Abstract
The aim of the study was to assess the efficacy of three methods of enamel remineralization on initial approximal caries: (1) a nano-hydroxyapatite gel, (2) gaseous ozone therapy, (3) combination of a nano-hydroxyapatite gel and ozone. Patients (n = 92, age 20–30 years) with initial approximal enamel lesions on premolar and molar teeth (n = 546) were randomly allocated to three groups subjected to a 6-months treatment: Group I: domestic nano-hydroxyapatite remineralizing gel, group II: in-office ozone therapy, group III: both domestic remineralizing gel and ozone therapy. Caries lesions were assessed on bitewing radiographs at baseline, after 1 year and after 2 years. At one-year follow-up, the smallest rate of lesions with remineralisation (36.5%) was found in group I, and the highest (69.3%)—in group III. In group III a significant remineralisation was noticed in after 1 year and then a demineralisation after 2 years. Thus nano-hydroxyapatite gel and ozone therapy exert some capacities to remineralize approximal enamel and dentine subsurface lesions of premolar and molar teeth. Moreover, the combination of both methods produces the best effect compared to nano-hydroxyapatite or ozone therapy applied alone. However, the treatment should be continued for a long time in order to achieve nonrestorative recovery of caries.
Highlights
The aim of the study was to assess the efficacy of three methods of enamel remineralization on initial approximal caries: (1) a nano-hydroxyapatite gel, (2) gaseous ozone therapy, (3) combination of a nano-hydroxyapatite gel and ozone
Recent epidemiological studies revealed a shift in the prevalence of caries with age; in younger subjects carious lesions are more prevalent on occlusal surfaces, whereas with advancing age—on approximal surfaces[1,2,3,4,5,6]
A total of 546 initial enamel lesions in 92 patients were subjected to observation and none of them was detectable during visual clinical examination
Summary
The aim of the study was to assess the efficacy of three methods of enamel remineralization on initial approximal caries: (1) a nano-hydroxyapatite gel, (2) gaseous ozone therapy, (3) combination of a nano-hydroxyapatite gel and ozone. Some properties of nano-hydroxyapatite are considered unique compared to hydroxyapatite, e.g. higher solubility, higher surface energy and better b iocompatibility[16] Another approach is to apply antibacterial agents in order to reduce the level of bacterial species associated to caries and to protect the lesion from microorganisms. Some recent papers report the use of ozone for the treatment of initial pit and fissure caries as an alternative to other non-invasive interventions[23,25,29] Both in vivo and in vitro studies can be found concerning the successful use of ozone to treat caries, disinfect cavities, reduce the level of caries-associated microorganisms in dental plaque or remineralize caries lesions. More clinical evidence for ozone application is required before it can be widely used for managing and preventing caries[32]
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