Artificial Caries Lesions Research Articles

Functional remineralization of dentin artificial caries lesions via poly-L-aspartic acid‑calcium complexes

Dental caries is a common oral disease and lacks an effective recovery method. The objective of the study was to investigate the remineralization efficiency of polyelectrolyte‑calcium complexes pre-precursor (PCCP) and polymer-induced liquid-like precursors (PILP) processes on mechanical and biochemical properties of dentin artificial caries lesions (ACLs) evaluated with micro-CT, SEM, TEM, ATR-FTIR, Raman spectra and nanoindentation. The human dentin ACLs were prepared with the depth of 100–120 μm. The intact dentin served as positive control and the dentin ACLs as negative control. The dentin ACLs were either incubated in poly-L-aspartic acid‑calcium suspension (PAsp-Ca, 4 g/L-5.44 M) followed by phosphate solution (0.325 M), and further incubated in artificial saliva serving as PCCP group, or in PAsp-stabilized amorphous calcium phosphate solution serving as PILP group. The micro-CT and SEM findings with EDX indicated that mineral contents of the dentin ACLs were dramatically increased in PCCP group, but, to some degree in PILP group. TEM and nanoindentation results showed that a heavy remineralization of dentin ACLs was obtained via PCCP process with an obvious recovery of mechanical properties while a poor remineralization via PILP process. In conclusion, the PCCP process is a promising strategy for functional remineralization of dentin caries lesions.

Changes in Early Caries Lesions on Enamel according to Microcosm Biofilm Maturity

Objective: In this study, we attempt to mature biofilms using a microcosm biofilm model and analyze early carious lesions formed on enamel based on the degree of biofilm maturation. Methods: Bovine tooth specimens were inoculated with saliva, immersed in basal mucin medium containing 1% sucrose, and cultured in an anaerobic pack. The Red/Green ​​and ΔF values ​​of biofilms and lower carious lesion images captured on days 7, 10, and 14 using QLF-D were analyzed. Results: The biofilms show darker red fluorescence over time. The carious lesion under the biofilm indicate a ΔF of -7.33±1.10 at 14 d. However, no demineralization is observed after 7 or 10 d. Conclusions: Artificial carious lesions utilizing microcosm biofilms are expected to facilitate similar studies involving actual carious lesions containing bacteria.

Comparative Study Between 0.125mm, 0.35mm and 0.75mmVoxel Sizes of Cone Beam Computed Tomography in Diagnosis of Secondary Caries Lesions Under Composite Restorations (An In vitro Study)

The aim of this study was to assess the diagnostic accuracy of Cone Beam Computed Tomography (CBCT) with different voxel sizes in detection of simulated recurrent caries beneath composite restoration. In this study, a total of 40 proximal slots of class II cavities were prepared on 40 extracted human premolars and molars. Then, 20 teeth were randomly selected out of these sample and artificial carious lesions were created on these teeth by a round diamond bur no .2(study group). All cavities were restored by using composites resin and radiographed with CBCT unit (Cranex 3D) using 5x5mm field of view at three voxel sizes 0.35mm, 0.125mm, 0.75mm. Intra- and inter-observer agreements were calculated with Kappa statistics (κ). The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ac curacy. The AUCs value for CBCT with voxel sizes 0.35mm, 0.125mm, 0.75mm was 0.983 ,0.900,0.817, respectively. The kappa value for inter-observer agreement was 0.993,0.989,0.938; respectively. Diagnostic Accuracy of CBCT was high in detecting the simulated small secondary proximal caries under composite restoration, voxel size 0.125mm can be used to detect caries lesions with adequate accuracy and the least patient exposure dose.

Remineralising enamel caries with a novel peptide: An in vitro study

ObjectiveTo evaluate the antibacterial and remineralising effects of GAPI peptide on artificial enamel caries. MethodsHuman enamel blocks were exposed to Streptococcus mutans biofilm to create artificial carious lesions. The blocks were randomly assigned to either the GAPI treatment group or the deionised water control group, treated twice daily for 21 days. The viability, growth kinetics, and morphology of S. mutans biofilms were assessed using confocal laser scanning microscopy (CLSM), colony-forming unit (CFU) counting, and scanning electron microscopy (SEM). Lesion depth, mineral loss, calcium-to-phosphorus ratio, Knoop hardness, enamel surface morphology, and crystal characteristics of enamel lesions were determined using micro-computed tomography (Micro-CT), SEM-energy dispersive spectroscopy (EDS), a microhardness tester, SEM, and X-ray diffraction (XRD). ResultsCLSM showed that the dead-to-live ratio of S. mutans was 0.8 ± 0.1 in the GAPI group and 0.4 ± 0.1 in the control group (p < 0.001). The Log CFUs were 6.9 ± 0.7 in the GAPI group and 8.1 ± 0.5 in the control group (p = 0.002). SEM revealed confluent growth of S. mutans in the control group but not in the GAPI group, which also exhibited cell damage. Micro-CT showed that the lesion depth (µm) was 142 ± 11 in the GAPI group and 178 ± 20 in the control group (p < 0.001), with mineral loss (gcm⁻³) of 1.1 ± 0.1 and 1.5 ± 0.1, respectively (p < 0.001). SEM-EDS indicated that the calcium-to-phosphorus ratio was 1.71 ± 0.02 in the GAPI group and 1.67 ± 0.03 in the control group (p = 0.006). Additionally, Knoop hardness was 302 ± 22 in the GAPI group and 242 ± 17 in the control group (p < 0.001). SEM revealed an orderly pattern of enamel rods in the GAPI group, and XRD showed better crystallisation of hydroxyapatite in the GAPI group compared to the control group. ConclusionGAPI exhibits antibacterial and remineralising properties against artificial enamel caries. Clinical significanceIf the anti-caries properties of GAPI are confirmed in clinical studies, it could be used for caries prevention.

Efficacy of silver diamine fluoride (SDF) in arresting dentin caries against inter-kingdom biofilms of Streptococcus mutans and Candida albicans.

To compare, in vitro, the efficacy of three proprietary silver diamine fluoride (SDF) products in mitigating progression of dentinal caries induced by an inter-kingdom, dual-species, bacterial-yeast biofilm. Human dentin blocks were demineralized to create artificial caries lesions and randomized into three SDF test groups: Saforide, Topamine, T-SDF, and an aqueous control (n = 26 per group). After application of foregoing SDF variants, the blocks were incubated with Streptococcus mutans and Candida albicans for 24 h for biofilm development, and subsequently subjected to a microbe-induced, pH-cycling process for 7 days, to mimic the oral eco-system. The biofilm cell viability and surface topography were assessed by colony-forming units (CFUs) and scanning electron microscopy respectively. The lesion depth and mineral density were evaluated by micro-computer tomography. SDF precipitate and matrix-to-mineral ratio were evaluated by X-ray diffraction and Fourier transform infrared spectroscopy, respectively. Standard, accepted methodology was used for all these evaluations and procedures. After pH cycling, the SDF groups demonstrated comparable inhibition of the biofilm relative to the control. the log CFU of S. mutans for Saforide, Topamine, T-SDF, and control were 6.69±0.73, 6.48±0.56, 6.63±0.66, and 8.01±0.45, respectively. For C. albicans, the log CFU were 4.86±0.44, 4.72±0.53, 4.92±0.29, and 5.60±0.27, respectively. The log CFU of S. mutans and C. albicans in the SDF groups were significantly lower than the control group (p<0.001). Further, the lesion depth decreased by approximately 14.79±7.00% in the SDF groups, while it increased by 11.07±8.61% in the control (p<0.001), and the mineral density increased by 16.36±4.58% in the SDF group, as opposed to a 5.59±2.64% reduction in the control (p<0.001) implying their caries mitigating effect. These findings were corroborated by SEM images of the lesions. SDF significantly mitigated dentin caries due to an assault by a polymicrobial plaque biofilm whilst arresting mineral loss and lesion growth. There was no difference in the caries-arresting efficacy of the compared SDF variants.

Comparing the remineralization potential of undemineralized dentin powder versus chicken eggshell powder on artificially induced initial enamel carious lesions: an in-vitro investigation

BackgroundWhite spot lesions are a widespread undesirable effect, especially prevalent during fixed orthodontic treatments. The study compared the in vitro enamel remineralization potential of undemineralized dentin matrix (UDD) versus chicken eggshell powder (CESP) for artificially induced enamel lesions.Methods100 caries-free and sound maxillary premolars were randomly divided into four groups each contain 25 teeth: Group I (Baseline): No treatment was done to the enamel surface. Group II (Negative control ): The enamel surface of the teeth underwent demineralization using demineralizing solution to create artificial carious lesions then kept in artificial saliva. Group III (CESP treated): After demineralizing the tooth surface, the teeth have been suspended in the CESP remineralizing solution. Group IV (UDD treated): After enamel demineralization, the teeth were suspended in UDD remineralizing solution. The remineralization potential was assessed by Vickers microhardness testing, scanning electron microscopic examination (SEM), and energy dispersive X-ray (EDX).ResultsThe current study demonstrated an increase in the mean microhardness of CESP and UDD-treated groups; however, It was nearer to the baseline level in the UDD group. SEM imaging revealed greater enamel remineralization in the UDD group compared to the remaining groups. The UDD group disclosed complete coverage for the prismatic enamel compared to the CESP group, which revealed a partially remineralized enamel surface. Interestingly, the Ca/P ratio increased significantly in the CESP group compared to the negative control group. In contrast, a higher significant increase in the mean Ca/P ratios was recorded in the UDD group compared to the test groups.Conclusionbiomimetic UDD and CESP powder should be utilized to treat enamel early carious lesions. However, UDD demonstrated the most significant remineralization potential.

Evaluation of REFIX Technology on the Remineralization of Artificial Early Enamel Caries Lesion by Laser Speckle Tracking Analysis.

To assess the effectiveness of the REFIX technology in the remineralization process of initial caries simulated on bovine enamel. The assessment involved the analysis of backscatter intensity, which was determined from laser speckle images. Twenty-one bovine teeth were divided into three groups: G1 and G7 were submitted to treatment with the REFIX technology for 1 and 7 days, respectively. The control group was treated with deionized water. A significant difference in backscatter was found between the carious and sound areas in all groups (p = 0.0038, p < 0.0001, and p = 0.0002 for the control group, G1, and G7, respectively). The intergroup comparison revealed no significant difference among the groups studied. REFIX technology did not alter the optical properties of the samples of bovine teeth with simulated initial caries lesions after 1 and 7 days of treatment.

Microleakage Assessment of Modified Resin Infiltration With Zinc Oxide (ZnO) and Magnesium Oxide (MgO) Nanoparticles on Artificial Enamel Caries Lesion: An In Vitro Study.

Background Incorporating nanoparticles into resin infiltrant (RI) can alter its physical properties, including microleakage. This study aimed to examine the microleakage properties of RI modified with 2.5% and 5% zinc oxide (ZnO) and magnesium oxide (MgO) nanoparticles on artificially induced carious lesions (ACLs) in bovine teeth. Materials and methods Modified RIs were applied to five sound and 30 ACLs on bovine incisors. They were divided into seven groups based on the procedure (Group 1: sound enamel (SE), Group 2: artificial caries lesion only (ACL), Group 3: RI, Group 4: RI+ 2.5% ZnO, Group 5: RI + 5% ZnO, Group 6: RI + 2.5% MgO, Group 7: RI + 5% MgO). The samples were subjected to 5000 thermal cycles and then exposed to methylene blue solution for 24 hours in an incubator. The teeth were sectioned and examined with a stereomicroscope to assess the depth of methylene blue penetration (MBP), quantifying microleakage according to the following scoring: 0 = no penetration, 1 = outer half of enamel, 2 = inner half of enamel, 3 = outer half of dentin, and 4 = inner half of dentin. An ANOVA test was conducted to assess the significance of differences among the groups. Post-hoc tests, including Tukey's HSD (honestly significant difference) test, were performed to identify specific group differences and determine which differences were statistically significant. Results SE samples (Group 1) showed minimal penetration, with 100% scoring 1, indicating high resistance to MBP. The ACL group had significant penetration, with 77.78% scoring 3 and 22.22% scoring 2. The RI group completely prevented MBP, with all samples scoring 0. Both RI+2.5% ZnO (Group 4) and RI+2.5% MgO (Group 6) were highly effective, with 88.89% scoring 0 and 11.11% scoring 1. RI+5% ZnO (Group 5) and RI+5% MgO (Group 7) also prevented MBP but had slightly higher minimal penetration, with 77.78% scoring 0 and 22.22% scoring 1. Significant differences were observed between the ACL group and all other groups, underscoring the effectiveness of RI treatments. No significant differences were found between RI+ZnO and RI+MgO at both concentrations, indicating similar effectiveness. Conclusions The study demonstrated that RI modified with 2.5% and 5% ZnO and MgO nanoparticles effectively reduced microleakage in ACLs on bovine teeth compared to untreated lesions. These modifications significantly inhibited MBP, particularly in enamel and dentin, indicating their potential to enhance the durability and effectiveness in clinical applications. This research emphasizes the promising role of nanoparticle-modified RI in minimizing microleakage and optimizing treatment outcomes. Further research is needed to confirm these findings and refine protocols.

Evaluating the Remineralizing Effects of Calcium Sucrose Phosphate and Casein Phosphopeptide-Amorphous Calcium Phosphate Toothpastes on Artificial Carious Lesions Using Micro-computed Tomography: An In Vitro Investigation.

Background White spot lesions (WSLs) are common early indicators of enamel demineralization, particularly in pediatric orthodontic patients. Effective remineralization of these lesions is crucial for preventing further dental decay. This study aimed to evaluate the three-dimensional remineralization efficacy of two commercial toothpastes, calcium sucrose phosphate (CaSP) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), using micro-computed tomography (micro-CT). Objectives To compare the remineralization efficacy of CaSP and CPP-ACP on artificially created WSLs in human premolar enamel using micro-CT assessment. Materials and methods Freshly extracted, caries-free human premolars were used for the purpose of the study. Teeth with any defects, including caries, non-carious lesions, fractures, or hypocalcifications, were excluded. Teeth were stored in a saline solution with 0.1% thymol at +4°C until experimentation. Enamel slabs (N = 18) of 3 x 3 x 1.5 mm were prepared from the buccal surfaces of the premolars and polished to a mirror-like finish. The slabs were divided into three groups (n=6 each): control, CaSP, and CPP-ACP. Specimens were demineralized in a demineralization solution for 72 hours and then treated with the respective toothpastes or remineralizing solutions for 13 days. Micro-CT scanning was performed to assess changes in enamel volume and mineral density. Statistical analysis included Shapiro-Wilk tests, paired t-tests, and one-way ANOVA with post-hoc Tukey's HSD tests. Results Enamel volume changes were significant between groups (p<0.01), with the CaSP group showing the largest remineralization effect. Enamel mineral density changes were also significant (p=0.004), with the CPP-ACP group showing the greatest improvement in mineral density. Conclusions CaSPand CPP-ACPare both effective in remineralizing artificial enamel lesions. While CaSP shows comparable efficacy to CPP-ACP, further research is needed to confirm these findings in clinical settings. CaSP pastecan be considered a viable, cost-effective alternative for enamel remineralization.

Distinguishing discolored caries lesions using biofluorescence and dental bleaching: An in vitro simulation model study

BackgroundDistinguishing between discoloration caused by caries and organic stains is challenging for dentists in clinical settings. Biofluorescence (BF)-bleaching assesses caries lesions by evaluating BF changes after removing organic stains through dental bleaching, leaving cariogenic discoloration. This study aimed to apply BF-bleaching to a simulation model mimicking cariogenic discoloration and compare the BF color changes between organic staining and cariogenic discoloration. MethodsThirty artificial caries lesions in bovine incisors were equally divided into three groups: non-stained (NS), organic-stained (OS), and cariogenic-stained (CS) groups. The specimens were treated with bleaching agent, then BF color of each specimen was evaluated using red BF intensity (ΔR), BF hue angle (h°), and hyperspectral BF spectrum. ResultsThe ΔR of CS was approximately 2.74 and 1.73 times higher than that of OS, at baseline and after bleaching for 20 min, respectively. After 20 min of bleaching, the h° of CS increased by approximately 8.1° compared to the baseline, while maintaining the red BF hue range (345‒15°). In contrast, the BF hue of OS shifted from orange (15‒45°) to yellow (45‒75°) simultaneously, and the h° change was approximately 21.9°. Both CS and OS exhibited first emission peaks near 515 nm, and CS showed second peaks in the red range (620‒780 nm). After bleaching, the first peaks were restored to the sound enamel direction (peak at 486 nm), whereas the second peaks of red BF in CS were maintained. ConclusionApplying BF-bleaching to discolored caries lesions allowed differentiation between cariogenic discoloration and organic staining based on BF color changes.

Comparison of remineralization ability of tricalcium silicate and of glass ionomer cement on residual dentin: an in vitro study

ObjectiveThis study aimed to compare the remineralization effects of a calcium silicate-based cement (Biodentine) and of a glass ionomer cement (GIC: Fuji IX) on artificially demineralized dentin.MethodsFour standard cavities were prepared in dentin discs prepared from 34 extracted sound human third molars. In each disc, one cavity was covered with an acid-resistant varnish before demineralization (Group 1). The specimens were soaked in a chemical demineralization solution for 96 h to induce artificial carious lesions. Thereafter, one cavity each was filled with Biodentine (Group 2) and GIC (Group 3), respectively, and one carious lesion was left unrestored as a negative control (Group 4). Next, specimens were immersed in simulated body fluid (SBF) for 21 days. After cross-sectioning the specimens, the Ca/P ratio was calculated in each specimen by using scanning electron microscopy–energy-dispersive X-ray spectroscopy (SEM-EDX). Finally, data were analyzed using repeated-measures ANOVA with post-hoc Bonferroni correction.ResultsBoth cement types induced dentin remineralization as compared to Group 4. The Ca/P ratio was significantly higher in Group 2 than in Group 3 (p < 0.05).ConclusionThe dentin lesion remineralization capability of Biodentine is higher than that of GIC, suggesting the usefulness of the former as a bioactive dentin replacement material.Clinical relevanceBiodentine has a higher remineralization ability than that of GIC for carious dentin, and its interfacial properties make it a promising bioactive dentin restorative material.

Effect of Bleaching on Resin-Infiltration-Masked Artificial White Spots In Vitro.

Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel.

Biomimetic Remineralization of Artificial Caries Lesions with a Calcium Coacervate, Its Components and Self-Assembling Peptide P11-4 In Vitro.

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 P11-4 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 (H3PO4, 5 s), air-dried and subsequently infiltrated for 10 min with either a CC (10 mg/mL PAA, 50 mM CaCl2 (Ca) and 1 M K2HPO4 (PO4)) (groups CC and CC + DS) or its components PAA, Ca or PO4. As a commercial control, the self-assembling peptide P11-4 (CurodontTM 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 = ΔZpHC - ΔZbaseline). Compared to the NTC, the mineral gain in the T group was significantly higher in the CC + DS, CC and PAA (p < 0.05, Wilcoxon). In all of the other groups, no significant differences between treated and untreated lesions were detected (p > 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.

Enamel Matrix Derivative, 58S5 Bioactive Glass, and Fluoride Varnish for Enamel Remineralization: A Multi-analysis Approach.

This study aimed to evaluate the enamel remineralization efficacy of enamel matrix derivative (EMD), experimental bioactive glass (BAG), and fluoride varnish in vitro. Artificial initial caries lesions were developed on fifty human enamel specimens using demineralization solution (pH 4.5, 37°C, 96 hours). Specimens were randomly assigned to five groups (n=10): I-5% NaF varnish (Enamelast), II-experimental 58S5 BAG+37% phosphoric acid (PA), III-EMD (Emdogain) + Ethylenediaminetetraacetic Acid (EDTA), IV-EMD+37% PA, V-Control (untreated). All remineralization agents were applied with pH cycling for seven days. The specimens were scanned by spectral domain optical coherence tomography (SD-OCT) at baseline, at demineralization, and after pH cycling. Lesion depths were measured using image analysis software (ImageJ). Lesions were evaluated using surface microhardness (SMH) and two fluorescence methods (FluoreCam and DIAGNOdent Pen [DDPen]). The data were statistically analyzed by Kruskal Wallis, Friedman, and Wilcoxon tests (α=0.05). According to SD-OCT results, fluoride varnish was found to be the most effective agent in reducing lesion depth (p=0.005). All agents increased the SMH values after pH cycling. No significant difference was found among fluoride varnish, BAG, and EMD+PA groups. These SMH values were significantly higher than EMD+EDTA and control groups (p<0.001). All groups showed lower DDPen scores compared with the control group (p<0.001), however, no significant difference was found among the remineralization agents. In FluoreCam assessment, size and intensity values of all treated groups showed improvement. However, there was no significant difference between the treatment groups in terms of FluoreCam size measurements (p=0.186). 58S5 BAG and EMD+PA have remineralization capacity as effective as fluoride varnish. EMD+PA showed better SMH and lesion intensity results than EMD+EDTA.

Comparative Evaluation of Remineralizing Potential of Topical Cream Containing Casein Phosphopeptide-Amorphous Calcium Phosphate and Casein Phosphopeptide-Amorphous Calcium Phosphate with Fluoride: An In Vitro Study

ABSTRACT The requirement for clinically effective treatments to remineralize early enamel caries lesions is dictated by the principles of minimally invasive dentistry. Numerous studies outlined the significance of treating early carious lesions with different remineralizing agents. This study aimed to evaluate and compare the remineralization potential of topical cream containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and CPP-ACP with fluoride in remineralizing artificial carious lesions on enamel. Forty-five freshly extracted human premolar teeth were selected as samples. These samples were divided into three groups: Group I-regular toothpaste without specific remineralizing agent; Group II-topical cream containing CPP-ACP and Group III topical cream containing CPP-ACP with fluoride. All the samples were viewed under scanning electron microscope (SEM) to assess the topographical pictures of the enamel surface and also subjected to energy dispersing X-ray analysis (EDX) for quantitative estimation of minerals, calcium (Ca), and phosphorous (P). In the result of the study, Group I does not show any increase in the Ca and P after applying toothpaste without any remineralizing agent but Group II and Group III showed a net increase in Ca and P- values after applying concerned remineralizing agents. Intergroup comparison showed Group III yielded higher net Ca and P- values than Group II. Two remineralizing agents showed remineralization potential on samples. Descriptive statistics were used to calculate the mean and standard deviation. Mann–Whitney test was used. The level of significance was set at 0.05. CPP-ACP containing fluoride showed better remineralizing potential than CPP-ACP. Hence, CPP-ACP containing fluoride can be considered the material of choice in remineralizing early enamel carious lesions.

Biomineralization and remineralizing potential of toothpastes containing nanosized β-calcium glycerophosphate: an in vitro study.

To evaluate the effect of 1100ppm F toothpastes supplemented with micrometric or nanosized β-CaGP (β-CaGPm/β-CaGPn) on artificial enamel remineralization, using a pH cycling model. Enamel blocks with artificial caries were randomly allocated into ten groups (n = 10), according to the toothpastes: without fluoride/β-CaGPm/β-CaGPn (negative control); 1100ppm F (1100F); 1100F plus 0.125%, 0.25%, 0.5%, and 1.0% of β-CaGPm or β-CaGPn. The blocks were treated 2×/day with slurries of toothpastes. After pH cycling, the percentage of surface hardness recovery (%SHR); integrated loss of subsurface hardness (ΔKHN); integrated mineral loss (ΔIMR); fluoride (F), calcium (Ca), and phosphorus (P) concentrations in the enamel; polydispersity index (PdI); and zeta potential (Zp) were determined. The data were analyzed by ANOVA (p < 0.001). For Zp/PdI, no significance was observed when comparing the means (p > 0.001). The treatment with 1100F-0.25%β-CaGPn led to %SHR ∼57 higher when compared to the 1100F group (p < 0.001). The lowest ΔKHN was observed for the 1100F-0.25%β-CaGPn group (p < 0.001). The ΔIMR was lower (∼201%) for the 1100F-0.25%β-CaGPn when compared to 1100F (p < 0.001). The association of β-CaGPm and β-CaGPn to 1100F did not influence its F concentration (p > 0.001). The highest increase in Ca and P was observed for 1100F-0.25%β-CaGPn (p < 0.001). The addition of 0.25%β-CaGPn to 1100F toothpaste was able to promote an additional remineralizing effect of artificial caries lesions.

Development of a novel in vitro model for non-cavitated carious lesion formation reflecting carious lesion activity

BackgroundOral biofilms are a critical component in dental caries formation. However, current remineralization studies often overlook the impact of microbial factors. Therefore, a comprehensive clinically relevant assessment of caries is needed. This study aimed to develop a novel in vitro model capable of generating non-cavitated carious lesions that incorporates both mineral loss and microbial activity using quantitative light-induced fluorescence-digital (QLF-D) technology. MethodsA total of 44 artificial early carious lesions were formed using bovine incisors. The extent of fluorescence loss (ΔF) was analyzed using a QLF-D camera. Oral microcosm biofilms were then employed to construct 22 active and 22 inactive carious lesions. The red fluorescence emission rate (ΔR) and bacterial viability (RatioG/G+R) was measured using QLF-D camera and a live-dead bacterial assay, respectively. Independent t-tests were performed to compare ΔF, ΔR, and bacterial viability of artificial carious lesions according to their activity status. ResultsNo significant difference in ΔF between the lesions was found based on activity status (p = 0.361). However, the ΔR of active lesions was 1.82 times higher than that of inactive lesions, and the RatioG/G+R was 1.49 times higher in active lesions than in inactive lesions (both p < 0.001). ConclusionsThe significant differences observed in ΔR and RatioG/G+R between active and inactive lesions emphasize the importance of considering lesion activity status when evaluating the potential efficacy of remineralization agents. This study presents a novel in vitro remineralization assessment model that reflects carious lesion activity while controlling baseline mineral distributions of lesions.

Remineralization potential of varying concentrations of two plant-based extracts of Cocos nucifera on white spot lesions using SEM and EDAX analysis: An in vitro study.

To evaluate the remineralization potential of varying concentrations of two plant-based extracts of Cocos nucifera on white spot lesions using SEM and EDAX in vitro testing methods. The pulp was freshly obtained from coconut and divided into two. Then, coconut milk was obtained by blending, while the next portion was freeze-dried and lyophilized. Third molar teeth were processed into tooth slabs (N = 40) and split equally into five groups by block randomization. After demineralization, one tooth slab was taken from each, and SEM analysis was done. Remineralization was then performed among the various groups that included Group 1, which acted as a control and consisted of the remineralization solution. Groups 2 and 3 comprised 1:1 and 2:1 concentrations of the coconut milk, whereas Groups 4 and 5 consisted of 1:1 and 2:1 concentrations of the lyophilized extract. SEM and EDAX testing were done post-remineralization. Ca and phosphate values were tabulated, and statistical significance was determined for the obtained values using ANOVA. Among the control and treatment groups, surface remineralization was better observed in 1:1 coconut milk and 2:1 coconut milk than in the 2:1 lyophilized coconut, control, and 1:1 lyophilized coconut. Between the control and treatment groups, Ca and phosphate percentages (P < 0.001) showed statistical differences. The lowest value of 2.3% was noted in the 2:1 lyophilized coconut group. Coconut extracts exhibit remineralization potential on the artificial carious lesion. Coconut milk exhibited significant improvement in the surface properties than lyophilized coconut.

Combined Effect of a Bioinspired Self-Assembling Peptide and Fluoride Varnish on Remineralisation of Artificial Early Enamel Caries Lesion: An in vitro Study

Introduction: This study aimed to investigate the remineralisation effect of combined use of a bioinspired self-assembling peptide (P26) and fluoride varnish on artificial early enamel caries lesions. Methods: Bovine enamel blocks with artificial early enamel caries lesions were prepared. The blocks were randomly allocated to four experimental groups to receive the following treatments: A = P26 + fluoride varnish, B = P26, C = fluoride varnish, and D. distilled water (negative control). The treated blocks were subjected to pH cycling. Enamel blocks were collected at time points of 7 days (d7) and 21 days (d21). The mineral gain, elemental analysis and crystal characteristics of the caries lesion were assessed by micro-computed tomography, scanning electron microscopy with energy dispersive X-ray and X-ray diffraction (XRD), respectively. Results: The mean ± standard deviation of mineral gain of group A to D were 17.4 ± 4.2%, 10.7 ± 2.2%, 10.1 ± 1.2%, and 6.8 ± 0.5% at d7, respectively, and 15.2 ± 2.6%, 8.7 ± 3.1%, 9.7 ± 1.2%, and 7.8 ± 2.3% at d21, respectively. A significant higher mineral gain was observed in group A when compared to other groups at both d7 and d21 (p < 0.05). The calcium-to-phosphate ratio remained consistent across all groups, ranging between 1.2 and 1.4. XRD analysis indicated that crystal composition on the surfaces was apatite for all groups. Conclusion: In conclusion, the present study provided a first indication of better remineralisation effects of the combined use of the bioinspired self-assembling peptide P26 and fluoride varnish compared to the effects of the respective individual uses of P26 or fluoride varnish.

Surface conditioning of artificial caries lesions with Er, Cr:YSGG laser before resin infiltration: an in vitro study

Surface conditioning of artificial caries lesions with Er, Cr:YSGG laser before resin infiltration: an in vitro study