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Results for “Tooth Remineralization”

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PubMed1990

Digital subtraction of radiograph in evaluating alveolar bone changes after initial periodontal therapy.

The purpose of this study was to determine the effect of initial periodontal therapy on crestal bone remineralization with the use of a digital subtraction method for quantitative analysis. Fifteen crestal sites randomly selected from five patients were examined at the initial visit, after completion of oral hygiene instruction, and 1, 3, and 6 months after scaling and root planing with standardized radiographs. The radiographs were digitized by means of a drum-scanning microdensitometer with a sampling aperture of 50 microns producing 256 gray levels and corrected for difference of contrast between image pairs. Results were as follows: (1) statistically significant changes were observed even 1 month after the therapy and (2) the extent of changes was quantitatively expressed and monotonically increased with time. These results indicate that subtraction radiography may be a reproducible and quantitative method for the evaluation of periodontal therapy.

Alveolar Process↗

PubMedDate not supplied

Effect of titanium tetrafluoride, amine fluoride and fluoride varnish on enamel erosion in vitro.

This study aimed at evaluating the effect of 1 and 4% titanium tetrafluoride (TiF4) gels, amine fluoride (AmF) 1 and 0.25% and a fluoride varnish (FP) on the prevention of dental erosion. Two experimental groups served as controls, one with no pretreatment and another one pretreated with a fluoride-free varnish (FP-blanco). Dental erosion was modelled using bovine enamel samples submitted to alternate cycles of acid exposure in citric acid and remineralization in artificial saliva. Calcium loss of all samples involved in the study was quantified by atomic absorption spectroscopy and erosion depths were estimated. Two samples of each experimental group were also analyzed by white light confocal microscopy. The cumulative erosion depth (in mum) after 72 min was: TiF4 gel 1% 8.29 +/- 0.39; TiF4 gel 4% 8.27 +/- 0.55; AmF 1% 8.69 +/- 0.66; AmF 0.25% 8.86 +/- 0.33; FP 3.43 +/- 1.07; FP-blanco 14.86 +/- 1.59 and control 9.77 +/- 0.49. A statistically significant protective effect (p < or = 0.001) was found only for the group pretreated with the fluoride varnish. Within the limitations of an in vitro study it may be concluded that topical applications of the fluoride varnish tested have a protective effect on the prevention of dental erosion.

Amines↗

PubMed2001

Current concept on the anticaries fluoride mechanism of the action.

The paper discusses a possible new concept of the role of fluoride and its mechanism of action in caries prevention. In the past fluoride inhibition of caries was ascribed to reduced solubility due to incorporation of fluoride (F) into the enamel minerals (firmly bound fluoride or fluorapatite). Based on the new findings, it appears that fluoride, either released into or present in the fluid phase bathing the hard tissue, is more important for the reduction of caries development and progression. There is convincing evidence that fluoride has a major effect on demineralization and remineralization of dental hard tissue and that it interferes with acid production from cariogenic bacteria. The provision of dissolved fluoride is the key to successful therapy. The source of this fluoride could either be fluorapatite or calcium fluoride (CaF2) (like) precipitates, which are formed on the enamel and in the plaque after application of topical fluoride. The precipitates of calcium fluoride do not dissolve quickly as was initially believed. Calcium fluoride coating at neutral pH by pellicle proteins and phosphate is the main reason for this. The dissolution of the fluoride from calcium fluoride is pH dependent. At lower pH, the coating is lost and an increased dissolution rate of calcium fluoride occurs. The CaF2, therefore, act as an efficient source of free fluoride ions during the cariogenic challenge. These are subsequently incorporated into the enamel as hydroxyfluorapatite or fluorapatite.

Calcium Fluoride↗

PubMed2001

Critical pH in resting and stimulated whole saliva in groups of children and adults.

OBJECTIVE: The concentrations of calcium and phosphate in saliva have significant influence on the protective mechanisms of dental hard tissues within the oral environment. A lower calcium concentration means: 1) a lower thermodynamic driving force for hydroxyapatite precipitation at normal oral pH; 2) a higher driving force for hydroxyapatite dissolution at low pH; 3) a lower critical pH. The aims of this study were to: 1. determine the calcium and phosphate concentrations 2. calculate the critical pH for enamel and 3. determine the driving forces for demineralization and remineralization in a group of children and adults. METHODS: In this comparative study, calcium and phosphate concentrations were measured in the resting and stimulated saliva of child and adult volunteers using a spectrophotometric system used in routine blood analysis. Salivary flow rates were also measured in each group. RESULTS: The calcium concentrations were lower in children than adults, but the phosphate concentrations were not significantly different. The critical pH was significantly higher for children than adults in both resting and stimulated saliva. Therefore, the thermodynamic driving forces for; (1) demineralisation at low oral pH, is greater, and (2) for remineralisation at normal oral pH, is lower, in children compared to adults. CONCLUSION: The results of this study show that from thermodynamic considerations alone, there is increased risk of demineralization in children compared with adults.

Adult↗

PubMed1979

Demineralization and remineralization of dental enamel.

Experimentation in vitro using organic acid buffers as demineralizing media shows that caries-like lesions can be obtained which are very similar in morphology and developmental stages to early lesions formed naturally under oral conditions. The use of these chemical systems and of mechanistic models advanced to explain the unique histological features of incipient caries have yielded a good understanding of the processes involved in caries formation. The study of natural and induced factors influencing the demineralization process has been greatly facilitated by the use of bacteriological systems in which demineralization is produced by direct colonization of cariogenic microorganisms on the surfaces of extracted teeth. Comparison of results obtained with these latter systems and with chemical systems has allowed us, for example, to elucidate the mechanism by which acquired salivary pellicles and fluoride topical solutions decrease the rate of enamel demineralization. The pellicle retards transport of matter across the enamel surface, whereas the fluoride topical solutions decrease the cariogenicity of the colonizing bacteria.

Acids↗

PubMed2003

Incorporation of casein phosphopeptide-amorphous calcium phosphate into a glass-ionomer cement.

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) nanocomplexes have been shown to prevent demineralization and promote remineralization of enamel subsurface lesions in animal and in situ caries models. The aim of this study was to determine the effect of incorporating CPP-ACP into a self-cured glass-ionomer cement (GIC). Incorporation of 1.56% w/w CPP-ACP into the GIC significantly increased microtensile bond strength (33%) and compressive strength (23%) and significantly enhanced the release of calcium, phosphate, and fluoride ions at neutral and acidic pH. MALDI mass spectrometry also showed casein phosphopeptides from the CPP-ACP nanocomplexes to be released. The release of CPP-ACP and fluoride from the CPP-ACP-containing GIC was associated with enhanced protection of the adjacent dentin during acid challenge in vitro.

Analysis of Variance↗

PubMedDate not supplied

A comparison of the effectiveness of two systems for the prevention of radiation caries.

The purpose of this study was to compare the effectiveness of two systems for the prevention of dental caries in patients who have received radiation treatment (mean number of rads; 5672 +/- 1113) for head and neck cancer. The baseline examination of 184 dentulous patients included measures of DMFS and the Root Caries Index (RCI), field of radiation, gingival inflammation, oral hygiene status, pocket depth and attachment loss. The patients were assigned randomly into two treatment groups. One group was instructed to use 0.4% Sn2 gel while toothbrushing everyday, and the other group was instructed to use a 1.1% neutral NaF gel for three months, followed by twice daily rinsing with a remineralizing mouthrinse (Salminsol Solutions, Iowa City, Iowa). One hundred and forty-three patients were re-examined after one-year, and 69, 56 and 18 patients continued in the NaF gel/remineralizing mouthrinse, SnF2 and non-compliant groups, respectively. Inter-group comparisons showed that the incidence of MT, DMFT, and DF surfaced, and the RCI were significantly higher in the non-compliant group compared to either the SnF2 or NaF gel/remineralizing mouthrinse groups (P less than 0.05). Also, the NaF gel/remineralizing mouthrinse group demonstrated a significantly higher incidence of carious root surfaces compared to the SnF2 group (P less than 0.05). Also the incidence of radiation caries was significantly higher when the field of radiation exposed a greater surface area of the major salivary glands.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1990

[Dependence of incisor dentin mineralization on plasma calcium levels in parathyroidectomized rats].

This experiment was performed to clarify whether mineralization of incisor dentin depends upon plasma calcium (Ca) levels. Male Wistar rats (7 weeks old) were parathyroidectomized (PTXed) and given vitamin D-deficient diets containing various amounts (0.3-2%) of Ca for 2 weeks in order to maintain the plasma Ca at various levels and to examine their relationship with the mineralization of incisor dentin. Plasma Ca levels, which were lowered to about 6 mg/dl by PTX, ranged from 5.1 to 10.1 mg/dl after feeding on diets containing various amounts of Ca; the plasma Ca level in the group given 2% Ca reached the same level as that in the sham-operated group. On the other hand, plasma phosphorus (P) levels, which were increased by PTX, reduced markedly with increases in dietary Ca, leading to hypophosphatemia in the group given 2.0% Ca. In this series of experiments, the plasma Ca levels in PTXed rats seemed to be kept constant by the dietary Ca without any involvement of hormones regulating the Ca metabolism because a high correlation was found between the plasma Ca and the dietary Ca (r = 0.987). Both dry and ash weights of the upper incisor also increased with the plasma Ca levels, but with the plasma P levels it was just the opposite. The content of ash in the incisor also increased with the plasma Ca levels. Transverse sections of the lower incisors stained with hematoxylin showed a zone of remineralization of the dentin on the lingual aspect in rats with plasma Ca levels of about 6.5-7.0 mg/dl; the width of the zone was greater in groups of rats with higher plasma Ca levels. Appositional rates of dentin (y, micron/3 days) as determined by a time marking method showed a high positive correlation with the plasma Ca levels (x, mg/dl). The regression equations were as follows: y = 4.8 + 5.7x (r = 0.915, p less than 0.001) on the lingual aspect and y = 6.0 + 5.8x (r = 0.959, p less than 0.001) on the labial aspect. There were a high positive correlation and a negative correlation between appositional rates of dentin and plasma Ca: P ratios (r = 0.928) and between appositional rates of dentin and plasma P levels (r = -0.927) or the products of plasma Ca x P (r = -0.834). These results suggest that the mineralization of incisor dentin depends upon the plasma Ca levels in PTXed rats.

Animals↗

PubMed1999

[Prevalence of dental erosion caused by sulfuric acid fumes in a smelter in Japan].

The effect of occupational sulfuric acid exposure and other factors on teeth was explored in a cross-sectional study with blind dental examinations. Among 350 male workers in a copper-smelter in Japan, 28 had mild dental erosion with silky-glazed opaque appearance of the enamel and/or shallow concavities on the enamel. While opaqueness was observed in 20 and concavities found in 11 workers, only 3 had both signs, suggesting that the concave lesions were often accompanied with enough remineralization to keep the dental surface gloss, possibly due to acid exposure at a low level. The cases had a history of working in an electrolytic refining plant (36%), significantly more than in the non-cases (14%, p < 0.05). Some significant differences were found between the cases and the non-cases: the cases were older, had less dental plaque, less gingivitis, and more frequent toothbrushing habits. No significant differences were observed in possibly related dietary habits such as several types of acidic drinks. It was concluded that the present cases with dental erosion were most probably associated with occupational acid exposure. The risk ratio of cross-sectional prevalence of dental erosion for those with a history of electrolytic refining plant work was 3.0 (95% CI: 1.3-6.7) compared with those without a history of acid exposure. Whether the present work environment can still develop new cases of dental erosion remains to be studied.

Adult↗

PubMed2004

Monitoring of demineralized dentin microhardness throughout and after bleaching.

PURPOSE: To evaluate the effect of six bleaching agents: Nite White [NW] 10% and 22% Excel 2Z (Discus Dental), Rembrandt (REM) 10% and 22% (DenMat), Opalescence (OPA) 10% and 20% (Ultradent) and a placebo agent on demineralized dentin microhardness at different time intervals. METHODS: 105 human dentin slabs (3 x 3 mm) were embedded, planed and submitted to cariogenic challenges, composed of de- and remineralization cycles. For 42 days, specimens were exposed to bleaching agents, consisting of applying them daily for 8 hours, removing and storing the specimens in artificial saliva for 16 hours. At the end of the bleaching treatment, specimens were kept in artificial saliva for 14 days. Knoop Microhardness tests were performed on specimens' surface before (baseline), during (8 hours, 7, 14, 21, 28, 35 and 42 days) and after bleaching procedures (7 and 14 days). RESULTS: The ANOVA for split-plot showed significant effect on the interaction between bleaching agent and time (alpha =0.05). Tukey's test revealed no significant differences on demineralized dentin microhardness exposed to bleaching agents until Day 7. Regression analyses demonstrated that NW 10% and 22% and OPA 10% and 20% increased dentin microhardness in different magnitudes, whereas REM 10% and 22% induced mineral loss during bleaching agent application, followed by microhardness recovery in the post-treatment period.

Analysis of Variance↗

PubMed2004

Abrasion of eroded root dentine brushed with different toothpastes.

This study evaluated the surface roughness change and wear provided by different dentifrices on root dentine previously exposed to erosive challenges. According to a randomized complete block design, 150 slabs of bovine root dentine (6 x 3 x 2 mm) were ground flat and polished. In an area of 4 x 3 mm on the dentine surface, specimens were submitted to five erosive/abrasive events, each one composed by: exposure to Sprite Diet or distilled water for 5 min, then to a remineralizing solution for 1 min, and simulation of 5,000 brushing strokes. Four dentifrices--regular (RE), baking soda (BS), whitening (WT) and tartar control (TC)--and distilled water (CO), used as control, were compared. Final texture and the wear depth were evaluated using a profilometer. ANOVA did not show significant interaction, indicating that the effect of dentifrices on both surface roughness change and wear did not depend on whether or not the dentine was eroded ( p>0.05). There was no difference between abrasion of eroded and sound dentine. The Tukey's test revealed that WT, BS and TC provided the highest increase in surface roughness differing from RE and CO. TC yielded the deepest wear of root dentine, whereas RE and CO, the shallowest. No significant difference in wear among BS, TC and WT were observed. Within the limitations of this study, the data showed that abrasion of both eroded and sound root dentine was dependent on the dentifrice used.

Analysis of Variance↗

PubMed2003

[Influence of the buffer capacity of amine fluoride-containing toothpastes and gels in enamel erosion].

The aim of the study was to evaluate the abrasion resistance of eroded enamel brushed with experimental toothpastes and fluoride gels of varying buffering capacities. 50 Specimens were prepared from extracted human molars and cycled through three alternating de- and remineralizations including brushing abrasion in a brushing machine. Demineralization was accomplished by immersing the samples in 1% citric acid (5 min), remineralization occurred during immersing the samples in artificial saliva (1 min). Groups of ten samples were brushed with either one of the toothpaste (A-C) or one of the fluoridated gels (D-E). Toothpastes and gels were produced on the basis of elmex toothpaste or elmex-gelée (GABA International AG, Switzerland). Amount of titrable acid was defined as amount (mg) of 1 N KOH needed for neutralization of 1 g toothpaste or gel (A: 6 mg, B: 12 mg, C: 24 mg, D: 3.1 mg, E: 10 mg KOH). The following abrasion values (mean + S.D. [micron]) were obtained profilometrically: A: 6.76 +/- 2.05, B: 6.84 +/- 1.19, C: 8.28 +/- 2.89, D: 4.19 +/- 1.09 and E: 0.83 +/- 0.61. No significant difference in abrasion between the toothpastes was found. The fluoride gel with the higher buffering capacity (E) exhibited significantly less abrasion than the gel with the lower buffering capacity (D). It is concluded that in eroded enamel buffering capacity of the tested fluoridated toothpastes has no effect on abrasion, whereas use of fluoride gel with a higher buffering capacity leads to reduced abrasion values.

Amines↗

PubMed1999

Artificial caries removal and inhibition of artificial secondary caries by pulsed CO2 laser irradiation.

PURPOSE: To investigate the inhibition of artifical secondary caries around restorations placed after removal of artificial caries by pulsed CO2 laser irradiation and by mechanical means. MATERIALS & METHODS: Beveled cavities were prepared mechanically on the facial surfaces of extracted human molars. Each cavity was subsequently exposed to an artificial caries (demineralizing) solution (pH 5.0) for 7 d to generate a demineralized zone approximately 100-200 microns thick on the cavity surface. The artificial carious/demineralized zones of the cavities were removed by a pulsed CO2 laser operating at a wavelength of 9.3 microns with pulse duration of 100 microseconds and an irradiation intensity of 5 J/cm2. Artificial control caries were removed mechanically with a carbide bur in a slow speed handpiece. The cavities were slightly undercut and restored with a resin-based composite without etching and bonding and the restored teeth were subjected to pH cycling solutions for 10 d as follows: Demineralization solution, pH 4.5 for 6 hrs, followed by remineralization solution, pH 7.0 for 18 hrs. Cycled teeth were sectioned through the restorations and the resulting lesions were analyzed in thin section using polarized light and Knoop microhardness. RESULTS: Mean microhardness delta Z values, indicating mineral loss were: 549 (SD 191) for control, and 140 (SD 127) N = 11. This difference is significant with t = 5.543 and P = 0.000 (Paired t-test). Caries penetration: Control side--231 microns (SD 71), Laser treated side: 123 microns (SD 79) N = 6. This difference is significant with t = 5.198 and P = 0.003 (Paired t-test). The results show that the laser treatment not only removed artificial caries, but also inhibited decalcification of the cavity wall in a subsequent artificial caries challenge by as much as 81% compared to control samples. No etching and bonding was used in this pilot study, which might have influenced the results. Future studies should address the inhibition effect of the laser treatment as compared to adhesive techniques, fluoride treatments and fluoride release restorative materials. CONCLUSION: Caries removal by a pulsed lambda = 9.3 microns CO2 laser produces a cavity surface morphology with marked resistance to artificial secondary caries as compared to mechanical removal.

Carbon Dioxide↗

PubMed1990

Class II glass ionomer/silver cermet restorations and their effect on interproximal growth of mutans streptococci.

The release of fluoride from glass ionomer materials is one of the most important features of this newly implemented material, and the remineralization effects of this phenomenon have been documented (Hicks and Silverstone 1986). This paper examines the effects of glass ionomer/silver cermet restorations on the plaque levels of interproximal mutans streptococci. Fifteen patients with Class II lesions in primary molars were selected for study. Interproximal plaque samples were obtained from each of the lesion sites and from one caries-free site approximal to a primary molar. One lesion was restored with composite resin to serve as a treated control to the glass ionomer/silver cermet (Ketac Silver, ESPE/Premier Sales Corp., Norristown, Pennsylvania) test site. A sound (unaltered) interproximal site served as the untreated control site. Plaque samples were collected before and at one week, one month, and three months post-treatment. Samples were serially diluted to enable colony counts of mutans streptococci. One week post-treatment counts showed that the glass ionomer/silver cermet restorations significantly reduced (P less than 0.05) the approximal plaque levels of mutans streptococci. Conversely, the untreated and treated control sites did not exhibit reductions in approximal plaque levels of mutans streptococci. These results indicate that glass ionomer restorations may be inhibitory to the growth of mutans streptococci in dental plaque approximal to this restorative material in the primary dentition.

Cermet Cements↗

PubMed2006

Progression of sealed initial bovine enamel lesions under demineralizing conditions in vitro.

The use of sealants for the infiltration of proximal enamel lesions could be a promising alternative to the common strategies of remineralization and operative treatment. The aim of the present study was to compare the progression of sealed initial enamel lesions after exposure to a demineralizing solution in vitro. In each of 54 bovine enamel specimens three subsurface lesions were created. Two of the lesions were etched with phosphoric acid and sealed with either a fissure sealant or with various adhesives (1-5) for 15 s or 30 s, respectively, whereas one lesion remained as the untreated control. Subsequently, half of each specimen was covered with nail varnish (baseline) and the other half was reexposed to a demineralizing solution for 14 days (experimental). The specimens were cut perpendicularly to the surface, infiltrated with a low-viscosity fluorescent resin and observed with a confocal laser scanning microscope (CLSM). For lesions sealed with the fissure sealant and adhesives 1-3, the progression of lesion depth (0-31 microm) was significantly decreased (p<0.01; paired t test) compared with the untreated control (57 microm). For the fissure sealant and adhesives 1 and 3 extended penetration times (30 s) resulted in significantly reduced lesion progression compared to 15 s. It can be concluded that filling of the pores in initial enamel lesions with the fissure sealant and adhesives 1-3 can inhibit further demineralization in vitro.

Acrylates↗

PubMed2002

Detection of in vitro demineralization of primary teeth using quantitative light-induced fluorescence (QLF).

INTRODUCTION: With the advent of remineralizing therapies and the new, conservative approach to restoration placement, interest in detecting and monitoring subclinical, precavitated lesions has increased. The increased understanding of clinicians about the processes of primary and secondary prevention and the detection of lesions to which these therapies may be applied, is one of the current goals in caries management. Quantitative light-induced fluorescence (QLF) is a new method for the detection of very early caries. OBJECTIVES: To determine the ability of QLF to detect and longitudinally monitor in vitro enamel demineralization. To present the device to the paediatric community and present future in vivo uses of the device. DESIGN: An in vitro study with combined in vivo pilot. SAMPLE AND METHODS: Twelve previously extracted, caries free, primary molars were selected and prepared. Two teeth were randomly selected as controls. Teeth were prepared by gentle pumicing and coating in an acid-resistant nail-varnish, except for an exposed window on the buccal surface. QLF baseline images were taken and the teeth then exposed to a demineralizing solution. Teeth were removed at regular intervals (24, 48, 72, 96, 120, and 144 h), air-dried and QLF images taken. QLF images were analysed by a single, blinded examiner (to control, to length of exposure). Mineral loss, as measured by DeltaQ, was recorded. RESULTS: Demineralization was noted in all experimental teeth by 48 h, and within 24 h in six teeth. The QLF successfully monitored the increase in mineral loss over time (P < 0.05). The detected lesions were not visible clinically until 144 h and then in only the most severe lesions. No demineralization was detected by QLF in control teeth. The device was user- and patient-friendly in vivo, detecting subclinical lesions. CONCLUSION: Detection of very early mineral loss and subsequent monitoring of this loss is possible in primary teeth using QLF. The device is well suited to use in paediatric dentistry and offers applications for both clinicians and researchers. The determination of the status of carious lesions (active/inactive) will be possible with readings taken at recall appointments.

Analysis of Variance↗