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[Trials of remineralization of artificially produced enamel lesions].

The purpose of the study was checking in vitro whether after application of calcifying preparations remineralization occurs of artificially damaged enamel prisms. The study was carried out on 32 enamel samples obtained from 8 human teeth. For remineralization saturated solutions were used of phosphate-calcium compounds in the form of fluid or gel. The degree of demineralization and remineralization of enamel was assessed on the basis of images of enamel breaks in JSM-50A scanning microscope. Partial remineralization of artificially damaged enamel was found. Detailed evaluation of the remineralization progress requires extension of investigation methods.

Calcium Phosphates↗

[Changes in the properties of the enamel of the permanent teeth in children using fluoride-containing toothpastes].

Focal demineralization of the enamel of permanent teeth was studied in 104 schoolchildren aged 9 to 12 over the course of prophylaxis (cleaning the teeth with fluorine-containing toothpastes). The parameters checked up were the intensity of coloring, size and electric conductivity of the spots, and the rate of remineralization of the enamel of permanent teeth. For a year a strong correlation between the tested characteristics of the enamel and saliva was observed. Some age-specific characteristics of permanent teeth enamel were detected. Age group of 11 to 12 years should be distinguished in prophylactic and control groups, because it is at this age that all the tested properties of the enamel are the most liable to change: electric conductivity, permeability, and remineralization rate. This period seems to be characterized by a specific reaction of all systems and organs of the body to environmental exposures. Remineralizing prophylaxis was found to be the most effective at the age of 9 to 10 years. The findings permit us emphasize the contribution of fluorine contained in the Blendax fluorine-containing toothpaste used by the children to the major components of the pathologic process (white spots) and enamel remineralization at the stage of its maturation.

Child↗

Reactivity of fluoride dentifrices with artificial caries. III. Quantitative aspects of acquired acid resistance (AAR): F uptake, retention, surface hardening and remineralization.

A pH cycling remineralization/dimineralization model has been used to compare remineralization and acid resistance benefits provided by commercial MFP and NaF dentifrices. Test results show that fluoride dentifrice systems were effective in enhancing lesion remineralization and providing acquired acid resistance (AAR) to carious lesions, with AAR benefits considerably greater in magnitude. Fluoride uptake into the carious lesions was associated with remineralization and AAR benefits. Dentifrices containing the highest levels of soluble ionic fluoride were found most effective in this protocol with MFP dentifrices showing significantly less activity. MFP dentifrice efficacy was enhanced slightly in calcium abrasives. The enhanced activity could be explained by increased levels of background ionic fluoride in the formulations. In contrast to the latter effects, a dual-active NaF+MFP dentifrice in a calcium abrasive system exhibited decreased efficacy relative to a silica abrasive formulation due to incompatibility of free fluoride ion. Comparison of analytical techniques for measurement of AAR in shallow lesions demonstrates that surface microhardness methods match radiographic measures and are thus adequate for ICT measurement of cariogenicity and F remineralization.

Analysis of Variance↗

[Remineralization of incipient caries studied by high-resolution electron microscopy].

The present study presents a study on the remineralization of enamel incipient caries by HREM (high-resolution electron microscopy). The electron-transparent specimens (200-100 A) were prepared with argon ion thinning technique. The result showed some special crystallites, single or conglomerate (mostly on both sides of sheath), their shape, size and degree of electron-transparency indicated that they might be remineralized crystallites. They were distributed in the centre and edge of the carious lesions. Two patterns of remineralization had been observed. One was formation of new crystallites, and the remineralized crystal nuclear during development were found under HREM. The other was growth of the original crystals. The HREM images directly showed that the remineralized crystallites' chemical structure was mainly apatite, but its characteristics should be further studied.

Crystallization↗

Influence of abrasion in clinical manifestation of human dental erosion.

The influence of abrasion from oral soft tissues on softened enamel lesion remineralization and erosion development was investigated. Using orange juice, softened enamel lesions were produced on 20 human premolars assigned randomly to 10 volunteers. Sections used as control and two test slabs were cut from each tooth. One of the two slabs from each tooth had an appliance built on it, which protected the lesion from abrasion. The two slabs (with/without appliance) were bonded to the palatal surfaces of upper right and left lateral incisor teeth of the participants who chewed sugar-free gum four times daily. After 28-day intra-oral exposure, mineral loss (Delta Z) and lesion depth (ld) in both control and test samples were quantified using transverse microradiography, and the data was analysed by paired t-test. Delta Z was significantly lower in lesions with appliance (protected), but higher in lesions without appliance (unprotected) when compared with control (unexposed). Similar pattern was observed with lesion depth. In unprotected slabs the lesions were abraded resulting in eroded enamel lesions. It was concluded that erosion observed clinically is the combined effect of demineralization of the tooth surface by an erosive agent and abrasion of the demineralized surface by surrounding oral soft tissues and through food mastication. Abrasion from oral soft tissues can contribute to site-specificity of dental erosion.

Adult↗

Prognosis of permanent teeth with internal resorption: a clinical review.

This study was performed in order to report the clinical features of internal resorption cases and evaluate their prognosis after endodontic treatment. Twenty-seven patients with 28 teeth with internal resorption were referred to our clinic and 20 teeth were treated endodontically. Sixteen teeth had non-perforating internal resorption and were treated by conventional root canal therapy. The remaining 4 teeth had perforating internal resorption and were initially treated by remineralization therapy with calcium hydroxide. The teeth treated by conventional root canal therapy showed clinical and radiographic evidence of healing. However, the remineralization therapy was successful in only one case. The three failed cases were subsequently treated by endodontic surgery. The surgical therapy was unsuccessful in one case due to extensive loss of marginal alveolar bone and increased tooth mobility.

Adolescent↗

[Fluoride ions and apatite recrystallization of apatite in enamel].

The authors discuss the basic process on which the principle of fluoridation in based--i.e. the mutual exchange of F- ions and the OH- group in hydroxyapatite of enamel. Model investigations assessing the energy difference between hydroxyapatite and F- and fluorapatite and the OH- group indicate that fluorapatite tends to release steadily fluoride ions and to change into hydroxyapatite. This tendency, apparently inopportune from the aspects of caries prevention, ensures, however, a permanent low F- level above the enamel surface. The presence of F- ions facilitates recrystalization of apatite in the initial caries stage. The investigation tries to throw new light, from the point of view of theoretical chemistry at a molecular level, on the mechanism of remineralization, one of the most important ways which implements the preventive action of fluoride.

Crystallization↗

Electron microprobe and microradiographic studies of carious enamel lesions covered with dental calculus.

From a large number of posterior teeth with arrested natural carious lesions some 0.56 percent were found to have arrested approximal lesions with a superficial layer of calculus. The lesions were examined using quantitative microradiography for mineral content and by electron microprobe analysis for Ca, Na, Cl, Mg and P. The conditions in the plaque, which caused the formation of calculus, might also be expected to cause a remineralization of the lesions. However, the lesions examined were found to have a low mineral content in their body, and moreover, had a lower Na/Ca ratio and a higher Cl/Ca ratio than sound enamel; these are characteristics also found in carious lesions not covered with dental calculus. On the assumption that the lesions developed before any plaque calcification occurred, it is concluded that conditions which favour the calcification of plaque do not favour the remineralization of carious lesions in vivo. As only 0.5% of the carious lesions in extracted teeth were covered with calculus, it must be admitted that consecutive periods of lesion formation followed by calculus formation on the same tooth face are rare.

Adult↗

Effect of a specially formulated remineralizing solution on the remineralizing capacity of saliva.

The present study was carried out to assess whether the remineralization of artificial caries like lesion by artificial saliva can be improved by daily 5 minute treatment in a specially formulated remineralizing solution containing Ca, P, Zn, Sr, F. Extracted human premolars were dipped for 24 hours in artificial saliva and subsequently daily for 5 minutes in the remineralizing solution for 3 weeks. Lesions were assessed using transverse microradiography, electron probe microanalysis (EPMA) and scanning electron microscope (SEM). The results showed that remineralization by specially formulated solutions repair the enamel lesion and enhances the salivary remineralizing potential.

Bicuspid↗

[Physiological remineralization of artificially decalcified monkey dentin under adhesive composite resin restoration].

This study was planned to investigate the remineralization potential of the inner carious dentin layer preserved under adhesive resin restoration in comparison with that under cement filling. Dentin caries models were artificially produced in vivo with acid on the Class V cavity floors of 25 bilateral tooth pairs from 3 monkeys. Thirteen cavity pairs were filled with adhesive composite and twelve pairs with polycarboxylate cement, 120 days and immediately before sacrificing the monkeys. The sections through the floor dentin layer were examined by an optical microscope, Knoop hardness tester, EPMA and SEM. The findings obtained were as follows: 1. Two different dentin layers were recognized on the decalcified floor dentin. 2. The outer highly decalcified layer of about 100 microns thickness was not found to be remineralizable in vivo. 3. The inner partially decalcified layer of about 80 microns thickness was proved to be physiologically remineralizable even under adhesive resin restoration, having the possible irritation of acid-etching or resin monomers. 4. Increase in the Ca content in the inner decalcified layer under resin restoration observed after 120 days was more remarkable than that under cement.

Animals↗