evaluated. (2) Soluble DPP was removed with 0.1 mol/L NaCl or was not removed from demineralized dentine sections in human tooth roots. Then all sections were subjected to remineralization treatment, and remineralization degrees were compared by atomic absorption spectrum, SEM and microradiography. RESULTS: (1) Soluble DPP was extracted with 1 mol/L NaCl. (2) Removal of soluble DPP resulted in significantly lower calcium concentration in remineralization solution (P < 0.01), less mean light-absorbed value in demineralized dentin sections by microradiography (P < 0.01). CONCLUSIONS: Soluble DPP may have an inhibiting effect on remineralization of demineralized dentine, this study suggests that the remove of soluble DPP from root caries lesions may enhance their remineralization potential.

Adolescent↗

PubMed2002

Influence of soft drinks on the thickness and morphology of in situ acquired pellicle layer on enamel.

Diet-induced demineralization is a key factor in tooth enamel loss, with soft drinks being a significant aetiological agent. In the oral environment, the acquired pellicle layer might modify the demineralization potential of drinks. The objectives of this exploratory in situ study were to determine the influence of soft drinks, volunteers, and exposure times on the thickness and morphology of pellicle layers using an atomic force microscope (AFM). Polished uninterrupted third molars were partly taped and exposed to the oral environment for periods of 2 and 5 days, respectively. Each day 1L of either mineral water, a "toothkind" blackcurrant drink, a "prototype" blackcurrant drink, or orange juice was consumed in this four-way crossover, single-center study. Subsequently the tape was removed and the surfaces imaged with an AFM before and after chemical cleaning. The pellicle layer morphology and thickness were investigated. The maximum pellicle layer thickness was observed after the consumption of the prototype blackcurrant drink, followed by the toothkind blackcurrant drink, orange juice, and water on days 2 and 5, respectively. A three-way ANOVA at the 95% confidence level showed statistically significant differences between the pellicle layer thicknesses, factors being drinks (p=0.0046), exposure time (p=0.0009), and volunteers (p=0.0244). Depending on the volunteer either a uniform or a patchy pellicle layer was observed. This demonstrates that AFM is a useful tool in obtaining simultaneously qualitative and quantitative data of in situ acquired pellicle layers.

Beverages↗

PubMed2000

Distribution and volumetric assessment of initial approximal caries lesions in human premolars and permanent molars using computer-aided three-dimensional reconstruction.

Serial sections from 21 extracted premolars and permanent molars, divided into three age groups (group 1, 10-19 years; group 2, 20-39 years; group 3, 50-69 years.), were viewed by polarized light microscopy for reconstruction of the caries lesions. The volumes of the lesional body and the transparent zone, and the volumes of early dentinal lesions were calculated; and an enamel demineralization index (EDI) and an enamel-dentine demineralization index (EDDI), representing the volumetric ratio of the body of the lesion to the translucent zone, and the body of the lesion to the volume of the early dentinal lesion, respectively, were determined. The method showed that there are three typical sites of individual initial caries lesions at the approximal surface: within the contact area, in the subcontact area, and in the cervical area. Volumetric assessment demonstrated a larger volume of the body of the lesion in older teeth with a smaller volume of the translucent zone relative to the lesional body. From these results it can be concluded that there are usually more than one individual initial caries lesions at the approximal tooth surface. Calculation of demineralization indices demonstrated different features for small lesions with pronounced transparent zones and for large lesions with small transparent zones. The computer-assisted three-dimensional reconstruction technique and the volumetric assessment are of value in investigations of the micromorphology and progression of natural caries lesions in permanent teeth.

Adolescent↗

PubMed1991

[Acid erosions of tooth surface. 1. Influence of saliva, medicaments, fruit acids and mechanical stress].

The clinical aspects, etiology, pathogenesis and classification of dental erosions are reviewed. Individual susceptibility or resistance to erosive damage has been attributed to variations in the quality and quantity of saliva. A lot of medicaments reduce the salivary secretion. Under the influence of acids, in particular of fruit acids, the peripheral tooth surface are demineralized in the absence of dental plaque. The citrus juices showed potentially the worst dental properties. Abrasive brushing techniques and functional influences wear down the already damaged layer of tooth surfaces.

Acids↗

PubMed2006

Chondroid metaplasia in inflamed pulp tissue: a case report.

OBJECTIVE: The aim of the present report is to report an unusual case of chondroid metaplasia of the dental pulp. STUDY DESIGN: A white 45-year-old female patient appeared with signs and symptoms of an irreversible pulpitis on an upper left decayed third molar. After extraction, the tooth was fixed, demineralized, and processed for light microscopy. RESULTS: Pulp tissue was replaced at one of the pulp horns by a colliquative necrosis surrounded by neutrophil leucocytes and congested blood vessels. Serial sections demonstrated a complete opening of the decayed tooth to the oral environment, and an area of chondroid metaplasia of the pulp was evident. Chondroid tissue was surrounded by a dense concentration of chronic inflammation cells. CONCLUSIONS: According to the best knowledge of the authors, this is possibly the first report of an occurrence of chondroid metaplasia in the dental pulp. This metaplasia could be the result of an attempt at tissue repair by the pulp tissue injured by the carious lesion. The pathologic changes in the dental pulp could have activated some of the mechanisms that have been described in other tissues, producing the formation of chondroid tissue. Pulp tissue may adapt to changed environmental stimuli by a deviation from normal cell differentiation.

Cartilage↗

PubMed1987

Human dentin matrix induces cartilage formation in vitro by mesenchymal cells derived from embryonic muscle.

Dentin matrix was assayed for its potential to elicit chondrogenesis of mesenchymal cells in vitro. The substratum was prepared by demineralization of human tooth root dentin, while embryonic thigh muscle was used as a source of mesenchymal cells. Formation of chondrocytes from mesenchymal cells occurred in the presence of dentin matrix, and in the same sequence as previously shown with substrata of demineralized bone.

Animals↗

PubMed2003

Occlusal pit-and-fissure caries diagnosis: a problem no more. A science-based diagnostic approach using a laser-based fluorescence device.

The subject of occlusal pit-and-fissure caries diagnosis elicits controversy and multiple opinions, depending on the clinician being questioned. The literature, however, points to which direction the profession should be headed in this field, as did the views expressed by the National Institutes of Health's "Consensus Development Conference on Caries Prevention and Management," held in March 2001, showing the need for more diagnostically specific caries management protocols and methods. Many clinicians have been surprised by the extent and severity of the carious involvement of a specific tooth, particularly when radiological as well as clinical examination indicates that little or no carious process should be present. It is unfortunate that at the stage when an explorer finally detects an occlusal catch, the degree and extent of demineralization and compromised tooth structure is already far advanced. This leads to the removal of large amounts of tooth structure to achieve a functional restoration. The consequential structural weakening of the tooth could have been prevented if the carious lesion had been detected earlier in its clinical course. Finite, quantitative, and reliable early diagnosis of carious occlusal lesions has remained elusive until now. Intercepting the carious process at an early stage leads to a conservative cavity preparation that preserves sound tooth structure and increases the structural integrity of the tooth. This article reviews the literature related to this topic and describes a relatively new diagnostic methodology that uses a laser fluorescence device (KaVo's DIAGNOdent). It is hoped that this article will serve as a catalyst for adopting a science-based approach to detecting and diagnosing occlusal pit-and-fissure caries at an early stage. The cases presented demonstrate the clinical efficacy and simplicity of this method of caries diagnosis, as well as show how invasive and destructive this "hidden caries" phenomenon can be.

Adolescent↗

PubMed1991

Effects of phosphoprotein moieties on the remineralization of human root caries.

The noncollagenous proteins, especially phosphoprotein, have been shown to modulate biomineralization. The objective of this study was to investigate the remineralization potential of human tooth root organic matrices which did or did not contain soluble non-collagenous proteins including phosphoprotein. Human tooth roots were completely demineralized using conditions that either removed or did not remove soluble phosphoprotein and were then subjected to remineralization conditions. Removal of soluble phosphoprotein resulted in remineralization while no remineralization occurred in tooth roots that still contained soluble phosphoprotein. Transmission electron microscopy and microradiography demonstrated that demineralized cementum did not remineralize under any of the conditions used in this study. Collagenase digestion of demineralized and salt-reextracted tooth root organic matrices revealed that a nonsoluble phosphoprotein was present in the matrices. Amino acid analysis and SDS-PAGE showed that this nonsoluble phosphoprotein was similar in composition to the soluble phosphoprotein. This work suggests that the removal of soluble, noncollagenous proteins, especially phosphoprotein from root caries lesions, may enhance their remineralization potential.

Amino Acids↗

PubMedDate not supplied

Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review.

Using laboratory, animal, and human in situ caries models, investigators have shown that casein phosphopeptide amorphous calcium phosphate complexes (CPP-ACP) exhibit an anticariogenic activity. The casein phosphopeptides (CPP) are produced from a tryptic digest of the milk protein casein by aggregation with calcium phosphate and purification by ultrafiltration. The CPP have a remarkable ability to stabilize calcium phosphate in solution and substantially increase the level of calcium phosphate in dental plaque. Through their multiple phosphoseryl residues, the CPP bind to forming clusters of amorphous calcium phosphate (ACP) in metastable solution, preventing their growth to the critical size required for nucleation and precipitation. The proposed mechanism of anticariogenicity for the CPP-ACP is that they localize ACP in dental plaque, which buffers the free calcium and phosphate lon activities, thereby helping to maintain a state of supersaturation with respect to tooth enamel depressing demineralization and enhancing remineralization. The CPP-ACP, unlike fluoride, can be added to sugar-containing foods and therefore have commercial potential as an additive to foods as well as to toothpastes and mouthwashes for the control of dental caries.

Amino Acid Sequence↗

PubMedDate not supplied

Aesthetic ridge and extraction site augmentation for anterior implant placement without barrier membrane.

Augmentation of the alveolar ridge to facilitate implant placement in a single tooth extraction site or a completely edentulous arch is currently a well-accepted and routinely performed therapeutic procedure. This article describes a method for augmenting extraction sites and ridges, without primary closure or the use of barrier membranes over bone grafts. The technique retains or enhances gingival architecture while creating bone for placement of an implant in the most optimal position. The tooth is extracted, demineralized freeze-dried bone allograft or another augmentation material of choice is placed, and a provisional mucoadhesion partial denture is delivered. When the implant is uncovered and the healing abutment is placed, a flap design is utilized to create papillae and proper labial contour. The learning objective is familiarity with this technique, which is particularly useful for maxillary anterior implant placement. A case report is used to document the clinical procedure.

Adult↗

PubMed1988

Comments on the clinical application of fibronectin in dentistry.

Several studies have demonstrated that citric acid demineralization of the root surface promotes tissue attachment. Since demineralization exposes collagen to which fibronectin binds, the role of fibronectin in the attachment of cells to the tooth surface has been of considerable interest. It is clear that fibronectin and other cell adhesion proteins can promote cell attachment to the tooth surface; therefore, attempts have been made to utilize these findings in a clinical setting. Using a quantitative ELISA procedure to measure the binding of fibronectin to demineralized bone and tooth, we have found that 1 microgram fibronectin can saturate approximately 1 mg of either demineralized bone or demineralized tooth powder. Since serum contains 300 micrograms fibronectin per mL, the bleeding that occurs during oral surgery should saturate exposed tooth surfaces with amounts of fibronectin adequate for cell adhesion. Thus, exogenous fibronectin would appear to be of little clinical benefit.

Animals↗

PubMed1999

Effect of a fluoride varnish on demineralization adjacent to orthodontic brackets.

Home fluoride regimens have long been used to reduce the amount of demineralization adjacent to orthodontic appliances. In the absence of patient compliance, another method of applying the fluoride must be used. The purpose of this study was to evaluate, in vitro, the ability of a fluoride varnish, Duraflor, to directly inhibit demineralization of enamel surrounding orthodontic brackets. Brackets were bonded to 36 extracted human canines and premolars with a traditional composite resin and randomly assigned to three equal groups of twelve. Group 1 served as the control with no topical application after bonding. Group 2 was treated with a single application of a nonfluoridated placebo varnish. Group 3 was treated with a single application of Duraflor. All groups were cycled in an artificial caries challenge for 1 hour two times daily for 37 days and were brushed with a medium bristled toothbrush to simulate mechanical wear of the varnish. Demineralization of enamel was evaluated in longitudinal buccolingual tooth sections using polarized light microscopy. Both average depth and area of demineralization were measured with a sonic digitizer. ANOVA (P </=. 0001) and Duncan's test (P </=.05) indicated significant differences in depth and area of demineralized enamel. Those teeth treated with Duraflor exhibited 50% less demineralization than the control teeth and an even greater difference when compared to the placebo group. Fluoride varnishes should be considered for use as a preventive adjunct to reduce enamel demineralization adjacent to orthodontic brackets, particularly in patients who exhibit poor compliance with oral hygiene and home fluoride use.

Analysis of Variance↗

PubMed1990

Effect of lipids on the lactic acid retardation capacity of tooth enamel and cementum pellicles formed in vitro from saliva of caries-resistant and caries-susceptible human adults.

The lipid content and composition of these pellicles and the effect of lipids on their ability to retard the diffusion of lactic acid were investigated. Lipids accounted for 22.4% of the dry weight of caries-resistant enamel pellicle and 19.2% of caries-resistant cementum pellicle; the pellicle of caries-susceptible enamel contained 24.6% lipids and that of caries-susceptible cementum, 23.4%. Enamel and cementum pellicles from caries-resistant saliva had a significantly lower content of neutral lipids and phospholipids, whereas the glycolipid content was lower, although not significantly, in caries-susceptible pellicles. Pellicles from caries-resistant saliva had a considerably greater capacity to retard lactic acid diffusion than those from caries-susceptible saliva. In all cases, the retardation capacity was clearly dependent upon the lipid constituents, removal of which caused a 50-52% drop in lactic acid impedance by caries-resistant enamel and cementum pellicles, and 32-35% drop by caries-susceptible pellicles. On reacting the delipidated pellicles with their lipids, it was found that, in all cases, the highest quantitative effect on the restoration of the retardation capacity occurred when phospholipids were added. The findings suggest that the events controlling the interaction of salivary phospholipids with enamel and cementum may determine the susceptibility of the tooth surface to demineralization by acids produced by cariogenic micro-organisms.

Adult↗