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BMC Oral Health Jan 2024White spot lesions represent the first stage of caries and their prevalence has been increasing in recent years, particularly in patients undergoing orthodontic...
BACKGROUND
White spot lesions represent the first stage of caries and their prevalence has been increasing in recent years, particularly in patients undergoing orthodontic treatment. DIferential diagnosis and lesion activity are essential to decide on the clinical approaches to treatment. The aim of this study is to understand if the new diagnostic tools such as fluorescence, microradiography and computed microtomography have the potential to change the conventional treatment of white spots".
METHODS
A systematic search of available studies in the literature was carried out, using PRISMA guidelines, in Pubmed and Scopus electronic databases and manually to identify relevant articles to answer the PICO question: "Do the new diagnostic tools have the potential to change the conventional treatment of white spots?". This systematic review included randomized controlled trials (RCT), cross-sectional and longitudinal studies complying with the following inclusion criteria: (i) studies in humans, (ii) studies about white spot lesions, (iii) studies published between 2012 and 2023, (iv) studies having both diagnosis and treatment and (v) studies with full text available. In this review we excluded other systematic reviews of clinical trials and in vitro studies. The RoB tool was used to assess the risk of bias.
RESULTS
The systematic literature search identified 143 potentially relevant references, which after applying the exclusion criteria, resulted in 20 articles. Regarding diagnostic methods, most articles found were based on conventional methods of visual examination (n:10) or fluorescence (n:7). The least referenced diagnostic techniques were based on the use of clinical photographs (n:2), cross-sectional microradiography (n:1) and computed microtomography (n:1). The use of DIAGNOdent was reported by 3 in vitro studies. With regard to therapies, most studies reported the use of infiltrating resin (n:7) and fluoride-based products (n:5). Other studies have reported the use of self-assembling peptide P11-4 (n:1), home care (n:1), casein phosphopeptide-amorphous calcium phosphate (n:2) and hydrochloric acid (n:1). Combination therapies were also considered.
CONCLUSION
Diagnostic tool does not have the potential to change the form of treatment, whether it is a conventional method or a more differentiated one.
Topics: Humans; Combined Modality Therapy; Dental Care; Caseins; Databases, Factual; Dental Caries; Fluorides
PubMed: 38195439
DOI: 10.1186/s12903-023-03720-6 -
Brazilian Dental Journal 2023Radiopaque properties in the infiltrant should be interesting for clinicians to feel more confident to indicate this treatment. Thus, the aim of this study was to...
Radiopaque properties in the infiltrant should be interesting for clinicians to feel more confident to indicate this treatment. Thus, the aim of this study was to evaluate the effect of the incorporation of barium and ytterbium particles on the physical properties of resin infiltrants. Groups were divided according to the addition of ytterbium oxide (Y) alone (30 or 40%) or Y with barium (YB) (15/15% or 20/20% respectively) in the Icon commercial infiltrant and in the experimental infiltrant base. Digital radiography (n=5), Microradiography (n=5), Microtomography (n=3), degree of conversion (n=5), water sorption (n=16), solubility (n=16), contact angle (n=16), flexural strength (n=16), elastic modulus (n=16) and Energy dispersive X-ray Spectroscopy (n=10) were performed. Analyses were performed using the R program, with a significance level of 5%, and microradiography and Microtomography analyses were evaluated qualitatively. In groups with 30 or 40% of ytterbium, radiopacity was higher or equal to enamel. Microradiography and Microtomography appear to have more radiopacity in groups with 40% (Y). Among the groups with no particle addition, those of the experimental infiltrant presented a higher degree of conversion than those of Icon®. In most groups, there was solubility below the ISO-recommended levels. The addition of particles resulted in higher viscosity. Groups with Icon had higher flexural strength and elastic modulus than groups with experimental infiltrant. The addition of 40% (Y) improved polymerization, had low solubility, and had greater radiopacity than enamel, however negatively affected the viscosity increasing then. Experimental groups with the base showed a higher water sorption than Icon groups.
Topics: Composite Resins; Barium; Ytterbium; Polymethacrylic Acids; Materials Testing; Water
PubMed: 37909646
DOI: 10.1590/0103-6440202305379 -
International Journal of Clinical... Aug 2023To compare the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (GC Tooth Mousse) and tricalcium phosphate formulation (Clinpro) by topical...
AIM
To compare the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (GC Tooth Mousse) and tricalcium phosphate formulation (Clinpro) by topical application and iontophoresis.
BACKGROUND
Noninvasive treatment of dental caries is a major advance in the clinical management of the disease.
MATERIALS AND METHODS
A total of 20 primary anterior and 20 primary molars were included in the study to be analyzed by transverse microradiography (TMR) and polarized light microscopy (PLM). The samples were coated with acid-resistant varnish, leaving a window on the buccal/lingual surface of enamel and immersed in demineralizing solution for 96 hours. Each sample was coated with varnish on the left half (control), and the right half served as a test. All the samples were divided into four groups. The test windows of specimens in groups I (GC Tooth Mousse) and II (Clinpro) were subjected to remineralization treatments for 10 days. Similarly, groups III and IV were subjected to iontophoresis using GC Tooth Mousse and Clinpro for 7 minutes. The samples were analyzed by TMR and PLM.
RESULTS
There was no significant difference in the mean difference of mineral loss among the four groups. There was a significant difference in the mean difference of lesion depth among the four groups.
CONCLUSION
Both iontophoresis and topical application were equally efficient, but one remineralization by iontophoresis equals 10 topical applications.
HOW TO CITE THIS ARTICLE
VC R, Muppa R, Nallanchakrava S, Evaluation of Iontophoresis as a Tool in Comparison to Topical Remineralization Systems by Transverse Microradiography and Polarized Light Microscopy: An Study. Int J Clin Pediatr Dent 2023;16(S-1):S85-S90.
PubMed: 37663207
DOI: 10.5005/jp-journals-10005-2625 -
Journal of Applied Oral Science :... 2023This investigation describes the effects of 5% sodium fluoride varnish and 38% silver diamine fluoride on demineralization protection of human enamel lesions of three...
OBJECTIVE
This investigation describes the effects of 5% sodium fluoride varnish and 38% silver diamine fluoride on demineralization protection of human enamel lesions of three different severities after a secondary acid challenge.
STUDY DESIGN
Specimens underwent color and enamel surface microhardness change measurements after demineralization and treatment events. Transverse microradiography was conducted following the secondary demineralization.
RESULTS
After treatments, enamel surface microhardness change showed that 24-hour lesions treated with fluoride varnish had less rehardening than 24-hour lesions treated with silver diamine fluoride (p<0.05), whereas 144-hour lesions from both treatment groups showed a beneficial decrease in surface microhardness change that was markedly better in samples treated with silver diamine fluoride (p<0.05). After the secondary demineralization, 24- and 144-hour lesions treated with silver diamine fluoride showed a sustained beneficial decrease in enamel surface microhardness change when compared to fluoride varnish-treated samples of the corresponding lesion severity (p<0.05). Transverse microradiography showed no difference between fluoride varnish- and silver diamine fluoride-treated samples of any corresponding lesion severity, indicating that remineralization in both fluoride varnish- and silver diamine fluoride-treated samples was proportional to each other after a secondary acid challenge.
CONCLUSIONS
Using silver diamine fluoride may have comparable benefits to fluoride varnish in mineral loss prevention.
Topics: Humans; Fluorides, Topical; Sodium Fluoride; Fluorides; Tooth Demineralization; Dental Caries
PubMed: 37937621
DOI: 10.1590/1678-7757-2023-0244 -
Journal of Dentistry Apr 2024To compare the remineralisation efficacy and ion bioavailability of two novel SnF-containing dentifrices in a blinded, cross-over, randomised in situ clinical study. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare the remineralisation efficacy and ion bioavailability of two novel SnF-containing dentifrices in a blinded, cross-over, randomised in situ clinical study.
METHODS
Six participants wore removal palatal appliances holding human enamel and dentine blocks with subsurface lesions. Appliances were worn for two treatment periods of 14 consecutive days each, with a one-week washout period in-between. Participants were randomly allocated to rinse with a 1:5 diluted coded slurry of one of two dentifrices containing either 5 % casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) +1100 ppm F as SnF [MIPOP], or 1100 ppm F as SnF [CT], for 1 min, four times a day. Saliva was collected post-treatment and analysed for tin, calcium, inorganic phosphate and fluoride ions using atomic absorption spectrophotometry and ion chromatography. Enamel and dentine lesions were analysed for percent remineralisation (%R) using transverse microradiography and percent surface microhardness recovery (%SMHR).
RESULTS
MIPOP released significantly higher F (3.00 ± 0.27 mM), Ca (15.23 ± 3.23 mM) and Sn (1.18 ± 0.13 mM) into saliva whereas CT released 2.89 ± 0.32 mM F and only 0.84 ± 0.11 mM Ca and 0.28 ± 0.10 mM Sn. MIPOP produced significantly higher %R than CT: 25.6 ± 1.5 % compared to 15.2 ± 0.7 % in enamel, and 33.6 ± 3.1 % compared to 20.6 ± 1.1 % in dentine. Additionally, MIPOP produced significantly higher %SMHR (18.2 ± 7.9 %) compared to CT (4.1 ± 0.6 %).
CONCLUSIONS
Both dentifrices promoted remineralisation, but the MIPOP dentifrice with added CPP-ACP and the ion-stabilising effects of CPP released higher amounts of bioavailable tin and produced significantly higher remineralisation and surface microhardness recovery.
CLINICAL SIGNIFICANCE
Modern dentifrices contain SnF for a range of oral health benefits. Challenges associated with stability of these formulations can affect ion bioavailability, reducing efficacy. Two dentifrices with SnF promoted remineralisation in situ, however the dentifrice with the added saliva biomimetic CPP-ACP was superior and therefore may produce greater health benefits.
Topics: Humans; Tin Fluorides; Dentifrices; Sodium Fluoride; Tin; Tooth Remineralization; Fluorides; Dental Enamel; Cross-Over Studies; Dentin; Cariostatic Agents
PubMed: 38387598
DOI: 10.1016/j.jdent.2024.104895 -
Pathogens (Basel, Switzerland) Aug 2023Novel approaches for caries lesion removal and treatment have been proposed. This study evaluates the combined use of an experimental ultrasound, aPDT (antimicrobial...
Novel approaches for caries lesion removal and treatment have been proposed. This study evaluates the combined use of an experimental ultrasound, aPDT (antimicrobial photodynamic therapy) and bioactive glasses on the removal, decontamination and remineralization of dentin caries lesions. A biological model created with a duo species biofilm ( and ) was used for the development of a caries-like lesion over the dentin for 7 days. Bovine dentin specimens (4 × 4 × 2 mm) were randomized according to the following caries removal techniques: bur (BUR) or ultrasound (ULT), decontamination (with or without aPDT) and remineralization materials (45S5 or F18 bioactive glasses). The following different groups were investigated: caries lesion (control); sound dentin (control); BUR; BUR + aPDT; ULT; ULT + aPDT; BUR + 45S5, BUR + F18; ULT + 45S5; ULT + F18; BUR + aPDT + 45S5; BUR + aPDT + F18; ULT + aPDT + 45S5; and ULT + aPDT + F18. Transverse microradiography (TMR), cross-sectional microhardness (CSH), FT-Raman spectroscopy and confocal microscopy (CLSM) were performed. A two-way ANOVA and Tukey's test were used (α = 0.05). (3) Results: The TMR revealed a lesion depth of 213.9 ± 49.5 μm and a mineral loss of 4929.3% vol.μm. The CSH increases as a function of depth, regardless of the group ( < 0.05). Removal with BUR (24.40-63.03 KHN) has a greater CSH than ULT (20.01-47.53 KHN; < 0.05). aPDT did not affect the CSH ( > 0.05). No difference was observed between 45S5 or F18 ( > 0.05), but a change was observed for ULT ( > 0.05). The FT-Raman shows no differences for the phosphate ( > 0.05), but a difference is observed for the carbonate and C-H bonds. The CLSM images show that aPDT effectively inactivates residual bacteria. A combination of ULT, aPDT and bioactive glasses can be a promising minimally invasive treatment.
PubMed: 37624012
DOI: 10.3390/pathogens12081052 -
PloS One 2024To show the effect of the phosphate group on the remineralization process of early enamel caries mediated by amelogenin peptide.
OBJECTIVE
To show the effect of the phosphate group on the remineralization process of early enamel caries mediated by amelogenin peptide.
METHODS
Freshly extracted, completed, and crack-free bovine teeth were used to create artificial early enamel caries, which were randomly divided into four groups: Group A: fluorination remineralized solution treatment group; Group B: pure remineralized solution treatment group. Group C: 100 g/ml recombinant Amelogenin peptide remineralized solution treatment group (with single phosphate group on N-terminus); Group D: 100 g/ml non-phosphorylated recombinant Amelogenin peptide remineralized solution treatment group (without single phosphate group on N-terminus). For 12 days, fresh remineralized solutions were replaced daily. Transverse microradiography (TMR) was used after remineralization to determine mineral loss and demineralization depth before and after each sample's remineralization. Each sample's depth of remineralization and mineral acquisition were then determined.
RESULTS
The recombinant amelogenin peptide group significantly outperformed the non-phosphorylated amelogenin peptide group in terms of mineral acquisition and mineralization depth (P<0.05).
CONCLUSIONS
The recombinant Amelogenin's solitary phosphate group at the N-terminus helps recombinant Amelogenin to encourage the remineralization process of early enamel caries.
Topics: Animals; Amelogenin; Dental Caries; Cattle; Tooth Remineralization; Dental Enamel; Phosphates; Peptides; Microradiography
PubMed: 38771806
DOI: 10.1371/journal.pone.0303147 -
Bioengineering (Basel, Switzerland) May 2024The application of calcium coacervates (CCs) may hold promise for dental hard tissue remineralization. The aim of this study was to evaluate the effect of the...
The application of calcium coacervates (CCs) may hold promise for dental hard tissue remineralization. The aim of this study was to evaluate the effect of the infiltration of artificial enamel lesions with a CC and its single components including polyacrylic acid (PAA) compared to that of the self-assembling peptide P-4 in a pH-cycling (pHC) model. Enamel specimens were prepared from bovine incisors, partly varnished, and stored in demineralizing solution (DS; pH 4.95; 17 d) to create two enamel lesions per sample. The specimens were randomly allocated to six groups (n = 15). While one lesion per specimen served as the no-treatment control (NTC), another lesion (treatment, T) was etched (HPO, 5 s), air-dried and subsequently infiltrated for 10 min with either a CC (10 mg/mL PAA, 50 mM CaCl (Ca) and 1 M KHPO (PO)) (groups CC and CC + DS) or its components PAA, Ca or PO. As a commercial control, the self-assembling peptide P-4 (Curodont Repair, Credentis, Switzerland) was tested. The specimens were cut perpendicularly to the lesions, with half serving as the baseline (BL) while the other half was exposed to either a demineralization solution for 20 d (pH 4.95; group CC + DS) or pHC for 28 d (pH 4.95, 3 h; pH 7, 21 h; all five of the other groups). The difference in integrated mineral loss between the lesions at BL and after the DS or pHC, respectively, was analyzed using transversal microradiography (ΔΔZ = ΔZ - ΔZ). Compared to the NTC, the mineral gain in the T group was significantly higher in the CC + DS, CC and PAA ( < 0.05, Wilcoxon). In all of the other groups, no significant differences between treated and untreated lesions were detected ( > 0.05). Infiltration with the CC and PAA resulted in a consistent mineral gain throughout the lesion body. The CC as well as its component PAA alone promoted the remineralization of artificial caries lesions in the tested pHC model. Infiltration with PAA further resulted in mineral gain in deeper areas of the lesion body.
PubMed: 38790332
DOI: 10.3390/bioengineering11050465 -
ACS Applied Energy Materials Apr 2024Porous composite battery electrode performance is influenced by a large number of manufacturing decisions. While it is common to evaluate only finished electrodes when...
Porous composite battery electrode performance is influenced by a large number of manufacturing decisions. While it is common to evaluate only finished electrodes when making process adjustments, one must then make inferences about the fabrication process dynamics from static results, which makes process optimization very costly and time-consuming. To get information about the dynamics of the manufacturing processes of these composites, we have built a miniature coating and drying apparatus capable of fabricating lab-scale electrode laminates while operating within an X-ray beamline hutch. Using this tool, we have collected the first radiography image sequences of lab-scale battery electrode coatings in profile, taken throughout drying processes conducted under industrially relevant conditions. To assist with interpretation of these image sequences, we developed an automated image analysis program. Here, we discuss our observations of battery electrode slurry samples, including stratification and long-term fluid flow, and their relevance to composite electrode manufacturing.
PubMed: 38606033
DOI: 10.1021/acsaem.4c00402