-
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 -
Caries Research 2022This study compared the effect of topically applied fluoride products on dentine lesions in an in vitro experiment. Demineralized bovine dentine specimens were treated...
This study compared the effect of topically applied fluoride products on dentine lesions in an in vitro experiment. Demineralized bovine dentine specimens were treated once with either SDF solution (35,400 ppm F), NaF varnish (22,600 ppm F), TiF4 solution (9,200 ppm F), SnF2 gel (1,000 ppm F), no treatment (control), or preserved as baseline lesions. After the application and subsequent removal of the fluoride products, the specimens were subjected to pH-cycling. Calcium loss and uptake in the de- and remineralization buffers were assessed daily. Fluoride release into the buffers was analyzed on days 1, 2, 3, 5, 8, and 13. After the pH-cycling period, mineral distribution throughout the lesion depth was analyzed using transversal microradiography (TMR). X-ray energy-dispersive spectroscopy (EDS) examined the deposition of silver, titanium, and tin after application of SDF, TiF4, and SnF2, respectively. Overall, calcium loss and uptake analysis in the de- and remineralization buffers revealed that the SDF product was the most effective in inhibiting lesion progression, followed by the TiF4, NaF, and SnF2 products. Fluoride analysis disclosed a steep reduction of the amount of fluoride released into de- and remineralization buffers with time. The fluoride effects on de- and remineralization continued beyond the days that fluoride was released into the buffers. TMR analysis showed significant remineralization in the outer zone of the dentine lesions for all fluoride products, with SDF giving hypermineralization in this zone. In the inner zone, lesions developed in all fluoride groups, with the smallest in the SDF group. EDS showed silver and titanium deposition in depth up to 85 μm and 8 μm, respectively, while no tin deposition was observed. The silver in the dentine lesions did not contribute significantly to the density of the TMR profiles in the SDF group. In conclusion, all topical fluoride products protected the dentine lesions against lesion progression, but at different degrees. SDF showed a superior effect in protection against further demineralization and enhancement of remineralization. This was probably attributed to its fluoride concentration that was the highest among the fluoride products.
Topics: Animals; Calcium; Cariostatic Agents; Cattle; Dentin; Fluorides; Humans; Hydrogen-Ion Concentration; Silver; Sodium Fluoride; Titanium; Tooth Demineralization; Tooth Remineralization
PubMed: 34937019
DOI: 10.1159/000521453 -
Australian Dental Journal Dec 2020The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs...
INTRODUCTION
The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs in vitro.
METHODS
MI varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and 2.26% fluoride and Duraphat varnish containing 2.26% fluoride (no added calcium) were compared with a placebo varnish (no added calcium or fluoride). Two WSLs were prepared in enamel slabs and varnish applied to cover one of the two lesions. Each slab was immersed in artificial saliva for 14 days at 37°C. Mineral content was determined using transverse microradiography and fluoride uptake using electron probe microanalysis. The data were statistically analysed using a linear mixed model.
RESULTS
Both MI and Duraphat varnishes significantly remineralized the covered and uncovered WSLs when compared with the placebo varnish (P < 0.001). The WSLs covered with varnish showed greater remineralization than those uncovered. MI varnish produced the highest level of remineralization and significantly greater fluoride uptake (0.44 ± 0.08 wt%) compared with Duraphat (0.24 ± 0.03 wt%) and the placebo varnish (0.06 ± 0.05 wt%).
CONCLUSION
Varnish containing fluoride and CPP-ACP was superior to varnish containing fluoride alone in promoting WSL remineralization and fluoride uptake.
Topics: Cariostatic Agents; Caseins; Dental Caries; Dental Enamel; Fluorides; Fluorides, Topical; Humans; Minerals; Tooth Remineralization
PubMed: 32678914
DOI: 10.1111/adj.12787 -
Materials (Basel, Switzerland) Feb 2023Certain dentin hypersensitivity treatment materials include oxalic acid to coat dentin surfaces with minerals, while certain organic acids possess a remineralization...
Certain dentin hypersensitivity treatment materials include oxalic acid to coat dentin surfaces with minerals, while certain organic acids possess a remineralization effect. Herein, an organic acid that inhibits the demineralization and coating of root surfaces was evaluated. Specimens were produced using five non-carious extracted bovines. Four different acids were used: oxalic acid (OA), malonic acid (MA), polyacrylic acid (PA), and succinic acid (SA). Each acid was applied to the root surface and washed using distilled water or a remineralization solution, and the surface was observed using scanning electron microscopy (SEM). All the surfaces of each specimen, barring the polished surface, were covered with wax and immersed in an automatic pH cycling system for two weeks. Dentin demineralization was analyzed using transverse microradiography (TMR) before and after pH cycling. SEM analysis demonstrated that the three acid groups demineralized the dentin surface, whereas the OA group generated crystals covering the dentin surface, even in a distilled water environment. TMR analysis revealed that the OA groups showed significantly lower integrated mineral loss compared with the other groups, even in the distilled water environment. The results suggest that OA generates insoluble calcium oxalate crystals on the dentin and suppresses demineralization even under low saliva conditions.
PubMed: 36837083
DOI: 10.3390/ma16041454 -
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 -
Archives of Oral Biology Oct 2020The neonatal line (NNL) in enamel is hypomineralized, but quantitative data on the enamel component volumes of the NNL are lacking. This study aimed at quantifying the...
OBJETIVES
The neonatal line (NNL) in enamel is hypomineralized, but quantitative data on the enamel component volumes of the NNL are lacking. This study aimed at quantifying the variation in the mineral, organic, and water volumes at the NNL and in pre- and postnatal enamel.
MATERIALS AND METHODS
In buccal enamel longitudinal ground sections of exfoliated primary incisors (upper and lower; n = 17), the enamel component volumes were quantified at five histological sites (located at 40 μm intervals along a transversal line): the NNL, two sites in prenatal enamel, and two sites in postnatal enamel. Mineral volume was quantified using microradiography, and non-mineral volumes were quantified using polarizing microscopy.
RESULTS
Differences in component volumes between the NNL and pre- and postnatal enamel had high effect sizes (Hedge's G ranging from 0.89, for the water volume, to 1.88, for the mineral volume; power > 90 %). The distance from the NNL correlated with the normalized component volume: r = 0.459, 95 % CI = 0.274/0.612 (mineral); r = -0.504; 95 % CI= -0.328/-0.647 (organic), and r = -0.294; 95 % CI= -0.087/-0.476 (water). Approaching the NNL from postnatal enamel, the percentage differences in component volumes were: -1.93 to -3.22 % for the mineral volume, +21.26 to +35.42 % for the organic volume, and +3.86 to +6.03 % for the water volume. Towards postnatal enamel, the percentage differences had the opposite trend.
CONCLUSIONS
The enamel NNL is slightly hypomineralized with an increased organic volume one order of magnitude higher than the percentage differences in both mineral and water volumes.
Topics: Dental Enamel; Female; Humans; Microradiography; Minerals; Pregnancy; Tooth, Deciduous; Water
PubMed: 32736142
DOI: 10.1016/j.archoralbio.2020.104850 -
Bone Oct 2019Bone loss in anorexia nervosa and following bariatric surgery is associated with an elevated circulating concentration of the gastrointestinal, anorexigenic hormone,...
OBJECTIVE
Bone loss in anorexia nervosa and following bariatric surgery is associated with an elevated circulating concentration of the gastrointestinal, anorexigenic hormone, peptide YY (PYY). Selective deletion of the PYY receptor Y1R in osteoblasts or Y2R in the hypothalamus results in high bone mass, but deletion of PYY in mice has resulted in conflicting skeletal phenotypes leading to uncertainty regarding its role in the regulation of bone mass. As PYY analogs are under development for treatment of obesity, we aimed to clarify the relationship between PYY and bone mass.
METHODS
The skeletal phenotype of Pyy knockout (KO) mice was investigated during growth (postnatal day P14) and adulthood (P70 and P186) using X-ray microradiography, micro-CT, back-scattered electron scanning electron microscopy (BSE-SEM), histomorphometry and biomechanical testing.
RESULTS
Bones from juvenile and Pyy KO mice were longer (P < 0.001), with decreased bone mineral content (P < 0.001). Whereas, bones from adult Pyy KO mice had increased bone mineral content (P < 0.05) with increased mineralisation of both cortical (P < 0.001) and trabecular (P < 0.001) compartments. Long bones from adult Pyy KO mice were stronger (maximum load P < 0.001), with increased stiffness (P < 0.01) and toughness (P < 0.05) compared to wild-type (WT) control mice despite increased cortical vascularity and porosity (P < 0.001). The increased bone mass and strength in Pyy KO mice resulted from increases in trabecular (P < 0.01) and cortical bone formation (P < 0.05).
CONCLUSIONS
These findings demonstrate that PYY acts as a negative regulator of osteoblastic bone formation, implicating increased PYY levels in the pathogenesis of bone loss during anorexia or following bariatric surgery.
Topics: Animals; Bone Density; Bone Development; Bone Resorption; Bone and Bones; Calcification, Physiologic; Cortical Bone; Female; Femur; Male; Mice, Inbred C57BL; Mice, Knockout; Organ Size; Osteoclasts; Peptide YY; Porosity
PubMed: 31306808
DOI: 10.1016/j.bone.2019.07.011 -
Frontiers in Genetics 2021Osteogenesis imperfecta (OI), which is most often due to a collagen type 1 gene mutation, is characterized by low bone density and bone fragility. In OI patients,...
Osteogenesis imperfecta (OI), which is most often due to a collagen type 1 gene mutation, is characterized by low bone density and bone fragility. In OI patients, gender-related differences were reported, but data in the literature are not convergent. We previously observed that sclerostin antibody (Scl-Ab), which stimulates osteoblast Wnt pathway via sclerostin inactivation, improved spine and long-bone parameters and biomechanical strength in female oim/oim mice, a validated model of human type 3 OI. Here, we wanted to highlight the effect of Scl-Ab on male oim/oim bones in order to identify a possible distinct therapeutic effect from that observed in females. According to the same protocol as our previous study with female mice, male wild-type (Wt) and oim/oim mice received vehicle or Scl-Ab from 5 to 14 weeks of age. Clinimetric and quantitative bone parameters were studied using X-rays, peripheral quantitative computed tomography, microradiography, and dynamic histomorphometry and compared to those of females. Contrary to Wt mice, male oim/oim had significantly lower weight, snout-sacrum length, and bone mineral content than females at 5 weeks. No significant difference in these clinimetric parameters was observed at 14 weeks, whereas male oim showed significantly more long-bone fractures than females. Scl-Ab improved bone mineral density and bone volume/total volume ratio (BV/TV) of vertebral body in Wt and oim/oim, without significant difference between male and female at 14 weeks. Male vehicle oim/oim had a significantly lower cortical thickness (Ct.Th) and BV/TV of tibial diaphysis than female and showed a higher number of fractures at 14 weeks. Scl-Ab increased midshaft periosteal apposition rate in such a way that tibial Ct.Th of male oim/oim was not significantly different from the female one at 14 weeks. The number of fractures was lower in male than female oim/oim after 14 weeks of Scl-Ab treatment, but this difference was not significant. Nevertheless, Scl-Ab-treated oim/oim male and female mice remained smaller than the Wt ones. In conclusion, our results highlighted differences between male and female oim/oim at 4 and 14 weeks of age, as well as some male-specific response of cortical bone to Scl-Ab. These gender-related particularities of oim/oim should be considered when testing experimental treatments.
PubMed: 34447412
DOI: 10.3389/fgene.2021.705505 -
Microorganisms Feb 2023This study validated a microbial caries model (artificial mouth) for dental caries development to determine the optimal time to create early caries suitable for...
This study validated a microbial caries model (artificial mouth) for dental caries development to determine the optimal time to create early caries suitable for evaluation of the efficacy of caries therapeutic agents. In all, 40 human enamel blocks were placed in an artificial mouth at 37 °C and 5% CO and were exposed to brain heart infusion broth inoculated with in continuous circulation (0.3 mL/min). The culture medium was replaced three times daily. Samples were exposed to 10% sucrose for 3 min, 3 times daily to promote biofilm growth. Five samples were harvested from the chamber after 3, 4, 5, 6, 7, 14, 21, and 28 days. At the end of experiment, samples were assessed visually by ICDAS criteria, while lesion depth (LD) and mineral loss (ML) were measured using polarizing light microscopy and transverse microradiography. Data were analyzed by Pearson correlation, ANOVA, and Tukey comparison test ( < 0.05). Results showed significant and strong positive correlation ( < 0.01) between all variables and biofilm growth time. LD and ML profiles of 7-day lesions seem to be the most suitable for remineralization studies. In conclusion, using the evaluated artificial mouth, early-stage caries suitable for products' evaluation studies was produced within 7 days of exposure to microbial biofilm.
PubMed: 36985202
DOI: 10.3390/microorganisms11030628 -
Biomimetics (Basel, Switzerland) Jan 2023Biomimetic technologies for the remineralisation of enamel subsurface lesions (ESLs) have been developed and include: fluorocalcium phosphosilicate bioglass (BG/F);...
Biomimetic technologies for the remineralisation of enamel subsurface lesions (ESLs) have been developed and include: fluorocalcium phosphosilicate bioglass (BG/F); casein phosphopeptide-amorphous calcium phosphate (CPP−ACP) and with fluoride (CPP−ACFP); and self-assembling oligopeptide P11-4 (SAP). The aim of this study was to compare the remineralisation of ESLs in vitro using these technologies. Human enamel slabs with ESLs were cut into two half-slabs; one half-slab was untreated (control), and the other half was treated by exposure to one of the four technologies with artificial saliva (AS) or AS alone for 14 days at 37 °C. The technologies were applied to the ESL surface according to the manufacturer’s instructions. At the completion of each treatment, the treated half-slabs and their paired control half-slabs were embedded, sectioned and the mineral content was determined using transverse microradiography. The change in mineral content (remineralisation) between treatments was statistically analysed using one-way ANOVA. The order from highest to lowest remineralisation was CPP−ACFP (52.6 ± 2.6%) > CPP−ACP (43.0 ± 4.9%) > BG/F (13.2 ± 2.5%) > SAP (5.8 ± 1.6%) > AS (2.1 ± 0.5%). Only CPP−ACFP and CPP−ACP produced remineralisation throughout the body of the lesions. All four biomimetic technologies had some effect on the remineralisation of ESLs; however, CPP−ACFP with calcium, phosphate and fluoride ions stabilised by CPP was superior in the level and pattern of remineralisation obtained.
PubMed: 36648803
DOI: 10.3390/biomimetics8010017